bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunotoxicity of an Electrochemically Fluorinated Aqueous Film-Forming Foam
Authors: McDonough Carrie A , Ward Chastity , Hu Qing , Vance Samuel , Higgins Christopher P , DeWitt Jamie C 
Published: August 2020

Abstract
Aqueous film-forming foams (AFFFs) are complex per- and polyfluoroalkyl substance (PFAS)-containing mixtures used extensively as fire suppressants. AFFF-impacted groundwater and surface water have contaminated drinking water with PFASs in many communities, raising concerns about health effects from drinking water exposures. As individual PFASs have been identified as immune hazards, the immunotoxicity of complex PFAS mixtures is also a concern. Adult female and male C57BL/6 mice were given a commercial AFFF formulation for 10 days via gavage; administered dose was based on combined content of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) measured in the formulation (0, 1.88, 3.75, 7.5, or 10 mg PFOS+PFOA/kg body weight). A PFOA positive control of 7.5 mg/kg body weight was also given. Compared with the 0 mg/kg group, the following changes were noted: Body weights of males exposed to 7.5 and 10 mg PFOS+PFOA/kg were reduced by 15%, on average; female body weights did not differ. Average relative liver weights were increased 50%–200% in males and 37.5%–193% in females and liver peroxisome proliferation was increased 2- to 12-fold in all doses of both sexes. Antigen-specific antibody production was suppressed, on average, by 13% in males and by 12.4% in females across all doses. Spleen cellularity and lymphocyte subpopulations did not differ by dose for either sex. Our data indicate that though this complex PFAS mixture contained fairly low PFOA content, it induced changes in C57BL/6 mice similar to changes induced by PFOA alone, likely due to the presence of PFOS and many other PFASs.
A Survey of Neonatal Clinicians' Use, Needs, and Preferences for Kangaroo Care Devices
Authors: Weber Ashley , Jackson Yamile 
Published: August 2020

Background:
Decades of research supports the benefits of kangaroo care (KC) for the parent and newborn. Supportive KC devices may be an important tool clinicians can use to assist parents with KC. In recent years, there has been a rise in the availability of KC devices. However, the use, needs, and preferences for these supportive devices by neonatal clinicians have not been documented.

Purpose:
To survey clinicians' use, needs, and preferences of KC supportive devices, and examine whether differences exist based on clinician and organizational characteristics.

Methods:
A cross-sectional, online survey was sent through neonatal organization Web sites, conferences, and social media.

Results:
Many clinicians (n = 68, 43%; N = 158) facilitated KC with a supportive device, with 81% of devices provided by the clinician's employer. The most important “Must Have” feature of a KC device was “Safety: Reduces patient falls if caregiver sleeps or needs to use hands” (84% of respondents) followed by washability (82%), and “immediate, effective access to the baby” (78%). Clinicians' responses did not differ based on hospital setting, type of unit, KC experience, or experience using a KC device.

Implications for Practice:
To support safe use of KC devices in neonatal intensive care unit (NICU) clinical care, a device must hold the proper KC position consistently, allow immediate access to the infant, and hold the infant in place without the parent's hands to prevent falls. Training is needed to ensure safe device use.

Implications for Research:
Future research should evaluate the safety, efficacy, and cost-effectiveness of these devices.
Age at menarche in Seveso daughters exposed in utero to 2,3,7,8-tetrachlorodibenzo-p-dioxin
Authors: Warner Marcella , Rauch Stephen , Ames Jennifer , Mocarelli Paolo , Brambilla Paolo , Eskenazi Brenda 
Published: August 2020

Background:
In utero exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is associated with delayed pubertal development in animal studies. No epidemiologic study has investigated this association. We examined the relationship of in utero exposure to TCDD with reported age at onset of menarche in female children born to a unique cohort of TCDD-exposed women resulting from an explosion in Seveso, Italy, on 10 July 1976.

Methods:
In 2014, nearly 40 years after the explosion, we enrolled postexplosion offspring, 2 to 39 years of age, in the Seveso Second Generation Study. Age at onset of menarche (years) was collected for 316 daughters by maternal report or self-report at interview. In utero TCDD exposure was defined by maternal TCDD serum concentrations extrapolated to the pregnancy.

