bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomarkers, Creatine Kinase, and Kidney Function of Special Operation Candidates During Intense Physiological Training
Authors: Shumway Joshua , Irvin Adam , Shia Regina , Goodyear Charles D 
Published: June 2020

AbstractIntroductionThe purpose of this pilot study was to assess for biomarkers indicative of passing intense physical training and establishing normative values within the tactical athlete population. Unfortunately, none of the biomarkers assessed were indicative of passing training, however, glucose, blood urea nitrogen, and creatine kinase (CK) levels stood out as abnormal. CK levels are commonly used in conjunction with muscle pain and/or myoglobinurea to diagnose exertional rhabdomyolysis (ER) in athletes and the military population. However, research shows that high CK levels may not correlate with acute kidney failure in ER.Materials and MethodsAfter IRB approval and informed consent, blood samples were obtained from 21 volunteers during two phases of the combat control training pipeline: the first phase (12 participants) was 2 hours of daily physical training followed by 8 hours of academics, and the second phase (nine volunteers) a grueling, 72 hour, intense training cycle (stress inoculation training, SIT) with a historic pass rate of only 50%. Biomarkers were also tracked 48 hours after cessation of SIT.ResultsNone of the biomarkers assessed showed a correlation with passing SIT, but high CK levels were well above the diagnostic threshold for ER—as high as 28,000 u/L. At a single point in time, a significant correlation did not exist between CK and others markers associated with rhabdomyolysis. Across time, partial correlations controlling for subject did exist between CK and other markers.ConclusionsIn our low-powered case control study (pilot study), a nonpathologic elevation of CK is prevalent in high-intensity military training, but not shown to correlate with values associated with acute kidney injury. We assume that real-time collection of these markers could be used once sensors are capable of real-time collection and have the potential for diagnostic affordance. When measured in a between subjects design, our study showed a lack of significance when correlating markers of acute renal injury and elevation of CK. However, when utilized for tracking purposes (within subjects design), the results do show a positive correlation between CK and renal failure biomarkers—specifically only at high physiological stress points.
Attendance and Quality and Quantity of Research Presentations at an Obstetrics and Gynecology Regional Meeting Pre- and Postchanges in Federal Funding
Authors: Thagard Andrew S , Poole Aaron T , Greer Joy A , Ennen Christopher S 
Published: June 2020

Abstract

Introduction
Participating in scientific meetings offers value to physician trainees and faculty. In 2012, the U.S. Government (including the Department of Defense) instituted restrictions on conference travel, requiring central approval to attend. Hence, our objective was to determine the academic impact of research presented at the American College of Obstetricians and Gynecologists (ACOG) Armed Forces District Meeting and the effect of this federally mandated policy change on attendance and the quality and quantity of research.

Materials and Methods
Attendance logs and meeting programs were reviewed for the 3 years immediately before and after institution of travel regulations. A PubMed search of each abstract was performed to determine if it resulted in publication and the mean duration in months from presentation to publication was calculated and compared between oral and poster presentations. The top journals accepting manuscripts were noted along with the corresponding impact factor.

Results
The overall meeting publication rate was 22%. Oral presentations were significantly more likely than posters to achieve publication (P &lt; 0.001). Following implementation of travel regulations, mean faculty attendance declined from 130 per year to 105 (P &lt; 0.05). Declines in resident attendance and publication rates were not statistically significant. The top journals publishing investigations included Obstetrics and Gynecology (n = 15), Military Medicine (n = 12), and Fertility and Sterility and Gynecologic Oncology (tied, both n = 11).

