bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduction in Pulmonary Vein Stenosis and Collateral Damage With Pulsed Field Ablation Compared With Radiofrequency Ablation in a Canine Model
Authors: Howard Brian , Haines David E. , Verma Atul , Packer Douglas , Kirchhof Nicole , Barka Noah , Onal Birce , Fraasch Steve , Miklavčič Damijan , Stewart Mark T. 
Published: July 2020

Background:
Pulmonary vein (PV) stenosis is a highly morbid condition that can result after catheter ablation for PV isolation. We hypothesized that pulsed field ablation (PFA) would reduce PV stenosis risk and collateral injury compared with irrigated radiofrequency ablation (IRF).

Methods:
IRF and PFA deliveries were randomized in 8 dogs with 2 superior PVs ablated using one technology and 2 inferior PVs ablated using the other technology. IRF energy (25–30 W) or PFA was delivered (16 pulse trains) at each PV in a proximal and in a distal site. Contrast computed tomography scans were collected at 0, 2, 4, 8, and 12-week (termination) time points to monitor PV cross-sectional area at each PV ablation site.

Results:

Maximum average change in normalized cross-sectional area at 4-weeks was −46.1±45.1% post-IRF compared with −5.5±20.5% for PFA (
P
≤0.001). PFA-treated targets showed significantly fewer vessel restrictions compared with IRF (
P
≤0.023). Necropsy showed expansive PFA lesions without stenosis in the proximal PV sites, compared with more confined and often incomplete lesions after IRF. At the distal PV sites, only IRF ablations were grossly identified based on focal fibrosis. Mild chronic parenchymal hemorrhage was noted in 3 left superior PV lobes after IRF. Damage to vagus nerves as well as evidence of esophagus dilation occurred at sites associated with IRF. In contrast, no lung, vagal nerve, or esophageal injury was observed at PFA sites.

Conclusions:
PFA significantly reduced risk of PV stenosis compared with IRF postprocedure in a canine model. IRF also caused vagus nerve, esophageal, and lung injury while PFA did not.
Adsorptive removal of phosphate by a Fe–Mn–La tri-metal composite sorbent: Adsorption capacity, influence factors, and mechanism
Authors: Zhu Yuanrong , Yue Xianming , Xie Fazhi 
Published: July 2020

Reducing input of phosphorus is the key step for control of eutrophication and algal blooming in freshwater lakes. Adsorption technology is a cost-effective technology for phosphate removal in water for the purpose. Thus, in this study, a novel Fe–Mn–La tri-metal composite sorbent was developed, and then evaluated for phosphate removal. The results showed that the maximum adsorption capacity could be approached to 61.80 mg g−1 at 25°C under pH of 6.03. Adsorption of phosphate by Fe–Mn–La tri-metal composite adsorbent fitted better by pseudo-second-order kinetic equation and Langmuir model, which suggested that the adsorption process was surface chemical reactions and mainly in a monolayer coverage manner. The thermodynamic study indicated that the adsorption reaction was an endothermic process. The phosphate removal gradually decreased with the increasing of pH from 3.02 to 11.00. The sequence of coexisting anions competing with phosphates was that CO32− > Cl− > SO42− > NO3−. Dissolved organic matter, fulvic acid as a representative, would also decrease adsorption capacities of phosphate by Fe–Mn–La tri-metal composite adsorbents. Adsorption capacity would be decreased with increasing addition of adsorbents, while removal efficiency would be increased in this process. The Fe–Mn–La tri-metal composite adsorbent showed a good reusability when applied to removal of dissolved phosphate from aqueous solutions. The Fourier transform infrared spectrometer and X-ray photoelectron spectroscopy analyses indicated that some hydroxyl groups (–OH) on the surface of adsorbent were replaced by the adsorbed PO43−, HPO42−, or H2PO4−. Aggregative results showed that the novel Fe–Mn–La tri-mental composite sorbent is a very promising adsorbent for the removal of phosphate from aqueous solutions.
The effectiveness of pulsed ultrasound treatment on pain, function, synovial sac thickness and femoral cartilage thickness in patients with knee osteoarthritis: a randomized, double-blind clinical, controlled study
Authors: Karakaş Ali , Dilek Banu , Şahin M Abdulkerim , Ellidokuz Hülya , Şenocak Özlem 
Published: July 2020

