bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problem Gambling Associated With Aripiprazole in First-Episode Psychosis Patients
Authors: Corbeil Olivier , Corbeil Stéphanie , Giroux Isabelle , Jacques Christian , Dorval Michel , Demers Marie-France , Roy Marc-André 
Published: March 2020

Abstract

Background
Aripiprazole (ARI), an antipsychotic drug used to treat various mental health disorders, has recently been associated with the emergence of problem gambling (PBG). However, few cases have been reported in the schizophrenia-related psychotic disorders population, and even fewer provided sufficient details to systematically assess the causality of the association.

Methods
This article describes 6 cases with first-episode psychosis in whom PBG emerged while on ARI. Detailed information was gathered from clinical staff and patients' families to systematically assess the causal link between ARI and the emergence of PBG using the Naranjo and Liverpool Adverse Drug Reaction scales.

Findings
Five of these cases were previously diagnosed with a substance use disorder and/or cluster B personality traits. Five had received a more potent dopaminergic antagonist treatment before being switched to ARI. Two of them had presented PBG before being diagnosed with a psychotic disorder. The level of certainty about the causal role of ARI varied from possible to certain, and in 4 cases, the 2 scales yielded different ratings.

Implications
Although these cases suggest that ARI may be associated with the emergence of PBG in the early course of schizophrenia-related psychotic disorders, they cannot prove the causality or the strength of this association. They provide the impetus to perform adequately powered and well-controlled prospective studies to draw more definite conclusion about the causality of this association and, in the meantime, further emphasize the need to carefully assess PBG in this population.
How Successful Are Residents and Fellows at Quality Improvement?
Authors: Eden Elizabeth L. , Harrington Terence , Chen Ling-Wan , Chelluri Lakshmipathi , Higgins Linda W. , Freel Jennifer A. , DeKosky Allison , Bump Gregory M. 
Published: March 2020

ABSTRACT

Background:
Nationally, there is an expectation that residents and fellows participate in quality improvement (QI), preferably interprofessionally. Hospitals and educators invest time and resources in projects, but little is known about success rates or what fosters success.

Purpose:
To understand what proportion of trainee QI projects were successful and whether there were predictors of success.

Methods:
We examined resident and fellow QI projects in an integrated healthcare system that supports diverse training programs in multiple hospitals over 2 years. All projects were reviewed to determine whether they represented actual QI. Projects determined as QI were considered completed or successful based on QI project sponsor self-report. Multiple characteristics were compared between successful and unsuccessful projects.

Results:
Trainees submitted 258 proposals, of which 106 (41.1%) represented actual QI. Non-QI projects predominantly represented needs assessments or retrospective data analyses. Seventy-six percent (81/106) of study sponsors completed surveys about their projects. Less than 25% of projects (59/258) represented actual QI and were successful. Project category was predictive of success, specifically those aimed at preventive care or education.

Conclusion:
Less than a quarter of trainee QI projects represent successful QI.

Implications:
Hospitals and training programs should identify interventions to improve trainee QI experience.
Association of Disability Benefits and/or Litigation With Time to Return to Work After Tibia Shaft Fracture Fixation
Authors: Rehman Yasir , Jones Aaron , Madden Kim , Heels-Ansdell Diane , Busse Jason W. 
Published: March 2020

Objectives:
We explored the association of compensation status with return to work (RTW) after tibial fracture.

Methods:
Eligible patients were adults with tibial shaft fractures enrolled in the Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures. We explored the association between disability benefits and/or litigation and RTW using multivariable discrete interval hazard analysis, adjusting for sex, age, country of residence, smoking status, body mass index, polytrauma, fracture severity, fracture gap, pain severity, and physical functioning.

Results:
Of 330 eligible patients, 111 (34%) had not returned to full-time work 1-year after surgery. In our adjusted model, receipt of disability benefits and/or involvement in litigation was associated with delayed RTW (HR = 0.71, 95% CI 0.52-0.96).

Discussion:
Tibial shaft fracture patients receiving disability benefits and/or involved in litigation are less likely to RTW.
Safety and Health Innovation in Preschools
Authors: Farewell Charlotte V. , Powers Jamie , Puma Jini 
Published: March 2020

Objective:
The primary objective of this study was to evaluate quality of work life in early childhood education (ECE) centers and implement a total worker health (TWH) pilot project with a small sample of ECE teachers.

