bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Prothrombin Complex Concentrates: Results of a Nationwide Survey of Critical Care Pharmacists
Authors: Curry Brooke , Mueller Scott , MacLaren Robert 
Published: October 2020

Background Prothrombin complex concentrates (PCCs) are frequently used. Objective To elucidate practices and perceptions of proprietary and nonproprietary PCCs use. Methods An electronic pretested cross-sectional survey e-mailed thrice to 1 critical care pharmacist at 1170 US institutions. Questions addressed hospital and pharmacy characteristics, use of PCCs, and perceptions of effectiveness and safety. Results 429 (39.5%) of 1086 eligible institutions completed the questionnaire. PCCs were used several times per month to several times per week (62.6%). An order set was routinely or always used to direct PCCs usage at 66.4% of institutions. Four-factor PCCs were preferred by 93% of institutions. The most common perceived indications for 4-factor PCCs were hemorrhage related to warfarin (92.1%) or oral Xa inhibitors (81.8%), intracranial hemorrhage (78.4%), trauma hemorrhage (66.2%), surgical hemorrhage (61.1%), and refractory hemorrhage (57.3%). The most common perceived contraindications were heparin-induced thrombocytopenia (42%), disseminated intravascular coagulopathy (39.2%), and active thromboembolism (38.9%). Most institutions considered patient weight (78.8%), indication (77.6%), and International Normalized Ratio (76.9%) when dosing PCCs. Only 43.8% of institutions used fixed dose, only 19.6% compounded PCCs at the bedside, and only 11.9% administered PCCs by rapid infusion. Compared to standard blood products, respondents believed PCCs acted more rapidly, were less likely to cause volume issues, and were more expensive. Respondents were neutral about PCCs acting longer, being more effective at preventing or treating hemorrhage, or causing thromboembolism. Conclusions Off-label use of PCCs is common. Differing perceptions surrounding indications, contraindications, and comparisons to blood products/procoagulants likely contribute to variable practices.
Consensus Recommendations for the Safe Handling of Cytotoxic Agents in Cytotoxic Academic Research Laboratories (CARL)
Authors: Nabhani Gebara Shereen , Barton Stephen , Appleford Ian , McCalla Pauline , Sewell Graham , Sabbagh Dit Hawasli Racha 
Published: October 2020

Cytotoxic agents, also called antineoplastic agents, are used in cancer treatment due to their inherent activity to inhibit cell growth or proliferation, or DNA, RNA and protein synthesis. They are, therefore, hazardous by nature in a non-selective manner leading to disruption of cell growth and function of both diseased and healthy cells of treated patients. While the benefits of receiving cytotoxic agents may outweigh the incurred risks for patients, the same cannot be said for exposed healthcare practitioners involved in the transport, preparation, administration, and resulting waste disposal of these agents. Consequently, many professional bodies around the world have set standards of practice to prevent occupational exposure of healthcare workers to cytotoxic agents, and hospitals have been active in defining strict policies in this concern. However, due to the variability of the practice and infrastructure in academic settings, some activities performed within the cytotoxic academic research laboratory often do not adhere to recommendations published by guidelines. The present recommendations were therefore set forward by members of a working group who are experts on the subject matter representing academic, clinical, and research backgrounds in an attempt to promote safe cytotoxic handling in academic institutions. The document maps out the trajectory of cytotoxic agents being investigated in academic research laboratories while providing recommendations on the delivery, storage, use and disposal of cytotoxic agents in university settings.
Diagnostic Value of Mid-esophageal Biopsies in Pediatric Patients With Eosinophilic Esophagitis
Authors: Chernetsova Elizaveta , Agarwal Amisha , Weir Arielle , Oltean Irina , Barkey Janet , Demellawy Dina El 
Published: October 2020

