bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pilot Trial of Platelets Stored Cold versus at Room Temperature for Complex Cardiothoracic Surgery
Authors: Strandenes Geir , Sivertsen Joar , Bjerkvig Christopher K. , Fosse Theodor K. , Cap Andrew P. , del Junco Deborah J. , Kristoffersen Einar Klæboe , Haaverstad Rune , Kvalheim Venny , Braathen Hanne , Lunde Turid Helen Felli , Hervig Tor , Hufthammer Karl Ove , Spinella Philip C. , Apelseth Torunn Oveland 
Published: October 2020

Background
This pilot trial focused on feasibility and safety to provide preliminary data to evaluate the hemostatic potential of cold-stored platelets (2° to 6°C) compared with standard room temperature–stored platelets (20° to 24°C) in adult patients undergoing complex cardiothoracic surgery. This study aimed to assess feasibility and to provide information for future pivotal trials.

Methods
A single center two-stage exploratory pilot study was performed on adult patients undergoing elective or semiurgent complex cardiothoracic surgery. In stage I, a two-armed randomized trial, platelets stored up to 7 days in the cold were compared with those stored at room temperature. In the subsequent single-arm stage II, cold storage time was extended to 8 to 14 days. The primary outcome was clinical effect measured by chest drain output. Secondary outcomes were platelet function measured by multiple electrode impedance aggregometry, total blood usage, immediate and long-term (28 days) adverse events, length of stay in intensive care, and mortality.

Results
In stage I, the median chest drain output was 720 ml (quartiles 485 to 1,170, n = 25) in patients transfused with room temperature–stored platelets and 645 ml (quartiles 460 to 800, n = 25) in patients transfused with cold-stored platelets. No significant difference was observed. The difference in medians between the room temperature– and cold-stored up to 7 days arm was 75 ml (95% CI, −220, 425). In stage II, the median chest drain output was 690 ml (500 to 1,880, n = 15). The difference in medians between the room temperature arm and the nonconcurrent cold-stored 8 to 14 days arm was 30 ml (95% CI, −1,040, 355). Platelet aggregation in vitro increased after transfusion in both the room temperature– and cold-stored platelet study arms. Total blood usage, number of adverse events, length of stay in intensive care, and mortality were comparable among patients receiving cold-stored and room temperature–stored platelets.

Conclusions
This pilot trial supports the feasibility of platelets stored cold for up to 14 days and provides critical guidance for future pivotal trials in high-risk cardiothoracic bleeding patients.

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Left Ventricular Hypertrophy Increases Susceptibility to Bupivacaine-induced Cardiotoxicity through Overexpression of Transient Receptor Potential Canonical Channels in Rats
Authors: Hino Hideki , Matsuura Tadashi , Kuno Miyuki , Hori Kotaro , Tsujikawa Shogo , Mori Takashi , Nishikawa Kiyonobu 
Published: October 2020

Background
Local anesthetics, particularly potent long acting ones such as bupivacaine, can cause cardiotoxicity by inhibiting sodium ion channels; however, the impact of left ventricular hypertrophy on the cardiotoxicity and the underlying mechanisms remain undetermined. Transient receptor potential canonical (TRPC) channels are upregulated in left ventricular hypertrophy. Some transient receptor potential channel subtypes have been reported to pass relatively large cations, including protonated local anesthetics; this is known as the “pore phenomenon.” The authors hypothesized that bupivacaine-induced cardiotoxicity is more severe in left ventricular hypertrophy due to upregulated TRPC channels.

Methods
The authors used a modified transverse aortic constriction model as a left ventricular hypertrophy. Cardiotoxicity caused by bupivacaine was compared between sham and aortic constriction male rats, and the underlying mechanisms were investigated by recording sodium ion channel currents and immunocytochemistry of TRPC protein in cardiomyocytes.

