bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of ELLA Approach to Measure Kidney Injury Molecule‐1
Authors: Krandel Jessica , Scheetz Marc H. , Gilchrist Annette 
Published: April 2020

Antibiotics with high nephrotoxic potential, such as polymyxins, are being used with increased frequency because of antibiotic resistance and few novel antibiotic agents. Dose escalation of polymyxins is limited by the kidney injury. The objective of this study was to develop a novel ELISA‐based assay using the ELLA instrument in an effort to increase sensitivity and decrease the amount of time required to detect sensitive biomarkers such as Kidney Injury Molecule‐1 (KIM‐1). KIM‐1 is a transmembrane glycoprotein expressed on the proximal convoluted tubule, shed into the urine and blood, and can be detected by ELISA as soon as 6 hours after cell injury, while remaining undetectable in persons with healthy kidneys. The FDA has qualified KIM‐1 for pre‐clinical and clinical study of drug‐induced nephrotoxicity. The ELLA platform has been reported to be more sensitive than MAGPIX for several biomarker assays such as IL‐1beta, PD‐L1, IL‐4, and TNF‐alpha. Improved sensitivity for KIM‐1 is needed for a blood assay as concentrations are considerably lower than the urinary assay counterpart. The ELLA platform is also reported to have better reproducibility given the reduction in manual steps. Each cartridge is manually loaded and then run hands‐off for approximately 1.5 hours.Using the ELLA open cartridge system we examined several commercially‐available monoclonal and polyclonal antibodies to human KIM‐1. Capture antibodies were digoxigenin‐labeled and detection antibodies were biotinylated. A standard curve was created by spiking diluent with known concentrations of rhKIM‐1. Two diluents were tested – SD13 (Biotechne) and PBS.Curves for rhKIM‐1 were run ranging from a minimum of 0.49 pg/mL to a maximum of 10000 pg/mL. Quality control urine and plasma samples of known concentrations were included with runs of unknown urine samples from patients treated with vancomycin. Results were analyzed using Graphpad Prism.We determined the optimum concentration for the detection and capture antibodies, and identified in which position
monoclonal and polyclonal antibodies performed better, providing the most sensitive and accurate assay. Currently measurement of KIM‐1 is done using an ELISA or MAGPIX approach. Thus, we compared the ELLA assay to a MAGPIX assay and found that the ELLA is quicker and provides a lower LLOQ. Further development of the ELLA approach may provide a test that can be rapidly employed in a hospital setting for blood or urine to examine KIM‐1 levels and identify patients at risk for acute kidney injury.Support or Funding InformationFunding: Kenneth A. Suarez Fellowship from Midwestern University, Biotechne, Intramural grant from Midwestern University (Chicago College of Pharmacy Pilot Grant, awarded to Dr. Gilchrist)
Dynamics of cytokines and heat shock proteins mRNA expression in thermally manipulated chicken challenged with intraperitoneally injection of Lipopolysaccharide (LPS).
Authors: Al-Zghoul Moh’d Borhan , Gerrard David , Dalloul Rami 
Published: April 2020

Heat stress is known to significantly affect broiler immunity and cytokine expression, but it is not yet clear how embryonic thermal manipulation (TM) might help alleviate the aforementioned effects. The aim of the present study was to evaluate the effects of TM on the splenic mRNA expressions of IL‐1β, IL‐6, TNF‐α, IFN‐α, IFN‐β, IFN‐γ, IL‐4, IL‐8, IL‐15, IL‐16, IL‐17, IL‐18, Hsp70 and HSF‐3 in broilers intraperitoneally injected with lipopolysaccharide (LPS). TM was performed by elevating the incubation temperature to 39°C at 65% relative humidity for 18 h daily during embryonic days 8 to 16. Whereas, control group was incubated at standard condition during the whole incubation period (37.8°C and 56% relative humidity). LPS was intraperitoneally injected at a dose of 0.5 mg/kg body weight (BW) on post‐hatch days 10 and 24. spleens was collected from all groups to evaluate mRNA expression by relative‐quantitative real‐time RT‐qPCR. TM results in alteration in the mRNA expression dynamics of cytokine and heat shock protein following intraperitoneally injection of LPS. The results of this study provided us with a valuable information about the mechanisms by which thermal manipulation may modify the immune system response in the thermally manipulated chicken.Support or Funding InformationDeanship of Research/ Jordan University of Science & Technology for its financial support of this work (Grant#: 44/2019).
Ultrasound’s limitations in investigating dynamic ligamentous ankle anatomy
Authors: Nix Jessica , McCullough Reid , Throckmorton Zachary 
Published: April 2020

