bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Preradiotherapy Education on Anxiety in Parents of Under-Five Children Undergoing Radiation Therapy for the First Time
Authors: Halemani Kurvatteppa , Kumar Basant 
Published: November 2020

Abstract

Introduction
Radiation or radiotherapy is a kind of cancer treatment where high-intensity rays are used to destroy abnormal cells. It is used for therapeutic as well as diagnostic purpose of various malignant diseases. The purpose of the study is to determine the parent's anxiety on radiotherapy and render valid radiotherapy teaching materials. A case study on Wilms' tumor is used to frame the study for pediatric surgical nurses.

Methods and Material
A longitudinal, single-center, quasi-experimental one-group pretest–posttest research design was adopted. Samples were based on convenient sampling techniques for those who fulfilled the inclusion criteria. Separate instruments were used for demographic information and the anxiety of parents. Data were collected from November 2018 to December 2019.

Result
Demographic characteristics measured by descriptive statistics in 26 patients. Most of the participants were aged between 36 and 45 years (n = 17, 65.4%); participants were fathers (n = 19, 73.1%) who had completed high school or college (n = 23, 88.5%) and parents with one or two children. There were no significant differences in parents' age, gender, and number of children. Most of the children were of preschool age (n = 23, 88.5%) and were male (n = 16, 61.5%) diagnosed with a malignant tumor (n = 18, 69.2%).
For the parents, education and family income were associated with less preoperative anxiety (p = .05). There were no significant differences in variables of the child's gender and type of tumor, whereas younger age was found significant for more anxiety (p = .05). The effectiveness of results showed that the paired t test was −10.25; mean and standard deviation in preintervention and postintervention were 70.61 ± 4.85 versus 54.80 ± 9.26, respectively.

Discussion
The present study finding was supported by previous studies, which imply that educational materials, charts, printed materials, and pamphlets remained highly significant on anxiety scores of parents of under-five children. Hence, the researcher assumed that preradiotherapy education intervention was effective for parents of under-five children.
Death and Grieving for Family Caregivers of Loved Ones With Life-Limiting Illnesses in the Era of COVID-19
Authors: Holland Diane E. , Vanderboom Catherine E. , Dose Ann Marie , Moore Derek , Robinson Kelly V. , Wild Ellen , Stiles Carole , Ingram Cory , Mandrekar Jay , Borah Bijan , Taylor Erin , Griffin Joan M. 
Published: November 2020

Purpose:
Family caregivers of a loved one with a life-limiting or terminal illness are often overwhelmed by, and underprepared for, their responsibilities. They often need help from family members and friends to provide comprehensive care. When death occurs, funerals and other death-related rituals bring family and communities together to honor the life and mourn the death of a loved one and provide needed support to family and caregivers. These collective rituals are often deeply rooted in culturally-bound values and can facilitate grief and help make sense about loss. Rituals act as bridge-building activities that allow people to organize and appraise emotions, information, and actions after a loss. With the emergence of the coronavirus disease-2019 (COVID-19) pandemic and the recommended restrictions to reduce infection and transmission, family members and caregivers are often faced with weighing options for honored rituals to help them grieve. Grieving during the pandemic has become disorganized. The purpose of this article is to provide case managers and other clinical staff with recommendations on guiding caregivers/families through safety precautions when a loved one dies either because of a life-limiting illness or from COVID-19 during the pandemic using guidelines from the Centers for Disease Control and Prevention (CDC). The authors also present information about complicated grief and ways to support coping with death and suggest safe alternatives to traditional death-related rituals and funerals in a COVID-19 era.

Primary Practice Setting(s):
Primary practice settings include home health care, hospice, hospital discharge planning, case management, and primary care.

Findings/Conclusions:
Precautions necessary in a COVID-19 era may add anxiety and stress to an already difficult situation of caring for loved ones at end-of-life and grieving with their loss. Utilization of CDC guidelines lessens the risk of infection while honoring loved ones' wishes and cultural traditions surrounding death and burial. Recognition of social and spiritual connections that comfort mourners must also be considered.