Methods:
An evidence-based strategic planning process to make policy, system, and environmental (PSE) changes related to TWH was implemented with six ECE centers. A pre-post design with mixed-methods was used to evaluate the impact.

Results:
Baseline findings suggest that there are significant disparities related to quality of work life among ECE teachers compared with the national population. After implementation of the pilot project, ECE centers averaged 4.7 PSE changes. Qualitative data informed facilitators and barriers to implementation of TWH-related changes.

Conclusions:
This pilot project reflects an evidence-based participatory approach to assessing and improving the well-being of ECE teachers.
Prehospital Life-Saving Interventions Performed on Pediatric Patients in a Combat Zone: A Multicenter Prospective Study
Authors: Reeves Lauren K. , Savell Shelia C. , Maddry Joseph K. , Samsey Kathleen M. , Mora Alejandra G. , Lairet Julio R. 
Published: March 2020

Objectives:
We aimed to describe and evaluate prehospital life-saving interventions performed in a pediatric population in the Afghanistan theater of operations.

Design:
Our study was a post hoc, subanalysis of a larger multicenter, prospective, observational study.

Setting:
We evaluated casualties enrolled upon admission to one of the nine military medical facilities in Afghanistan between January 2009 and March 2014.

Patients:
Adult and pediatric (<17 yr old) patients.

Measurements:
We conducted initial descriptive analyses followed by comparative tests. For comparative analysis, we stratified the study population (adult vs pediatric), and subsequently, we compared injury descriptions and the interventions performed. Following tests for normality, we used the t test or Wilcoxon rank-sum test (nonparametric) for continuous variables and chi-square or Fisher exact for categorical variables. We reported percentages and 95% CIs.

Main Results:
We enrolled 2,106 patients, of which 5.6% (n = 118) were pediatric. Eighty-two percent of the pediatric patients were male, and 435 had blast related injuries. A total of 295 prehospital life-saving interventions were performed on 118 pediatric patients, for an average of 2.5 life-saving interventions per patient. Vascular access (IV 96%, intraosseous 91%) and hypothermia prevention–related interventions (69%) were the most common. Incorrectly performed life-saving interventions in pediatric patients were rare (98% of life-saving interventions performed correctly) and n equals to 24 life-saving interventions over the 6-year period were missed. The most common incorrectly performed and missed life-saving interventions were related to vascular access. When compared with adult life-saving interventions received in the prehospital environment, pediatric patients were more likely to receive intraosseous access (p < 0.0001), whereas adult patients were more likely to have a tourniquet placed (p = 0.0019), receive wound packing with a hemostatic agent (p = 0.0091), and receive chest interventions (p = 0.0003).

Conclusions:
In our study, the most common intervention was vascular access followed by hypothermia prevention and hemorrhage control. The occurrence of missed or incorrectly performed life-saving interventions were rare.
Unintentional Pediatric Poisoning Exposures in an Emergency Department
Authors: Johnson Amberly R. , Tak Casey R. , Mundorff Michael , Plumb Jennifer , Crouch Barbara I. 
Published: March 2020

Objectives
The purpose of this study is to describe the demographics and clinical characteristics of patients referred to a pediatric emergency department (ED) for unintentional poisoning exposures by a poison control center (PCC) compared with patients/caregivers who self-refer.

Methods
The electronic data warehouse at a pediatric hospital was queried from October 1, 2014, to September 30, 2015, for unintentional poisoning-related ED visits and subsequent inpatient admissions. Eligible patients aged 18 years and younger were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes for pharmaceuticals, non-pharmaceuticalchemicals, fumes/vapors, foreign bodies, adverse food reactions, food poisoning, and bites/stings. Referral classification (PCC referral vs self-refer) was determined by PCC and hospital medical records.
Descriptive statistics were used to characterize the patient demographics and ED visits by referral classification and age group. Simple and multiple logistic regression models examined the individual and combined impact of demographic and clinical characteristics on self-referral.

Results
Of the 705 patients identified, 84.4% presented as caregiver/self-referred compared with PCC-referred. As compared with those who self-referred, a higher percentage of patients who contacted the PCC before ED presentation were white (93.9% [89.4–98.2%] vs 83.8% [80.7–86.7%]) and had commercial insurance (62.7% [51.5–69.5%] vs 53.0% [48.9–57.0%]). Pharmaceutical (71.9%) and chemical (14.0%) exposures were the most common exposure types for PCC-referred patients whereas foreign bodies (54.3%) were the most common for self-referred patients. The largest predictors of self-referral were age, insurance, and exposure type.

