bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observation of asexual reproduction with symbiont transmission in planktonic foraminifera
Authors: Takagi Haruka , Kurasawa Atsushi , Kimoto Katsunori 
Published: June 2020

AbstractGamete release has been frequently observed in laboratory cultures of various species of planktonic foraminifera. Those observations have been taken as evidence that these organisms produce new generations exclusively by sexual reproduction. We report here the first observation of asexual reproduction in Globigerinita uvula, a small, microperforate foraminifera. The asexual phase was associated with the release of ca. 110 offspring, all of which hosted symbiotic algae that must have been passed on directly from the parent. This event was also the first observation of vertical transmission of symbionts in planktonic foraminifera. Although the trigger of the observed asexual reproduction and its frequency in nature remain unknown, our observation indicates that among the planktonic foraminifera, at least G. uvula has not abandoned the asexual phase of its life cycle.
Medial Plating of Pauwels Type III Femoral Neck Fractures Decreases Shear and Angular Displacement Compared with a Derotational Screw
Authors: Nwankwo Chima D. , Schimoler Patrick , Greco Victor , Kharlamov Alexander , Westrick Edward R. , Miller Mark Carl 
Published: June 2020

Objectives:
The purpose of this mechanical study was to compare 2 methods of augmented stabilization of Pauwels type III femoral neck fractures.

Methods:
Ten matched pairs of young cadaveric femurs were cut 22 cm distal to the lesser trochanter. All specimens received a 70-degree osteotomy, which was stabilized with a 135-degree sliding hip screw. One of each pair received augmented fixation with a 6.5 mm fully threaded cannulated screw. The other specimen in the matched pair had additional fixation with a 3.5 mm 5-hole tubular plate placed at the inferior-medial femoral neck. Each specimen was tested under cyclic axial loading conditions (5000 cycles between 200 and 1400 N at 2 cycles/sec) and subsequently loaded to failure. The angular displacement (varus), interfragmentary (shear) displacement, and failure loads were calculated.

Results:
In the augmented plate group, 7 specimens failed by angular displacement and 3 failed by shear displacement. In the augmented screw group, 8 specimens failed by angular displacement and 2 by shear displacement. The plate group was found to have significantly less angular displacement, regardless of completed cycles, than the augmented screw group (0.75 ± 0.35 degrees vs. 2.15 ± 1.99 degrees averaged across completed cycles, P < 0.01). Similarly, the plate group was found to have significantly less shear displacement, regardless of completed cycles, than the augmented screw group (0.77 ± 0.70 mm vs. 1.22 ± 0.92 mm averaged across completed cycles, P = 0.01). The average failure load of the plate group (4930 ± 1578 N) was also larger but not significantly different from the screw group (3824 ± 2140 N), P = 0.12.

Conclusions:
Augmenting sliding hip screw stabilization of a Pauwels type III fracture with a medial plate applied to the femoral neck significantly decreases angular displacement and shear displacement compared with augmentation with a derotational screw.
Risk of Injury to the Neurovascular Structures in the Pararectus Approach Used in Acetabular Fractures: A Cadaver Study
Authors: Kati Yusuf A. , Kose Ozkan , Acar Baver , Turan Adil , Ozturk Serra , Sindel Muzaffer 
Published: June 2020

Objectives:
Complex acetabular fractures involving the quadrilateral plate may necessitate infrapectineal buttress plating, which can be performed through the pararectus approach. The aim of this cadaveric study was to identify the anatomical guide points to protect neurovascular structures at the risk of injury during the pararectus approach.

Methods:
Six fresh frozen cadavers (12 hemipelves) were dissected in this study. Location of the inferior epigastric artery (IEA), obturator nerve and corona mortis (CM) was measured using common anatomic landmarks, namely, anterior superior iliac spine, symphysis pubis (SP), and sacroiliac (SI) joint.