Implications for Case Management Practice:
Lower-Dose Propofol Use for MRI
Authors: Johnson Kay L. , Cochran Joel , Webb Sally 
Published: November 2020

ObjectiveThe aim of the study was to evaluate, in children undergoing procedural sedation for magnetic resonance imaging (MRI) scans, whether lower doses of propofol than previously published permitted a high rate of successful MRI completion, whether lower dosages result in a more rapid recovery, and whether age or behavioral diagnosis increases propofol requirements.MethodsAfter institutional review board approval, we retrospectively reviewed the pediatric sedation team's sedation database of children receiving propofol infusion for MRI scans between 2007 and 2016. Data collected included propofol induction dose (in milligrams per kilogram), propofol infusion dose (in micrograms per kilogram per hour), total propofol dose (in milligrams per kilogram and in milligrams per kilogram per hour), and the number of administered ancillary sedative medications. Additional data included the American Society of Anesthesiologist status, sedation duration, recovery duration, and successful completion of MRI. Dosing data were also stratified by age.ResultsA total of 2354 patients met inclusion criteria. Eight percent of patients received propofol infusion alone, 79% received midazolam before their propofol induction, and 13% received a combination of propofol and other drugs. Mean induction dose was 2.2 + 0.9 mg/kg, mean infusion dose was 93.5 + 29.0 μg/kg per minute, and total mean dose was 9.0 + 3.0 mg/kg per hour. Mean recovery time was 44 minutes, and 99.3% of the scans were completed with good images. We noted an increase requirement in the mean induction dose and total dose in children younger than 1 year.ConclusionsPropofol infusion doses lower than commonly reported permit successful completion of scans and similar recovery times in a single institution. Younger children require more propofol for successful procedural sedation.
Influence of dapivirine vaginal ring use on cervicovaginal immunity and functional microbiome in adolescent girls
Authors: Farr Zuend Christina , Noël-Romas Laura , Hoger Sarah , McCorriser Stuart , Westmacott Garrett , Marrazzo Jeanne , Hillier Sharon L. , Dezzutti Charlene , Squires Kathleen , Bunge Katherine E. , Burgener Adam 
Published: November 2020

Objective:
The antiretroviral-based dapivirine vaginal ring reduced HIV risk among women in phase III clinical trials. However, limited data exists on the impact of dapivirine on the vaginal microenvironment in adolescents.

Design:
A comprehensive metaproteomics approach was used to assess host proteome and microbiome changes in cervicovaginal mucus with dapivirine ring use in adolescents enrolled in the MTN-023/IPM 030 (MTN-023) trial.

Methods:
Participants were randomized 3 : 1 to use dapivirine or placebo vaginal rings monthly for 6 months. Cervicovaginal samples from a subset of 35 participants (8 placebo, 27 dapivirine) were analyzed.

Results:
Mass spectrometry analysis identified 405 human and 2467 bacterial proteins belonging to 15 unique genera. The host proteome belonged to many functional pathways primarily related to inflammation. When stratified by study treatment arm, 18 (4.4%) and 28 (6.9%) human proteins were differentially abundant (adjusted P < 0.05) between baseline and follow-up in the placebo and dapivirine arms, respectively. The vaginal microbiome was predominantly composed of Lactobacillus, Gardnerella, and Prevotella. Although bacterial taxa did not differ by arm or change significantly, Lactobacillus crispatus increased (P < 0.001) and Lactobacillus iners decreased (P < 0.001) during the 6-month follow-up. There were no significant differences in bacterial functions by arm or time in the trial. Protected vaginal sex significantly associated with decreased neutrophil inflammatory biomarkers and may be associated with changes in bacterial taxa and metabolism.