Introduction Eosinophilic esophagitis (EoE) is histologically defined as the presence of 15 or more intraepithelial eosinophils per high-power fields. Limited consensus exists on where to sample the esophagus in pediatrics. This study aimed to identify whether endoscopic and histologic examination of the mid esophagus offers diagnostic value compared to proximal/distal esophageal biopsies. Methods A retrospective chart review of pediatric patients with EoE was performed. Endoscopic and histologic parameters were assessed at the initial and follow-up visits, and concordance between proximal/distal biopsy and mid biopsy was determined. Results A total of 100 patients with a mean age of 9.6 ± 4.07 years were included. Endoscopic parameters between proximal/distal and mid esophagus were concordant in 84% to 97% of patients (initial assessment) and in 80% to 97% of patients (at follow-up). Mid esophagus showed endoscopic abnormalities, which were absent at the proximal/distal esophagus in 1% to 5% of patients, as well as histologic abnormalities in 2% to 8% of patients overall at initial and follow-up examinations. Conclusions We recommend continued endoscopic and histologic assessment of the proximal/distal biopsy; however, examination of the mid esophagus does offer small diagnostic value in our subset of patients. Future studies need to be conducted before conclusive recommendations supporting the use of mid-esophageal biopsies can be made.
PRF1 mutation alters immune system activation, inflammation, and risk of autoimmunity
Authors: Sidore Carlo , Orrù Valeria , Cocco Eleonora , Steri Maristella , Inshaw Jamie RJ , Pitzalis Maristella , Mulas Antonella , McGurnaghan Stuart , Frau Jessica , Porcu Eleonora , Busonero Fabio , Dei Mariano , Lai Sandra , Sole Gabriella , Virdis Francesca , Serra Valentina , Poddie Fausto , Delitala Alessandro , Marongiu Michele , Deidda Francesca , Pala Mauro , Floris Matteo , Masala Marco , Onengut-Gumuscu Suna , Robertson Catherine C , Leoni Lidia , Frongia Annapaola , Ricciardi Maria Rossella , Chessa Margherita , Olla Nazario , Lovicu Mario , Loizedda Annalisa , Maschio Andrea , Mereu Luisa , Ferrigno Paola , Curreli Nicolo , Balaci Lenuta , Loi Francesco , Ferreli Liana AP , Pilia Maria Grazia , Pani Antonello , Marrosu Maria Giovanna , Abecasis Goncalo R , Rich Stephen S , Colhoun Helen , Todd John A , Schlessinger David , Fiorillo Edoardo , Cucca Francesco , Zoledziewska Magdalena 
Published: October 2020

Background: Defective alleles within the PRF1 gene, encoding the pore-forming protein perforin, in combination with environmental factors, cause familial type 2 hemophagocytic lymphohistiocytosis (FHL2), a rare, severe autosomal recessive childhood disorder characterized by massive release of cytokines—cytokine storm. Objective: The aim of this study was to determine the function of hypomorph PRF1:p.A91V g.72360387 G > A on multiple sclerosis (MS) and type 1 diabetes (T1D). Methods: We cross-compare the association data for PRF1:p.A91V mutation derived from GWAS on adult MS and pediatric T1D in Sardinians. The novel association with T1D was replicated in metanalysis in 12,584 cases and 17,692 controls from Sardinia, the United Kingdom, and Scotland. To dissect this mutation function, we searched through the coincident association immunophenotypes in additional set of general population Sardinians. Results: We report that PRF1:p.A91V, is associated with increase of lymphocyte levels, especially within the cytotoxic memory T-cells, at general population level with reduced interleukin 7 receptor expression on these cells. The minor allele increased risk of MS, in 2903 cases and 2880 controls from Sardinia p = 2.06 × 10−4, odds ratio OR = 1.29, replicating a previous finding, whereas it protects from T1D p = 1.04 × 10−5, OR = 0.82. Conclusion: Our results indicate opposing contributions of the cytotoxic T-cell compartment to MS and T1D pathogenesis.
Romidepsin Induces G2/M Phase Arrest and Apoptosis in Cholangiocarcinoma Cells
Authors: Li Pihong , Liu Luguang , Dang Xiangguo , Tian Xingsong 
Published: October 2020

