bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incomplete Kawasaki Disease as Presentation of COVID-19 Infection in an Infant: A Case Report
Authors: Raut Sumantra , Roychowdhoury Satyabrata , Bhakta Subhajit , Sarkar Mihir , Nandi Mousumi 
Published: June 2020

ABSTRACT

Background
Recently a severe form of COVID-19 infection has been described in a cluster of children presenting as multisystem inflammatory condition. One of the important spectrum of this condition is incomplete Kawasaki disease (KD).

Case report
A 5-month-old male child presented with high-spiking fever for 5 days with skin rash, bilateral non-purulent conjunctivitis and irritability. His C-reactive protein was markedly elevated (215.4 mg/l). Echocardiography revealed dilated left main coronary artery (3.0 mm, Z score +4.30) and left anterior descending artery (2.37 mm, Z score +3.76). Concomitantly Reverse Transcription- Polymerase Chain Reaction for COVID-19 was positive on fifth day sample. He was diagnosed as incomplete KD with COVID-19 infection and treated with intravenous immunoglobulin (IVIG) (2 g/kg), oral aspirin and azithromycin. Patient improved after 48 h and was discharged on oral aspirin.

Conclusion
Incomplete KD may co-exist with COVID-19 infection in infant. Early institution of IVIG may lead to better outcome.
A first cladistic analysis of Antarctoperlinae (Plecoptera: Gripopterygidae) and a new micropterous species from Patagonia
Authors: Pessacq Pablo , Duarte Tácio , Epele Luis B 
Published: June 2020

AbstractGripopterygidae is a diverse family of stoneflies, Plecoptera, distributed in the Southern Hemisphere. It has been traditionally divided into five subfamilies, but the monophyly of most of these is not supported by molecular the more comprehensive molecular analysis of the order. To test the monophyly of Antarctoperlinae, and to establish the phylogenetic position of a new Gripopterygidae species, we performed a morphological cladistic analysis including 38 morphological characters and 27 terminal taxa, with representatives of the four subfamilies present in South America and three Austroperlidae. Based on published information, we rooted the tree with Penturoperla barbata, Austroperlidae. As a result, Antarctoperlinae was recovered as polyphyletic, with Vesicaperla kuscheli and Plegoperla punctata, two members of the subfamily, placed outside the clade that includes the nine remaining genera of Antarctoperlinae. Vesicaperla also falls outside the family in previous molecular analysis. Based on this evidence, it should not be placed in Antarctoperlinae. Plegoperla punctata, known only from the type series, possesses many missing entries in our data matrix. Based on this, it seems convenient to maintain its subfamilial placement. In the tree obtained, the potential new species nests together with Pehuenioperla llaima. We thus accept it as a member of Pehuenioperla and describe it as P. microptera sp. nov.
PA job availability in primary care during 2014 and 2016
Authors: Rana Rachel , Blazar Melinda , Jones Quincy , Butterfield Rita , Everett Christine M. , Morgan Perri 
Published: June 2020

ABSTRACT

Objectives:
The objective of this project was to evaluate demand for PAs by examination of job postings. We compared proportions of PAs in primary care with proportions of job postings in primary care in 2014 and 2016 and described job postings for PAs by specialty in 2014 and 2016.

Methods:
Internet job postings for PAs supplied by Burning Glass Technologies were evaluated for practice specialty. Job postings were compared with existing filled positions by specialty as reported by the National Commission for the Certification of Physician Assistants.

Results:
In both years, more than 25% of PAs in practice were in primary care and fewer than 20% of job openings were in primary care. More than half of postings were in medical and surgical subspecialties.

Conclusions:
Our findings provide insights into which specialties have emerging high demand for PAs. The demand for PAs appears to remain much stronger for specialty jobs than for primary care jobs.
Nurse Educators’ Guide to Clinical Judgment: A Review of Conceptualization, Measurement, and Development
Authors: Klenke-Borgmann Laura , Cantrell Mary Ann , Mariani Bette 
Published: June 2020

Abstract

AIM
The purpose of this article is to define clinical judgment, examine valid and reliable instruments to measure the construct, review established strategies by which to develop it, and propose key future nursing education research priorities in clinical judgment.

BACKGROUND
A pressing interest in prelicensure nursing students’ clinical judgment development has emerged in response to the National Council of State Boards of Nursing project Next Generation NCLEX.