Conclusion:
Condom use may associate with differences to inflammation and bacterial function but dapivirine ring use does not, thereby supporting the mucosal safety profile of this vaginal ring for adolescents.
A Novel Design of V-shaped Radial Forearm Free Flap Facilitates the Direct Closure of Donor Site Wound
Authors: Li Hao , Xu Wenguang , Wang Yuxin , Liu Zhe , Cao Yazhou , Han Wei 
Published: November 2020

Abstract
The radial forearm free flap (RFFF) is one of the commonly used flaps in the repair of head and neck soft tissue defects, especially small and medium-sized defects. The free skin grafts from abdomen are usually used to repair the RFFF donor site wound. This study aims to design a novel V-shaped RFFF, hoping that it might facilitate the direct closure of the forearm donor site wound. From August to December in 2019, 20 patients with oral cancers received radical surgeries, and V-shaped RFFFs were designed to repair the soft defects and the forearm donor site wound was directly closed. The patients were followed up for 6 months to assess the final outcome of repair. The results showed that the pre-designed V-shaped RFFF met the needs of soft tissue defect repair, with the size ranging from 24 cm2 to 30 cm2. Fifteen patients with tongue cancers and four with buccal cancers had satisfactory repair results, and only one patient with buccal cancer had mild limitation of mouth opening. There were 3 patients with a small area of ischemia. The mean postoperative hospital stay was 13.85 ± 1.09 days. In 5 patients, wrist tilt motility decreased compared with that before surgery. The postoperative influence score of wrist exercise on daily life was 2.75 ± 0.44 points. In conclusion, the V-shaped RFFF can meet the needs of small and medium-sized defect repair. This novel design can directly close the forearm donor site wound, which avoids surgical trauma to secondary donor site, and significantly reduces related complications.
Perioperative Outcomes of Rectovaginal Fistula Repair Based on Surgical Approach: A National Contemporary Analysis
Authors: Raju Rubin , Linder Brian J. , Bews Katherine A. , Tappy Erryn , Habermann Elizabeth B. , Occhino John A. 
Published: November 2020

Objective
To compare the perioperative outcomes of transvaginal/perineal and abdominal approaches to rectovaginal fistula (RVF) repair using a national multicenter cohort.

Methods
The American College of Surgeons National Surgical Quality Improvement Program database was utilized to identify women undergoing RVF repair from 2005 to 2016. Emergent cases and those with concomitant bowel diversion were excluded. Baseline patient demographics, procedure characteristics, 30-day postoperative complications, return to the operating room, and readmission were evaluated. Baseline characteristics were compared across surgical approach. Multivariable logistic regression models identified preoperative characteristics independently associated with postoperative complications.

Results
A total of 2288 women underwent RVF repair: 1560 (68.2%) via transvaginal/perineal approach and 728 (31.8%) via abdominal approach. Patients undergoing transvaginal/perineal repair were significantly younger (median age, 46 years vs 63 years), with lower American Society for Anesthesiologist (ASA) scores, and less frequency of diabetes mellitus, dyspnea, severe chronic obstructive pulmonary disease, hypertension, disseminated cancer, and bleeding disorders (all P < 0.01). Those undergoing abdominal repair had higher rates of major complications (25.8% vs 8.7%), minor complications (13.5% vs 6.3%), and readmission (13.2% vs 7.8%). On multivariable analyses, ASA Class 3/4, disseminated cancer, and hematocrit <30% (P < 0.01) were associated with major complications in both groups.

Conclusions
Patients undergoing RVF repair via abdominal approach were older with more comorbidities and had higher postoperative complications rates, likely secondary to underlying differences in the treated populations. Irrespective of surgical approach, ASA class, disseminated cancer, and preoperative anemia were associated with higher postoperative morbidity. This may enhance preoperative counseling and allow for careful patient selection.
Mesenteric lymphadenopathy in COVID-19 infection (Jammu and Kashmir sign) as a presenting sign in adult: case report
Authors: Wani Imtiaz , Tantray Hanief M. , Agha Nadeem , Rashid Masood , Lone Wasim , Younus Umar , Khan Nawab , Ashraf Samina , Pandith Samiullah , Jan Tariq 
Published: November 2020

Introduction:
Mesenteric lymphadenopathy in an adult with gastrointestinal COVID-19 infection is a very rare. Ultrasonography is helpful in the diagnosis of mesenteric lymphadenopathy in COVID-19 infection.