Results
The time to cardiac arrest by bupivacaine was shorter in aortic constriction rats (n =11) than in sham rats (n = 12) (mean ± SD, 1,302 ± 324 s vs. 1,034 ± 211 s; P = 0.030), regardless of its lower plasma concentration. The half-maximal inhibitory concentrations of bupivacaine toward sodium ion currents were 4.5 and 4.3 μM, which decreased to 3.9 and 2.6 μM in sham and aortic constriction rats, respectively, upon coapplication of 1-oleoyl-2-acetyl-sn-glycerol, a TRPC3 channel activator. In both groups, sodium ion currents were unaffected by QX-314, a positively charged lidocaine derivative, that hardly permeates the cell membrane, but was significantly decreased with QX-314 and 1-oleoyl-2-acetyl-sn-glycerol coapplication (sham: 79 ± 10% of control; P = 0.004; aortic constriction: 47± 27% of control; P = 0.020; n = 5 cells per group). Effects of 1-oleoyl-2-acetyl-sn-glycerol were antagonized by a specific TRPC3 channel inhibitor.

Conclusions
Left ventricular hypertrophy exacerbated bupivacaine-induced cardiotoxicity, which could be a consequence of the “pore phenomenon” of TRPC3 channels upregulated in left ventricular hypertrophy.

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The POSITIONED Study: Prone Positioning in Nonventilated Coronavirus Disease 2019 Patients—A Retrospective Analysis
Authors: Jagan Nikhil , Morrow Lee E. , Walters Ryan W. , Klein Lauren P. , Wallen Tanner J. , Chung Jacqueline , Plambeck Robert W. 
Published: October 2020

Objectives:
Given perceived similarities between coronavirus disease 2019 pneumonia and the acute respiratory distress syndrome, we explored whether awake self-proning improved outcomes in coronavirus disease 2019-infected patients treated in a rural medical center with limited resources during a significant local coronavirus disease 2019 outbreak.

Design:
Retrospective analysis of prospectively collected clinical data.

Setting:
Single-center rural community-based medical center in Grand Island, NE.

Patients:
One hundred five nonintubated, coronavirus disease-infected patients.

Interventions:
None.

Measurements and Main Results:
After patients were educated on the benefits of awake self-proning, compliance was voluntary. The primary outcome was need for intubation during the hospital stay; secondary outcomes included serial peripheral capillary oxygen saturation measured by pulse oximetry to the Fio2 ratios, in-hospital mortality, and discharge disposition. Of 105 nonintubated, coronavirus disease-infected patients, 40 tolerated awake self-proning. Patients who were able to prone were younger and had lower disease severity. The risk of intubation was lower in proned patients after adjusting for disease severity using Sequential Organ Failure Assessment scores (adjusted hazard ratio, 0.30; 95% CI, 0.09–0.96; p = 0.043) or Acute Physiology and Chronic Health Evaluation II scores (adjusted hazard ratio, 0.30; 95% CI, 0.10–0.91; p = 0.034). No prone patient died compared with 24.6% of patients who were not prone (p < 0.001; number needed to treat = 5; 95% CI, 3–8). The probability of being discharged alive and peripheral capillary oxygen saturation measured by pulse oximetry to the Fio2 ratios were statistically similar for both groups.

Conclusions:
Awake self-proning was associated with lower mortality and intubation rates in coronavirus disease 2019-infected patients. Prone positioning appears to be a safe and inexpensive strategy to improve outcomes and spare limited resources. Prospective efforts are needed to better delineate the effect of awake proning on oxygenation and to improve patients’ ability to tolerate this intervention.
Delayed Development of Coronary Artery Dilitation in Suspected Severe Acute Respiratory Syndrome Coronavirus 2 Multisystem Inflammatory Syndrome: More Research Needed
Authors: Orr William B. , Elward Alexis M. , Lin John C. , Reich Patrick J. , Scheel Janet N. , Hayes Ericka V. , Remy Kenneth E. 
Published: October 2020

Background:
Although significant disease burden in the severe acute respiratory syndrome coronavirus 2 pandemic has been relatively uncommon in children, worldwide cases of a postinfectious multisystem inflammatory syndrome in children and possible atypical Kawasaki-like disease attributing to severe acute respiratory syndrome coronavirus 2 infection have arisen. Original thinking for coronavirus disease-19 disease was that an overwhelming proinflammatory response drove disease pathogenesis. Emerging reports suggest that a robust immune suppression may be more relevant and predominant. Recently reported data on children with multisystem inflammatory syndrome in children have demonstrated a heterogeneity of immune phenotypes among these patients, with concern for a strong initial proinflammatory state; however, data are lacking to support this. Likewise, understanding development of certain clinical findings to changes in the immune system is lacking.

