bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infratemporal fossa surgical approaches to primary/recurrent malignancies of salivary origin: paradigm surgical shift, patient selection, and oncologic outcomes
Authors: Bradley Patrick J. 
Published: February 2020

Purpose of review
To review, the surgical approaches available on diagnosing a patient with salivary gland malignancy in the infratemporal fossa (ITF). To comment on patient evaluation and method of treatment selection. To identify and report on patient outcome data and make recommendations on future needs.

Recent findings
There is a need to define the anatomic boundaries contents of the ITF, masticator space, parapharyngeal space (PPS), pterygopalatine fossa, ventral skull base, and paramedian skull base, as evidence from publications. The pathological subtypes identified mainly include adenoid cystic and mucoepidermoid carcinomas. The source of these tumours originates from primary disease in the sinonasal tract and nasopharynx superiorly, and the PPS/deep lobe of parotid inferiorly. Current surgical options available, in suitable selected patient, available in tertiary head and neck cancer hospitals, which have available facilities and staffing is the endoscopic endonasal approach. This approach offers patients a ‘complete margin-free surgical excision’, minimal complications, shorter hospital stay, and no delay with commencement of any adjuvant treatment compared with the traditional ‘open transcutaneous’ approach.

Summary
The current evidence specifically to the surgical management of salivary gland malignancy involving the ITF is sparse, with great difficult identifying treated patients and their details among a heterogeneous group of patients with many lesions. There is a need for patient data that have specific pathologic conditions to be amalgamated from such centers and publish on outcome events.
Analysis of Symptomatic Marginal Ulcers in Patients Who Underwent Pancreaticoduodenectomy for Periampullary Tumors
Authors: Park Yejong , Hwang Dae Wook , Lee Jae Hoon , Song Ki Byung , Jun Eunsung , Lee Woohyung , Kwon Jaewoo , Kim Song Cheol 
Published: February 2020

Object
The objectives are to investigate the incidence and risk factors associated with symptomatic marginal ulcer (sMU) and analyze their relationship with the use of prophylactic proton pump inhibitors (PPIs) after pancreaticoduodenectomy.

Methods
Clinical postoperative outcomes of 72 sMU and 1266 non-sMU were compared and analyzed. We performed a subanalysis of 72 patients with sMU diagnosed within (n = 18) and after 4 months (n = 54). The risk factors associated with sMU incidence were analyzed.

Results
Of the 1338 patients, 72 (5.4%) were diagnosed as having sMU. Eighteen patients (25.0%) were diagnosed during the first 4 months, and 48 (66.7%), within 16 months. Cumulative sMU incidence differed according to the duration of prophylactic PPI use (≥4 months: 7.1% vs <4 months: 10.1%, P < 0.001). The duration of prophylactic PPI use was identified as a risk factor in the multivariable analysis (hazard ratio, 2.294; 95% confidence interval, 1.436–3.664; P = 0.001).

Conclusions
Two-thirds or more of the patients were diagnosed as having sMU within 16 months after surgery. The duration of the prophylactic PPI use was an independent risk factor. We recommend the use of prophylactic PPI for more than 16 months after pancreaticoduodenectomy for periampullary tumors.
Natural Course and Treatment of Pancreatic Exocrine Insufficiency in a Nationwide Cohort of Chronic Pancreatitis
Authors: Kempeneers Marinus A. , Ahmed Ali Usama , Issa Yama , van Goor Harry , Drenth Joost P. H. , van Dullemen Hendrik M. , van Hooft Jeanin E. , Poen Alexander C. , van Veldhuisen Sophie L. , Besselink Marc G. , van Santvoort Hjalmar C. , Bruno Marco J. , Boermeester Marja A. 
Published: February 2020

Objectives
Pancreatic exocrine insufficiency (PEI) is a common complication of chronic pancreatitis. However, little is known about the natural course of PEI and the effect of pancreatic enzyme replacement therapy on symptoms. The aim of this study was to evaluate the natural course and treatment of PEI in a nationwide cohort of patients with chronic pancreatitis.

Methods
Patients with chronic pancreatitis were selected from the multicenter Dutch Chronic Pancreatitis Registry. Patients were classified in 3 groups: definite PEI, potential PEI, and no PEI. Definite PEI and no PEI were compared regarding the course of disease, symptoms, treatment, and quality of life.

Results
Nine hundred eighty-seven patients were included from 29 centers, of which 304 patients (31%) had definite PEI; 451 (46%), potentially PEI; and 232 (24%), no PEI. Patients with definite PEI had significantly more malabsorption symptoms, a lower body mass index, and aberrant defecation. Lowered quality of life was not independently associated with PEI. Of the PEI patients using pancreatic enzyme replacement therapy, 47% still reported steatorrhea.