Conclusions
Among patients presenting at 1 pediatric ED, disparities with PCC utilization exist among age groups, racial identification, and poison exposure type. Educational outreach interventions are needed to ensure optimal use of the PCC services by patients, caregivers, and health care professionals.
Integrated Electromyography: Discriminant Analysis and Prediction of Recovery 3 to 6 Years After Brachial Plexus Birth Injury
Authors: Elnaggar Ragab K. 
Published: March 2020

Purpose:
To assess the recovery likelihood, 3 to 6 years after brachial plexus birth injury (BPBI), and predict the functional recovery from integrated electromyography (IEMG).

Methods:
Thirty children with BPBI limited to C5-C6 lesion participated. Maximal electromyography activity of deltoid and biceps brachii was measured at entry. Shoulder and elbow functions were assessed at the baseline and at 4 intervals across 2 years.

Results:
Shoulder and elbow function significantly changed across the follow-up period. Shoulder and elbow functions were significantly dependent on deltoid and biceps brachii muscles' IEMG level, respectively, with the groups showing higher IEMG achieving better recovery. The deltoid and biceps IEMG explained a portion of the improvement in shoulder and elbow function over 2 years.

Conclusion:
Recovery of the shoulder and elbow function continues 3 to 6 years after BPBI. IEMG may partially explain variation in the prognosis for children with BPBI.
Thymic Granuloma Mimicking Malignancy on 18F-FDG PET/CT
Authors: Zhang Jun , Lin Xumiao , Bai Yushu , Dong Aisheng , Wang Yang 
Published: March 2020

Abstract
We present a case with an unexpected nodule in the thymus showing increased 18F-FDG uptake on PET/CT. The nodule was surgically removed. Histopathologic examination revealed granuloma in the thymus. This case indicates physicians and radiologists must be aware that although thymic granuloma is rare, it should be included in the differential diagnosis of the thymic lesions with 18F-FDG accumulation along with neoplastic and nonneoplastic conditions.
Quality and Safety in Healthcare, Part LXVIII
Authors: Harolds Jay A. 
Published: March 2020

Abstract
Suggestions to improve the well-being in medical students include establishing learning communities, having pass-fail grading at least in the freshman and sophomore years, giving the students some control over their learning environment (such as with evaluations and serving on the curriculum committee), encouraging more protected time and more money for faculty teaching and mentoring, and eliminating mistreatment of medical students. Also, the Medical Student and Physician Well-Being Index should be freely available to the medical students and staff for both self-evaluation and for evaluating the learning environment. Burnout in medical school may continue in residency and not only causes misery to the individual, but adversely affects professionalism and patient care.
Avulsion Fat Graft Gluteoplasty
Authors: Isakson Matthew H. , Vasilakis Vasileios , Kortesis Bill G. , Hunstad Joseph P. , Bharti Gaurav 
Published: March 2020

Background
The popularity of gluteoplasty has grown significantly in recent years, and there are a variety of techniques described to address gluteal aesthetic deformities. The aim of this study was to describe the avulsion fat graft gluteoplasty technique.

Methods
A review of all consecutive patients undergone avulsion fat graft gluteoplasty from February 2018 to March 2019 was performed. Data included demographics, operative details, and clinical outcomes.

Results
A total of 7 patients with a minimum of 6 months follow-up were analyzed and included in the study. The avulsion fat graft gluteoplasty technique is described in a step-by-step fashion and illustrated by preoperative, postoperative, and intraoperative photographs, as well as video. The average total weight of the avulsed specimen was 372 g (range, 176–596 g) per patient. The average total volume of fat grafting was 593 mL (range, 344–900 mL) per patient.

