bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nicotinamide adenine dinucleotide phosphate oxidase 2–derived reactive oxygen species contribute to long-term potentiation of C-fiber-evoked field potentials in spinal dorsal horn and persistent mirror-image pain following high-frequency stimulus of the sciatic nerve
Authors: Xu Jing , Wei Xuxia , Gao Feng , Zhong Xiongxiong , Guo Ruixian , Ji Yun , Zhou Xin , Chen Jialiang , Yao Peiwen , Liu Xianguo , Wei Xuhong 
Published: November 2019

Abstract
High-frequency stimulation (HFS) of the sciatic nerve has been reported to produce long-term potentiation (LTP) and long-lasting pain hypersensitivity in rats. However, the central underlying mechanism remains unclear. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX) belongs to a group of electron-transporting transmembrane enzymes that produce reactive oxygen species (ROS). Here, we found that NOX2 was upregulated in the lumbar spinal dorsal horn after HFS of the left sciatic nerve, which induced bilateral pain and spinal LTP in both male and female rats. Blocking NOX2 with blocking peptide or shRNA prevented the development of bilateral mechanical allodynia, the induction of spinal LTP, and the phosphorylation of N-methyl-d-aspartate (NMDA) receptor 2B (GluN2B) and nuclear factor kappa-B (NF-κB) p65 after HFS. Moreover, NOX2 shRNA reduced the frequency and amplitude of both spontaneous excitatory postsynaptic currents and miniature excitatory postsynaptic currents in laminar II neurons. Furthermore, 8-hydroxyguanine (8-OHG), an oxidative stress marker, was increased in the spinal dorsal horn. Spinal application of ROS scavenger, Phenyl-N-tert-butylnitrone (PBN), depressed the already established spinal LTP. Spinal application of H2O2, one ROS, induced LTP and bilateral mechanical allodynia, increased the frequency and amplitude of spontaneous excitatory postsynaptic currents in laminar II neurons, and phosphorylated GluN2B and p65 in the dorsal horn. This study provided electrophysiological and behavioral evidence that NOX2-derived ROS in the spinal cord contributed to persistent mirror-image pain by enhancing the synaptic transmission, which was mediated by increasing presynaptic glutamate release and activation of NMDA receptor and NF-κB in the spinal dorsal horn.
Advancing Health Equity and Social Justice in Forensic Nursing Research, Education, Practice, and Policy: Introducing Structural Violence and Trauma- and Violence-Informed Care
Authors: Befus Deanna R. , Kumodzi Trina , Schminkey Donna , St. Ivany Amanda 
Published: November 2019

ABSTRACT
Initial conceptualizations of violence and trauma in forensic nursing have remained relatively narrowly defined since the specialty's inception. The advent of trauma-informed care has been important but has limitations that obfuscate social and structural determinants of health, equity, and social justice. As forensic nursing practice becomes more complex, narrow definitions of violence and trauma limit the effectiveness of trauma-informed care in its current incarnation. In keeping with the nursing model of holistic care, we need ways to teach, practice, and conduct research that can accommodate these increasing levels of complexity, including expanding our conceptualizations of violence and trauma to advance health equity and social justice. The objective of this article is to introduce the concepts of structural violence and trauma- and violence-informed care as equity-oriented critical paradigms to embrace the increasing complexity and health inequities facing forensic nursing practice.
Firefighter's Acute Inflammatory Response to Wildfire Suppression
Authors: Main Luana C. , Wolkow Alexander P. , Tait Jamie L. , Della Gatta Paul , Raines Jenni , Snow Rodney , Aisbett Brad 
Published: November 2019