Conclusions
Pancreatic exocrine insufficiency is associated with malabsorption symptoms and a lower body mass index. Some form of pancreatic enzyme replacement therapy is reasonably effective in alleviating malabsorption symptoms, but improvement of treatment is needed.
Exogenous Secretin Improves Parenteral Nutrition‐associated Liver Disease in Rats
Authors: Cao Xuehui , Feng Feng , Liu Xuelai , Sun Chi , Yang Xiaofeng , Fang Yanbin , Li Suolin 
Published: February 2020

ABSTRACTObjectives:Intestinal failure‐associated liver disease (IFALD) is a feared and life‐threatening complication in neonates with intestinal failure (IF) receiving long‐term total parenteral nutrition (TPN). This study aims to investigate the effect of exogenous secretin on liver pathology and hepatic function in a rat model of PN‐associated liver disease (PNALD).Methods:Male Sprague‐Dawley rats underwent right jugular venous catheterization to receive 14‐day continuous TPN therapy. All rats were allocated into 3 groups: the Control group (n = 8) did not have surgery or TPN and was fed standard rat chow ad libitum; the TPN group (n = 8) underwent catheter insertion and TPN treatment; and the TPN/S group (n = 8) also underwent catheter insertion, TPN treatment, and exogenous secretin treatment (2.5 nmol · kg−1 · day−1) daily. Fourteen days after initial surgery, we collected the animals’ liver and blood samples for further test.Results:The TPN/S group had diminished direct bilirubin (TPN, 2.1 ± 0.7 μmol/L; TPN/S, 1.5 ± 0.2 μmol/L) and liver total bile acid levels (TPN, 144.5 ± 21.2 μmol/L; TPN/S, 123.4 ± 10.4 μmol/L) and improved histological outcomes compared with those in the TPN group. Exogenous secretin also enhanced the canalicular transporter (BSEP, 0.5‐fold, P = 0.011) and inhibited the basolateral transporter (OSTA, −0.48‐fold, P = 0.002; OSTB, −0.6‐fold, P = 0.013) of liver bile acid.Conclusions:In this animal model of PNALD, secretin may improve cholestasis by enhancing canalicular transport, inhibiting the basolateral export of liver bile acid, and eventually decreasing the total bile acid level in the liver. Exogenous secretin treatment may potentially prevent and treat IFALD in IF patients relying on long‐term TPN therapy.
Factors Impacting Time to Engraftment in Patients With High-risk Neuroblastoma Following Autologous Stem Cell Transplant
Authors: Hillier Kirsty , Cheng W. Susan , Whittle Sarah B. , Krance Robert , Foster Jennifer H. 
Published: February 2020

Background:
Despite advances in supportive measures, myeloablative chemotherapy with stem cell rescue remains limited by toxicity and treatment-related mortality. The purpose of this study was to identify factors influencing the rate of hematopoietic recovery following autologous stem cell transplant in high-risk neuroblastoma.

Procedure:
We retrospectively studied 54 patients with high-risk neuroblastoma who received a single autologous stem cell transplant between 2006 and 2016. Race, sex, conditioning regimen, chemotherapy delays and bone marrow involvement were analyzed using Kaplan-Meier Log-Rank test while the amount of cells infused, age, and length of hospital stay were analyzed using univariate Cox Proportional Hazards Regression.

Results:
The conditioning regimen administered was significant (P=0.016) for time to engraftment of neutrophils, with busulfan/melphalan (Bu/Mel) at 16.6 days, and carboplatin/etoposide/melphalan at 12.1 days. A delay of chemotherapy during induction (n=24) was significant (P<0.001) for time to platelet engraftment of >75,000/µL. Female patients had a longer time to engraftment (P=0.029).

Conclusion:
Patients receiving Bu/Mel as a conditioning regimen, patients who had a delay in induction chemotherapy and patients of female sex were found to be significant for delayed engraftment of neutrophils, platelets, and hemoglobin, respectively, in patients with high-risk neuroblastoma undergoing autologous stem cell transplant. Knowing these factors may lead to new expectations and possible interventions to decrease the morbidity and mortality of treatment and recovery.
Relation Between Cardiac T2* Values and Electrocardiographic Parameters in Children With Transfusion-dependent Thalassemia
Authors: Aggarwal Priyanka , Kumar Ishan , Jain Anubha , Verma Ashish , Gupta Vineeta 
Published: February 2020

Background/Objectives:
Cardiac T2* magnetic resonance imaging (MRI) is the gold standard to determine myocardial iron overload. As availability of Cardiac T2* is not uniform across developing nations, our strategy was to identify a more accessible and cost effective tool to assess myocardial iron accumulation. As children with transfusion-dependent thalassemia also experience various electrocardiographic abnormalities, we performed electrocardiography (ECG) as well as Cardiac T2* MRI on all children registered in our thalassemia unit.