Conclusion
Approximately one in five presentations at the ACOG Armed Forces District Meeting are published, many in high impact journals within the specialty. Implementation of stricter travel regulations adversely impacted faculty physician attendance, but not trainee participation or the publication rate.
Host Immune Response to Enterovirus and Parechovirus Systemic Infections in Children
Authors: Sasidharan Anjana , Hassan Wail M , Harrison Christopher J , Hassan Ferdaus , Selvarangan Rangaraj 
Published: June 2020

AbstractBackgroundEnterovirus (EV) and parechovirus type A3 (PeV-A3) cause infections ranging from asymptomatic to life-threatening. Host immune responses in children, particularly innate responses to PeV-A3, remain largely unknown. The aim of this study was to determine aspects of the cytokine/chemokine responses to EV and PeV-A3 in cerebrospinal fluid (CSF) and plasma obtained from children with systemic/central nervous system infection.MethodsA total of 74 salvaged CSF samples (27 with EV, 23 with PeV-A3, and 24 with neither EV nor PeV-A3) and 35 paired blood samples (10 with EV, 14 with PeV-A3, and 11 with neither) were studied. Concentrations of cytokines and chemokines were measured using a customized 21-plex MILLIPLEX MAP Human Cytokine/Chemokine Magnetic Bead Panel. Additionally, clinical characteristics data for all the patients were collected from electronic medical records to evaluate the potential association between the immune response and presentations.ResultsWe demonstrate that EV and PeV-A3 infections induce different cytokine/chemokine immune responses in children. EV induces more robust responses in CSF with significantly elevated levels of fractalkine, interferon (IFN)-α2, IFN-γ, interleukin (IL)-1Rα, IL-4, IL-8, and tumor necrosis factor α; PeV-A3 induces less robust or absent responses in CSF but robust responses in plasma, with significantly higher concentrations of IFN-α2, IL-15, IL-1Rα, interferon-γ-inducible protein–10, and monocyte chemoattractant protein–1.ConclusionsHigh cytokine/chemokine concentrations in the plasma of PeV-A3 patients compared with EV patients could explain higher/more prolonged fever in PeV-A3 patients, whereas relatively low cytokine/chemokine concentrations in PeV-A3 CSF might explain the absence of CSF pleocytosis.
Symptoms of COVID-19 Outpatients in the United States
Authors: Pullen Matthew F , Skipper Caleb P , Hullsiek Kathy H , Bangdiwala Ananta S , Pastick Katelyn A , Okafor Elizabeth C , Lofgren Sarah M , Rajasingham Radha , Engen Nicole W , Galdys Alison , Williams Darlisha A , Abassi Mahsa , Boulware David R 
Published: June 2020

Abstract

Background
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel pathogen causing the current worldwide coronavirus disease 2019 (COVID-19) pandemic. Due to insufficient diagnostic testing in the United States, there is a need for clinical decision-making algorithms to guide testing prioritization.

Methods
We recruited participants nationwide for a randomized clinical trial. We categorized participants into 3 groups: (1) those with confirmed SARS-CoV-2 infection, (2) those with probable SARS-CoV-2 infection (pending test or not tested but with a confirmed COVID-19 contact), and (3) those with possible SARS-CoV-2 infection (pending test or not tested and with a contact for whom testing was pending or not performed). We compared the frequency of self-reported symptoms in each group and categorized those reporting symptoms in early infection (0–2 days), midinfection (3–5 days), and late infection (&gt;5 days).

Results
Among 1252 symptomatic persons screened, 316 had confirmed, 393 had probable, and 543 had possible SARS-CoV-2 infection. In early infection, those with confirmed and probable SARS-CoV-2 infection shared similar symptom profiles, with fever most likely in confirmed cases (P = .002). Confirmed cases did not show any statistically significant differences compared with unconfirmed cases in symptom frequency at any time point. The most commonly reported symptoms in those with confirmed infection were cough (82%), fever (67%), fatigue (62%), and headache (60%), with only 52% reporting both fever and cough.