Objectives:The purpose of this study was to determine the inflammatory response to a 12-hour wildfire suppression shift, in firefighters attending the “Black Saturday” natural disaster.Methods:Thirty-eight male volunteer firefighters provided venous blood samples before and after a 12-hour firefighting shift. Pre- to post-shift changes in pro-inflammatory (Interleukin [IL]-1β, IL-2, IL-6, IL-8, IL-12P70, granulocyte macrophage-colony stimulating factor [GM-CSF], tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFNγ]), and anti-inflammatory (IL-4, IL-5, IL-7, IL-10, IL-13) cytokines were measured with paired samplettests, or Wilcoxonttests for non-parametric data.Results:Interleukin (IL)-6 (P = 0.003) and IL-8 (P = 0.017) were significantly increased following 12-hours of wildfire suppression. There was also a significant decrease in IL-10 (P = 0.021).Conclusions:The observed acute inflammatory response may have resulted from multiple stressors including physical exertion, thermal strain, or smoke inhalation experienced during the shift, and may be a necessary response for the body to adapt to stressor exposure.
An innovative technique to promote understanding of anatomy for nurse practitioner students
Authors: Whited Teresa M. , DeClerk Leonie , Berber Albrey , Phelan Kevin D. 
Published: November 2019

ABSTRACT
Nurse practitioner (NP) students are required to have a clear understanding of the complexities of the human body. Students enter graduate studies with varying experiences and backgrounds in anatomy and physiology. Evidence suggests that human anatomy laboratories increase learning outcomes when compared with comparative anatomy modalities. The purpose of this evaluation was to determine if teaching with a computed tomography (CT)-based three-dimensional (3D) anatomy table and cadaveric specimens improves Doctor of Nursing Practice (DNP) and NP students' understanding of anatomy in health assessment. Students participated in a hands-on anatomy review using a 3D anatomy table and human cadavers to master the five included body systems. Presurveys and postsurveys were administered to determine how much time had lapsed since our students' most recent anatomy class and the type of dissection laboratory provided within that class; to assess knowledge confidence in pediatric Head, Eyes, Ears, Nose and Throat (HEENT) anatomy; and to assess students' confidence in pediatric anatomical knowledge for all five body systems. Data were analyzed using a Mann–Whitney U test with independent samples. All areas with the exception of HEENT showed clinically significant improvement, including overall scores. Many positive themes were identified using qualitative thematic analysis. Teaching with a CT-based, 3D anatomy table with cadaveric specimens improved DNP and NP students' confidence levels in pediatric anatomy knowledge for all five systems. This innovative combination of human cadavers and virtual technology has the potential to produce advanced anatomical understanding for prospective health care professionals and to validate their capacity to conduct complex health assessments and procedures.
Identifying essential clinical skills and procedures for FNP students using an electronic clinical documentation system
Authors: Rivera Lara , Stevens Crystal , Waugh Shirley , Dinkel Shirley 
Published: November 2019

ABSTRACT
Nurse practitioner (NP) education is designed to prepare graduates for competent entry-level practice. However, many new family NPs (FNPs) report a lack of preparation in performing clinical skills and procedures (CSPs). There is no approved list of CSPs for FNP students. Further, there is a dearth of literature reporting CSPs frequently performed by NPs to guide NP curricula development. The purpose of this investigation was to summarize frequently encountered CSPs reported by students enrolled in an FNP program from August 2012 through December 2018 at a Midwest university and to compare results with those found in the literature. After a comprehensive review of literature, a retrospective, longitudinal assessment of CSPs identified by FNP students and extracted from a proprietary, electronic clinical documentation system (eLOGS) was conducted. Comparison was made with current literature on CSPs used by practicing FNPs. Overall, there was consistency between CSPs documented by students in eLOGS and those found in the literature. Unique to this investigation was the frequent reporting of behavioral health assessments by students. Because behavioral health conditions are often first diagnosed and treated in the primary care setting, competency in care of behavioral health conditions is clearly a necessary CSP. Educators have a responsibility to prepare graduates for the skill set needed in the workplace. This includes a standardized set of CSPs essential to FNP practice. Development of a universally accepted list of CSPs will be instrumental in refining evidence-based NP curricula that best prepares graduates with the experience and confidence necessary to enter practice.
Implementation of home-based international normalized ratio testing in adult patients treated with warfarin
Authors: Van Beek Andrea , Bowers Margaret , Hall Bruce , Meyer Barry 
Published: November 2019

ABSTRACT

Background and local problem:
Patients who take warfarin require frequent testing of their international normalized ratio (INR) level to ensure accurate dosage. Frequent testing can be inconvenient for patients in rural settings, the workforce, the homebound, or those who travel. Patients who have a home INR monitor can test their blood remotely.

Methods:
To circumvent barriers to INR testing, a quality improvement project was designed to implement home INR testing in an anticoagulation clinic setting.