Results:
At interview, 287 daughters were postmenarche and reported age at menarche averaged 12.1 years (±1.3 years). Overall, we found no change in risk of menarche onset with a 10-fold increase in in utero TCDD exposure (hazard ratio [HR] = 0.86; 95% confidence interval [CI] = 0.71, 1.04). When we considered maternal menarche status in 1976 as a potentially sensitive developmental exposure window, in utero TCDD (log10) was associated with later age at menarche among daughters whose mothers were premenarche (HR = 0.71; 95% CI = 0.52, 0.97) but not postmenarche (HR = 0.89; 95% CI = 0.71, 1.12) at the time of the explosion (P int = 0.24).

Conclusions:
These results suggest that in utero TCDD exposure may alter pubertal timing among daughters of women who were prepubescent at the time of the Seveso accident.
CHARACTERISTICS AND SURGICAL OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT IN OLDER ADULTS
Authors: Patel Samir N. , Starr Matthew R. , Obeid Anthony , Ryan Edwin H. , Ryan Claire , Forbes Nora J. , Soares Rebecca R. , Ammar Michael , Patel Luv G. , Capone Antonio , Emerson Geoffrey G. , Joseph Daniel P. , Eliott Dean , Regillo Carl D. , Gupta Omesh P. , Hsu Jason , Yonekawa Yoshihiro ,   for the Primary Retinal Detachment Outcomes (PRO) Study Group
Published: August 2020

Purpose:
To describe characteristics and outcomes of primary rhegmatogenous retinal detachment in older adults (age ≥ 80).

Methods:
Consecutive patients with rhegmatogenous retinal detachment undergoing pars plana vitrectomy (PPV), scleral buckling (SB), or PPV/SB in the Primary Retinal Detachment Outcomes Study were evaluated. Outcome measures included single surgery anatomic success and visual acuity.

Results:
Of 2,144 patients included, 125 (6%) were 80 years or older. Compared with younger patients (age 40–79), older adults were more likely to be pseudophakic (P < 0.001), have macula-off detachments (P < 0.001), and have preoperative proliferative vitreoretinopathy (P = 0.02). In older adults, initial surgery was PPV in 73%, PPV/SB in 27%, and primary SB in 0%. Single surgery anatomic success was 78% in older adults compared with 84% in younger patients (P = 0.03). In older adults, single surgery anatomic success was 74% for PPV and 91% for PPV/SB (P = 0.03). The final mean logMAR was lower for older adults (0.79 [20/125] vs. 0.40 [20/40], [P < 0.001]). In older adults, the final mean logMAR for eyes that underwent PPV was 0.88 (20/160) compared with 0.50 (20/63) for PPV/SB (P = 0.03).

Conclusion:
Octogenarians and nonagenarians presented with relatively complex pseudophakic rhegmatogenous retinal detachments. Single surgery anatomic success and visual outcomes were worse compared with younger patients, and PPV/SB had better outcomes compared with PPV alone.
A Cluster of Corneal Donor Rim Cultures Positive for Achromobacter Species Associated With Contaminated Eye Solution
Authors: André Camille , Durand Marlene L. , Buckley Thomas , Cadorette James , Gilmore Michael S. , Ciolino Joseph B. , Bispo Paulo J. M. 
Published: August 2020

Purpose:
To investigate a cluster of corneoscleral rim cultures positive for Achromobacter species over a 6-month period at Massachusetts Eye and Ear.

Methods:
An increased rate of positive corneal donor rim cultures was noted at Massachusetts Eye and Ear between July and December 2017. Positive cultures were subjected to identification and antimicrobial susceptibility testing by phenotypic (MicroScan WalkAway) and genotypic (16S rDNA sequencing) methods. Samples of the eye wash solution (GeriCare) used in the eye bank were also evaluated. Antimicrobial activity of Optical-GS against Achromobacter spp. at 4°C and 37°C was assessed by time-kill kinetics assay.

Results:
Of 99 donor rims cultured, 14 (14.1%) grew bacteria with 11 (78.6%) due to uncommon nonfermenting Gram-negative bacilli. These had been identified by standard automated methods as Achromobacter (n = 3), Alcaligenes (n = 3), Ralstonia (n = 2), Pseudomonas (n = 2), and Stenotrophomonas (n = 1). Eight of these 11 isolates were subsequently available for molecular identification, and all were identified as Achromobacter spp. Six bottles of eyewash solution were evaluated and were positive for abundant Achromobacter spp. (3.4 × 105 ± 1.1 CFU/mL). Optisol-GS had no bactericidal activity against Achromobacter spp. at 4°C after 24-hour incubation but was bactericidal at 37°C. None of the patients who had received the contaminated corneas developed postoperative infection.