Presentation of Case:
A 33-year-old man presented with recurrent abdominal pain of 5 days duration. Ultrasonography and computed tomography of abdomen documented findings of the diffuse mesenteric lymphadenopathy, mostly on the left upper abdomen followed by right upper abdomen. Real time-polymerase chain reaction for SARS-CoV-2 was found reactive. Patient was managed by the local protocol and had regression of mesenteric lymphadenopathy.

Discussion:
This is a first kind of case report where an adult patient having gastrointestinal COVID-19 infection presented with mesenteric lymphadenopathy only and named as the “Jammu and Kashmir sign (JK sign) in COVID-19 infection.”

Conclusion:
Mesenteric lymphadenopathy in an adult with COVID-19 infection is very rare. This may be the only presenting sign in gastrointestinal COVID-19 infection.
Neuroanatomical abnormalities in a nonhuman primate model of congenital Zika virus infection
Authors: Seelke Adele M. H. , Beckman Danielle , Bennett Jeffrey , Dougherty Paige , Van Rompay Koen K. A. , Keesler Rebekah I. , Pesavento Patricia A. , Coffey Lark L. , Morrison John H. , Bliss-Moreau Eliza 
Published: November 2020

AbstractZika virus (ZIKV) infection of pregnant women can cause major congenital neuronal abnormalities. In the present study, we evaluated neuropathological consequences of fetal ZIKV exposure in rhesus macaques, a highly translatable animal model for human neural development. Quantitative neuroanatomical analyses of the nearly full-term brains of fetuses infected with ZIKV at gestational days 50, 64, and 90, and three procedure-matched sham-inoculated controls were carried out. Whole tissue sections across a complete cerebral hemisphere were evaluated using immunohistochemical and neuroanatomical staining techniques to detect virus localization, identify affected cell types and evaluate gross neuroanatomical abnormalities. None of the subjects were microcephalic. Immunohistochemical staining revealed the presence of ZIKV in the frontal lobe, which contained activated microglia and showed increased apoptosis of immature neurons. ZIKV-infected animals exhibited macrostructural changes within the occipital lobe, including a reduction in gyrification as well as a higher proportion of white matter. Finally, the ZIKV-infected subjects had abnormalities throughout the visual pathway, including disorganization within the lateral geniculate nucleus (LGN) and primary visual cortex (V1). Regional differences tracked with the temporal patterns of the developing brain and likely reflect the neural progenitor cell tropism ZIKV exhibits – painting a picture of inflammatory processes related to viral infiltration sweeping through the cortex, followed by a wave of cell death resulting in morphological changes. These findings may help explain why some infants born with normal sized heads during the ZIKV epidemic manifest developmental challenges as they age, and ultimately may contribute to developing effective treatments and interventions.One sentence summaryMacaque fetuses infected with Zika virus show both macro- and micro-scale neuropathological abnormalities, including decreased gyrencephality, relative increases in cortical white matter, activation of glia, and increased apoptosis.
Neuromesodermal Progenitors Advance Network Formation of Spinal Neurons and Support Cells in Neural RibbonsIn Vitroand Unprotected Survival in a Rat Subacute Contusion Model
Authors: Olmsted Zachary T. , Stigliano Cinzia , Scimemi Annalisa , Marzullo Brandon , Wolfe Tatiana , Cibelli Jose , Horner Philip J. , Paluh Janet L. 
Published: November 2020