Background: Cholangiocarcinoma (CCA) is an extremely intractable malignancy since most patients are already in an advanced stage when firstly discovered. CCA needs more effective treatment, especially for advanced cases. Our study aimed to evaluate the effect of romidepsin on CCA cells in vitro and in vivo and explore the underlying mechanisms. Methods: The antitumor effect was determined by cell viability, cell cycle and apoptosis assays. A CCK-8 assay was performed to measure the cytotoxicity of romidepsin on CCA cells, and flow cytometry was used to evaluate the effects of romidepsin on the cell cycle and apoptosis. Moreover, the in vivo effects of romidepsin were measured in a CCA xenograft model. Results: Romidepsin could reduce the viability of CCA cells and induce G2/M cell cycle arrest and apoptosis, indicating that romidepsin has a significant antitumor effect on CCA cells in vitro. Mechanistically, the antitumor effect of romidepsin on the CCA cell lines was mediated by the induction of G2/M cell cycle arrest and promotion of cell apoptosis. The G2/M phase arrest of the CCA cells was associated with the downregulation of cyclinB and upregulation of the p-cdc2 protein, resulting in cell cycle arrest. The apoptosis of the CCA cells induced by romidepsin was attributed to the activation of caspase-3. Furthermore, romidepsin significantly inhibited the growth of the tumor volume of the CCLP-1 xenograft, indicating that romidepsin significantly inhibited the proliferation of CCA cells in vivo. Conclusions: Romidepsin suppressed the proliferation of CCA cells by inducing cell cycle arrest through cdc2/cyclinB and cell apoptosis by targeting caspase-3/PARP both in vitro and in vivo, indicating that romidepsin is a potential therapeutic agent for CCA.
Endoscopic Orbital Decompression: Technical Pearls and Pitfalls of an Evolving Technique
Authors: Shah Janki , Ting Jonathan , Sindwani Raj 
Published: October 2020

Background First described in the early 1990s, endoscopic orbital decompression has become increasingly popular and has been shown to be a safe and effective approach for surgical decompression of the medial and inferior orbit. Methods We present our preferred technique for performing an endoscopic orbital decompression, highlighting key pearls and pitfalls. Results An endoscopic wide maxillary antrostomy and sphenoethmoidectomy is performed in standard fashion. We prefer to resect the middle turbinate for optimal exposure and access. The medial orbital wall is skeletonized and the lamina papyracea is carefully elevated, preserving the underlying periorbita. The orbital floor medial to the infraorbital nerve is resected. Once the periorbita is fully exposed, parallel axial incisions along the medial orbit and orbital floor are made from posterior to anterior using a sickle knife, taking care not to bury the tip to avoid injuring underlying orbital contents. The remaining fibrous bands are incised and prolapse of orbital fat is observed. Post extubation bag mask ventilation is limited to avoid subcutaneous emphysema. Conclusion Compared to open techniques, endoscopic orbital decompression provides superior visualization of critical anatomical landmarks, assures healthy sinus functioning post procedure, offers a lower complication rate, and avoids external incisions.
Main Non-Clinical Factors Influencing Endodontic Referral
Authors: Broome Joseph L 
Published: October 2020

Specialisation in endodontics allows for endodontic referrals by general dental practitioner (GDPs) and the study of factors influencing referral. These centre on a triad consisting of the referral process, non-clinical and clinical reasons for referral. Many non-clinical factors have been identified which may influence the referral process to the endodontist. A systematic review study was undertaken into the main non-clinical factors influencing endodontic referral by general dental practitioners to endodontists. Such awareness and appreciation of these factors benefits the commercial aspect of the referral practice, increases access by reducing barriers to care, and ultimately improves patient care. A literature search yielded three papers that met the eligibility criteria. All studies included were cross sectional survey studies completed by GDPs. The main non-clinical factors seen from the studies include: • Availability. • Personality, relationships and communication. • Location. Availability presented as a common thread throughout all the studies. In conclusion, endodontic referral is multifactorial and influenced by several factors, that are not related to the nature of the endodontic disease, and this is a dynamic process. Due to the lack of high level studies, and limitations of the available studies, further research is suggested into relevant area of non-clinical endodontic factors for endodontic referral and thus allowing for further analysis.
Patients’ perception of radiation safety of radiological investigations in urology
Authors: Kumar Prakrit R , Irving Stuart 
Published: October 2020

Background: This study analyses patients’ knowledge of common radiological investigations. Methods: At a university teaching hospital, 100 patients attending urological clinics, who had had a plain X-ray of the kidney, ureter and bladder, magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound scan (USS), completed a 14-item Likert scale questionnaire assessing patients’ perception of safety (both qualitatively and quantitatively) and the hazards of radiological investigations. Results: Using a radiation risk score, patients perceived the following investigations to be in rank order of increasing radiation risk: USS (0.84), MRI (1.4), CT (1.5) and plain X-ray (1.6). On the same scale (0–5), only 17% of patients correctly attributed a risk score of 3 or 4 for a CT scan, and 49% were able to identify a plain X-ray’s risk score correctly as 1 or 2. In addition, more patients identified CT (34%) as having a lower risk of 0 than an X-ray (24%). The mean (1.35 vs. 1.60), median (1 vs. 1) and mode (0 vs. 1) for the CT risk scores are less than those for a plain X-ray, demonstrating that patients perceived CT scans to be safer. Further, the majority of patients understood USS to have no radiation exposure (56%) but thought that MRI posed a radiation risk (62%). Patients were unable to quantify radiation exposure correctly: USS (37% correctly attributed – 0 mSv), MRI (22% – 0 mSv), X-ray (47% – 1 mSv) and CT scan (28% – 10 mSv). Conclusion: This demonstration of suboptimal patient awareness of radiation exposure of common radiological investigations highlights the need to educate patients in order to improve patient autonomy and possibly reduce the demand for unnecessary radiological investigations such as CT. Level of evidence: Level 2.
Cost-Effectiveness of Adult Spinal Deformity Surgery
Authors: Alvarado Anthony M. , Schatmeyer Bryan A. , Arnold Paul M. 
Published: October 2020