Conclusions:
An eyewash solution arising from a single lot was implicated in the contamination of donor rims by Achromobacter spp. The isolates were able to survive in the Optisol-GS medium at the recommended storage temperature. This highlights the need to continue improving protocols for tissue preparation and storage.
Combined Epithelial, Stromal, and Anterior Chamber Ingrowth After Penetrating Keratoplasty
Authors: Farahani Mina , Minckler Don , Chu Joshua , Huynh Kyle , Farid Marjan 
Published: August 2020

Purpose:
To present a case of primary graft failure after penetrating keratoplasty found to have epithelial ingrowth into the host stroma on histopathologic analysis.

Methods:
This is a single observational case report.

Results:
We herein describe the clinical course of a case of primary graft failure after penetrating keratoplasty. The corneal button was sent for histopathologic analysis. Analysis of the patient's failed corneal button revealed circumferential epithelial full-thickness wound invasion and stromal epithelial invasion into corneal stroma.

Conclusions:
Based on histopathologic analysis and this patient's presentation, the stromal ingrowth followed recipient epithelial invasion of the wound and stromal invasion through clefts in the donor corneal edges. Cases of primary graft failure should be assessed for histopathologic evidence of epithelial stromal ingrowth, despite its rarity. To our knowledge, epithelial ingrowth into the corneal donor stroma after penetrating keratoplasty has not been previously reported.
Type D Personality Associated With Increased Risk for Mortality in Adults With Congenital Heart Disease
Authors: Kauw Dirkjan , Schoormans Dounya , Sieswerda Gertjan Tj. , Van Melle Joost P. , Vliegen Hubert W. , Van Dijk Arie P.J. , Hulsbergen-Zwarts Mariët S. , Post Marco C. , Ansink Tieneke J. , Mulder Barbara J.M. , Bouma Berto J. , Schuuring Mark J. 
Published: August 2020

Background
Type D personality has been previously shown to increase the risk for mortality in patients with acquired heart disease.

Objective
We aimed to compare mortality in adult patients with congenital heart disease (CHD) with and without type D.

Methods
Survival was assessed using prospective data from the Dutch national Congenital Corvitia registry for adults with CHD. Patients were randomly selected from the registry and characterized at inclusion in 2009 for the presence of type D using the DS14 questionnaire.

Results
One thousand fifty-five patients, with 484 (46%) males, a mean (SD) age of 41 (14) years, 613 (58%) having mild CHD, 348 (33%) having moderate CHD, and 94 (9%) having severe CHD, were included. Type D personality was present in 225 patients (21%). Type D was associated with an increased risk for all-cause mortality independent of age, sex, New York Heart Association class, number of prescribed medications, depression, employment status, and marital status (hazard ratio, 1.94; 95% confidence interval, 1.05–3.57; P = .033).

Conclusion
Type D personality was associated with an increased risk for all-cause mortality in adult patients with CHD.
Improving Timeliness of Internal Medicine Consults in the Emergency Department: A Quality Improvement Initiative
Authors: Beckerleg Weiwei , Hasimja-Saraqini Delvina , Kwok Edmund S. H. , Hamdy Noha , Battram Erica , Wooller Krista R. 
Published: August 2020

ABSTRACT

Introduction:
Emergency department (ED) wait time is an important health system quality indicator. Prolonged consult to decision time (CTDT), the time it takes to reach a disposition decision after receiving a specialty consultation request, can contribute to increased overall length of stay in the ED.

Objective:
To identify delays in the consultation process for general internal medicine (GIM) and trial interventions to reduce CTDT.

Methods:
The study was conducted at a large tertiary teaching hospital with GIM inpatient wards at two campuses. Four interventions were trialed over sequential Plan-Do-Study-Act cycles: (1) process mapping, (2) resident education sessions, (3) audit and feedback of CTDT, and (4) adding a swing shift during peak consult volume.

Measurements:
The primary outcome measures were mean CTDT for patients admitted to GIM and the proportion of admitted patients with CTDT of less than 3 hours.

Results:
Mean CTDT decreased from 4.61 hours before intervention to 4.18 hours after intervention (p < .0001). The proportion of GIM patients with CTDT less than 3 hours increased from 25% to 33% (p < .0001).