Results:
In the superficial dissection of the abdominal wall, the mean distance between the IEA and anterior superior iliac spine was 106.7 ± 5.2 (range, 99.2–116.4) mm, and the mean distance between IEA and SP was 77.9 ± 3.5 (range, 70.6–82.2) mm. In deep dissection, the mean distance between the SI joint and the SP was 133.1 ± 5.7 (range, 126.0–142.0) mm. The mean distance between the SI joint and ON was 37.3 ± 2.8 (range, 31.0–41.0) mm. The CM was unable to be detected in 2 cadavers, 1 on the right and 1 on the left hemipelves. The mean distance between the CM and SP was 47.7 ± 3.9 (range, 43.0–55.0) mm.

Conclusions:
A pararectus approach is a useful approach which allows infrapectineal plating in the treatment of complex acetabular fractures; however, the preservation of critical neurovascular structures is essential during dissection. This study is helpful to identify the structures at risk according to commonly used anatomic landmarks. These data might be a necessary guideline for hip and trauma surgeons.
Abdominal Involvement in Children With Bacteriologically Confirmed Tuberculosis
Authors: Sartoris Giulia , Seddon James A. , Rabie Helena , Nel Etienne D. , Losurdo Giuseppe , Schaaf H. Simon 
Published: June 2020

Background:
Abdominal tuberculosis (TB) in children is poorly described and often poses a diagnostic challenge. We evaluated abdominal involvement in children presenting with bacteriologically confirmed TB.

Methods:
We undertook a retrospective study at Tygerberg Hospital, Cape Town, from January 1, 2014, through December 31, 2018, of all children (<13 years) diagnosed with bacteriologically confirmed TB, in whom abdominal involvement was found. Demographic and clinical data were collected through folder review, laboratory records and imaging reports.

Results:
Of 966 children with bacteriologically confirmed TB, 111 (11.5%) had abdominal involvement; 16 (14.4%) were excluded from further analysis because of lack of clinical data. The median age of the remaining 95 children was 43 months (interquartile range 20–94); 26 (27%) were HIV positive. The main gastrointestinal symptoms/signs were weight loss (84.2%), abdominal distention (54.7%), hepatomegaly (60.0%) and abdominal pain (26.3%). The main pathologic types were intra-abdominal lymph nodes (68.4%), solid organ involvement (54.7%), peritoneal type (23.2%) and intestinal type (10.5%). Splenic abscesses and solid organ involvement on ultrasonography were more common in HIV-positive children (P < 0.001 and P = 0.008, respectively). Liver abscesses were associated with age less than 5 years (P = 0.03), while abdominal lymphadenopathy on ultrasonography was more common in children older than 5 years (P = 0.038). Abdominal specimens were collected in an attempt to identify Mycobacterium tuberculosis in 15 of 95 (15.8%) patients and were positive in 13 of 15 (86.7%).

Conclusions:
Over 10% of children with confirmed TB had abdominal involvement. Abdominal TB should be considered in any pediatric TB case with abdominal symptoms, and ultrasonography should be the radiologic study of choice.
Conceptual aspects, impact, and state of the art of dependent prescription in Brazil: narrative review
Authors: Andrade Heuler S. , Guimarães Eliete A.A. , Obreli Neto Paulo R. , Pereira Mariana L. , Zanetti Maria O.B. , Reis Tiago M. , Baldoni André O. 
Published: June 2020

Abstract

Background:
Nonmedical prescription is recognized in several countries as an excellent strategy in facing emerging demands that put a strain on the health system. It is a practice carried out by professionals who are not doctors and who, after obtaining specific qualifications and legal authorization, can prescribe medication and curatives. In Brazil, although there is already a legal subsidy for prescription in some professions, it is still an underdeveloped activity with few studies.

Objective:
This study aimed to describe the conceptual aspects and state of the art of this type of prescription in Brazil.

Methods:
It is a narrative review of the literature that included national and international regulations related to the subject, as well as available articles, published in electronic journals in different databases. Key terms used were nonmedical prescription, nursing prescription, and pharmaceutical prescription.

Results:
It was evidenced that nonmedical prescription has ample potential for improving the quality of care and the health conditions of patients. One can highlight as positive results the improvement of work satisfaction and self-confidence of those who have developed this practice; improvement of teamwork reported by other professionals due to the reduction of work overload; greater patient satisfaction in relation to access; and care provided by prescribers.

