bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Tropical Infections: A Focus on Cutaneous Larva Migrans
Authors: Gill Navdip , Somayaji Ranjani , Vaughan Stephen 
Published: June 2020

ABSTRACT
Cutaneous larva migrans is a hookworm infection and one of the most common skin diseases of tourists in tropical countries. Most commonly, the infection is transmitted by contact with feces of dogs and cats containing hookworm eggs. This case-based review explores the epidemiology, diagnosis, clinical features, and management of cutaneous larva migrans infection.

GENERAL PURPOSE
To provide information about infection with cutaneous larva migrans (CLM).

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, NPs, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:
1. Distinguish the clinical features, diagnosis, and management of CLM.
2. Explain the epidemiology of CLM.
Clinical Factors Influencing the Outcomes of an Acellular Dermal Matrix for Skin Cancer Treatment: A Retrospective Study
Authors: Ferrari Barbara , Reggiani Camilla , Francomano Mariangela , Bellini Pierantonio , Ferrari Federica , Giacomelli Luca , Mannocci Alice , Magnoni Cristina 
Published: June 2020

ABSTRACT

OBJECTIVE
To evaluate the efficacy and safety of a biologically engineered dermal matrix used in reconstructive surgery after skin tumor resection, focusing on the frequency of successful grafting and identifying potential factors influencing treatment outcomes.

DESIGN AND PARTICIPANTS
This retrospective analysis involved consecutive patients diagnosed with skin cancer in any area of the body and for which treatment with a dermal skin template was recommended as alternative to traditional surgery.

MAIN OUTCOME MEASURES
Percentage of successful grafting and the patient and tumor characteristics influencing treatment outcome via univariate analysis.

MAIN RESULTS
A total of 302 patients were included. Surgical reconstruction with the matrix was effective in 88.9% of the patients within 21 days of surgery. Notably, the matrix was successful regardless of tumor location, type, or size. Infection was the only variable significantly associated with graft failure (P < .001).

CONCLUSIONS
The studied dermal matrix provides an efficient alternative to traditional reconstructive surgery in patients who present specific comorbidities or risk factors. The only variable significantly associated with graft failure was infection, which should be properly controlled through appropriate treatment.
Sonority-Related Novel Word Learning Ability of Children With Cochlear Implants With Optimal Oral Language Exposure
Authors: Hamza Yasmeen , Okalidou Areti , Dierckx Ann , van Wieringen Astrid 
Published: June 2020

Objectives:
The present study investigated how children with cochlear implants (CIs), with optimal exposure to oral language, perform on sonority-related novel word learning tasks. By optimal oral language exposure, we refer to bilateral cochlear implantation below the age of 2 years. Sonority is the relative perceptual prominence/loudness of speech sounds of the same length, stress, and pitch. The present study is guided by a previous study that investigated the sonority-related novel word learning ability of a group of children with CIs, in the Greek language, of which the majority were implanted beyond the age of 2 unilaterally.

Design:
A case-control study with 15 Dutch-speaking participants in each of the three groups, i.e., children with CIs, normal-hearing children (NHC), and normal-hearing adults, was conducted using a sonority-related novel “CVC” word learning task. All children with CIs are implanted before the age of 2 years with preimplant hearing aids. Thirteen out of the 15 children had bilateral CIs. The CVC words were constructed according to four sonority conditions, where N is nonsonorous and S is a sonorous phoneme: NSN, NSS, SSN, and SSS. Outcome measures were accuracy and reaction times (RTs). In addition, the Peabody picture vocabulary test and the digit span forward test were administered to the children.

Results:
There were no statistical differences in accuracy or RTs between the children groups on the overall score and across the different conditions. However, children with CIs, unlike NHC, scored statistically less accurately and with longer RTs relative to normal-hearing adults, on the overall task. Within-group comparisons showed that none of the groups performed statistically differently on any of the conditions. The NHC showed higher receptive vocabulary scores relative to children with CIs. In addition, the group of children with CIs entailed a statistically significantly higher number of children with “weak” short-term memory.

Conclusions:
Children with CIs who have optimal oral language exposure showed age-appropriate sonority-related novel word learning abilities and strategies relative to their NH peers. However, children with CIs continue to show lower receptive vocabulary scores than NHC, despite the equivalent novel word learning ability. This suggests that children with CIs may have difficulties in retaining newly learned words. Future work should look into possible causes of the gap in performance. This would eventually aid in rehabilitation tailored to the needs of the individual.
Aberrant reactive aldehyde detoxification by aldehyde dehydrogenase-2 influences endometriosis development and pain-associated behaviors
Authors: McAllister Stacy L. , Sinharoy Pritam , Vasu Megana , Gross Eric R. 
Published: June 2020