Case Summary:
We report a 12-year-old multiracial male with negative coronavirus disease-19 nasopharyngeal RNA polymerase chain reaction testing but positive severe acute respiratory syndrome coronavirus 2 serology, subsequent development of vasodilatory shock with myocardial depression, and subsequent delayed development of coronary artery dilatation after resolution of myocardial depression. Unlike previous reported cases of multisystem inflammatory syndrome in children, he exhibited profound lymphopenia without specific inflammatory cytokines elevations, whereas nonspecific markers (ferritin and C-reactive protein) were increased. He subsequently was discharged on day 12 of hospitalization with complete recovery.

Conclusion:
Our representative case of a patient with coronavirus disease-19-associated multisystem inflammatory syndrome in children without robust hyperinflammation and a delayed finding of coronary artery dilatation compared with reported case series highlights the need for further mechanistic understanding of coronavirus disease-19 disease and subsequent multisystem inflammatory syndrome in children or Kawasaki disease development. This report offers a number of disease mechanisms and clinical evolution considerations for further elucidation to guide development of potential therapies.
External Evaluation of Population Pharmacokinetics and Pharmacodynamics in Linezolid-Induced Thrombocytopenia: The Transferability of Published Models to Different Hospitalized Patients
Authors: Ogami Chika , Tsuji Yasuhiro , Nishi Yoshifumi , Kawasuji Hitoshi , To Hideto , Yamamoto Yoshihiro 
Published: October 2020

Background:
The objective of this study was to perform an external evaluation of published linezolid population pharmacokinetic and pharmacodynamic models, to evaluate the predictive performance using an independent data set. Another aim was to offer an elegant environment for display and simulation of both the concentration and platelet count after linezolid administration.

Methods:
We performed a systematic literature search in PubMed for all studies evaluating the population pharmacokinetic and pharmacodynamic parameters of linezolid in patients and selected the models to be used for the external validation. The bias of predictions was visually evaluated by plotting prediction errors (PEs) and relative PEs. The precision of prediction was evaluated by calculating the mean absolute error (MAE), root mean squared error (RMSE), and mean relative error (MRE).

Results:
Three articles (models A, B, and C) provided linezolid-induced platelet dynamic models using population pharmacokinetic and pharmacodynamic modeling approaches. The PE and relative PE of both linezolid concentrations and platelet counts for models A and C showed similar predictive distributions. With respect to the prediction accuracy of total linezolid concentration, the MAE, RMSE, and MRE of population prediction values for model C was the smallest. The comparison of the MAE, RMSE, and MRE of patient-individual prediction values for the 3 pharmacodynamic models revealed no large differences.

Conclusions:
We confirmed the transferability of published population pharmacokinetic and pharmacodynamic models and showed that they were suitable for extrapolation to other hospitals and/or patients. This study also introduced application software based on model C for the therapeutic drug monitoring of linezolid.
The Impact of Air Pollution on Neurodegenerative Diseases
Authors: Wang Jian , Ma Tengfei , Ma Ding , Li Huimin , Hua Li , He Qing , Deng Xiaobei 
Published: October 2020

Background:
With the development of industrialization in human society, ambient pollutants are becoming more harmful to human health. Epidemiological and toxicological studies indicate that a close relationship exists between particulate matter with a diameter ≤2.5 µm (PM2.5) and neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD). To further confirm the relationship, we focus on possible relevant mechanisms of oxidative stress and neuroinflammation underlying the association between PM2.5 and neurodegenerative diseases in the review.

Methods:
A literature search was performed on the studies about PM2.5 and neurodegenerative diseases via PubMed. A total of 113 articles published were selected, and 31 studies were included.

Results:
PM2.5 can enter the central nervous system through 2 main pathways, the blood–brain barrier and olfactory neurons. The inflammatory response and oxidative stress are 2 primary mechanisms via which PM2.5 leads to toxicity in the brain. PM2.5 abnormally activates microglia, inducing the neuroinflammatory process. Inflammatory markers such as IL-1β play an essential role in neurodegenerative diseases such as AD and PD. Moreover, the association between lipid mechanism disorders related to PM2.5 and neurodegenerative diseases has been gaining momentum.