Conclusions:
It is understood that there are many challenges for the consolidation of this activity in Brazil and that its success depends on a joint effort of health and educational institutions, health professionals, and patients.
Implementation of an infection control program with emphasis on cohorting to patients with carbapenemase-producing Enterobacteriaceae. The experience of 2 years in a tertiary teaching hospital in northern Portugal
Authors: Vigário Ana , Gonçalves João A. , Costa Ana R. , Pinheiro Guiomar , Reis Ernestina , Oliveira Júlio R. 
Published: June 2020

Abstract

Background:
The emergence of carbapenemase-producing Enterobacterales (CPE) represents a major public health threat. Our purpose was to evaluate a surveillance and cohorting program implemented in patients infected or carriers of CPE.

Methods:
A prospective registry of CPE carriers or infected patients was analyzed from October 2015 until December 2017. All inpatients presenting with CPE were included in a hospital cohort with dedicated healthcare staff and contact precaution measures.

Results:
A total of 480 patients were identified, of which 15.8% (n = 76) were infected. Men comprised 56.7% of the cohort (n = 272) and 69.2% (n = 332) were elderly. About 46.3% (n = 222) had a previous hospital admission and 81.7% (n = 392) had at least 1 antibiotic course in the previous 90 days. There was a decline in infected patients in 2017. Periodic and admission screenings accounted for 63% and 74% of cases in 2016 and 2017, with increased detection rate comparing with contact/investigation screenings. In 2017, significantly fewer patients were identified outside the admission/point of prevalence screening (P = .009). In 2017 the proportion of invasive carbapenem-resistant Klebsiella pneumoniae amongst CPE in our center was below the national average (2016: 13.3% vs 5.2%; 2017: 6.6% vs 8.6%). A reduction of the consumption of carbapenems was also observed in 2017.

Conclusion:
The implementation of the program has increased the number of patients identified by the preventive method and stabilized the emergence of new CPE cases. Furthermore, the program cohort compared well with the national picture, with a lower number of infected patients and a lower proportion of carbapenem-resistant K pneumoniae in invasive specimens. These indicators reflect the added value of the CPE surveillance and cohorting program.
Job Demands and the Effects on Quality of Life of Employed Family Caregivers of Older Adults With Dementia: A Cross-Sectional Study
Authors: WANG Yu-Nu , HSU Wen-Chuin , SHYU Yea-Ing Lotus 
Published: June 2020

ABSTRACT

Background
Employed family caregivers are affected by job demands, which can affect quality of care provided to recipients. However, it is important to understand how job demands and the ability to reconcile employment and caregiving influence family caregivers’ quality of life.

Purpose
The aim of this study was to examine the extent to which job demands influenced quality of life for employed family caregivers of older adults with dementia in Taiwan.

Methods
This cross-sectional study analyzed secondary data from self-completed questionnaires collected from December 2010 to December 2011. Participants were 214 employed family caregivers of older adults with dementia in Taiwan. How job demands and caregiving influence quality of life was determined with hierarchical multiple regression analysis. Job demands included working hours, workplace inflexibility, work inefficiency, and difficulty in reconciling work and family caregiving.

Results
After controlling for demographics, caregiving resources, and caregiving role demands, employed family caregivers of older adults with dementia with fewer working hours and greater work efficiency reported significantly better quality of life (β = −.130, p = .049; β = −.263, p < .001) than those with more working hours and less work efficiency.

Conclusions/Implications for Practice
Employed family caregivers of older adults with dementia who had more working hours and less work efficiency had a greater likelihood of poorer quality of life than other employed family caregivers. Clinicians could use these findings to identify groups at high risk for poor quality of life. We suggest developing policies and interventions to help employed family caregivers of older adults with dementia to reduce working hours and improve work efficiency in order to improve quality of life, which could also improve quality of care for recipients.
Thromboembolic Events in Patients With Left Ventricular Assist Devices Are Related to Microparticle-Induced Coagulation
Authors: Kramser Nicolas , Oehler Daniel , Saeed Diyar , Aubin Hug , Akhyari Payam , Kelm Malte , Westenfeld Ralf , Horn Patrick 
Published: June 2020