Conclusions
The avulsion fat graft gluteoplasty is a powerful technique with consistent results and low-risk profile. It provides durable lift and augmentation and produces a predictable and aesthetic scar.
Role of Local Flaps to Achieve Primary Wound Closure in Medication-Related Osteonecrosis of the Jaws Osseous-Resective Surgery
Authors: Marcianò Antonia , Peditto Matteo , Cicciù Marco , Rubino Erasmo , Oteri Giacomo 
Published: March 2020

Abstract
The aim of the present work is to evaluate the most suitable surgical technique in relation to location and extent of medication-related osteonecrosis of the jaws (MRONJ) through comparison of success rate between the routinely used mucoperiostal flaps and different local flaps designs and propose a standardization of surgical procedures according to MRONJ stage and localization with 2 objectives: to provide the surgeon with an algorithm of treatment according to MRONJ localization and extension; to maximize the success of surgical treatment.
Thirteen consecutive patients affected by focal MRONJ were surgically treated with radical osteotomy at the Center for Treatment of the Osteonecrosis of the Jaws (University of Messina, Italy).
Initial defects were classified according to the classification of the Italian Societies of Oral Medicine and Maxillofacial Surgery (the SICMF-SIPMO staging system) which consider not only bone exposure but also radiological bone involvement. Treatment outcome was retrospectively assessed according to the different adopted surgical procedure: mucoperiostal flaps (GROUP A) advanced mucoperiostal flaps or rotation flaps (GROUP B) local flaps (GROUP C).
Outcome after surgical treatment of focal MRONJ was positive in every group irrespective of MRONJ localization and extension. This may be due to the appropriate selection of surgical procedure.
The results obtained demonstrated that focal MRONJ surgical treatment is a reliable procedure irrespective of the initial clinical situation. Radical osteotomy combined with appropriate selection of soft tissue management is crucial.
Sapphire-Supported Nanopores for Low-Noise DNA Sensing
Authors: Xia Pengkun , Zuo Jiawei , Paudel Pravin , Choi Shinhyuk , Chen Xiahui , Song Weisi , Im JongOne , Wang Chao 
Published: March 2020

AbstractSilicon-supported (SiS) solid-state nanopores have broad applications in single-molecule biosensing and diagnostics, but their high capacitive noise has seriously limited both their sensing accuracy and recording speed. Nanopores on insulating glass have demonstrated reduced capacitance and noise, but it remains challenging to bulk-etch amorphous glass to create membranes reproducibly and uniformly. Here a new approach is reported to form triangular sapphire-supported (SaS) nanopore membranes by batch-processing-compatible anisotropic wet etching of sapphire, with membrane dimension demonstrated from ~200 μm to 5 μm. A SaS nanopore in 68 μm-wide silicon nitride membrane has 130 times smaller capacitance (10 pF) compared to a SiS nanopore (~4 μm SiN membrane, ~1.3 nF), despite a 100 times larger membrane. It has a current noise of 18 pA over 100 kHz bandwidth, much smaller than that from our SiS nanopore (46 pA) and comparable with the best reported low-noise nanopores. Further, the SaS nanopore displays a higher signal-to-noise ratio (SNR, 21 versus 11 for SiS nanopore) in DNA sensing, although the SNR can be further improved using thinner membranes and smaller pores. The SaS nanopore presents a simple platform in both fabrication and structure that is particularly suitable for low-noise and high-speed molecular diagnostics.
Functional modeling of NMIHBA-causingPRUNE1variants reveals a requirement for its exopolyphosphatase activity
Authors: Nistala Harikiran , Dronzek John , Gonzaga-Jauregui Claudia , Chim Shek Man , Rajamani Saathyaki , Nuwayhid Samer , Delgado Dennis , Burke Elizabeth , Karaca Ender , Franklin Matthew C. , Sarangapani Prasad , Podgorski Michael , Tang Yajun , Dominguez Melissa G. , Withers Marjorie , Deckelbaum Ron A. , Scheonherr Christopher J. , Gahl William A. , Malicdan May C. , Zambrowicz Brian , Gale Nicholas W. , Gibbs Richard A. , Chung Wendy K. , Lupski James R. , Economides Aris N. 
Published: March 2020