METHOD
Sequential literature reviews uncovered six instruments that measure clinical judgment and 24 studies that demonstrate the effects of high-fidelity simulation on clinical judgment in prelicensure learners.

RESULTS
Six themes emerged: number of simulation-based experience exposures, specific nursing specialty simulations, debriefing and its effect on clinical judgment, assessment, clinical decision-making, and reflection.

CONCLUSION
Based on these results, key future research priorities investigating the effects of interprofessional simulation and simulation in the classroom were identified.
Understanding the most commonly billed diagnoses in primary care
Authors: Rogers Julia , Baker Manisa 
Published: June 2020

Abstract:
Atherosclerotic cardiovascular disease (ASCVD), the buildup of plaque within the arterial walls, contributes to acute coronary syndrome, angina, stroke, transient ischemic attack, and peripheral arterial disease. This second article in a series about the most commonly billed diagnoses in primary care describes the pathophysiologic processes of ASCVD as well as how the clinical manifestations and treatments are linked to the pathogenesis of the disease.
ACL Growth With Age in Pediatric Patients: An MRI Study
Authors: Putur Danielle E. , Slaven Sean E. , Niu Emily L. 
Published: June 2020

Background:There is limited knowledge of morphologic changes of the anterior cruciate ligament (ACL) during childhood. The purpose of the study is to describe normal ACL growth in pediatric patients.Methods:We performed retrospective review of patients under 19 years of age with at least 2 serial magnetic resonance imaging (MRI) examinations of the same knee without ACL tear. The parameters measured included length of the ACL, width of the ACL in sagittal and coronal planes, physeal status, ACL-tibial inclination angle, Notch Width Index, ACL tibial attachment width and midpoint, and anterior to posterior length and height of the tibial epiphysis. Pearson correlation coefficients were calculated to determine the strength of correlation of each parameter relative to age. Growth curves were calculated for individual parameters, producing a predictive model for growth of the ACL over time.Results:One hundred forty-seven patients (365 MRIs) were included. The average age at initial MRI was 12.2 years (range: 1.2 to 18.4 y). The Pearson correlation coefficient for each parameter was statistically significant relative to age. Younger patients had more oblique, anteriorly attached ACLs. Three distinct phases of growth were observed: patients age 1.5 to 5.75 years average 2.25 mm of growth per year; patients aged 6 to 11.5 average 1.46 mm of growth per year; growth slows at age 11.75, stopping by 18.5 years. The growth model for ACL sagittal width increased 0.45 mm/y from age 1.5 to 14.5 after which it plateaus, whereas coronal width increased 0.22 mm/y from age 1.5 to 18.75.Conclusions:In the pediatric patient, the ACL grows in length and width in a predictable manner until age 18. This model aids clinicians in predicting normal ACL parameters for anatomic reconstruction procedures in the skeletally immature patient.Level of Evidence:Level IV.
Long-term Follow-up of Eosinophilic Granulomas of the Axial and Appendicular Skeleton Managed With Biopsy Alone
Authors: Erol Bulent , Sofulu Omer , Caliskan Emrah 
Published: June 2020

Background:
This study aimed to evaluate the long-term clinical and radiologic follow-up results of eosinophilic granulomas (EGs) of the axial and appendicular skeleton managed with biopsy alone.

Methods:
Fifty-five patients with unifocal osseous EGs of the axial and appendicular skeleton were followed after biopsy. Patients were divided into 2 groups on the basis of localization of the lesions. In group 1, there were 32 (58.2%) children with extremity long bone involvement: femur, tibia, humerus, ulna, and radius. Group 2 included 23 (41.8%) patients with lesions located in other appendicular and axial skeleton bones: pelvis, scapula, clavicle, lumbar, and thoracic vertebrae. After confirming the diagnosis by a closed biopsy, no further surgical intervention was performed. Clinical recovery included regression of the localized symptoms, mainly pain resolution. Functional improvement was assessed by Musculoskeletal Tumor Society (MSTS) scoring. Radiologic healing was defined as ossification of the entire lesion with cortical thickening in long and flat bones, and restoration of vertebral body height in the spine. Complications, including local recurrence, were determined.