Objective: This study aims to investigate the efficacy of therapeutic pulsed ultrasound on pain, function, synovial sac and femoral cartilage in knee osteoarthritis. Design: Randomized, double-blind, controlled study Setting: Dokuz Eylul University, Department of Physical Medicine and Rehabilitation Subjects: A total of 96 patients with knee osteoarthritis Interventions: Participants were randomized into two groups; Group I ( n = 48, pulsed ultrasound) and Group II ( n = 48, sham ultrasound). The sessions were held three times a week for 8 weeks. The study continued for 12 weeks (with 4 weeks follow-up). All participants performed exercises at home for 12 weeks. Main measures: Knee pain (at rest and ADLs) was assessed using the visual analog scale (VAS). Functionality was assessed using the Timed Up and Go test and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire. Femoral cartilage and synovial sac thickness was measured using ultrasonography. All evaluations were performed at the baseline, at the 8 and 12 weeks after baseline. Results: The study was completed with a total of 75 patients ( n = 39 in group I and n = 36 in group II). The mean (SD) pain at ADLs score at baseline and week 12 was 7.2 (2.1), with 3.6 (2.9) in the group I, and 6.7 (2.0) and 4.3 (2.2) in the group II, respectively. Both groups presented significant improvements in terms of pain and function ( P < 0.001). There was no difference between groups for any parameters. Conclusion: Treatment of pulsed ultrasound has no positive effect on knee pain, function, femoral cartilage and synovial sac thickness in knee osteoarthritis.
Iron Deficiency and Its Role in Sleep Disruption in Patients With Angelman Syndrome
Authors: Ryan Conor S. , Edlund Wendy , Mandrekar Jay , Wong-Kisiel Lily C. , Gavrilova Ralitza H. , Kotagal Suresh 
Published: July 2020

Objective: To determine if Angelman syndrome patients with sleep complaints have an increased risk of iron deficiency, and if iron therapy improves their sleep difficulties. Background: About two-thirds of Angelman syndrome patients experience sleep difficulties, which are likely multifactorial. Because iron deficiency can contribute toward restlessness in sleep, we investigated whether it might be a contributing factor in this special population. Methods: This retrospective study involved medical record review of Angelman syndrome patients <18 years old who had attended our multidisciplinary Angelman syndrome clinic and had sleep complaints. Serum ferritin levels were compared to age- and sex-matched controls. Sleep history and nocturnal polysomnogram findings of the Angelman syndrome patients were also characterized. Results: Nineteen Angelman syndrome patients (9 female, mean age 6.2±4.4 years) were identified. All 19 reported sleep difficulties. The mean serum ferritin level was 19.9±8.5 μg/L, while that in controls was 27.8±17.8 μg/L ( P value .13). The odds ratio of iron deficiency in Angelman syndrome compared to controls was 4.17 (95% confidence interval 1.23-14.10), using normal serum ferritin level of 24 μg/L based on literature. Fifteen Angelman syndrome patients underwent nocturnal polysomnogram with 9/15 showing an elevated periodic limb movement index (overall mean 9.8±10.4). Seventeen of 19 received iron therapy. Twelve had follow-up after iron therapy, with parents reporting improved sleep quality. Eight had serum ferritin levels rechecked after iron therapy, showing a mean increase of 24±5.1 μg/L. Conclusions: Sleep difficulties in Angelman syndrome, though multifactorial, may in part be related to iron deficiency. Treatment with iron improved sleep to a modest degree in this population.
Acute Kidney Injury in Pediatric Acute Respiratory Distress Syndrome
Authors: Kaushik Shubhi , Villacres Sindy , Eisenberg Ruth , Medar Shivanand S. 
Published: July 2020