Interventions:
Patients who received a home INR monitor were compared against two usual care testing arms (laboratory and clinic testing patients) in the outcomes of time in therapeutic range (TTR), adverse events, and patient satisfaction using the Duke Anticoagulation Satisfaction Scale (DASS).

Results:
The DASS survey demonstrated the home testing patients had a statistically significant advantage over the clinic testing group in the subdomain of hassles and burdens (p = .048), as well as the lowest overall scores (indicating highest satisfaction) over the clinic testing group (p = .041). No patients in the home testing group had clotting or bleeding issues necessitating hospital admission. There were no significant differences between groups in the TTR analysis (laboratory 70.8%, home 68.9%, and clinic 64.5%) (p = .683).

Conclusions:
Home INR testing provides convenience for patients and reduces the hassles and burdens of warfarin management, leading to improved satisfaction. This engagement in self-care translates to reduced adverse events. Home INR testing can be used in warfarin patients who are highly motivated and willing to engage in their care.
Characteristics and related factors of bronchiectasis in chronic obstructive pulmonary disease
Authors: Yu Qihong , Peng Haiying , Li Bo , Qian Hongyu , Zhang Hong 
Published: November 2019

Abstract
The purpose of this study was to understand the incidence, clinical characteristics and related factors of bronchiectasis in chronic obstructive pulmonary disease (COPD) patients.
From January 2015 to January 2017, 133 patients with moderate to severe COPD admitted to our hospital were enrolled in the study. Bronchiectasis analysis was performed by high resolution CT of the chest, the clinical data of all patients were collected including increasing state of COPD, peripheral blood samples, pulmonary function, blood gas. And sputum samples were collected for detection of microorganisms.
the patients were aged 70.18 ± 8.31 years, and 62.4% of the patients were male. FEV1 accounted for an estimated value of 37.91 ± 10.68%, and 104 (78.2%) were severe COPD, and 43 (32.3%) had bronchiectasis. Bronchiectasis is mainly bilateral, multiple and columnar bronchiectasis. The most easily involved sites are the left lower lobe, left lingual lobe and right middle lobe. Bronchiectasis is associated with history of disease (P = .027), at least one hospitalization exacerbated by COPD in the past year (P = .025), and the separation of potential pathogenic microorganisms from sputum (P = .022). The most commonly isolated pathogen was Pseudomonas aeruginosa (P < .001).
Bronchiectasis should be noted in patients with COPD who often suffer from exacerbation or repeated respiratory infections, especially in those who isolate P aeruginosa from respiratory specimens.
The effect of salpingectomy on the ovarian reserve and ovarian response in ectopic pregnancy
Authors: Luo Jiaqi , Shi Yu , Liu Dan , Yang Danni , Wu Jiahui , Cao Lijuan , Geng Lan , Hou Zhenhui , Lin Hongbo , Zhang Qiuju , Jiang Xuefeng , Qian Weiping , Yu Zhiying , Xia Xi 
Published: November 2019

Abstract

Background:
Salpingectomy is routinely performed in ectopic pregnancy (EP). However, the effect of the surgery on the ovarian reserve and ovarian response in EP patients is still uncertain and has not been systematically evaluated. Therefore, we conducted this meta-analysis to provide a comparison of the ovarian reserve and ovarian response between the pre-salpingectomy and post-salpingectomy in EP patients.

Methods:
Pubmed, Embase, and Cochrane Library were searched for all relevant articles published up to December 2018. We retrieved the basic information and data of the included studies. The data was analyzed by Review Manager 5.3 software (Cochrane Collaboration, Oxford, UK).

Results:
A total of 243 articles were extracted from the databases, and 7 studies were included in the meta-analysis. The ovarian reserve including anti-Mullerian hormone (inverse variance [IV] −0.7 [95% confidence interval [CI] −0.63, 0.49]), antral follicle count (IV 1.7 [95% CI −2.02, 5.42]) and basal follicle stimulating hormone (IV 0.02 [95% CI −0.63, 0.68]) was comparable between the pre-salpingectomy group and the post-salpingectomy group. The amount of gonadotropin was significantly higher in the post-salpingectomy group when compared with that in the pre-salpingectomy group (IV −212.65 [95% CI −383.59, −41.71]). There was no significant difference in the left parameters of the ovarian response including the duration of gonadotropin stimulation (IV −0.32 [95% CI −0.76, 0.12]), the estrogen level on the human chorionic gonadotropin triggering day (IV −4.12 [95% CI −236.27, −228.04]) and the number of retrieved oocytes (IV 0.35 [95% CI −0.76, 1.46]) between 2 groups.