The distal tibiofibular joint, or tibiofibular syndesmosis, is supported by the anterior and posterior inferior tibiofibular ligaments, tibiofibular interosseous membrane and ligament, and inferior transverse ligament. As a component of the ankle complex, the tibiofibular syndesmosis exhibits little mobility, with the fibula translating not only laterally (Harris 1991), but also posteriorly, with external rotation (Malhotra et al. 2019), during ankle dorsiflexion to accommodate the foot’s internal rotation and talar wedging. The mobility of the tibiofibular syndesmosis is relevant in both clinical and evolutionary contexts; disruption of the syndesmosis results in a high ankle sprain, one of the most recalcitrant orthopedic injuries (Gerber et al. 1998), and flexibility of the syndesmosis is thought to be critical to arboreal resource acquisition via tree climbing (Venkataraman, Kraft, and Dominy 2013). While Mei‐Dan et al. (2009) argued dynamic ultrasound investigation of the anterior inferior tibiofibular ligament could be used to diagnose distal tibiofibular syndesmotic injury after analyzing 47 professional athletes, to our knowledge no studies have sought to quantify basic normal variation of the tibiofibular interosseous ligament in non‐professional athletes (i.e., most people). We hypothesized the length of the tibiofibular interosseous ligament measured via ultrasound would be greater during closed‐packed dorsiflexion than closed‐packed standing in adults lacking a prior history of an ankle injury. Data were collected after obtaining informed consent from a mixed‐sex and mixed‐ancestry population of young adults (n = 78), via ultrasounding the distal tibiofibular joint during standing with the knee in closed‐packed position, measuring the tibiofibular interosseous ligament within the tibiofibular clear space, then measuring the same structure within the tibiofibular clear space during squatting with the ankle in closed‐packed position. We found approximately 25% of subjects’ tibiofibular interosseous ligaments decreased in length as measured by ultrasound – which we attribute to registration error inherent to the non‐reproducibility of consistent ultrasound probe placement throughout the ankle’s range of movement. These results cast doubt on the utility of ultrasound in investigating dynamic ligamentous ankle anatomy, consistent with the findings of Prakash (2018), and likely a consequence of the fibula’s complex pattern of motion relative to the tibia during ankle movement.Support or Funding InformationThis work was supported by the Arkansas College of Osteopathic Medicine.
Multiparametric cardiac magnetic resonance imaging of the heart in people with spinal cord injury
Authors: Scott Berkeley A. , Soriano Jan E. , Rosentreter Ryan E. , Satriano Alessandro , Dufour Antoine , Charbonneau Rebecca , Feuchter Patricia , Rivest Sandra , Sandonato Rosa , Flewitt Jacqueline , Garcia Julio , West Christopher , White James , Phillips Aaron 
Published: April 2020

Cardiovascular disease is the foremost cause of death for individuals with spinal cord injuries and is a patient priority in this population. To reduce cardiovascular disease, health care costs, and address key patient‐centered priorities, we must understand how and why heart health deteriorates after high‐level spinal cord injuries. Using high‐resolution cardiac magnetic resonance imaging and analysis approaches (ie., 4D strain analysis, 4D flow imaging, late gadolinium enhancement), our objective was to evaluate the impact of high‐level spinal cord injury on cardiac structure and function. Cardiac dimensions including chamber wall thickness were reduced in people with cervical spinal cord injury compared to matched controls and fibrosis was more apparent. Furthermore, we observed changes in global markers of strain in the heart including both longitudinal and circumferential strain after spinal cord injury. Cardiac magnetic resonance imaging revealed deficits in structure and function of the left ventricle after SCI. The next steps are to establish the risk factors leading to abnormal hearts after spinal cord injury, and develop strategies for prevention and treatment.Support or Funding InformationNatural Sciences and Engineering Research Council of Canada, Canadian Institutes of Health Research, Stephenson Cardiac Imaging Centre, University of Calgary, Libin Cardiovascular Institute, Hotchkiss Brain Institute, Campus Alberta Neuroscience, Clinical Neurosciences Pilot Research Fund Program, Compute Canada, Rick Hansen Institute, Wings for Life Foundation
Anti‐inflammation Ameliorates Repairment of Frostbite‐induced Skin Injuries
Authors: Tu Huiyin , Zhang Dongze , Wadman Michael C. , Muelleman Robert L. , Li Yu-Long 
Published: April 2020