Objectives: To describe the incidence of and risk factors for acute kidney injury (AKI) in children with acute respiratory distress syndrome (ARDS) and study the effect of AKI on patient outcomes. Design: A single-center retrospective study. Setting: A tertiary care children’s hospital. Patients: All patients less than 18 years of age who received invasive mechanical ventilation (MV) and developed ARDS between July 2010 and July 2013 were included. Acute kidney injury was defined using p-RIFLE (risk, injury, failure, loss, and end-stage renal disease) criteria. Interventions: None. Measurements and Main Results: One hundred fifteen children met the criteria and were included in the study. Seventy-four children (74/115, 64%) developed AKI. The severity of AKI was risk in 34 (46%) of 74, injury in 19 (26%) of 74, and failure in 21 (28%) of 74. The presence of AKI was associated with lower Pao 2 to Fio 2 (P/F) ratio ( P = .007), need for inotropes ( P = .003), need for diuretics ( P = .004), higher oxygenation index ( P = .03), higher positive end-expiratory pressure (PEEP; P = .01), higher mean airway pressure ( P = .008), and higher Fio 2 requirement ( P = .03). Only PEEP and P/F ratios were significantly associated with AKI in the unadjusted logistic regression model. Patients with AKI had a significantly longer duration of hospital stay, although there was no significant difference in the intensive care unit stay, duration of MV, and mortality. Recovery of AKI occurred in 68% of the patients. A multivariable model including PEEP, P/F ratio, weight, need for inotropes, and need for diuretics had a better receiver operating characteristic (ROC) curve with an AUC of 0.75 compared to the ROC curves for PEEP only and P/F ratio only for the prediction of AKI. Conclusions: Patients with ARDS have high rates of AKI, and its presence is associated with increased morbidity and mortality.
Australian military and veterans’ mental health care: improving assessment of military personnel and veterans
Authors: Wallace Duncan , Lane Jonathan , Heffernan Kristi , Nas Jones Carolyn 
Published: July 2020

Objective: To describe key practical knowledge and skill components required for clinicians involved with the assessment of military personnel and veterans. Conclusions: Assessment of military and veterans’ mental health issues involves a tailored history-taking process that includes specific aspects of service, transition and reporting requirements. Recommendations for the detailed assessment of military personnel and veterans are provided. Comorbid conditions, chronic pain and the needs of both women and older veterans are also discussed.
Prednisolone-induced diabetes mellitus in the cat: a historical cohort
Authors: Nerhagen Sivert , Moberg Hanne L , Boge Gudrun S , Glanemann Barbara 
Published: July 2020

Objectives Prednisolone is a commonly used drug in cats and potential adverse effects include hyperglycaemia and diabetes mellitus. The aims of this study were to evaluate the frequency and investigate potential predisposing risk factors for the development of prednisolone-induced diabetes mellitus (PIDM) in cats. Methods The electronic records of a tertiary referral centre were searched for cats receiving prednisolone at a starting dose of ⩾1.9 mg/kg/day, for >3 weeks and with follow-up data available for >3 months between January 2007 and July 2019. One hundred and forty-three cats were included in the study. Results Of the 143 cats, 14 cats (9.7%) were diagnosed with PIDM. Twelve out of 14 cats (85.7%) developed diabetes within 3 months of the initiation of therapy. Conclusions and relevance Cats requiring high-dose prednisolone therapy should be closely monitored over the first 3 months of therapy for the development of PIDM.
Concentration standardization improves the capacity of drainage CRP and IL-6 to predict surgical site infections
Authors: Bi Xiaoqin , Li Yan , Lin Jie , Li Chunjie , Li Jiping , Cao Yubin 
Published: July 2020