Thromboembolic events (TEs) are a feared complication in patients supported by a continuous-flow left ventricular assist device (LVAD).
The aim of the study was to analyze the role of circulating microparticles (MPs) in activating the coagulation system in LVAD patients, which might contribute to the occurrence of TEs. First, we analyzed the effect of LVAD support on endothelial function, on the levels of endothelial MPs (EMPs) and platelet MPs (PMPs), and on the procoagulative activity of circulating MPs (measured as MP-induced thrombin formation) before LVAD implantation, post-implantation, and at a 3 month follow-up (n = 15). Second, these parameters were analyzed in 43 patients with ongoing LVAD support who were followed up for the occurrence of TEs in the following 12 months.
In patients undergoing LVAD implantation, the levels of PMPs and MP-induced thrombin formation increased post-LVAD implantation. The flow-mediated vasodilation (FMD) decreased, while the levels of EMPs increased post-LVAD implantation.
TEs occurred in eight patients with ongoing LVAD support despite adequate coagulation. The levels of PMPs and MP-induced thrombin formation were higher in LVAD patients with TEs than in LVAD patients without TEs and were independent predictors for the risk of TEs under LVAD support. As conclusion, implantation of LVAD enhanced MP-induced coagulation, which was independently associated with the occurrence of TEs. These parameters may serve in risk stratification for early transplantation and individualized modification of standard LVAD therapy.
Novel Orally Administered Recombinant Anti-TNF Alpha Fusion Protein for the Treatment of Ulcerative Colitis
Authors: Almon Einat , Shaaltiel Yoseph , Sbeit Wisam , Fich Alex , Schwartz Doron , Waterman Mattitiahu , Szlaifer Mali , Reuveni Hadar , Amit-Cohen Bat-chen , Alon Sari , Chertkoff Raul , Paz Alona , Ilan Yaron 
Published: June 2020

Background and Objective:
OPRX-106 is an orally administered BY2 plant cell-expressing recombinant TNF fusion protein (TNFR). Oral administration of OPRX-106 was shown to be safe and effective in inducing favorable anti-inflammatory immune modulation in humans. The current study was aimed at determining the safety and efficacy of OPRX-106 in patients with ulcerative colitis (UC).

Methods:
Twenty-five patients with active mild-to-moderate UC were enrolled in an open-label trial. Patients were randomized to receive 2 or 8 mg of OPRX-106 administered orally once daily, for 8 weeks. Patients were monitored for safety and efficacy including clinical response or clinical remission, based on the Mayo score. The histopathological improvement in Geboes score, calprotectin level and hs-CRP, and exploratory immune parameters by means of fluorescence-activated cell sorting and cytokine levels were monitored.

Results:
Oral administration of OPRX-106 was found to be safe and well tolerated without absorption into the circulation. Out of 24 patients, 18 completed the trial. The analysis of the patients completing treatment demonstrated clinical efficacy as measured by clinical response or remission in 67% and 28%, respectively. Reduction in calprotectin levels and improved Geboes score were noted in the majority of the treated patients. The beneficial clinical effect was associated with an increase in a CD4+CD25+FoxP3 subset of suppressor lymphocytes and a reduction in interleukin 6 and interferon gamma serum levels.

Conclusions:
Oral administration of the nonabsorbable OPRX-106 is safe and effective in mild-to-moderate UC, and not associated with immune suppression, while inducing favorable anti-inflammatory immune modulation.
Patient and Family Member Experiences in Critical Care Research and Quality Improvement Projects
Authors: Bench Suzanne , O’Shea Alison , Boaz Annette 
Published: June 2020

Background
Public and patient involvement in healthcare research is increasing, but the effect of involvement on individuals, service delivery, and health outcomes—particularly in specialist population groups like critical care—remains unclear, as does the best way to involve people who have experienced critical illness.

Objectives
The aim of the study was to explore former patients’ and family members’ views and experiences of involvement in critical care research and/or quality improvement.

Methods
Using a qualitative methodology, semistructured telephone interviews were conducted with seven former intensive care unit patients and three close family members across England. Data were analyzed using a standard process of inductive thematic analysis.

Results
Four key themes were identified: making it happen, overcoming hurdles, it helps, and respect and value. Findings center on the need for flexibility, inclusivity, and transparency. They further highlight the particular challenges faced by critical illness survivors and their family members in relation to research involvement, the importance of individualized support and training, and the vital role that project leads have in making people feel valued and equal partners in the process.