Materials and Methods:
Forty-eight transfusion-dependent thalassemia children with transfusion burden ≥12 times/y (6 to 19 y) in the Thalassemia Unit of the Division of Hematology Oncology, Department of Pediatrics were enrolled. Patients were divided into 3 groups based on severity of T2* value, that is group I (T2*<10), group II (T2* 10 to 20), group III (T2*>20). A T2* value >20 was taken as normal. ECG and serum ferritin was also performed on the day of MRI.

Results:
Among the various ECG parameters, QRS duration, and QTc interval were significantly increased if cardiac iron overload was high with a P-value of 0.036 and 0.000, respectively. Also, high serum ferritin predicted a decline in T2* value with a P-value of 0.001. QT interval and QTc interval significantly correlated inversely with T2* (P=0.042, r=−0.295 and P=0.002, r=−0.446, respectively) but not QRS duration (P=0.05, r=−0.282). Serum ferritin also was found to have a significant inverse correlation with T2* value (P=0.000, r=−0.497).

Conclusions:
Abnormalities on ECG, that is prolongation of QRS duration, QT interval, and QTc interval were significantly associated with cardiac iron overload, that is decrease in the value of Cardiac T2* in our study.
Nursing Students' Mindsets Matter
Authors: Williams Cheryl A. 
Published: February 2020

Background
Dweck's growth mindset model, as a cognitive psychology model, details how various individuals perceive intelligence and academic ability. The growth mindset model has demonstrated academic success in students across many disciplines for more than 30 years.

Problem
The growth mindset model has not been examined in prelicensure nursing education.

Approach
This article introduces the growth mindset model, highlights differences and implications on learning between the 2 mindsets, and offers suggestions to cultivate the growth mindset model in nursing education.

Conclusions
Given the scholastic merits attributed to the growth mindset model, a closer investigation into the potential integration of the model into nursing education may be warranted.
Chlamydia trachomatis Is Associated With Medically Indicated Preterm Birth and Preeclampsia in Young Pregnant Women
Authors: Hill Ashley V. , Perez-Patron Maria , Tekwe Carmen D. , Menon Ramkumar , Hairrell Deanna , Taylor Brandie D. 
Published: February 2020

Background
Studies on Chlamydia trachomatis–associated pregnancy outcomes are largely conflicting, ignoring the heterogeneous natures of pregnancy complications and potential effect modification by maternal age. This study determined if prenatal C. trachomatis infection is associated with preterm birth (PTB) and preeclampsia subtypes.

Methods
A retrospective cohort study was conducted using 22,772 singleton pregnancies with a prenatal C. trachomatis diagnostic test. Spontaneous and medically indicated PTBs, and term and preterm preeclampsia were outcomes. Modified Poisson regression calculated relative risk (RR) and 95% confidence intervals (CI) with propensity score adjustments stratified by maternal ages <25 and ≥25 years.

Results
Overall, C. trachomatis was significantly associated with term preeclampsia (adjusted RR [RRadj], 1.88; 95% CI, 1.38–2.57). Among young women (age <25 years), C. trachomatis was significantly associated with medically indicated PTB (RRadj, 2.29; 95% CI, 1.38–3.78) and term preeclampsia (RRadj, 1.57; 95% CI, 1.05–2.36) in propensity-adjusted models. No significant associations in older women were detected.

Conclusion

C. trachomatis was associated with medically indicated PTB and term preeclampsia in young women. Associations between chlamydia and perinatal outcomes may depend on the subtype of PTB and preeclampsia, which should be investigated through mechanistic studies.
Partner Notification Among Persons With Early Syphilis in Shenzhen, China, 2011–2017: Implications for Practice and Policy
Authors: Wang Cheng , Zhao Peizhen , Tang Weiming , Smith M. Kumi , Ong Jason J. , Wong Ngai Sze , Fu Hongyun , Tucker Joseph D. , Zheng Heping , Luo Zhenzhou , Yang Bin 
Published: February 2020

Background
Partner notification (PN) is an essential component of syphilis control and is recommended by Chinese Sexually Transmitted Disease guidelines. However, in China, studies examining local practice are limited. This study evaluated PN outcomes among persons with early syphilis infection in an urban district in China.