The early detection of surgical site infection (SSI) remains an unsolved problem. Inflammatory factors in fluids drained from surgical sites may be a promising tool for predicting SSI. Previous attempts to predict SSI via such factors have not taken baseline concentrations into account. However, this may have comprised predictive efficacy. In the current study, concentrations of C-reactive protein (CRP) and interleukin 6 (IL-6) in fluid samples drained from surgical sites in 20 patients with SSI and 60 matched controls were assessed, and concentrations from day 2 to day 4 were divided by the concentration at day 1 to achieve concentration standardization. There were no significant differences of CRP or IL-6 concentrations at day 1 or day 2 ( p >  0.05), but there were significant differences at day 3 and day 4 ( p <  0.05). The areas under the curve (AUCs) for SSI of standardized concentrations were higher than those of the corresponding absolute concentrations of CRP and IL-6 in fluid drained at days 3 and 4. Standardized concentrations of CRP at day 4 yielded the highest AUC (0.92; 95% confidence interval: 0.84–0.97), with a sensitivity of 90% and specificity of 80% at the best cutoff. Concentration standardization may improve the efficacy of predicting SSI via CRP and IL-6 in fluids drained from surgical sites. Although the sample size was small, the study demonstrated the feasibility of non-invasive, accurate, and early detection of postoperative SSI in a diverse real population. Further studies are needed to validate the results of the present study and investigate their broader applicability. Impact statement The ability to predict surgical site infections (SSIs) early would be advantageous. Previous studies have investigated the use of inflammatory factors in fluids drained from surgical sites to predict SSI, but the diagnostic efficacy of this method requires improvement. Baseline levels of inflammatory factors vary between individuals, but this variation tends to differ in patients with and without SSIs. Therefore, we standardized subsequently acquired concentrations of interleukin 6 and C-reactive protein in fluids drained from surgical sites by dividing them by the concentrations determined at day 1 to preclude the confounding effects of differences in baseline levels. The standardized concentrations had higher predictive efficacy than the absolute concentrations. Standardizing the data rendered SSI prediction more precise and practical in a diverse group of real patients. This translational study suggests that inflammatory factors in fluid drained from injury sites are promising tools for the prediction of SSI in the clinic.
Does a delay in surgery for distal radial fractures affect patient outcome?
Authors: Howard Matthew , Curtis Alex , Everett Sam , Harries Luke , Donaldson Oliver , Sheridan Barnaby 
Published: July 2020

Current guidelines from the British Orthopaedic Association state that if fractures of the distal radius are operated on then this should take place within 3 days of injury for intra-articular fractures, 7 days for extra-articular fractures and 3 days when a trial of conservative management has failed. This retrospective cohort study aimed to assess whether there was any difference in outcome between patients receiving timely or delayed surgery, using the Patient-Rated Wrist Evaluation score at >12 months after injury as the primary outcome measure. Data from 380 patients treated at two district general hospitals over a 5-year period were obtained using electronic databases to capture the demographics and treatment details and postal questionnaires to assess current function. The study showed no statistical or clinical differences in outcome measures between the timely or delayed cohorts in any of the three treatment groups. Level of evidence: III
Improved urinary melatonin level as the perspective indicator that leads to better sleeping quality in bladder cancer patients
Authors: Cheng Tse-Chou , Lee Yi-Hua , Chang Yuan-Ping , Lee De-Chih 
Published: July 2020

Background: Individuals with higher-than-average melatonin concentrations are less likely to develop cancer. In cancer patients, psychosomatic coping patterns and treatment side effects are important indicators of cancer prevention and immune system deterioration. This study focused on changes in the urinary melatonin concentration, life resilience, and sleep quality in bladder cancer patients before, and 3 months after, treatment. Methods: A controlled before-and-after study was performed. The subjects were patients who were previously diagnosed with bladder cancer and had received treatment (transurethral resection of bladder tumor + intravesical chemotherapy). Data from 23 subjects were analyzed. Results: The results showed a significant difference in the melatonin concentration before and after treatment (Wilcoxon signed-rank test, Z = −2.220, p = 0.026). The melatonin concentration in 16 patients (70%) increased after treatment. The mean Pittsburgh Sleep Quality Index (PSQI) score before treatment was 7.348 (SD = 4.030), which was associated with poor sleep quality. The mean PSQI score after treatment was 6.435 (SD = 3.300; Z = −2.071; p = 0.038). These results represent the improved sleep quality in patients post-treatment. Conclusions: After treatment, the urinary melatonin concentration and sleep quality (PSQI) improved, both of which were statistically significant in bladder cancer patients. Consequently, bladder cancer treatment should be initiated as soon as possible. There was no significant difference in overall life resilience before and after treatment, possibly because elderly individuals have strong personality traits and emotional stability and are not easily affected by life events or stress.
Pharmacogenomics Instruction Depth, Extent, and Perception in US Medical Curricula
Authors: Basyouni Dara , Shatnawi Aymen 
Published: July 2020

