bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insights into the biomarkers of viral encephalitis from clinical patients
Authors: Khushafa Thekra , jing Liu , Zhaojun Zeng , Jiameng Sun , haixia Zhu 
Published: November 2020

ABSTRACT
Background: biomarkers can be helpful in identifying patients who may profit by explicit treatments or evaluating the reaction to the treatment of specific disease. Finding unique biomarkers in the process of disease could help clinicians in identifying serious disease in the early stage, so as to improve prognosis. Objective: these investigations, nonetheless, have made constrained progress. Numerous infections are known to cause intense viral encephalitis (VE) in people which can cause a variable level of meningeal just as parenchymal aggravation. Initial clinical manifestations in most encephalitis are nonspecific, resembling a viral-like illness. However, with disease progression, symptoms can become quite severe and fatal, including prominent cranial hypertension, cognitive problems, cerebral hernia and respiratory failure. Forwards: the clinical and research center discoveries in huge numbers of those viral issues are to a great extent comparable and in this way increasingly explicit biomarkers for indicative and prognostic intentions are justified. These biomarkers are progressively significant in the acknowledgment and treatment of the viral central nervous system (CNS) issue. Conclusion: Clinical manifestations have been the indicative approaches for analysis of viral encephalitis. Lots of studies have been endeavored to distinguish progressively objective laboratory-based quantitative CSF biomarkers for VE.
Spousal Educational Attainment and Sleep Duration Among American Older Adults
Authors: Sheehan Connor , Iida Masumi 
Published: November 2020

Abstract

Objectives
Sleep has consistently been shown to have a dyadic nature among married older adults; however, less is known about the influence of a spouses’ social characteristics on one’s own sleep. Focusing on older adults, we examined the association between one’s spouses’ educational attainment and one’s own sleep duration.

Method
We used the 2004–2018 National Health Interview Survey (NHIS) to analyze heterosexual married adults aged 50–84 (N = 89,180). Respondents reported typical sleep duration in a 24-hr period, which was categorized as short (≤6 hr), normal (7–8 hr), or long (≥9 hr). We fit multinomial logistic regression models predicting these categories of sleep duration and accounted for demographic, household socioeconomic characteristics, and health/health behaviors. Using interaction terms, we tested if the association varied by the respondent’s gender and educational attainment.

Results
Older adults married to spouses with college or more education had significantly lower relative risk of short sleep than those whose spouses had some college, high school, or less than high school education, net of the covariates including their own education. The benefit of higher levels of spousal education was significantly more protective against short sleep for women and more highly educated older adults.

Discussion
Older adults married to spouses with high levels of education reported more favorable sleep durations, but this benefit was significantly stronger for women and the highly educated which has important implications for their aging. These findings suggest that social inequality may condition the dyadic nature of sleep for heterosexual married older adults.
Mathematical evaluation of sloped solar chimney power plant for power generation in different regions of Nepal
Authors: Baral Suresh 
Published: November 2020

Abstract
Sloped solar chimney power plant (SSCPP) could be one of the appropriate technologies for powering Nepalese communities. The main components of the plant are chimney, collector and power-generating unit. In this study, the mathematical evaluation of the SSCPP has been conducted for the estimation of the power generation in Nepalese context. For the analysis, the mathematical models have been developed from the governing equations. The parameters such as chimney height and radius, collector radius, ambient temperature and solar insolation have been taken as inputs for simulation of the overall system. The output parameters such as overall system efficiency, chimney efficiency, air velocity, power output from the turbine and electrical power from the proposed system have been evaluated. The results showed that power developed by air, turbine power and electrical power is 120, 66 and 44 kW, respectively. The developed power is estimated when the height and the radius of the chimney were 190 and 5 m, respectively. It is seen that ambient temperature and velocity of air also play an important role in the power generation. The performance influencing the power output based on turbine pressure ratio, thermal conductivity and specific heat capacity of soil and the mass flow rate have also been estimated. Besides, the solar insolation data were taken for five different regions of Nepal to find the power generation and collector efficiency.
Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman
Authors: Schoenmakers Sam , Snijder Pauline , Verdijk Robert M , Kuiken Thijs , Kamphuis Sylvia S M , Koopman Laurens P , Krasemann Thomas B , Rousian Melek , Broekhuizen Michelle , Steegers Eric A P , Koopmans Marion P G , Fraaij Pieter L A , Reiss Irwin K M 
Published: November 2020