Methods
From 2011 to 2017, persons diagnosed with early syphilis were asked to participate in an evaluation of supportive patient referral partner services for all recent sex partners, and the contact and case finding indices were determined in Nanshan District, Shenzhen, China.

Results
During the study period, 642 index patients with early syphilis reported 1749 sex partners. Of those partners, 678 were potentially contactable and 525 (30%) were contacted. The overall contact index was 0.82. Among the 1749 partners reported, 1108 (63%) were described as casual partners, and only 37 (3%) were contacted (contact index 0.13) compared with 641 partners who were either spouses and regular partners (contact index, 1.37). Among those 525 partners contacted, 418 (80%) were tested, and 205 (39%) were diagnosed with and treated for syphilis. Among those, 9 (4%) were primary, 26 (13%) were secondary, 16 (8%) were early latent, and 154 (49%) were other syphilis infections. The overall case finding index was 0.29.

Conclusions
There is a need to improve PN practices in China, which include developing operational guidelines of PN and to develop and evaluate novel PN ways like using Internet-based strategy.
Detection of Three Sexually Transmitted Infections by Anatomic Site: Evidence From an Internet-Based Screening Program
Authors: Jordan Nikki N. , Jett-Goheen Mary , Hsieh Yu-Hsiang , Gaydos Joel C. , Gaydos Charlotte A. 
Published: February 2020

Abstract
Urogenital and rectal specimens collected from the “IWantTheKit” Internet-based sexually transmitted infection screening program were evaluated for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Of 881 paired specimens submitted from August 2013 to December 2016, 15.0% (n = 132) tested positive for 1 or more sexually transmitted infections, of which 50.8% (n = 67) were identified exclusively through rectal testing.
Evaluation of an Online Educational Tool to Improve Postresuscitation Debriefing in the Emergency Department
Authors: Eaton Patricia L. , Mullan Paul C. , Papa Linda , Chen Jerome Gene , Cramm Kelly , Buning Brian , Vazifedan Tuzraj , Zinns Lauren E. 
Published: February 2020

Objective
Postresuscitation debriefing (PRD) addresses Accreditation Council for Graduate Medical Education core competencies and is recommended by the American Heart Association. Postresuscitation debriefing improves resuscitation outcomes, promotes team morale, supports emotional well-being, and reduces burnout. Despite these benefits, PRD occurs infrequently. Commonly cited barriers to PRD include lack of training and comfort in facilitating PRD. We are unaware of any video-based educational tools that train physicians in PRD. We aimed to evaluate the impact of an educational tool on the frequency of PRD using a before- and after-study design.

Methods
We created and distributed a 20-minute, video-based educational tool via youtube.com on PRD to pediatric emergency medicine (EM) fellows, pediatric EM attendings, senior EM residents, and EM attending physicians. Participants completed web-based surveys before, immediately after, and 3 months after watching the tool. We analyzed the effects of participation on PRD knowledge, comfort conducting PRD, and frequency of PRD performance.

Results
Thirty-five (63%) of 56 participants completed all 3 surveys. Participation in our study showed significant improvements in reported frequency of performing PRD (23% presurvey, 38% follow-up survey; 95% confidence interval [CI], 2%–29%; P = 0.03), perceived knowledge of PRD (odds ratio, 6.1; 95% CI, 3.05–12.29; P < 0.001), and comfort in conducting PRD (odds ratio, 3.7; 95% CI, 1.96–7.03; P < 0.001). Most respondents (94%) reported that the tool was worthwhile. Most (83%) would recommend the tool to colleagues, and 86% reported positive effects on their teams with PRD.

Conclusions
Implementation of a video-based educational tool on PRD in the emergency department was associated with increased provider report of PRD frequency, knowledge, and comfort level.
Variation in Prehospital Protocols for Pediatric Seizure Within the United States
Authors: Ramgopal Sriram , McCans Kerry , Martin-Gill Christian , Owusu-Ansah Sylvia 
Published: February 2020

Objective
The objective of this study was to compare statewide prehospital protocols for the management of pediatric seizures.

Methods
We performed a descriptive analysis comparing statewide protocols for emergency medical services management of pediatric seizures within the United States, excluding states for which no statewide protocol/model was available. We compared antiepileptic drugs (AEDs), routes and doses of administration, and differences in febrile seizure management.