Study Design: Review article. Objective: A review of the literature evaluating the cost-effectiveness of undergoing adult spinal deformity surgery and potential avenues for reducing costs. Methods: A review of the current literature and synthesis of data to provide an update on the cost effectiveness of undergoing adult spinal deformity surgery. Results: Compared with nonoperative management, operative management for adult spinal deformity is associated with improved patient-reported outcomes and quality of life; however, it is associated with significant financial and resource use. Conclusion: Operative management for adult spinal deformity has been shown to be effective but is associated with significant cost and resource utilization. The optimal operative treatment is highly dependent on the patients’ symptomatology and is surgeon dependent. Maximizing preoperative surgical health and minimizing postoperative complications are key measures in reducing the cost and resource utilization of adult spinal deformity surgery. Future studies are needed to evaluate how to optimize the cost-effectiveness.
Epilepsy and Malaria in Children Aged 1 to 15 Years in Parakou in 2018: Case-Control Study
Authors: Thierry Adoukonou , Falilatou Agbeille , Covalic Bokossa , Elodie Dovoedo , Mendinatou Agbétou , Didier Adedemy , Alphonse Noudamadjo , Joseph Agossou 
Published: October 2020

Objective:To study the link between malaria and epilepsy in children in Parakou district.Methods:This case-control study included children 1-15 years of age with epilepsy. Each case of epilepsy was matched to 2 controls for age, sex and neighborhood of residence. The exposure variables were a history of malaria (number and type), family history of epilepsy and other past medical history. The odds ratios (OR) and their confidence interval were used to estimate association.Results:A total of 123 children including 41 children with epilepsy and 82 controls were included. The overall average number of malaria episodes per year in both groups combined was 1.8 ± 0.9 episodes. In the multivariate analysis, cerebral malaria (OR: 50.35 [5.28-480.30]), family history of epilepsy (OR: 12.17 [2.15-69.01]) and number of malaria episodes (OR: 13.27 [4.53-98.48]) were associated.Conclusion:This study supports the association between cerebral malaria and the onset of epilepsy.
Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy
Authors: Tazaki Masakazu , Hirano Takaaki , Akiyama Yui , Mitsui Hiroyuki , Hirata Kazuaki , Niki Hisateru 
Published: October 2020

Background: Lateral column lengthening (LCL) for flexible flatfoot is an effective surgery with powerful correction of deformity because it tightens only the lateral third of the long plantar ligament (LPL). However, LCL has been associated with joint damage at the osteotomy site and loss of foot flexibility owing to joint fixation. We focused on the cuboid and investigate a novel anatomical LCL osteotomy site that effectively tightens the LPL without damaging any joints. Methods: We studied 24 feet of 12 cadavers (mean age, 80.8 years). The lengths of the LPL and short plantar ligament, locations of the attachments, and shape and location of the cuneocuboid joint on the medial side of the cuboid were studied. ImageJ software was used to measure the osteotomy angle. Results: The lateral cuboid attachment of the LPL on average was located 4.6 mm from the calcaneocuboid joint, and the cuneocuboid joint on average was located 6.7 mm from the cuboid-metatarsal joint on the medial surface of the cuboid. The direct line connecting the anterior cuneocuboid joint and the oblique crest of the cuboid on average was at a 10.3-degree inclination posterior to the cuboid-metatarsal joint. Conclusion: A straight line must be selected between a point 4 mm from the calcaneocuboid joint laterally and 6 mm from the cuboid-metatarsal joint medially at a 10-degree posterior tilt to the cuboid-metatarsal joint to perform a cuboid osteotomy LCL without damaging the articular surface. Clinical Relevance: We investigated a potential novel cuboid osteotomy method for LCL.
Reduced prevalence of SARS-CoV-2 infection in ABO blood group O
Authors: Barnkob Mike Bogetofte , Pottegård Anton , Støvring Henrik , Haunstrup Thure Mors , Homburg Keld , Larsen Rune , Hansen Morten Bagge , Titlestad Kjell , Aagaard Bitten , Møller Bjarne Kuno , Barington Torben 
Published: October 2020