Abstract

Background
In general, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is not considered to be an increased risk for severe maternal outcomes but has been associated with an increased risk for fetal distress. Maternal-fetal transmission of SARS-CoV-2 was initially deemed uncertain; however, recently a few cases of vertical transmission have been reported. The intrauterine mechanisms, besides direct vertical transmission, leading to the perinatal adverse outcomes are not well understood.

Methods
Multiple maternal, placental, and neonatal swabs were collected for the detection of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR). Serology of immunoglobulins against SARS-CoV-2 was tested in maternal, umbilical cord, and neonatal blood. Placental examination included immunohistochemical investigation against SARS-CoV-2 antigen expression, with SARS-CoV-2 ribonucleic acid (RNA) in situ hybridization and transmission electron microscopy.

Results
RT-qPCRs of the oropharynx, maternal blood, vagina, placenta, and urine were all positive over a period of 6 days, while breast milk, feces, and all neonatal samples tested negative. Placental findings showed the presence of SARS-CoV-2 particles with generalized inflammation characterized by histiocytic intervillositis with diffuse perivillous fibrin depositions with damage to the syncytiotrophoblasts.

Conclusions
Placental infection by SARS-CoV-2 leads to fibrin depositions hampering fetal-maternal gas exchange with resulting fetal distress necessitating a premature emergency cesarean section. Postpartum, the neonate showed a fetal or pediatric inflammatory multisystem-like syndrome with coronary artery ectasia temporarily associated with SARS-CoV-2 for which admittance and care on the neonatal intensive care unit (NICU) were required, despite being negative for SARS-CoV-2. This highlights the need for awareness of adverse fetal and neonatal outcomes during the current coronavirus disease 2019 pandemic, especially considering that the majority of pregnant women appear asymptomatic.
Use of selective PGE2 receptor antagonists on human endometriotic stromal cells and peritoneal macrophages
Authors: Makabe Tomoko , Koga Kaori , Nagabukuro Hiroshi , Asada Mari , Satake Erina , Taguchi Ayumi , Takeuchi Arisa , Miyashita Mariko , Harada Miyuki , Hirata Tetsuya , Hirota Yasushi , Wada-Hiraike Osamu , Fujii Tomoyuki , Osuga Yutaka 
Published: November 2020

Abstract
Non-hormonal therapeutic strategies for endometriosis are needed. The aim of this study was to characterize the effects of prostaglandin (PG)E2 receptor inhibitors to explore their potential as novel therapeutic strategies for endometriosis. The expression of PGE2 receptors (EP2 and EP4) in donated tissues from human ovarian endometriosis, adenomyosis and peritoneal endometriosis was examined using immunohistochemistry. Human endometriotic stromal cells (ESC) isolated from ovarian endometriotic tissue and peritoneal macrophages were treated with EP2 and EP4 antagonists. cAMP accumulation and the effect of EP antagonists were measured using cAMP assays. DNA synthesis in ESC was detected using bromodeoxyuridine incorporation analysis. Interleukin (IL)-6 and IL-8 protein levels in ESC supernatants were measured using ELISAs. mRNA expression level for aromatase by ESC, and selected cytokines by peritoneal macrophages was measured using RT–PCR. EP2 and EP4 receptors were expressed in cells derived from control and diseased tissue, ovarian endometriotic, adenomyotic and peritoneal lesions. A selective EP2 antagonist reduced DNA synthesis, cAMP accumulation and IL-1β-induced proinflammatory cytokine secretion and aromatase expression. A selective EP4 antagonist negated IL-1β-induced IL-6 secretion and aromatase expression. In peritoneal macrophages, EP expression was elevated in endometriosis samples but the EP4 antagonist reduced cAMP levels and expression of vascular endothelial growth factor, chemokine ligand 2 and chemokine ligand 3 mRNA. EP2 and EP4 are functioning in endometriosis lesions and peritoneal macrophages, and their selective antagonists can reduce EP-mediated actions, therefore, the EP antagonists are potential therapeutic agents for controlling endometriosis.
Marjolin Ulcer: A Comprehensive Review
Authors: Khan Kamran , Schafer Charles , Wood Jeyhan 
Published: November 2020