Conclusions:
The interventions trialed led to a sustained reduction in CTDT over a 12-month period and demonstrated the effectiveness of education in influencing physician performance.
Effect of blood glucose and body weight on image quality in brain [18F]FDG PET imaging
Authors: Henriksen Otto M. , Holm Søren , Marner Lisbeth , Law Ian 
Published: August 2020

Objectives
The aims of the present study were to assess the influence of mild to moderate hyperglycaemia and body weight on brain 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) PET, and to what extent a simple algorithm for maintaining count density may compensate for these effects.

Methods
We prospectively included 63 patients undergoing routine brain [18F]FDG PET. Scan time and injected activity were adjusted in patients with hyperglycaemia or increased body weight. Measures of perceived image quality, image noise and image contrast were obtained in both standard scans and intervention scans.

Results
Elevated blood glucose and increased body weight were associated with reduced count density and increased image noise that in turn were associated with lower scores of perceived image quality. The proposed simple algorithm effectively maintained the image noise level and improved perceived image quality across the full range of elevated blood glucose values and body weights, although the effect of intervention on perceived image quality was attenuated by lower image contrast in patients with moderate hyperglycaemia. In patients with increased body weight or blood glucose, the fraction of scans with poor image quality decreased from 9/29 to 2/29 (P = 0.04) and the fraction with good image quality increased from 7/29 to 20/29 (P = 0.001) when applying the proposed algorithm.

Conclusions
Increasing blood glucose and body weight are associated with increased image noise in standard imaging conditions. Improving count density by prolonging scan time and increasing injected activity significantly improves image quality in hyperglycaemic patients, although the image contrast remains reduced in patients with most pronounced hyperglycaemia.
Understanding Variation in Postacute Care
Authors: Reistetter Timothy A. , Eschbach Karl , Prochaska John , Jupiter Daniel C. , Hong Ickpyo , Haas Allen M. , Ottenbacher Kenneth J. 
Published: August 2020

Objective
The aims of the study were to demonstrate a method for developing rehabilitation service areas and to compare service areas based on postacute care rehabilitation admissions to service areas based on acute care hospital admissions.

Design
We conducted a secondary analysis of 2013–2014 Medicare records for older patients in Texas (N = 469,172). Our analysis included admission records for inpatient rehabilitation facilities, skilled nursing facilities, long-term care hospitals, and home health agencies. We used Ward’s algorithm to cluster patient ZIP Code Tabulation Areas based on which facilities patients were admitted to for rehabilitation. For comparison, we set the number of rehabilitation clusters to 22 to allow for comparison to the 22 hospital referral regions in Texas. Two methods were used to evaluate rehabilitation service areas: intraclass correlation coefficient and variance in the number of rehabilitation beds across areas.

Results
Rehabilitation service areas had a higher intraclass correlation coefficient (0.081 vs. 0.076) and variance in beds (27.8 vs. 21.4). Our findings suggest that service areas based on rehabilitation admissions capture has more variation than those based on acute hospital admissions.

Conclusions
This study suggests that the use of rehabilitation service areas would lead to more accurate assessments of rehabilitation geographic variations and their use in understanding rehabilitation outcomes.
A New Surgical Method for Medial Ectropion Repair: Fixing the Lower Eyelid Retractor to the Back of the Tarsal Plate
Authors: Kokubo Kenichi , Katori Nobutada , Hayashi Kengo , Fujii Akiko , Kitamura Sho , Maeda Chie , Haga Shoko , Kawabata Tomotaka , Maegawa Jiro 
Published: August 2020

Abstract
Involutional ectropion is a disease in which the eyelids are everted outwards, and because the eyelids move away from the eyeballs, the ocular surface and conjunctiva are exposed causing inflammation, pain, photophobia, foreign body sensation, epiphora, and blurred vision. It is thought to be caused by horizontal and vertical laxity. Various surgical methods have reportedly been used to correct involutional ectropion. Shortening the lower eyelid retractor (LER) is an indispensable surgical operation for medial ectropion. When the LER is shortened, it is usually fixed to the lower edge of the tarsal plate. Herein we describe a new type of surgery that has now been performed on 6 eyes in 4 patients. The procedure involves separating the conjunctiva from the tarsal plate, inserting the LER between the conjunctiva and the tarsal plate, and then fixing it to the back of the tarsal plate. In all 6 eyes, the lower eyelid now contacts the eyeball, and morphological improvements were achieved. This new surgical method is a useful way to raise the tarsal plate.
Three-Dimensional Analysis of Craniofacial Structures of Individuals With Nonsyndromic Unilateral Complete Cleft Lip and Palate
Authors: Parveen Shahistha , Husain Akhter , Johns Gejo , Mascarenhas Rohan , Reddy Srinivas Gosla 
Published: August 2020