Conclusions:
In conclusion, PM2.5 could significantly increase the risk of neurological disorders, such as AD and PD. Furthermore, any policy aimed at reducing air-polluting emissions and increasing air quality would be protective in human beings.
Encapsulated Gamma Source Contact Dose Conversion Factors: Updating NCRP-40 Guidance
Authors: Waller Edward , Heritage Eric 
Published: October 2020

Abstract
Secondary electron generation on the surface of encapsulated gamma sources can play a large role in the dose measured near the surface of the encapsulation. The National Council on Radiation Protection and Measurements Report No. 40 contains contact dose rate conversion factors for encapsulated gamma sources, along with recommended secondary electron correction factors. However, secondary electron correction factors were based on experiments performed in the 1930s and 1940s with encapsulated radium sources, and the correction factors for the other sources listed in the report were estimated based on these radium source measurements. Monte Carlo simulations were performed using the Particle and Heavy Ion Transport code System (PHITS) to calculate the contact dose rate conversion factors for each encapsulated gamma source presented in NCRP-40, taking into account the dose from both gamma rays and secondary electrons. These simulations showed that the contact dose rate conversion factors are much lower than those presented in NCRP-40, and the secondary electron contribution was much greater than the values proposed by NCRP-40. The original research used results from encapsulated 226Ra experiments to determine the secondary electron correction factors for NCRP-40. To support the current Monte Carlo calculations, experiments were conducted using an encapsulated 137Cs source, rare earth magnet, and ion chamber detector to show that the secondary electron correction factors presented in NCRP-40 were not applicable to the geometry of tissue in direct contact with the encapsulation. In this work, contact dose conversion factors for common encapsulated radionuclide sources are presented.
COMPARISON OF 25- AND 27-GAUGE SUTURELESS CANNULA-BASED INTRAOCULAR LENS SCLERAL FIXATION VISUAL ACUITY OUTCOMES AND COMPLICATION RATES
Authors: Kadakia Ankit B. , Wong Tien P. , Wykoff Charlie C. , Shah Ankoor R. 
Published: October 2020

Purpose:
To compare the visual outcomes and complication rates of sutureless cannula-based intraocular lens scleral (SCILS) fixation performed with 25-gauge (25 G) versus 27-gauge (27 G) instrumentation.

Methods:
A retrospective chart review of consecutive cases of eyes without capsular support that underwent SCILS fixation of a three-piece intraocular lens. Sutureless cannula-based intraocular lens scleral fixation was performed by transconjunctival use of either 25-G or 27-G trocar cannulas. During postoperative follow-up evaluations, visual acuity and intraocular pressure were measured, and slit-lamp and indirect ophthalmoscopy examinations were performed to assess for development of known complications.

Results:
A total of 69 eyes underwent 25 G (27 eyes) or 27 G (42 eyes) SCILS fixation. The mean preoperative logarithm of the minimum angle of resolution visual acuity trended toward improvement from 0.95 ± 0.68 (20/178 Snellen equivalent) to 0.67 ± 0.64 (20/94 Snellen equivalent) for 25 G group at 1 year. Similar trend toward visual acuity improvement was seen in 27 G group with a mean preoperative logarithm of the minimum angle of resolution visual acuity of 1.43 ± 0.94 (20/538 Snellen equivalent) improving to 0.86 ± 1.00 (20/145 Snellen equivalent) at 1 year. Statistically significant improvement was seen as early as postoperative week one for 27 G group (P < 0.01), whereas statistically significant worsening was noted at the same time in 25 G group (P = 0.01). There was a statistically significant reduction in intraocular lens displacement (P = 0.01) and need for reoperation (P = 0.01) in 27 G group.

Conclusion:
Compared with 25 G SCILS fixation, eyes managed with 27 G SCILS fixation experienced more rapid visual acuity improvement. In addition, there was a lower rate of complications including intraocular lens displacement and need for reoperation.
Effect of ethanolic extract of Zataria multiflora Boiss (Shiraz thyme extract) on the kidney and spleen tissues of mice infected with visceral candidiasis and the stimulation of Th1, Th17, and Treg immune cells
Authors: Bayat Mansour , Hassannejad Niloofar , Ghazanfari Hadi 
Published: October 2020

Background and aims:
Candidiasis is one of the most important fungal infections, which has been associated with antimicrobial resistance.