ABSTRACT
This article aims to provide a comprehensive review of Marjolin ulcer (MU) to assist clinicians in understanding the epidemiology, etiology, pathogenesis, diagnosis, and treatment of MU. Marjolin ulcer presents with clear signs and symptoms of malignant degeneration in chronic wounds. It can be prevented by raising awareness and educating wound care providers appropriately about its signs and symptoms.

GENERAL PURPOSE
To provide a comprehensive review of Marjolin ulcer (MU) to assist clinicians in understanding the epidemiology, etiology, pathogenesis, diagnosis, and treatment of MU.

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:
1. Describe the epidemiology, pathogenesis, and clinical manifestations of MU.
2. Summarize the diagnostic and treatment approaches for patients who have an MU.
Scarring at Donor Sites after Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial
Authors: Karlsson Matilda , Elmasry Moustafa , Steinvall Ingrid , Sjöberg Folke , Olofsson Pia 
Published: November 2020

ABSTRACT

OBJECTIVE
To investigate if previous findings on the association between dressing treatments and subjective opinion on final donor site scar outcome using the Patient and Observer Scar Assessment Scale (POSAS) can be confirmed objectively. The previous study showed that patients dressed with hydrofiber covered with film were more satisfied with their donor site scars than patients receiving porcine xenograft or polyurethane foam dressings.

METHODS
Scar outcome measurements were assessed by a blinded observer using POSAS and the Cutometer dual MPA 580 device to measure the viscoelasticity of skin.

RESULTS
A total of 17 participants were included in this study, five of whom were treated with hydrofiber, six with polyurethane foam, and another six with porcine xenograft. There were no significant differences among groups in any of the POSAS items or in the viscoelasticity measurements made with the Cutometer.

CONCLUSIONS
The investigators could not confirm previous associations between dressing treatment and long-term donor site scars. No associations between donor sites’ healing times and final scarring were found. Hypopigmentation was reported in 15 of 17 donor sites evaluated.
A review of inherited cancer susceptibility syndromes
Authors: Brown Gina R. , Simon Madeline , Wentling Chris , Spencer Danielle M. , Parker Ashley N. , Rogers Corey A. 
Published: November 2020

ABSTRACTInherited cancer syndromes are caused by genetic mutations that place patients at an increased risk for developing cancer. Although most cancers are not caused by genetic inheritance, clinicians must understand these syndromes and be able to recognize their common characteristics. A thorough family history and identification of common patterns as well as specific clinical signs and symptoms can help with early recognition. This article describes symptoms of the more common cancer syndromes, including hereditary breast and ovarian cancer, Li-Fraumeni, Lynch, familial adenomatous polyposis, retinoblastoma, multiple endocrine neoplasia, and von Hippel-Lindau. Important patient education regarding genetic testing also is covered.
Advanced kidney disease
Authors: Puzantian Houry , Mead Daniel R. 
Published: November 2020

Abstract:
Nonnephrology NPs often encounter patients with advanced chronic kidney disease. As patients transition to nephrology care, NPs need to communicate with them about their disease status and treatment. This article describes the treatment approach in patients with advanced kidney disease including medical management, hemodialysis, peritoneal dialysis, and transplantation.
Managing postoperative pain with opioid-sparing therapies
Authors: Barnett Taylor , Denke Linda 
Published: November 2020