AbstractImproved human stem cell interventions to treat CNS trauma requires continued expansion ofin vitromodels and delivery platforms to fill gaps in analysis and treatment. Transplanted neural stem cells (NSCs) face unique, multi-faceted challenges beyond survival that include differentiation, maturation, and integration into a complex cytokine-releasing microenvironment that impinges on a multipotent cell type. Alternate strategies to transplant neurons and neuronal networks deserve reevaluation, particularly since novel differentiation protocols mimicking region-specific developmental and positional cues have recently emerged. To investigate transplantation of neurons and their early networks, we generatein vitroneural ribbons containing spinal neurons and support cells anatomically matched for cervical spinal cord injury (SCI). These glutamate-responsive, electrically-active neural ribbons apply a new hiPSC differentiation strategy transiting through neuromesodermal progenitors (NMps) to derive developmentally relevant spinal motor neurons (SMNs), interneurons (INs), and oligodendrocyte progenitor cells (OPCs). Bioinformatic profiling validates region-specific identities. Neurons and neuronal networks are functionally evaluated for action potential firing, calcium signaling, population activity, and synaptogenesis. NMp-derived neurons survivein vivowithin the subacute phase hemi-contusion injury cavity when delivered either as free suspension or as encapsulated networks of pre-formed CNS cytoarchitectures. Delivery as encapsulated networks further supports survival of lower cell numbers and rapid graft penetration into host tissue. Neural network ribbons therefore provide a novel intermediary approach between cell suspensions and complex organoids for investigating network formation and early transplantation events with hiPSC-derived neurons, providing flexibility to rapidly tune cell type(s), cell ratios, and traceable biomarkers.Significance StatementIn the two decades since human stem cell technologies have emerged, the challenge has remained to improve the developmentally relevant derivation of therapeutic cells. The ability to now generate anatomically matched neurons for SCI necessitates a re-evaluation of these cells and their networksin vitroandin vivo. In this study, we apply developmental cues via neuromesodermal progenitors to generate spinal neurons from hiPSCs. Genetic and functional evaluation of these cells asin vitroneuronal networks, due to their capacity to survive and graft effectively within the rat subacute contusion cavity, offer novel approaches for customizing SCI transplantation. This work demonstrates a strategy to develop transplantable, chemically-responsive networks linkingin vitromodels with injury customization towards improvedin vivooutcomes.
Maternal nutritional stress alters sperm competence in male mice offspring leading to reduced fertility
Authors: Muranishi Yuki , Parry Laurent , Vachette-Dit-Martin Mélanie , Saez Fabrice , Coudy-Gandilhon Cécile , Sauvanet Pierre , Volle David , Tournayre Jérémy , Bottari Serge , Carpentiero Francesca , Escoffier Jessica , Bruhat Alain , Maurin Anne-Catherine , Averous Julien , Arnoult Christophe , Fafournoux Pierre , Jousse Céline 
Published: November 2020

AbstractInfertility represents a growing burden worldwide, with one in seven couples presenting difficulties conceiving. Amongst these, 10-15% of the men have idiopathic infertility that does not correlate with any defect in the classical sperm parameters measured. In the present study, we used a mouse model to investigate the effects of maternal undernutrition on fertility in male progeny. Our results indicate that mothers fed on a low protein diet during gestation and lactation produce male offspring with normal sperm morphology, concentration and motility but exhibiting an overall decrease of fertility when they reach adulthood. Particularly, sperm from these offspring show a remarkable lower capacity to fertilize oocytes when copulation occurs early in the estrus cycle relative to ovulation, due to an altered sperm capacitation.Our data demonstrate for the first time that maternal nutritional stress can have long-term consequences on the reproductive health of male progeny by affecting sperm physiology, especially capacitation, with no observable impact on spermatogenesis and classical quantitative and qualitative sperm parameters. Moreover, our experimental model could be of major interest to study, explain, and ultimately treat certain categories of infertilities.