Conclusions
Symptomatic persons with probable SARS-CoV-2 infection present similarly to those with confirmed SARS-CoV-2 infection. There was no pattern of symptom frequency over time.
The Starting at Home Principle: On Ritual Animal Slaughter, Male Circumcision and Proportionality
Authors: Porat Iddo 
Published: June 2020

Abstract—
Many argue that ritual animal slaughter and male circumcision should be banned using a balancing and proportionality approach: freedom of religion considerations are outweighed by the infringements of the rights of children and animals. I argue that the proportionality approach to the problem is misguided and suggest applying an approach that I term starting at home: members of a minority have a right not to be subjected to more stringent moral criteria than the majority is willing to subject itself to. There is, in other words, a right given to the minority that the majority start with its own moral rectitude before taking care of the minority’s. Applying this principle to ritual animal slaughter and male circumcision, I argue that banning these practices in Europe is wrong.
Influence of water and rock particle contents on the shear behaviour of a SRM
Authors: Liu Longqi , Mao Xuesong , Xiao Yajun , Wang Tiequan , Nie Menglan 
Published: June 2020

Abstract
The contents of both water and rock particles are important factors affecting the mechanical strength of a soil–rock mixture (SRM) filled subgrade in the western mountainous area of China. Therefore, the purpose of this paper is to study the mechanisms of reconstituted landslide deposit samples with different water and rock particle contents by analysing the characteristics of shear strength, volumetric strain and ‘jumping’ phenomenon via large-scale direct shear tests. The results show that the influence of water content on shear strength is greater than the influence of rock particle content under a lower normal stress, and the results are reversed in the case of a higher normal stress. The effect of water content on the equivalent cohesion is bigger, especially for the sample with a high rock particle content. The friction angle of the specimen with same water content increases with the increasing rock particle content, but when the number of rock particles increases to a certain extent, there is a little effect on the friction angle. However, the friction angle decreases with increasing water content at the same rock particle content. Specimens with the same rock particle content change from dilation to compression with increasing water content. Finally, the continuous stage of the ‘intense jumping’ at different water content has been analysed. The ‘jumping’ phenomenon of samples with low water and rock particle content will first strengthen and then weaken the samples with increasing normal stress.
Using portable falling weight deflectometer to determine treatment depth of subgrades in highway reconstruction of Southern China
Authors: Zhang Junhui , Ding Le , Zeng Ling , Gao Qianfeng , Gu Fan 
Published: June 2020

Abstract
Based on a highway reconstruction project in southern China, this study aims to put forward a method to determine the proper treatment depth of the existing subgrade. First, some field tests including the Beckman beam deflection test and portable falling weight deflectometer (PFWD) test were carried out. The results showed that there was a good correlation between the Beckman beam deflection (L) and PFWD modulus (Ep). Subsequently, a subgrade section was excavated and backfilled with cement-stabilized soil in layers. Compaction test, dynamic cone penetrometer rate test, plate load test and Beckman beam deflection test were performed to evaluate the treatment effect. To make sure, the subgrade was treated deeply enough, the Beckman beam deflection (L) was used as the controlled indicator among all the measured indexes for it was the hardest metric to meet. According to the design deflection and decreasing law of the measured deflections with the different number of the stabilized layers, the treatment depth was finally determined. As the PFWD test is superior to the deflection test in the detection efficiency, and the deflection value can be calculated from PFWD modulus by correlation formulas, thus the latter index can be used as a more suitable parameter for estimating the treatment depth instead of the former. Consequently, based on the measured PFWD moduli of the existing subgrade, six treatment schemes considering different treatment depths were proposed. It was confirmed that the method developed from this study is feasible and worth being extensively applied.
An Interprofessional Approach to Assessing Research Ethics Capacity in Vietnam: Implications for Nursing Education
Authors: Upvall Michele , Thao Nguyen Thanh , Beever Jonathan , Huy Nguyen Vu Quoc 
Published: June 2020