Abstract:
The analgesic properties of opioids make them valuable pharmacologic options for patients with severe post-op pain, but healthcare providers must be cautious due to opioid-related adverse reactions. This article reviews select nonopioid adjuvant and adjunctive medications, as well as select nonpharmacologic therapies, as part of a multimodal approach to postoperative analgesia. The role of nurses in assessing, monitoring, and educating patients is also explored.
Effect on Patient Safety of a Resident Physician Schedule Without 24-Hour Shifts
Authors: Landrigan Christopher P. , Rahman Shadab A. , Sullivan Jason P. , Vittinghoff Eric , Barger Laura K. , Sanderson Amy L. , Wright Kenneth P. , O'Brien Conor S. , Qadri Salim , St Hilaire Melissa A. , Halbower Ann C. , Segar Jeffrey L. , McGuire John K. , Vitiello Michael V. , de la Iglesia Horacio O. , Poynter Sue E. , Yu Pearl L. , Zee Phyllis C. , Lockley Steven W. , Stone Katie L. , Czeisler Charles A. 
Published: November 2020

(Abstracted from N Engl J Med 2020;382:2514–2523)
Over the last 4 decades, a body of literature has studied the effect of extended shifts (working ≥24 hours) for resident physicians on their alertness and performance, and by extension, patient safety. Since then, the results of further studies have been inconsistent.
Trainee Wellness and Safety in the Context of COVID-19: The Experience of One Institution
Authors: Kemp Michael T. , Rivard Samantha J. , Anderson Sara , Audu Christopher O. , Barrett Meredith , Fry Brian T. , Lane Megan , Vu Joceline V. , Young Bree Ann C. , Englesbe Michael , Sandhu Gurjit , Coleman Dawn M. 
Published: November 2020

The COVID-19 pandemic has had significant ramifications for provider well-being. During these unprecedented and challenging times, one institution’s Department of Surgery put in place several important initiatives for promoting the well-being of trainees as they were redeployed to provide care to COVID-19 patients. In this article, the authors describe these initiatives, which fall into 3 broad categories: redeploying faculty and trainees, ensuring provider safety, and promoting trainee wellness.
The redeployment initiatives are the following: reframing the team mindset, creating a culture of grace and forgiveness, establishing a multidisciplinary wellness committee, promoting centralized leadership, providing clear communication, coordinating between departments and programs, implementing phased restructuring of the department’s services, establishing scheduling flexibility and redundancy, adhering to training regulations, designating a trainee ombudsperson, assessing physical health risks for high-risk individuals, and planning for structured deimplementation.
Initiatives specific to promoting provider safety are appointing a trainee safety advocate, guaranteeing personal protective equipment and relevant information about these materials, providing guidance regarding safe practices at home, and offering alternative housing options when necessary.
Finally, the initiatives put in place to directly promote trainee wellness are establishing an environment of psychological safety, providing mental health resources, maintaining the educational missions, solidifying a sense of community by showing appreciation, being attentive to childcare, and using social media to promote community morale.
The initiatives to carry out the department’s strategy presented in this article, which were well received by both faculty and trainee members of the authors’ community, may be employed in other departments and even outside the context of COVID-19. The authors hope that colleagues at other institutions and departments, independent of specialty, will find the initiatives described here helpful during, and perhaps after, the pandemic as they develop their own institution-specific strategies to promote trainee wellness.
Advocating for a Loved One in the Setting of Uncertainty
Authors: Umberger Reba A. , Todt Kendrea , Talbott Elizabeth , Sparks Laurie , Thomas Sandra P. 
Published: November 2020

Background
The trajectory of recovery after sepsis varies. Survivors may have considerable ongoing limitations, requiring a caregiver for a prolonged period.

Objectives
To learn about experiences, quality of life, coping, resilience, and social support of caregiver caring for survivors of sepsis.