Materials and Methods:

Candida albicans ATCC10231 strain were isolated from the patient's body. To prepare the desired yeast number in a specific size, the serial dilution was performed. Doses of 2 × 107–108 were used and four mice were selected for each dose. The PAS staining was performed on the sections of the kidney and spleen prepared in paraffin blocks. The chloroform fraction of Zataria multiflora Boiss ethanolic extract was obtained and standardized by HPLC. Forty-two female BALB/C mice were randomly included with ages of 6–8 weeks. The administration of drugs into mice in each group was performed 24 h of C. albicans injection (the onset of the visceral candidiasis appearance in mice), and a single dose of 0.1 ml of the extract was injected to each group for every 6 days. Mononuclear cells of spleen and kidney were prepared from buffy coat layer and culture in 50 ml of 1640 RPMI medium. Th1, Th17, and Treg cells were measured in MNCs.

Results:
In mice that had medication intervention (including chloroform fraction of Shiraz thyme, thymol, carvacrol, or fluconazole), the fungal purification rate in the spleen was higher than the kidney (groups 1–5). In mice with no medication (group 6), the fungal purification rate in the kidney was higher than the spleen. All groups having medication intervention had a significant difference in terms of fungal elimination with group 7 and their fungal load was significantly decreased. In this regard, the amounts of fungal load reduction in spleen and kidney tissues in relation to extracts were the most. After extract, the highest rate of tissue cleansing was related to fluconazole followed by thymol and carvacrol. Thymol and carvacrol had no significant difference in terms of the effect on reducing the fungal load in the studied tissues. The percentage of TH1 cells in the culture of these cells was higher than that of the kidney cells. The highest percentage of TH17 cells was observed in group 1. The percentage of Treg cells in the kidney and spleen in the extract-receiving group had a significant decrease compared with the nondrug-receiving group.

Conclusion:
The Z. multiflora Boiss fraction can be considered as a powerful alternative to other drug treatments for achieving proper outcomes. Therefore, the use of this compound as a therapeutic agent in visceral candidiasis is possibly a new turning point in treatment, which can postpone the progress of the disease among patients.
Frequent Detection of Undiagnosed HIV Within Emergency Departments in Botswana
Authors: Pintye Jillian , Ortblad Katrina F. , Mawandia Shreshth , Bakae Odirile , Tau Lenna , Grande Matias , Mogomotsi Goabaone Panky , Mmatli Esther , Ngombo Modise , Norman Tebogo , Seckel Laura , Ledikwe Jenny 
Published: October 2020

Abstract
Among 130,161 HIV testing records from unique individuals at 149 programmatic sites in Botswana, frequency of detecting undiagnosed HIV infection within emergency departments (EDs) was 4.7% (455/9695), 2-fold higher than other clinic-based HIV counseling and testing. Men and noncitizens less frequently initiated same-day antiretroviral therapy after testing HIV positive within emergency departments.
The Effect of Surgical Timing on 30-Day Outcomes in Cleft Palate Repair
Authors: Peck Connor J. , Gowda Arvind U. , Shultz Blake N. , Wu Robin T. , Bourdillon Alexandra , Singh Anusha , Steinbacher Derek M. 
Published: October 2020

Background:
The optimal age for cleft palate repair continues to be debated, with little discussion of surgical risk related to operative timing. This study of 3088 cleft palate patients analyzed the impact of surgical timing on perioperative and 30-day postoperative outcomes.

Methods:
Primary cleft palate repairs were identified in the National Surgical Quality Improvement Program database from 2012 to 2015. Data were combed for total postoperative complications, rates of readmission and reoperation, operating room time, and length of stay. Bivariate analyses were performed comparing 3-month periods from months 6 to 18, and months 0 to 5, 18 to 23, 24 to 29, and 30 to 59.

Results:
Despite a higher proportion of isolated soft palate closure, children operated on before 6 months had a higher complication rate than children at other ages (7.1 percent versus 3.2 percent; OR, 2.4; p = 0.04), and higher rates of both readmission (3.6 percent versus 1.4 percent; OR, 3.6; p = 0.02) and reoperation (2.4 percent versus 0.5 percent; OR, 4.7; p = 0.04). There were no differences in short-term outcomes for any other age group younger than 5 years, and no differences in hospital length of stay among any age groups.

Conclusions:
The authors’ findings suggest a relative contraindication to operation before 6 months. As there were no differences between any other age groups, long-term speech optimization should continue to be the primary consideration for operative planning. These findings improve the current rationale for palatoplasty timing, and can aid surgeons and parents in the surgical decision-making process.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.