Abstract
Cleft lip and palate (CLP) is one of the most common congenital deformities. Primary surgeries at an early age result in scar formation, which may impede the growth of craniofacial structures of the maxilla. Orthodontist's role in the management of individuals with CLP is important and starts from the time of birth. The knowledge of craniofacial structures in individuals with a cleft is essential for treatment planning. The purpose of this study was to analyze and compare craniofacial structures of cleft and noncleft side of individuals with non-syndromic unilateral complete cleft lip and palate (NSUCCLP) using cone-beam computed tomography (CBCT). CBCT scans of individuals with NSUCCLP (n = 42) were retrieved from the databases of two cleft centers, which followed the same protocols for timing and type of primary surgeries and secondary alveolar bone grafting (SABG). DICOM files of CBCT scans were integrated into Dolphin 3D software, and analysis was carried out in multiplanar views. The craniofacial structures of individuals with NSUCCLP were analyzed using fourteen parameters. Measurements were also recorded between the cleft and noncleft sides for comparison. The volume of the maxilla was generated by isolating it from adjacent structures on a 3D reconstructed model. MAWC, MAWPM1, MAWPM2, MAWM1, and MV of the cleft side was less than noncleft side (P < 0.05). MHP @ N Aper is less on the noncleft side (P < 0.05). There is an asymmetry of structures around the dentoalveolar and nasal region; however, asymmetries were not affected at deeper structures of the craniofacial region of individuals with NSUCCLP.
Genetic and epigenetic contributions to variation in transposable element expression responses to abiotic stress in maize
Authors: Liang Zhikai , Anderson Sarah N. , Noshay Jaclyn M. , Crisp Peter A. , Enders Tara A. , Springer Nathan M. 
Published: August 2020

SummaryTransposable elements (TEs) pervade most eukaryotic genomes but the repetitive nature of TEs has complicated the analysis of their expression. Although the majority of TEs are silent, we document the activation of some TEs during abiotic stress.TE expression was monitored in seedling leaf tissue of maize inbreds subjected to heat or cold stress conditions. DNA methylation profiles and comparative genomics were used to probe the variability of TE expression responses.Although there was no evidence for a genome-wide activation of TEs, a subset of TE families generate transcripts only in stress conditions. There is substantial variation for which TE families exhibit stress-responsive expression in the three genotypes. The stress-responsive activation of a TE family can often be attributed to a small number of elements in the family. These elements that are activated often contain small regions lacking DNA methylation, while fully methylated elements are rarely expressed. A comparison of the expression of specific TEs in different maize genotypes reveals high levels of variability that can be attributed to both genome content differences and epigenetic variation.This study provides insights into the genetic and epigenetic factors that influence TE regulation in normal and stress conditions.
Serum Amyloid P inhibits single stranded RNA-induced lung inflammation, lung damage, and cytokine storm in mice
Authors: Karhadkar Tejas R. , Pilling Darrell , Gomer Richard H. 
Published: August 2020

AbstractSARS-CoV-2 is a single stranded RNA (ssRNA) virus and contains GU-rich sequences distributed abundantly in the genome. In COVID-19, the infection and immune hyperactivation causes accumulation of inflammatory immune cells, blood clots, and protein aggregates in lung fluid, increased lung alveolar wall thickness, and upregulation of serum cytokine levels. A serum protein called serum amyloid P (SAP) has a calming effect on the innate immune system and shows efficacy as a therapeutic for fibrosis in animal models and clinical trials. In this report, we show that aspiration of the GU-rich ssRNA oligonucleotide ORN06 into mouse lungs induces all of the above COVID-19-like symptoms. Men tend to have more severe COVID-19 symptoms than women, and in the aspirated ORN06 model, male mice tended to have more severe symptoms than female mice. Intraperitoneal injections of SAP starting from day 1 post ORN06 aspiration attenuated the ORN06-induced increase in the number of inflammatory cells and formation of clot-like aggregates in the mouse lung fluid, reduced ORN06-increased alveolar wall thickness and accumulation of exudates in the alveolar airspace, and attenuated an ORN06-induced upregulation of the inflammatory cytokines IL-1β, IL-6, IL-12p70, IL-23, and IL-27 in serum. Together, these results suggest that aspiration of ORN06 is a simple model for both COVID-19 as well as cytokine storm in general, and that SAP is a potential therapeutic for diseases with COVID-19-like symptoms as well as diseases that generate a cytokine storm.