AbstractNeurodevelopmental disorder with microcephaly, hypotonia, and variable brain anomalies (NMIHBA) is an autosomal recessive neurodevelopmental and neurodegenerative disorder characterized by global developmental delay and severe intellectual disability. Microcephaly, progressive cortical atrophy, cerebellar hypoplasia and delayed myelination are neurological hallmarks in affected individuals. NMIHBA is caused by biallelic variants inPRUNE1encoding prune exopolyphosphatase 1. We provide in-depth clinical description of two affected siblings harboring compound heterozygous variant alleles, c.383G>A (p.Arg128Gln), c.520G>T (p.Gly174*) inPRUNE1. To gain insights into disease biology, we biochemically characterized missense variants within the conserved N-terminal aspartic acid-histidine-histidine (DHH) motif and provide evidence that they result in the destabilization of protein structure and/or loss of exopolyphosphatase activity. Genetic ablation ofPrune1results in midgestational lethality in mice, associated with perturbations to embryonic growth and vascular development. Our findings suggest that NMIHBA results from hypomorphic variant alleles in humans and underscore the potential key role of PRUNE1 exopolyphoshatase activity in neurodevelopment.
BoneMA – Synthesis and Characterization of a Methacrylated Bone-derived Hydrogel for Bioprinting of Vascularized Tissues
Authors: Parthiban S. Prakash , Athirasala Avathamsa , Tahayeri Anthony , Abdelmoniem Reyan , George Anne , Bertassoni Luiz E. 
Published: March 2020

AbstractIt has long been proposed that recapitulating the extracellular matrix (ECM) of native human tissues in the laboratory may enhance the regenerative capacity of engineered scaffolds in-vivo. Organ- and tissue-derived decellularized ECM biomaterials have been widely used for tissue repair, especially due to their intrinsic biochemical cues that can facilitate repair and regeneration. The main purpose of this study was to synthesize a new photocrosslinkable human bone-derived ECM hydrogel for bioprinting of vascularized scaffolds. To that end, we demineralized and decellularized human bone fragments to obtain a bone matrix, which was further processed and functionalized with methacrylate groups to form a photocrosslinkable methacrylate bone ECM hydrogel – BoneMA. The mechanical properties of BoneMA were tunable, with the elastic modulus increasing as a function of photocrosslinking time, while still retaining the nanoscale features of the polymer networks. The intrinsic cell-compatibility of the bone matrix ensured the synthesis of a highly cytocompatible hydrogel. The bioprinted BoneMA scaffolds supported vascularization of endothelial cells and within a day led to the formation of interconnected vascular networks. We propose that such a quick vascular network formation was due to the host of pro-angiogenic biomolecules present in the bone ECM matrix. Further, we also demonstrate the bioprintability of BoneMA in microdimensions as injectable ECM-based building blocks for microscale tissue engineering in a minimally invasive manner. We conclude that BoneMA may be a useful hydrogel system for tissue engineering and regenerative medicine.
Cardiac CapZ regulation during acute exercise
Authors: Laskary Andrew , Townsend Logan K. , Wright David , Pyle W. Glen 
Published: March 2020

AbstractPurposeExercise requires a rapid cardiac response to maintain cardiovascular function. CapZ is a critical stress-response protein in cardiac myocytes. While its role in the pathological stress response has been explored, its part in the physiological response to exercise is unknown. This study examined CapZ regulation during acute exercise and sought to determine its importance in the cardiac response to exercise.MethodsWildtype or cardiac CapZ-deficient transgenic mice were subjected to 20 min of swimming, or exhaustive exercise protocols. Time to exhaustion was a measurement of exercise capacity. Following submaximal exercise, cardiac myofilaments were isolated and probed for CapZ and key regulatory proteins. Myofilament function was assessed using an actomyosin MgATPase assay and total protein phosphorylation quantified with ProQ Diamond staining. Myofilament regulatory proteins following submaximal exercise were quantified by immunoblotting.ResultsTotal myofilament CapZ was unaffected by exercise but increased total CapZIP and decreased phosphorylated CapZIP indicated weakened CapZ-actin interaction. CapZ-deficient transgenic myofilaments lacked changes in CapZIP but BAG3 increased 10%. Time to exhaustion was lower in CapZ-deficient mice in both swimming and running protocols. Actomyosin MgATPase activity was maintained in wildtype mice and impaired with CapZ deficiency. Exercise increased the phosphorylation of several myofilament proteins in wildtype mice but not transgenic animals. Exercise-dependent Increases in myofilament PKC-α and -ε were mitigated in CapZ-deficient mice. Tcap levels decreased 39 ± 8% in CapZ-deficient myofilaments with exercise and leiomodin 2 increased 78 ± 28% in wildtype myofilaments.ConclusionsCardiac CapZ is a critical player in the physiological response to exercise. CapZ-actin binding is rapidly altered with exercise. Decreased cardiac CapZ limits exercise capacity, impairs myofilament regulation, and leads to a less stable contractile apparatus.