Abstract
Endometriosis affects ∼176 million women worldwide, yet on average, women experience pain ∼10 years from symptom onset before being properly diagnosed. Standard treatments (drugs or surgery) often fail to provide long-term pain relief. Elevated levels of reactive aldehydes such as 4-hydroxynonenal (4-HNE) have been implicated in the peritoneal fluid of women with endometriosis and upon accumulation, reactive aldehydes can form protein-adducts and/or generate pain. A key enzyme in detoxifying reactive aldehydes to less reactive forms is the mitochondrial enzyme aldehyde dehydrogenase-2 (ALDH2). Here, we tested the hypothesis that aberrant reactive aldehyde detoxification by ALDH2 underlies endometriosis and its associated pain. We determined, in the eutopic and ectopic endometrium of women with severe (stage IV) peritoneal endometriosis, that ALDH2 enzyme activity was decreased, which was associated with decreased ALDH2 expression and increased 4-HNE adduct formation compared to the eutopic endometrium of controls in the proliferative phase. Using a rodent model of endometriosis and an ALDH2*2 knock-in mouse with decreased ALDH2 activity, we determined that increasing ALDH2 activity with the enzyme activator Alda-1 could prevent endometriosis lesion development as well as alleviate pain-associated behaviors in proestrus. Overall, our findings suggest that targeting the ALDH2 enzyme in endometriosis may lead to better treatment strategies and in the proliferative phase, that increased 4-HNE adduct formation within the endometrium may serve as a less invasive diagnostic biomarker to reduce years of suffering in women.
Neuronal/astrocytic expression of chemokine (C-C motif) ligand 2 is associated with monocyte/macrophage recruitment in male chronic pelvic pain
Authors: Liu Zhiqiang , Murphy Stephen F. , Wong Larry , Schaeffer Anthony J. , Thumbikat Praveen 
Published: June 2020

Abstract
Chronic pelvic pain syndrome is a multisymptom syndrome with unknown etiology. The experimental autoimmune prostatitis (EAP) mouse model of chronic pelvic pain syndrome is associated with immune cell infiltration into the prostate, expression of C-C chemokine ligand 2 (CCL2), and neuroinflammation in the spinal cord. Here, we studied CCL2 expression in tissues along the nociceptive pathway and its association with neuroimmune cells during pain development. Examination of prostate tissues at days 14 and 28 after EAP induction revealed CCL2 expression was increased in epithelial cells and was associated with increased numbers of macrophages lying in close apposition to PGP9.5-positive afferent neuronal fibers. C-C Chemokine ligand 2 immunoreactivity was elevated to a similar degree in the dorsal root ganglia at day 14 and day 28. D14 of EAP was associated with elevated IBA1+ cells in the dorsal root ganglia that were not evident at D28. Adoptive transfer of green fluorescent protein+ leukocytes into EAP mice demonstrated monocytes are capable of infiltrating the spinal cord from peripheral blood with what seemed to be a proinflammatory phenotype. In the lower dorsal spinal cord, CCL2 expression localized to NeuN expressing neurons and GFAP-expressing astrocytes. Myeloid derived cell infiltration into the spinal cord in EAP was observed in the L6-S2 dorsal horn. Myeloid-derived CD45+ IBA1+ cells were localized with IBA1+ TMEM199+ microglia in the dorsal horn of the spinal cord in EAP, with intimate association of the 2 cell types suggesting cell–cell interactions. Finally, intrathecal administration of liposomal clodronate ameliorated pelvic pain symptoms, suggesting a mechanistic role for macrophages and microglia in chronic pelvic pain.
Respiratory Disorders Resulting From Exposure to Low Concentrations of Ammonia
Authors: Mahdinia Mohsen , Adeli Seyyed Hassan , Mohammadbeigi Abolfazl , Heidari Hamidreza , Ghamari Farhad , Soltanzadeh Ahmad 
Published: June 2020

Objective:
This study aimed to investigate respiratory disorders associated with exposure to low concentrations of ammonia.

Method:
This cohort study was conducted on 122 industrial workers. Data gathering were based on the officially registered data, the NMAM 6016 and the American Thoracic Society and European Respiratory Society protocols.

Results:
The prevalence rate of respiratory disorders significantly increased in the exposure group over 5 years (P < 0.05). The frequencies of these symptoms in the exposure group were significantly higher than non-exposure group (P < 0.05). Respiratory functions were decrease significantly in the exposure group and were lower than non-exposure group (P < 0.05). Exposure and the amount of exposure to ammonia had a significant relationship with respiratory disorders and respiratory functions (P < 0.05).