Frostbite occurs when tissues freeze with cold external temperature. Freeze (ice crystals) destructs the cells and blood vessels, increases permeability in vessel walls and blood leaks into the tissues, and causes inflammation‐related further tissue damage. A mouse model of skin frostbite injuries was used to observe the effect of dexamethasone (Dex) on morphological recovery of damaged skin.Under anesthetized condition, C57/BL6 mice were subjected to 5 minutes of the freezing by placing magnets pre‐frozen in dry ice (−20°C) to create frostbite injuries on back skin within 3‐cm diameter circle. Dex treatment (1 mg/kg/day, i.p.) began on the day of frostbite induction and lasted for 7 days. Histological data demonstrated that frostbite resulted in swelling and severe skin damage from the first day, including epidermal necrosis and loss, blood vessel breaking, liquid leakage, degeneration of the panniculus adiposus and carnosus. Pro‐inflammatory factors (IL‐1β and TNFα) were elevated from day 3 to day 14 after frostbite (p < 0.05, compared to control), reaching the maximum level at day 7 after frostbite. After 7 days of frostbite, the skin tissue starts to regenerate. Treatment with Dex attenuated the elevation of TNFα and IL‐1β (p<0.05, compared to frostbite group), promoted CD31 expression (a marker for vascularization; p<0.05, compared to frostbite group), and accelerated collagen deposition and wound closure. These results suggest that Dex treatment attenuates frostbite‐induced inflammation and improves the tissue repairment.
What We Can Do About Maternal Mortality—And How to Do It Quickly
Authors: Mann Susan , Hollier Lisa M. , McKay Kimberlee , Brown Haywood 
Published: April 2020

(Abstracted from N Engl J Med 2018;379(18):1689–1691)
Women in the United States are more likely to die from childbirth- or pregnancy-related causes than women in any other high-income country, with black women dying at a rate 3 to 4 times that of white women. The Centers for Disease Control and Prevention identifies 3 types of complications as the most common potentially preventable causes of pregnancy-related death: postpartum hemorrhage, severe hypertension, and venous thromboembolism.
The Transition From Latent to Active Labor and Adverse Obstetrical Outcomes
Authors: Rosenbloom Joshua I. , Woolfolk Candice L. , Wan Leping , Stout Molly J. , Tuuli Methodius G. , Macones George A. , Cahill Alison G. 
Published: April 2020

(Abstracted from Am J Obstet Gynecol 2019;221:487.e1–487.e8)
Previously defined time limits for latent labor (defined as ending at 6 cm) have been removed by recommendations on preventing primary cesarean delivery (which also urge clinicians to avoid cesarean delivery for labor abnormalities in the latent phase). However, relatively little is known about the implications of labor curve abnormalities from 4 to 6 cm and subsequent outcomes.
Chromosomal Microarray vs. NIPS: Analysis of 5541 Low-Risk Pregnancies
Authors: Sagi-Dain Lena , Vig Lital Cohen , Kahana Sarit , Yacobson Shiri , Tenne Tamar , Agmon-Fishman Ifat , Klein Cochava , Matar Reut , Basel-Salmon Lina , Maya Idit 
Published: April 2020

(Abstracted from Genet Med 2019;21:2462–2467)
Prenatal genetic testing is conducted today using a variety of methods: noninvasive prenatal screening (NIPS) and invasive prenatal testing with karyotyping and/or chromosomal microarray analysis (CMA). While NIPS can detect some genetic aberrations without an invasive procedure, karyotyping and CMA require amniocentesis or chorionic villi sampling.
The Orthopaedic Trauma Service and COVID-19: Practice Considerations to Optimize Outcomes and Limit Exposure
Authors: Stinner Daniel J. , Lebrun Christopher , Hsu Joseph R. , Jahangir A. Alex , Mir Hassan R. 
Published: April 2020

Abstract:
The COVID-19 pandemic has presented challenges to healthcare systems, including the cancellation and then staged resumption of elective procedures. The orthopaedic trauma community has continued to provide care to patients with acute musculoskeletal injuries that cannot be delayed in all scenarios. This article summarizes and provides relevant information (orthopaedic trauma service, outpatient fracture clinic, inpatient surgery) to the practicing orthopaedic traumatologist on maximizing outcomes while limiting exposure during the pandemic.