Results:
The patients comprised 28 boys and 27 girls with an average age of 9.2 years (range, 3 to 16 y). The average follow-up was 76 months (range, 28 to 132 mo). The median time from biopsy to clinical recovery was 17 days [95% confidence interval (CI), 13.3-20.6] and 36 days (95% Cl, 32.8-39.1) in group 1 and group 2, respectively. MSTS scores increased progressively till the end of 12 months in both groups. The median time from biopsy to radiologic healing was 16 months (95% CI, 11.5-20.4) and 42 months (95% Cl, 39.3-44.6) in group 1 and group 2, respectively. Both clinical recovery (P=0.021) and radiologic healing (P=0.009) were significantly faster in group 1 compared with group 2. No major complication was seen after biopsy. All lesions regressed without a local recurrence.

Conclusions:
Unifocal osseous EGs have spontaneous healing potential and confirming the diagnosis by biopsy is enough to obtain good clinical and radiologic results without any additional surgical intervention.

Type of Study:
This was a therapeutic study.

Level of Evidence:
Level IV.
Successful Ponseti-treated Clubfeet at Age 2 Years: What Is the Rate of Surgical Intervention After This?
Authors: Siebert Matthew J. , Karacz Chelsea M. , Richards B. Stephens 
Published: June 2020

Background:
In recent decades, nonoperative Ponseti casting has become the standard of care in the treatment of idiopathic clubfoot. However, the rate of recurrence, even after successful Ponseti treatment is not insignificant. The purpose of this study was to determine the future rate, timing, and type of surgery needed in patients whose idiopathic clubfeet treated by Ponseti casting were considered successful at the age of 2 years.

Methods:
Inclusion criteria for this retrospective study were patients under 3 months with idiopathic clubfoot treated exclusively by Ponseti casting, who had successful outcomes at 2 years of age without surgery, and who had at least 5 years of follow-up. The total number of surgical interventions in the age range 2 to 5 and above 5 years, the number and type of procedures performed, and the timing of surgery were reviewed.

Results:
Three hundred thirty-six patients with a total of 504 clubfeet fulfilled the inclusion criteria. One hundred twenty-two of these 336 patients (36.3%) eventually underwent surgical intervention. Between 2 and 5 years of age, 79 patients (23.5%) with 104 feet (20.6%) underwent surgery. The most common procedures performed between 2 and 5 years were limited (a la carte) in scope: tibialis anterior tendon transfer, posterior release, plantar fascia release, and repeat tendo-Achilles lengthening. At age above 5 years, 53 patients (20.1%) with 65 feet (16.9%) underwent surgery. Ten of these 53 patients had already undergone surgery between 2 and 5 years of age. The procedures most commonly performed were similar.

Conclusions:
In patients with idiopathic clubfoot who reached 2 years of age with successful outcomes from Ponseti cast treatment, ∼35% eventually underwent surgical intervention, mostly limited (a la carte), to regain or maintain a plantigrade foot. The most commonly performed procedures include tibialis anterior tendon transfer, posterior capsular release, plantar fascia release and repeat tendo-Achilles lengthening, either in isolation or in combination. However, before considering surgery, the need for these procedures can, and should, be minimized by recasting recurrent deformities using Ponseti method.

Level of Evidence:
Level III.
Assessment of circulating tumor DNA in cerebrospinal fluid by whole exome sequencing to detect genomic alterations of glioblastoma
Authors: Duan Hao , Hu Ji-Long , Chen Zheng-He , Li Jue-Hui , He Zhen-Qiang , Wang Zhen-Ning , Zhang Guan-Hua , Guo Xiao-Yu , Liang Lun , Mou Yong-Gao 
Published: June 2020

Abstract

Background
Cerebrospinal fluid (CSF) has been demonstrated as a better source of circulating tumor DNA (ctDNA) than plasma for brain tumors. However, it is unclear whether whole exome sequencing (WES) is qualified for detection of ctDNA in CSF. The aim of this study was to determine if assessment of ctDNA in CSF by WES is a feasible approach to detect genomic alterations of glioblastoma.

Methods
CSFs of ten glioblastoma patients were collected pre-operatively at the Department of Neurosurgery, Sun Yat-sen University Cancer Center. ctDNA in CSF and genome DNA in the resected tumor were extracted and subjected to WES. The identified glioblastoma-associated mutations from ctDNA in CSF and genome DNA in the resected tumor were compared.