Conclusions:
The current results suggest that salpingectomy has no negative effect on the ovarian reserve and ovarian response.
Carbetocin vs oxytocin for prevention of postpartum hemorrhage after vaginal delivery
Authors: Jin Xin-Hang , Li Dan , Li Xia 
Published: November 2019

Abstract

Objective:
To evaluate the efficacy and safety of carbetocin for prevention of postpartum hemorrhage in women undergoing vaginal delivery compared with oxytocin.

Methods:
We conducted a systemic literature search in PubMed, the Cochrane Library, and Embase without language restrictions from inception of each of database to November 18th, 2018. Randomized controlled trials with outcome measure of blood loss ≥500 ml were eligible if they compared carbetocin with oxytocin to prevent postpartum hemorrhage during the third stage of labor in women undergoing vaginal delivery.

Results:
This meta-analysis of 5 randomized controlled trials (30,314 women) indicated that there was no significant difference between carbetocin and oxytocin in blood loss ≥500 ml in women undergoing vaginal delivery (relative risks (RRs), 0.52; 95% confidence intervals (CIs), 0.24 to 1.15; P = .11; I
2 = 69%). Sensitivity analyses showed the same results. No significant differences were found in blood loss ≥1000 ml, use of additional uterotonic agents, blood transfusion, uterine massage, flushing, vomiting, abdominal pain, nausea, dizziness, headache, palpitation, itching, and shivering.

Conclusions:
This meta-analysis showed that carbetocin was as effective and safe as oxytocin for prevention of postpartum hemorrhage in women undergoing vaginal delivery, and the choice of carbetocin for routine prophylaxis will depend on cost-effectiveness.
Serum YKL-40 positively correlates with MMP-9 and CRP in patients with acute ST segment elevation myocardial infarction following emergency treatment
Authors: Tan Yuanfei , Ji Xiaoying , Mo Zhifeng , Zhou Yaoliang 
Published: November 2019

Abstract

Objective:
To investigate the role of YKL-40 in ST segment elevation myocardial infarction (STEMI) and its relationship to C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9).

Methods:
This prospective study included 358 STEMI patients who were sent to the Emergency Department of our hospital from April 2014 to December 2017. Serum levels of YKL-40, CRP and MMP-9 were determined using commercially available Enzyme linked immunosorbent assay (ELISA) kits. Major adverse cardiovascular events (MACE) and overall survival time were analyzed.

Results:
GRACE scores (P < .001) and the levels of YKL-40 (P < .001), MMP-9 (P < .001), and CRP (P < .001) were significantly higher in deceased patients compared to those that survived. The levels of CRP (P = .007) and MMP-9 (P = .022) were significantly higher in the high YKL-40 group. The GRACE scores were also significantly elevated (P = .011, 95% CI 2.1 (−9.7 to −1.3)). Cumulative MACE rates and cardiac death rates were significantly higher in the high YKL-40 group (P < .001, 95% CI 3.9 (1.9–8.2)). Overall survival times were significantly longer in patients with lower YKL-40 levels (P < .0001).

Conclusion:
Elevated YKL-40 levels positively correlate with CRP and MMP-9 levels and are associated with clinical outcomes including MACE and 6-month survival in STEMI patients.
Severe hyperammonemia from intense skeletal muscle activity
Authors: Taneja Vikas , Jasuja Haneesh 
Published: November 2019

Abstract

Rationale:
Adult hyperammonemia is most often the result of hepatic dysfunction. Hyperammonemia in the setting of normal hepatic function is a much less common phenomenon and has usually been associated with medications and certain disease states. Here, we present an unusual case of severe hyperammonemia caused physiologically by intense muscle activity in a patient lacking any evidence of liver disease.