Abstract
Identification of risk factors for contracting and developing serious illness following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of paramount interest. Here, we performed a retrospective cohort analysis of all Danish individuals tested for SARS-CoV-2 between 27 February 2020 and 30 July 2020, with a known ABO and RhD blood group, to determine the influence of common blood groups on virus susceptibility. Distribution of blood groups was compared with data from nontested individuals. Participants (29% of whom were male) included 473 654 individuals tested for SARS-CoV-2 using real-time polymerase chain reaction (7422 positive and 466 232 negative) and 2 204 742 nontested individuals, accounting for ∼38% of the total Danish population. Hospitalization and death from COVID-19, age, cardiovascular comorbidities, and job status were also collected for confirmed infected cases. ABO blood groups varied significantly between patients and the reference group, with only 38.41% (95% confidence interval [CI], 37.30-39.50) of the patients belonging to blood group O compared with 41.70% (95% CI, 41.60-41.80) in the controls, corresponding to a relative risk of 0.87 (95% CI, 0.83-0.91) for acquiring COVID-19. This study identifies ABO blood group as a risk factor for SARS-CoV-2 infection but not for hospitalization or death from COVID-19.
Fabrication and Physical Properties of Single-Crystalline Βeta-FeSi2 Nanowires
Authors: Yang Chih-Yung , Yang Shu-Meng , Chen Yu-Yang , Lu Kuo-Chang 
Published: October 2020

AbstractIn this study, self-catalyzed β-FeSi2 nanowires, having been wanted but seldom achieved in a furnace, were synthesized via chemical vapor deposition method where the fabrication of β-FeSi2 nanowires occurred on Si (100) substrates through the decomposition of the single-source precursor of anhydrous FeCl3 powders at 750–950 °C. We carefully varied temperatures, duration time, and the flow rates of carrier gases to control and investigate the growth of the nanowires. The morphology of the β-FeSi2 nanowires was observed with scanning electron microscopy (SEM), while the structure of them was analyzed with X-ray diffraction (XRD) and transmission electron microscopy (TEM). The growth mechanism has been proposed and the physical properties of the iron disilicide nanowires were measured as well. In terms of the magnetization of β-FeSi2, nanowires were found to be different from bulk and thin film; additionally, longer β-FeSi2 nanowires possessed better magnetic properties, showing the room-temperature ferromagnetic behavior. Field emission measurements demonstrate that β-FeSi2 nanowires can be applied in field emitters.
A Highly Sensitive FET-Type Humidity Sensor with Inkjet-Printed Pt-In2O3 Nanoparticles at Room Temperature
Authors: Wu Meile , Wu Zhanyu , Jin Xiaoshi , Lee Jong-Ho 
Published: October 2020

AbstractIn this work, Pt-doped In2O3 nanoparticles (Pt-In2O3) were inkjet printed on a FET-type sensor platform that has a floating gate horizontally aligned with a control gate for humidity detection at room temperature. The relative humidity (RH)-sensing behavior of the FET-type sensor was investigated in a range from 3.3 (dry air in the work) to about 18%. A pulsed measurement method was applied to the transient RH-sensing tests of the FET-type sensor to suppress sensor baseline drift. An inkjet-printed Pt-In2O3 resistive-type sensor was also fabricated on the same wafer for comparison, and it showed no response to low RH levels (below 18%). In contrast, the FET-type sensor presented excellent low humidity sensitivity and fast response (32% of response and 58 s of response time for 18% RH) as it is able to detect the work-function changes of the sensing material induced by the physisorption of water molecules. The sensing mechanism of the FET-type sensor and the principle behind the difference in sensing performance between two types of sensors were explained through the analysis on the adsorption processes of water molecules and energy band diagrams. This research is very useful for the in-depth study of the humidity-sensing behaviors of Pt-In2O3, and the proposed FET-type humidity sensor could be a potential candidate in the field of real-time gas detection.