Results
Due to the ctDNA in CSF was unqualified for exome sequencing for one patient, nine patients were included into the final analysis. More glioblastoma-associated mutations tended to be detected in CSF compared with the corresponding tumor tissue samples (3.56 ± 0.75 vs. 2.22 ± 0.32, P = 0.097), while the statistical significance was limited by the small sample size. The average mutation frequencies were similar in CSF and tumor tissue samples (74.1% ± 6.0% vs. 73.8% ± 6.0%, P = 0.924). The R132H mutation of isocitrate dehydrogenase 1 and the G34V mutation of H3 histone, family 3A (H3F3A) which had been reported in the pathological diagnoses were also detected from ctDNA in CSF by WES. Patients who received temozolomide chemotherapy previously or those whose tumor involved subventricular zone tended to harbor more mutations in their CSF.

Conclusion
Assessment of ctDNA in CSF by WES is a feasible approach to detect genomic alterations of glioblastoma, which may provide useful information for the decision of treatment strategy.
Age-dependent changes of total and differential white blood cell counts in children
Authors: Li Kun , Peng Ya-Guang , Yan Ruo-Hua , Song Wen-Qi , Peng Xiao-Xia , Ni Xin 
Published: June 2020

Abstract

Background
Total and differential white blood cell counts are important for the diagnostic evaluation of suspected diseases. To facilitate the interpretation of total and differential white blood cell counts in pediatric patients, the present study investigated age-dependent changes in total and differential white blood cell counts in healthy reference children.

Methods
Data were obtained from the Pediatric Reference Intervals in China study (PRINCE), which aims to establish and verify pediatric reference intervals for Chinese children based on a nationwide multicenter cross-sectional study from January 2017 to December 2018. Quantile curves were calculated using the generalized additive models for location, shape, and scale method. The 2.5th, 50th, and 97.5th quantile curves were calculated for both total and differential white blood counts. Percents of stacked area charts were used to demonstrate the proportions of differential white blood cells. All statistical analyses were performed using R software.

Results
Both 50th and 97.5th quantiles of total white blood cell count and monocyte count were highest at birth, then rapidly decreased in the first 6 months of life; relatively slow reduction continued until 2 years of age. The lymphocyte count was low during infancy and increased to its highest level at 6 months of age; it then exhibited moderate and continuous reduction until approximately 9 years of age. The pattern of neutrophil count changed with age in a manner opposite to that of lymphocyte count. Besides, there were two inter-sections of lymphocyte count and neutrophil count during infancy and at approximately 5 years of age, based on locally weighted regression (LOESS) analysis. There were no apparent age-related changes in eosinophil or basophil counts.

Conclusion
These data regarding age-related changes in total and differential white blood cell counts can be used to assess the health of pediatric patients and guide clinical decisions.
Global Alliance against Chronic Respiratory Diseases symposium on air pollution: overview and highlights
Authors: Schraufnagel Dean E. 
Published: June 2020

Abstract
A 1-day symposium before the annual meeting of the Global Alliance against Chronic Respiratory Diseases, gathered authorities and researchers from around the world to discuss the impact of air pollution on human and planetary health. Air quality is a high priority for Global Alliance against Chronic Respiratory Diseases and China, the host country. This article presents a summary, commentary, and amplification of the 17 presentations. Air pollution is closely linked with global warming and harms most body systems even at levels below international standards. Information about the genetic, cellular, and metabolic effects of exposure to air pollution is important for better understanding of individual responses and even potential therapeutic mediation. Reducing air pollution at its source leads to prompt and important benefits and should be the first priority for political and public action.
Quantifying the Size of the Pterygium Head by Evaluating the Fibrous Area or the Vascularized Area
Authors: Lee Olivia L. , Shi Yue , Brown Tyler , Maram Jyotsna 
Published: June 2020

Purpose:
Pterygium is characterized by the development of wing-shaped fibrovascular tissue from the bulbar conjunctiva across the limbus onto the cornea. The purpose of this study was to quantify the discrepancy of the pterygium size between the fibrous area and the vascularized area.

Methods:
Color photographs of 146 eyes with pterygia obtained with a single-lens reflex camera system were analyzed by 2 independent graders for width (vertical dimension), length (horizontal dimension), and surface area of the pterygium head using 2 methods: the fibrous method, which measures any fibrovascular tissue crossing the corneal limbus, and the vascular method, which measures only tissue with discernible active blood flow, without any avascular tissue or opacity. Statistics of intraclass correlation coefficients for intergrader and intragrader reproducibility were calculated, and the paired t test between methods was used.