Results
Of 50 states, 34 had either statewide protocols or models and were included. All had a protocol for the management of seizures and provided specific recommendations for the management of pediatric seizures. Twelve states (35%) preferentially recommended midazolam over other benzodiazepines. Thirty-two (94%) of 34 allowed for use of midazolam, with variable use of other AEDs. All allowed for use of intramuscular AED. Twenty-six (77%) allowed for intranasal AED. Nine (27%) allowed emergency medical services to administer a patient's own abortive AED, and 6 (18%) allowed for use of a patient's vagal nerve stimulator, when present. There was a wide variability with respect to dosing ranges for medications. Thirty-two (94%) of 34 included blood glucose measurement within the protocol. Twenty-one protocols (62%) provided recommendations for febrile seizures, including recommending active/passive cooling (8/34, 24%) and antipyretic administration (9/34, 26%).

Conclusions
All statewide protocols carried specific guidelines for the prehospital management of pediatric seizures; however, there was wide variability with respect to specific AEDs, routes of administration, and drug dosages. In addition to broader availability of statewide guidance, areas of potential protocol improvement and research include AED dose optimization, reprioritization of blood glucose, and greater emphasis on intranasal or intramuscular medication dosing.
The Parent Perspective on Return Visits to the Pediatric Emergency Department
Authors: Litwin Sasha P. , Diallo Mamadou , Ostrow Olivia 
Published: February 2020

Objectives
Return visits to the pediatric emergency department (ED) give insight into the unmet needs of patients and families. The aim of this study was to capture the parent perspective on factors contributing to return visits to the pediatric ED.

Methods
This is a prospective cohort study consisting of an 11-item survey that was administered to parents of children who had a return visit to the ED less than 72 hours from their initial visit. Surveys were distributed over an 8-month period between November 2015 and June 2016.

Results
The primary reason parents report for returning to the ED is that their child had ongoing or worsening symptoms (55%). Parents were satisfied with the care they received at the initial ED visit (89% report excellent, very good or good care). For parents who report that the initial visit could have been improved, they report wanting more tests done (54%), a better follow-up plan arranged by the ED (31%), consultation with a specialist (26%), admission to hospital on the initial visit (26%), and better communication and more time spent with the ED physician (21%). The majority (97%) of parents reported that their child has a primary care provider, and 39% of parents brought their child to a health care provider for the same problem in the 7 days before their return visit to the ED.

Conclusions
The parent perspective gives important insights into the reasons for return visits to the pediatric ED. Conclusions from this study will help inform future quality improvement initiatives that direct health care resources to provide high value care to patients and families.
Plasma β-Hydroxybutyrate for the Diagnosis of Diabetic Ketoacidosis in the Emergency Department
Authors: Tremblay Elise Schlissel , Millington Kate , Monuteaux Michael C. , Bachur Richard G. , Wolfsdorf Joseph I. 
Published: February 2020

Objective
Diabetic ketoacidosis (DKA) is a common emergency department presentation of both new-onset and established diabetes mellitus (DM). β-Hydroxybutyrate (BOHB) provides a direct measure of the pathophysiologic derangement in DKA as compared with the nonspecific measurements of blood pH and bicarbonate. Our objective was to characterize the relationship between BOHB and DKA.

Methods
This is a cross-sectional retrospective study of pediatric patients with DM presenting to an urban pediatric emergency department between January 1, 2016, and September 30, 2018. Analyses were performed on each patient's initial, simultaneous BOHB and pH. Diagnostic test characteristics of BOHB were calculated, and logistic regression was performed to investigate the effects of age and other key clinical factors.

Results
Among 594 patients with DM, with median age of 12.3 years (interquartile range, 8.7–15.9 years), 176 (29.6%) presented with DKA. The inclusion of age, transfer status, and new-onset in the statistical model did not improve the prediction of DKA beyond BOHB alone. β-Hydroxybutyrate demonstrated strong discrimination for DKA, with an area under the curve of 0.95 (95% confidence interval, 0.93–0.97). A BOHB value of 5.3 mmol/L predicted DKA with optimal accuracy (90.6% of patients were correctly classified). The sensitivity, specificity, and positive and negative predictive values of this cut point were 76.7% (95% confidence interval, 69.8%–82.7%), 96.4% (94.2%–98.0%), 90.0% (84.0%–94.3%), and 90.8% (87.7%–93.3%), respectively.

Conclusions
β-Hydroxybutyrate accurately predicts DKA in children and adolescents. More importantly, because plasma BOHB is the ideal biochemical marker of DKA, BOHB may provide a more optimal definition of DKA for management decisions and treatment targets.