Methods
We conducted a convergent mixed-methods study, recruiting informal caregivers of patients who had survived sepsis in the past year and were readmitted to the intensive care unit with sepsis. Individual face-to-face, semistructured interviews and validated surveys on quality of life, coping, caregiver burden, resilience, and social support were administered to caregivers. Interview transcripts were analyzed using content analysis. Surveys were scored and summarized using descriptive statistics.

Results
Caregivers were primarily middle-aged, White, and female. Half were spouses of their care recipient. Caregivers reported some deficits in mobility, pain, and anxiety/depression. Coping styles varied, with engaged coping being more prevalent. Most caregivers reported mild to moderate burden, all reported either normal or high resilience levels, and types of social support were similar. However, interviews and survey findings were not always consistent. Major themes that emerged from the analysis included (1) advocating for and protecting their loved one, (2) coping with caregiving, (3) uncertain future, (4) rewards of caregiving, and (5) need to optimize communication with family.

Discussion
Caregivers of sepsis survivors are protective of their care recipient and use a variety of strategies to advocate for their loved one and to cope with the uncertainty involved in a new intensive care unit admission. More advocacy and support are needed for this population.
Socioeconomic, behavioural and sexual-health factors associated with nutritional status of female commercial sex workers in Dhaka city, Bangladesh: a cross-sectional study
Authors: Kawser Mahbuba , Khan Muhammad Nazrul Islam , Hossain Kazi Jahangir , Islam Sheikh Nazrul 
Published: November 2020

Abstract

Objectives:
To investigate the prevalence of nutitional status of female commercial sex workers (FCSWs) in Dhaka city and to determine which socio-economic, behavioural and sexual health practices associated with chronic energy deficiency (CED) and overweight/obesity.

Methods:
Cross-sectional study conducted among 635 FCSWs (308 hotel-based/HBSWs and 327 floating-based/FBSWs). Research tools were pretested questionnaire and anthropometric measurement (height–weight). Multistage sampling technique was employed to collect the data according to probability proportional to size from 7 hotels and 3 spots. Socio-demographic, sexual-health and behavioural data were collected by direct interview of the FCSWs from working places and were processed by statistical software package. Multinomial logistic regression model was used to determine the factors influencing BMI kg/m2 of FCSWs.

Results:
Mean age of the FCSWs was 21.1 years with a range of 14 to 55 years. Vast majority of FCSWs were illiterate (65.8%), widowed/separated/abandoned (44.6%) followed by 43.5% married. Prevalence of CED (<18.5 kg/m2) and overweight/obesity (≥25) was 22.8% and 16.3%, respectively. CED rate was almost doubled among FBSWs than HBSWs (P < .001). From the fitted MNLR model, variables like being HBSWs [odds ratio (OR) = .518], no mass media exposure (OR = 2.29) are found to be significant (P < .05) in the model of normal BMI verses CED. Similarly, being HBSWs (OR = 2.2), <26 years age (OR = .418), one-time coital frequency with normal clients (OR = .412), 1 to 7 days monthly absent (OR = .381), no alcohol consumption (OR = .149), drug habit (cannabis) (OR = .441), monthly income ≤7000 BDT (OR = .487) are found to be significant in the model of normal BMI verses overweight/obesity.

Conclusion:
FCSWs face double burden of malnutrition. Older age, higher income, being hotel-based FCSW, frequency of coitus, monthly abstinence from sex work, regular alcohol consumption and taking no drug are influential factors for overweight/obesity while being floating FCSW and having no mass media items (TV/Radio) are important determinants of CED.
Accreditation 101: Develop, Assess, and Report Program Goals
Authors: Snyder Jennifer A. , Quincy Brenda 
Published: November 2020

Abstract
The aim of this article is to highlight the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accreditation requirements for PA program goals, describe methods for writing effective goals, provide examples and analysis of hypothetical goals, and encourage the use of effective reporting strategies. Programs are encouraged to use one of 3 mnemonic conventions with each providing a useful framework for identifying key elements of goals: FAST, SMART, and Objectives and Key Results. These 3 acronyms are easy to remember and will yield goals that are consistent with the requirements of ARC-PA.