Level of Evidence:
Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
Morbidity and Mortality in Critically Ill Children. I. Pathophysiologies and Potential Therapeutic Solutions*
Authors: Pollack Murray M. , Banks Russell , Holubkov Richard , Meert Kathleen L. ,   and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
Published: April 2020

Objectives:
Developing effective therapies to reduce morbidity and mortality requires knowing the responsible pathophysiologies and the therapeutic advances that are likely to be impactful. Our objective was to determine at the individual patient level the important pathophysiological processes and needed therapeutic additions and advances that could prevent or ameliorate morbidities and mortalities.

Design:
Structured chart review by pediatric intensivists of PICU children discharged with significant new morbidity or mortality to determine the pathophysiologies responsible for poor outcomes and needed therapeutic advances.

Setting:
Multicenter study (eight sites) from the Collaborative Pediatric Critical Care Research Network of general and cardiac PICUs.

Patients:
First PICU admission of patients from December 2011 to April 2013.

Interventions:
None.

Measurements and Main Results:
Two-hundred ninety-two patients were randomly selected from 681 patients discharged with significant new morbidity or mortality. The median age was 2.4 years, 233 (79.8%) were in medical/surgical ICUs, 59 (20.2%) were in cardiac ICUs. Sixty-five (22.3%) were surgical admissions. The outcomes included 117 deaths and 175 significant new morbidities. The most common pathophysiologies contributing to the poor outcomes were impaired substrate delivery (n = 158, 54.1%) and inflammation (n = 104, 35.6%). There were no strong correlations between the pathophysiologies and no remarkable clusters among them. The most common therapeutic needs involved new drugs (n = 149, 51.0%), cell regeneration (n = 115, 39.4%), and immune and inflammatory modulation (n = 79, 27.1%). As with the pathophysiologies, there was a lack of strong correlations or meaningful clusters in the suggested therapeutic needs.

Conclusions:
There was no single dominant pathophysiology or cluster of pathophysiologies responsible for poor pediatric critical care outcomes. Therapeutic needs often involved therapies that are not close to implementation such as cell regeneration, improved organ transplant, improved extracorporeal support and artificial organs, and improved drugs.
Reducing Cardiac Arrests in the PICU: Initiative to Improve Time to Administration of Prearrest Bolus Epinephrine in Patients With Cardiac Disease*
Authors: Ferguson Lee P. , Thiru Yamuna , Staffa Steven J. , Guillén Ortega Margarita 
Published: April 2020

Objectives:
To evaluate the effectiveness of a quality-improvement initiative in reducing cardiac arrests in infants and children in the cardiac ICU.

Design:
Prospective observational before-after cohort study.

Setting:
Single pediatric cardiac ICU in the United Kingdom.

Patients:
All patients less than 18 years old admitted to the ICU.

Intervention:
Initial interdisciplinary training in cardiac arrest prevention followed by clinical practice change whereby patients with high-risk myocardium were identified on daily rounds. High-risk patients had bolus epinephrine preordered and prepared for immediate administration in the event of acute hypotension.

Measurements and Main Results:
Interrupted time series analysis was used to compare the cardiac arrest rate in the 18 months before and 4.5 years after implementation. Mean monthly cardiac arrest rate was 17.2 per 1,000 patient days before and 7.6 per 1,000 patient days after the initiative (56% decrease). Patient characteristics and ICU interventions were similar in the control and intervention periods. In the time series analysis, monthly cardiac arrest rate in the ICU decreased by 12.4 per 1,000 patient days (95% CI, –1.5 to –23.3; p = 0.03) immediately following the intervention, followed by a nonsignificant downward trend of 0.36 per 1,000 patient days per month (95% CI, –1.3 to 0.6; p = 0.44). Bolus epinephrine was administered during 110 hypotension events in 77 patients (eight administrations per 1,000 ICU days); responder rate was 77%. There were no significant changes in ICU and hospital mortality.

Conclusions:
Implementation of the initiative led to a significant, sustained reduction in ICU cardiac arrest rate.
Relationship Between Preoperative Gait Speed and Discharge Disposition After Open Heart Surgery: An Observational Study
Authors: Wilson Christopher M. , Willett Darian , Kostsuca Stephanie 
Published: April 2020

Purpose:
To examine the relationship between gait speed before open heart surgery and discharge disposition. The hypothesis was that slower gait speeds before surgery may increase the likelihood of discharge to a skilled nursing facility after surgery and faster gait speeds may predict that patients were more likely to discharge home.