Abstract
This study assessed the knowledge, practices, attitudes, and educational needs related to research ethics across health professions faculty, including nursing, in a university located in Vietnam. Consistent themes across five focus groups and two interviews included promoting knowledge of research ethics, ethics in context, and the value of international partnerships to promote ongoing knowledge of research ethics. Results from this study can be used to strengthen the university’s curriculum reform efforts for nursing programs and other health profession curricula across the university. Research partnership opportunities may further the development of research ethics among nursing faculty and students.
New Simulation Orientation for Sophomore Nursing Students: Continuous Quality Improvement
Authors: Porembski Lauren , Fletcher Linnea , King Tara Spalla 
Published: June 2020

Abstract
This quality improvement project focused on reducing simulation-related anxiety and stress and building confidence in nursing students. The authors evaluated two methods to provide orientation to simulation on the first simulation day: the traditional faculty-led orientation and interactive orientation led by a high-fidelity simulator. Given the small sample size, there was no statistical difference in student-reported anxiety or stress; there was one significant difference in confidence. Qualitative data provided valuable qualitative feedback about the simulation experience that will be used to enhance future simulations.
Using the CNE as an Innovative Strategy to Support Junior Nursing Faculty Transitioning From Clinical Practice
Authors: Kinneary Patricia , Sutton Elizabeth 
Published: June 2020

Abstract
For new nurse educators, the certified nurse educator credential can be more than a mark of expertise. This article explains how two junior nurse faculty discovered that preparation for certification facilitated the change process from clinician to academic nurse educator. We describe barriers overcome on the path to certification and highlight key factors for attaining success. The important fruits of certification are explored, and recommendations for professional development for new nurse educators are offered.
Resurrecting Philosophers in an Online Doctoral Philosophy Course in Nursing
Authors: Volkert Delene , Castleberry Jennifer , Fellows Bonnie J. , Goodreau Meredythe , Hesser Lisa , Whitley Catherine 
Published: June 2020

Abstract
Philosophy courses are hallmarks for research-focused doctoral nursing programs. They help students develop inductive reasoning to build critical thinking skills, but students often find them dry and boring and have difficulty developing enthusiasm for the material. Students in an online EdD in Nursing Education program were able to engage with philosophical topics meaningfully by designing and facilitating creative peer-learning activities. To assess the realization of learning outcomes, participating students completed a survey at the end of the module. Five of the six participants (83 percent) indicated they agreed or strongly agreed that the activities helped meet course learning outcomes.
Interventional radiology for the obstetric patient
Authors: Lambrecht Sigrid , Van De Velde Marc 
Published: June 2020

Purpose of review
To discuss the recent results of the use of interventional radiology modalities treating postpartum hemorrhage (PPH).

Recent findings
PPH still is a leading cause of maternal morbidity and mortality. An important risk factor for the development of PPH is the placenta accreta spectrum. In patients with placenta accreta, we can use prophylactic balloon occlusion of the common or internal iliac artery or abdominal aorta to prevent PPH. Balloon occlusion of the abdominal aorta seems to ensure better results than balloon occlusion of the iliac artery in terms of blood loss, transfusion rate and hysterectomy rate reduction with a minimal risk of complications. To treat PPH uterine artery embolization can be effective and potentially fertility-sparing, while having a low complication rate.

Summary
The use of aortic balloon occlusion catheters for the prevention of PPH and uterine artery embolization for the treatment of PPH are well tolerated and feasible options for patients with placenta accreta spectrum.
Is there a place for regional anesthesia in nonoperating room anesthesia?
Authors: Faddoul Annibal , Bonnet Francis 
Published: June 2020

Purpose of review
General anesthesia and monitored anesthesia care (MAC) are the most widely used techniques in nonoperating room anesthesia (NORA). However, regional anesthesia is slowly finding viable applications in this field. This review aims at providing an update on the current practice of regional anesthesia techniques outside of the operating theatre.