Results:
Both intergrader and intragrader intraclass correlation coefficients for both methods were above 0.85. The vascular measurement was significantly larger in width (vertical dimension, fibrous 3.97 ± 1.02 mm vs. vascular 4.49 ± 1.33 mm, P = 0.01), whereas the fibrous measurement was significantly larger in length (horizontal dimension, fibrous 2.41 ± 1.16 mm vs. vascular 2.23 ± 1.05 mm, P = 0.04). No significant difference was found in the surface area (fibrous 7.27 ± 4.65 mm2 vs. vascular 7.40 ± 5.13 mm2, P = 0.67).

Conclusions:
With both methods, reproducibility of the size of the pterygium head was high. Significant differences were shown between the two methods in quantification of the width and length but not in the surface area. Such methods can be used to standardize the evaluation of pterygia in clinical research and clinical trials.
Assessment of Factors Associated With Postoperative Pain After Photorefractive Keratectomy
Authors: Palochak Cherilyn Mae A. , Santamaria Joseph , Justin Grant A. , Apsey Douglas A. , Caldwell Matthew C. , Steigleman Walter A. , Evangelista Charisma , Legault Gary L. , Gillis John 
Published: June 2020

Purpose:
To define the factors that affect patient's self-assessed postoperative pain after photorefractive keratectomy (PRK).

Methods:
Patients who underwent PRK in 2016 were evaluated. Anonymized data collected included patient gender, age, and season at the time of surgery, ablation depth, surgeon status (attending vs. resident), topical tetracaine use, and subjective pain scores at postoperative days (PODs) 1 and 7. Average pain scores and amount of pain medication taken were analyzed for each of the previously mentioned variables.

Results:
Overall, 231 patients who underwent PRK were analyzed. The mean pain score and SD were 0.78 ± 1.87 on POD 1 and 0.03 ± 0.37 by POD 7. Patients who used topical tetracaine reported significantly higher pain on POD 1 and 7 compared with patients who did not use tetracaine (P < 0.001 and P = 0.038, respectively). No significant differences in pain scores were seen based on surgeon status, ablation depth, gender, and season. Patients who used topical tetracaine took a higher amount of oral pain medication (9.44 ± 6.01) compared with those who did not (7.02 ± 4.71) (P = 0.022).

Conclusions:
Postoperative pain was significantly elevated in patients who used tetracaine on POD 1 and POD 7. These patients were also more likely to take oral pain medication than those who did not use topical tetracaine. Surgeon status, season, gender, and ablation depth showed no significant differences in subjective pain scores. Oral pain medication should be evaluated to assess efficacy and safety in inhibiting ocular pain after PRK.
The transition from acute to persistent pain: the identification of distinct trajectories among women presenting to an emergency department
Authors: Burns John W. , Janssen Imke , Lillis Teresa , Mulcahy Morgan , Purim-Shem-Tov Yanina A. , Bruehl Stephen , Burgess Helen J. , Fischer Alexandra , Rim Katie , Aranda Frances , Pinkerton Linzy , Hobfoll Stevan 
Published: June 2020

AbstractPosttraumatic stress disorder (PTSD) symptoms and other negative psychosocial factors have been implicated in the transition from acute to persistent pain. Women (N = 375) who presented to an inner-city emergency department (ED) with complaints of acute pain were followed up for 3 months. They completed a comprehensive battery of questionnaires at an initial visit and provided ratings of pain intensity at the site of pain presented in the ED during 3 monthly phone calls. Latent class growth analyses were used to detect possible trajectories of change in pain intensity from the initial visit to 3 months later. A 3-trajectory solution was found, which identified 3 groups of participants. One group (early recovery; n = 93) had recovered to virtually no pain by the initial visit, whereas a second group (delayed recovery; n = 120) recovered to no pain only after 1 month. A third group (no recovery; n = 162) still reported elevated pain at 3 months after the ED visit. The no recovery group reported significantly greater PTSD symptoms, anger, sleep disturbance, and lower social support at the initial visit than both the early recovery and delayed recovery groups. Results suggest that women with high levels of PTSD symptoms, anger, sleep disturbance, and low social support who experience an acute pain episode serious enough to prompt an ED visit may maintain elevated pain at this pain site for at least 3 months. Such an array of factors may place women at an increased risk of developing persistent pain following acute pain.