Methods:
Retrospective analysis of 720 medical records. Gait speed was measured through a 5-m walk test before cardiac surgery. Discharge disposition was examined for a relationship to gait speed.

Results:
Slower gait speeds before surgery increased the likelihood of discharge to a rehabilitation facility or a skilled nursing facility while faster gait speeds increased the likelihood of discharge home. Mean gait speed for discharge home (5.2 seconds) was statistically significantly different from discharge to rehab or institution (6.9 seconds, P < .0001). There was also a significant correlation between discharge disposition and preoperative assistive device use (P < .0001).

Conclusions:
Slower gait speeds before surgery showed an increased likelihood of discharge to a skilled nursing facility after surgery, and faster gait speeds lead to patients being able to go home after the surgery.
Occupational Contamination with a Highly Enriched Uranium Solution
Authors: Mullinax Ross A. , Iddins Bart O. , Alday Michael A. , McLaughlin David A. 
Published: April 2020

Abstract
This medical case report describes the first reported instance of occupational skin contamination with a uranyl nitrate solution containing highly enriched uranium. The report provides an overview of the unique medical treatment and management considerations in such a case. Internal dose assessment is covered in detail. The discussion covers key points regarding uranium characteristics, chemical and radiological damage to body tissues from HEU exposure, and resources available for assistance with a case of radiological contamination. This information adds to the limited medical literature on this topic and provides a valuable reference for medical personnel when dealing with this uncommon problem.
CLINICAL CHARACTERISTICS AND NATURAL HISTORY OF RHO-ASSOCIATED RETINITIS PIGMENTOSA
Authors: Nguyen Xuan-Thanh-An , Talib Mays , van Cauwenbergh Caroline , van Schooneveld Mary J. , Fiocco Marta , Wijnholds Jan , ten Brink Jacoline B. , Florijn Ralph J. , Schalij-Delfos Nicoline E. , Dagnelie Gislin , van Genderen Maria M. , de Baere Elfride , Meester-Smoor Magda A. , De Zaeytijd Julie , Balikova Irina , Thiadens Alberta A. , Hoyng Carel B. , Klaver Caroline C. , van den Born L. Ingeborgh , Bergen Arthur A. , Leroy Bart P. , Boon Camiel J.F. 
Published: April 2020

Purpose:
To investigate the natural history of RHO-associated retinitis pigmentosa (RP).

Methods:
A multicenter, medical chart review of 100 patients with autosomal dominant RHO-associated RP.

Results:
Based on visual fields, time-to-event analysis revealed median ages of 52 and 79 years to reach low vision (central visual field <20°) and blindness (central visual field <10°), respectively. For the best-corrected visual acuity (BCVA), the median age to reach mild impairment (20/67 ≤ BCVA < 20/40) was 72 years, whereas this could not be computed for lower acuities. Disease progression was significantly faster in patients with a generalized RP phenotype (n = 75; 75%) than that in patients with a sector RP phenotype (n = 25; 25%), in terms of decline rates of the BCVA (P < 0.001) and V4e retinal seeing areas (P < 0.005). The foveal thickness of the photoreceptor–retinal pigment epithelium (PR + RPE) complex correlated significantly with BCVA (Spearman's ρ = 0.733; P < 0.001).

Conclusion:
Based on central visual fields, the optimal window of intervention for RHO-associated RP is before the 5th decade of life. Significant differences in disease progression are present between generalized and sector RP phenotypes. Our findings suggest that the PR + RPE complex is a potential surrogate endpoint for the BCVA in future studies.
Atypical Corneal Ectasia Associated With Vitamin C Deficiency
Authors: Clijsters Leen , Van Wijngaerden Eric , Delbeke Heleen 
Published: April 2020

Purpose:
To demonstrate a possible correlation between corneal ectasia and vitamin C deficiency.

Methods:
Case series.

Results:
This case series covers 3 patients with atypical features of corneal ectasia. All 3 had a peculiar general history and visited our tertiary ophthalmology department complaining about decreased visual acuity. Corneal tomography by Scheimpflug imaging (Pentacam) indicated an irregular astigmatism congruent with a corneal ectasia. A blood test diagnosed vitamin C deficiency.

Conclusions:
To the best of our knowledge, this is the first time a possible correlation between corneal ectasia and vitamin C deficiency is established. Although more research is of course of the essence, it proves useful to determine vitamin C plasma levels in patients presenting with atypical ectasia. To the extent that vitamin C deficiency is indeed diagnosed, it should be substituted orally.