Recent findings
Some anesthetic departments have implemented the use of regional anesthesia in novel applications outside of the operating room. In most cases, it remains an adjunct to general anesthesia but is sometimes used as the sole anesthetic technique. The use of the paravertebral block during radiofrequency ablation of different tumors is a recent application in interventional radiology. In emergency medicine, regional anesthesia is gaining traction in analgesia for trauma patients.

Summary
Regional anesthesia is finding its way into broader applications every day, offering a range of potential benefits in anesthetic care. Its implementation in NORA is promising and may aid in decreasing patient morbidity. However, great care should be taken in applying the recommended safety precautions for regional anesthesia in any setting.
Implementing a Skin-to-Skin Care and Parent Touch Initiative in a Tertiary Cardiac and Surgical Neonatal Intensive Care Unit
Authors: Levesque Valerie , Johnson Krystal , McKenzie Amy , Nykipilo Andrea , Taylor Barbara , Joynt Chloe 
Published: June 2020

Background
Skin-to-skin care (SSC) has been integrated as an essential component of developmental care for preterm infants. Despite documented benefits, SSC is not routinely practiced in the cardiac and surgical neonatal intensive care unit, with a predominantly term population, due to staff apprehension, patient factors and acuity, and environmental constraints.

Purpose:
The purpose of this quality improvement project was to increase SSC, parental holds, and parent touch events for infants in our cardiac and surgical neonatal intensive care unit. When traditional SSC was not possible, alternative holds and alternative parent touch (APT) methods were encouraged.

Methods:
Quality improvement and qualitative descriptive methodology were utilized to assess baseline, develop education and practice changes, and evaluate the use of SSC, holds, and APT methods at 12 and 18 months postintervention. Implementation included educational tools and resource development, simulations, peer champions, in-class teaching, and team huddles. Decisions around the type of hold and parent touch were fluid and reflected complex infant, family, staff, and physical space needs.

Findings:
Given its initial scarcity, there was an increased frequency of SSC and variety of holds or APT events. Staff survey results indicated support for the practice and outlined persistent barriers.

Implications for Practice:
Skin-to-skin care, holds, and APT practices are feasible and safe for term and preterm infants receiving highly instrumented and complex cardiac and surgical care.

Implications for Research:
Future research regarding the intervention's impact on neurodevelopmental outcomes of infants and on parent resilience in the surgical and cardiac neonatal intensive care unit is warranted.
Remodeling of Sagittal Plane Malunion After Pediatric Supracondylar Humerus Fractures
Authors: Gamble James G. , Vorhies John S. 
Published: June 2020

Background:
Pediatric supracondylar humeral fractures (SCHFs) can heal in hyperextension malunion after casting or surgical treatment. Here the authors present quantitative evidence concerning the ability of children to remodel sagittal plane malunion. Their null hypothesis was that like varus and valgus malunion, children have little capacity to remodel sagittal plane malunion after SCHFs.

Methods:
The authors performed a prospective longitudinal radiographic study of 41 children, aged 22 to 126 months, who were registered during the study interval. They calculated the percent displacement of the center of the capitellum behind the anterior humeral line (AHL) as the distance of the midpoint of the capitellum from the AHL, divided by the diameter of the capitellum, multiplied by 100. Longitudinal measurements were made using the embedded software on our institution’s digital radiographic system. The primary outcome focus was the percent displacement of the center of the capitellum relative to AHL on the initial and on the latest radiograph.

Results:
The average initial displacement (hyperextension) of the capitellum behind the AHL for all patients was 61% (range, 23% to 134%). At an average follow-up of 21 months, 24 children (60%) had remodeled 100% the sagittal plane malunion, 12 children (30%) had remodeled such that the AHL passed through the central third of the capitellum, and 5 children (10%) had minimal or no remodeling.

Conclusions:
The authors rejected their null hypothesis. Children do have the capacity to remodel radiographically measurable sagittal plane malunion of SCHFs. Children younger than 5 years of age can remodel 100% displacement of the center of the capitellum, whereas those over 8 years of age have minimal remodeling capacity.