Patient concerns:
A 36-year-old woman was brought to the emergency department for a suicide attempt after being found covered in Lysol and Clorox germicidal bleach. She was noted to be in a state of violent psychosis with extreme agitation and had to be sedated and intubated for airway protection.

Diagnosis and interventions:
Initial labs revealed hyperammonemia, lactic acidosis, and anion gap metabolic acidosis. Aminotransferases, bilirubin, and creatine kinase (CK) were normal. Renal function, prothrombin time, activated partial thromboplastin time, and international normalized ratio were also unremarkable and remained so at 24 hours. Ethyl alcohol, acetaminophen, salicylate, and valproic acid were all undetectable in blood. She received 2 doses of lactulose overnight, with a subsequent bowel movement. Next day, her mentation, serum ammonia level, and lactic acid level were back to normal, and she was extubated. Aminotransferases and CK levels were elevated but improved with supportive care. A detailed history and relevant biochemical investigations were unremarkable for any other etiology of hyperammonemia including the common inborn errors of metabolism (IEM). The combination of clinical findings of extreme skeletal muscle activity along with hyperammonemia and lactic acidosis, and subsequently rhabdomyolysis in the setting of unremarkable history and otherwise normal hepatic function strongly suggest the myokinetic origin of hyperammonemia in the patient.

Outcome:
The patient recovered well with supportive care and was discharged on day 5.

Lessons:
This unique case illustrates the important role of skeletal muscle in the human metabolism of ammonia. In our discussion, we also elucidate the underlying pathophysiology, with the objective of improving clinician understanding of various differential diagnoses.
Atrophic gastritis and chronic diarrhea due to Helicobacter pylori infection in early infancy
Authors: Kakiuchi Toshihiko , Nakayama Aiko , Shimoda Ryo , Matsuo Muneaki 
Published: November 2019

Abstract

Rationale:

Helicobacter pylori infection causes atrophic gastritis in childhood, but atrophic gastritis due to H pylori infection is extremely rare in infancy. The relationship between H pylori infection and chronic diarrhea without protein leakage remains controversial.

Patient concerns:
An 8-month-old male infant presented to our hospital with severe watery diarrhea, erythema, and failure to thrive from approximately 1 month after birth. Blood, stool, esophagogastroduodenoscopy, total colonoscopy, and H pylori urease analysis results were positive, thereby suggesting atrophic gastritis.

Diagnoses:
Atrophic gastritis and chronic diarrhea due to H pylori infection.

Interventions:
We performed H pylori eradication therapy using triple therapy with vonoprazan (6 mg/kg), amoxicillin (300 mg/d), and clarithromycin (120 mg/kg) for 7 days.

Outcomes:
From approximately 1 week after the H pylori eradication therapy, the frequency of defecation had decreased, stool shape had improved, and body weight had gradually increased.

Lessons:

H pylori infection can cause atrophic gastritis and chronic diarrhea even in infancy. Early eradication therapy for H pylori infection may be useful for prevention of gastric cancer and improvement in growth disorders.
Skin-stretching device promotes the treatment effect of vacuum sealing drainage technique on phases III and IV stress-induced injuries in aged patients with chronic critical illness
Authors: Zhang Fulian , Gu Yuecheng , Wu Linjun 
Published: November 2019

Abstract
Stress-induced injury is a common complication associated with patients with chronic critical illness (CCI). Skin-stretching device (SSD) and vacuum sealing drainage (VSD) technique are 2 approaches that can facilitate wound healing.
In the present study, the effect of the concatenated application of the 2 techniques on the phases III and IV stress-induced injuries in aged patients with CCI was assessed. About 70 patients with CCI with stress-induced injuries were selected from February 2015 to October 2017. The treatment outcomes of the combined method and VSD method were assessed by comparing their clinicopathologic parameters.
The results showed that the combined treatment shortened the average healing duration of wounds. Moreover, the total area of pressure sores, incidence of bleeding, bacteria amount, 28-day cure rate, peripheral C-reactive protein (CRP) level, and the hospitalization duration were all significantly improved in patients treated with SSD and VSD. The overall effective rate (97.14%) of patients treated with VSD and SSD was significantly higher than that (77.14%) in patients treated with VSD.
The present study showed that the combined application of VSD and SSD improved the treatment outcomes of phases III and IV stress-induced injuries in aged patients with CCI.