Discussion
This is the first study to explore patients’ experiences of involvement in critical care research. Despite the small, homogenous sample, the study provides valuable and important data to guide future practice. It highlights the need to enable and support people to make informed choices at a time when they are ready to do so. It further highlights the importance of gatekeepers to avoid vulnerable people contributing before they are ready—a practice that could negatively affect their health status.
Repeatability and Validity of Peripheral Refraction with Two Different Autorefractors
Authors: Morrison Ann M. , Mutti Donald O. 
Published: June 2020

SIGNIFICANCE
The Welch Allyn SureSight (Welch Allyn, Skaneateles Falls, NY) and Plusoptix PowerRefractor (Plusoptix, Nuremberg, Germany) are often used with infants, but little is known about the repeatability and validity of their peripheral refractive error measurements. Selecting the best instrument will support future refractive error and emmetropization studies.

PURPOSE
The purpose of this study was to determine the validity and repeatability of peripheral refractive error measurements and peripheral refraction profiles measured with the Welch Allyn SureSight and Plusoptix PowerRefractor compared with the criterion standard Grand Seiko WR-5100K (Grand Seiko Co., Hiroshima, Japan).

METHODS
Cycloplegic (tropicamide 1%) autorefraction was measured in the right eyes of 21 adult subjects (31.4 ± 10.4 years) with the three instruments in randomized order on two separate visits, at least 24 hours apart, centrally, and at 30 and 20° temporal and nasal gaze.

RESULTS
The SureSight measurements were within 0.24 D and not significantly different from the Grand Seiko WR-5100K in any gaze (P < .65), whereas the PowerRefractor measurements were more myopic by as much as −0.97 D and significantly different in four of the five gaze directions (P < .04). The 95% limits of agreement between occasions by gaze ranged from ±0.38 to ±0.61 D for the SureSight, similar to or slightly better than the WR-5100K (±0.31 to ±1.51 D) and the PowerRefractor (±0.72 to ±1.71 D). There were no significant differences between visits for any instrument in any gaze (P < .94). The repeatability of the SureSight was also better than that for the Grand Seiko when peripheral refraction was represented by quadratic fits to the data.

CONCLUSIONS
These findings suggest that the Welch Allyn SureSight is the most suitable portable autorefractor to use to monitor peripheral autorefraction based on better repeatability between occasions and better validity compared with the criterion standard Grand Seiko WR-5100K.
Effect of Topical Pilocarpine on Choroidal Thickness in Healthy Subjects
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Vasiliev Alexander S. 
Published: June 2020

SIGNIFICANCE
This is a proof-of-concept study showing the possibility of pharmacological control for choroidal thickness using pilocarpine as an agent that causes 2 to 5% choroidal thinning in healthy eyes after the instillation.

PURPOSE
The purpose of this article was to study the effect of instillation of 1% pilocarpine on choroidal thickness in healthy subjects.

METHODS
Sixteen healthy individuals (seven males and nine females; mean ± standard deviation age, 25.8 ± 3.3 years) were included. All participants received optical coherence tomography to evaluate subfoveal choroidal thickness (SCT) and choroidal area on cross-sectional scan within 4-mm central area. Axial length was measured using optical biometry. Optical coherence tomography was performed before and after pilocarpine was instilled six times for a 75-minute period in one eye; the fellow eye was used as the control. Subfoveal choroidal thickness and choroidal area were measured by two masked graders in random fashion and averaged for analysis.

RESULTS
After instillation of 1% pilocarpine, percentage SCT change in study and control eye was −3.3 ± 3.8% and 0.4 ± 3.2%, respectively (P = .03). Percentage change choroidal area in study and control eye was −2.3 ± 2.5% and 0.8 ± 3.3%, respectively (P < .001). There was a correlation between percentage SCT change and axial length (r = −0.56, P < .001), as well as between percentage SCT change and baseline SCT (r = 0.72, P < .001).

CONCLUSIONS
Instillation of 1% pilocarpine causes a decrease of choroidal thickness, which is more substantial in eyes with short axial length and thick choroid.