Introduction: This descriptive study aimed to evaluate the depth, extent, and perception of pharmacogenomics instruction in schools and colleges of medicine in the United States. Changes in medical pharmacogenomics instruction over the past decade were also assessed by comparing our results with those of a previous study. Methods: An electronic survey was emailed to all accredited allopathic and osteopathic medical schools across the US using Qualtrics online survey software. Multiple email reminders were sent to increase the response rate. Results: Of 151 targeted eligible medical schools across the United States, 22 responded to the survey. One invalid response was excluded, resulting in a response rate of 13.9%. Of responding schools, 85.7% cover pharmacogenomics in their curriculum, mainly in the second year, however, none teach pharmacogenomics as a stand-alone course. The depth and the extent of pharmacogenomics coverage varied among responding programs. Although 66.7% of respondents believe that neither physicians nor other health care professionals possess appropriate knowledge in pharmacogenomics, only 23.8% plan to increase pharmacogenomics instruction in their curricula in the near future. Conclusions: Most medical schools surveyed include some pharmacogenomics instruction in their curricula, although the depth and the extent of the instruction varies. Most respondents believe that physicians and other health care professionals today do not possess an appropriate level of knowledge in pharmacogenomics; however, few institutions report short-term plans to increase pharmacogenomics instruction. Pharmacogenomics plays a significant role in personalized medicine; greater efforts by medical school decision-makers are needed to improve the level of pharmacogenomics instruction in medical curricula.
A model to strengthen utility of quality pharmaceutical health systems data in resource-limited settings
Authors: Kagoya Harriet Rachel , Kibuule Dan , Rennie Timothy William , Kabwebwe Mitonga Honoré 
Published: July 2020

Background: Limited utility of quality health data undermines efforts to strengthen healthcare delivery, particularly in resource-limited settings. Few studies model the effective utility of quality pharmaceutical information system (PIS) data in sub-Saharan Africa, typified with weak health systems. Aim: To develop a model and guidelines for strengthening utility of quality PIS data in public healthcare in Namibia, a resource-limited setting. Methods: A qualitative model based on Dickoff et al. practice-oriented theory, Chinn and Jacobs’ systematic approach to theory, and applied consensus techniques. Data from nationwide studies on quality and utility of PIS data in public healthcare conducted between 2018 and March 2020 informed the development of the model concepts. Pharmaceutical and public health systems experts validated the final model. Results: Overall, four preliminary national studies that recruited 58 PIS focal persons at 38 public health facilities and national level informed the development of four model concepts. The model describes concepts on access, management, dissemination, and utility of quality PIS data. Activities to implement the model in practice include grass-root integration of real-time automated pharmaceutical intelligence systems to collect, consolidate, monitor, and report PIS data. Strengthening coordination, human resources, and technical capacity through support supervisory systems at grass-root facilities are key activities. PIS focal persons at health facility and national level are agents to implement these activities among recipients, that is, healthcare professionals at points of care. Guidelines for implementation of the model at point of care are included. Experts described the model as clear, simple, comprehensive, and integration of pharmaceutical intelligence systems at point of care as novel and of importance to enhance utility of quality PIS data in resource-limited settings. Conclusion: While utility of quality PIS data is limited in Namibia, advantages of the model are encouraging, toward building resilient pharmaceutical intelligence systems at grass roots in resource-limited countries, where there are not only weak health systems, but high burden of misuse of medicines.
Bilateral, Solitary, Extramacular Vitelliform Retinal Lesions in a Patient With Best Disease
Authors: Duker Jacob , Patel Nimesh A. , Yannuzzi Nicolas A. , Prakhunhungsit Supalert , Negron Catherin I. , Berrocal Audina M. 
Published: July 2020

Purpose: This work describes the first published case of Best vitelliform macular dystrophy (BVMD) with bilateral, solitary, extramacular retinal lesions. Methods: A case report is presented. Results: An 8-year-old girl with a family history of BVMD was referred for suspicious peripheral retinal lesions. Multimodal imaging disclosed bilateral, solitary, extramacular lesions consistent with the vitelliform lesions found in BVMD. There were no abnormalities in the macula. Conclusions: This is the first documented case of solitary, bilateral, extramacular vitelliform lesions in BVMD.