Conclusion:
Exposure to ammonia lower than threshold limit value (TLV), can act as a risk factor of respiratory disorders.
Defining Excellence in Physical Therapist Education: A Comparison of 2 Theoretical Perspectives
Authors: Jette Diane U. , Brechter Jacklyn H. , Heath Amy E. , Tschoepe Barbara 
Published: June 2020

Background and Purpose.
Defining excellence and assessing quality in physical therapist education are challenging for many reasons, including the variable nature of curricular approaches, program structure and settings, teaching approaches, and institutional culture. In addition, the stakeholders differ depending on the unique program mission or outcome one considers. Thus, there are tensions about measuring inputs, processes, or outcomes, using quantitative versus qualitative data, and the value of program diversity. Recently, 2 approaches to measuring physical therapist education program excellence have been reported in the literature. Although these studies were not connected, the foundations of each suggest some unifying core concepts. This paper evaluates the 2 approaches to assessing program excellence, comparing clusters and attributes of the Engagement Theory of Program Quality applied by the American Council of Academic Physical Therapy task force for benchmarking excellence with the dimensions and elements for education reform proposed by the study of Excellence and Innovation in Physical Therapist Education.

Position and Rationale.
The Engagement Theory of Program Quality is a generic model designed to assess graduate programs, whereas the theoretical model proposed by the study of Excellence and Innovation in Physical Therapist Education is specific to physical therapist education. The models, however, demonstrate considerable correspondence, suggesting that excellence in graduate programs in higher education has common roots regardless of type of program.

Discussion and Conclusion.
There is clear convergence of major constructs across the 2 theoretical models. The most salient commonalities include the emphases on shared vision; leadership; collaborative relationships/partnerships; adequate resources to support students, faculty, and infrastructure; and the capacity for transformation of the people and institutions involved in the educational endeavor. These commonalities suggest a basis for initial consensus of a professional shared vision, as well as the foundation for further efforts at defining excellence and developing structures and processes for appraising quality in physical therapist education programs. We urge development of a culture of assessment to move our physical therapist education programs closer to achieving excellence.
Is the blood pressure different between the paralyzed and unaffected arms or legs?
Authors: Tao Liang , Tang Min , Peng Hai-ping , Gu Meng-bi , Zhang Hua-zhong , Zhou Guang , Su Hai 
Published: June 2020

Objectives
To investigate whether the blood pressure (BP) levels are similar between the paralyzed and unaffected arms or legs.

Methods
This study enrolled 236 post-stroke patients with hemiplegic paralysis. Simultaneous four-limb BP was measured using four automatic BP devices for three times, and the average was used as final value. The inter-arm difference (IAD) and inter-ankle difference (IAND) were the BP difference between the arms or ankles, respectively. The difference between maximal BP reading and minimal BP reading was calculated as △BP to reflect the variation of three BP readings.

Results
The paralyzed arm had similar mean SBP (134.8 ± 18.7 vs. 135.1 ± 19.0 mmHg, NS) and DBP (79.5 ± 11.3 vs 78.1 ± 10.4 mmHg, NS) levels as compared with the unaffected arm. Similarly, the mean ankle SBP (143.6 ± 19.1 vs. 143.7 ± 18.6 mmHg, NS) and DBP (77.9 ± 17.7 vs. 75.8 ± 11.1 mmHg, NS) in the paralyzed legs were also similar to those in the unaffected legs. The detection rate of systolic IAD ≥10 mmHg was 5.9% and that for systolic IAND ≥15 mmHg was 20.3%. Meanwhile, △SBP levels were similar between two arms or ankles.

Conclusion
In the post-stroke patients with hemiplegic paralysis, the SBP and DBP levels of the paralyzed and unaffected arms or ankles were similar.
The impact of primary biliary cholangitis on non-alcoholic fatty liver disease
Authors: Iluz-Freundlich Daniel , Uhanova Julia , Grubert Van Iderstine Micah , Minuk Gerald Y. 
Published: June 2020

Background
The impact of chronic cholestatic liver diseases such as primary biliary cholangitis (PBC) on non-alcoholic fatty liver disease (NAFLD) has yet to be described.

Objectives
To document and compare the severity and course of liver disease in patients with NAFLD/PBC versus NAFLD alone.

Methods
In this retrospective, case-control study 68 adult NAFLD/PBC patients were matched 1:2 for age and sex with 136 NAFLD alone patients. Disease activity and severity were documented by serum aminotransferases, albumin, bilirubin and international normalized ratio (INR) values and hepatic fibrosis by Fib-4 and aspartate aminotransferase/platelet ratio indices (APRI).

Results
On presentation (baseline), NAFLD/PBC patients had similar serum aminotransferase, albumin and bilirubin levels but lower INR values than NAFLD alone patients. Fib-4 and APRI levels were similar. Despite longer follow-up (favouring more advanced disease) in NAFLD/PBC patients, serum aminotransferases and bilirubin values were similar but albumin and INR levels significantly lower in NAFLD/PBC versus NAFLD alone patients at the end of follow-up. NAFLD/PBC patients also had significantly lower and less worsening of Fib-4 values at the end of follow-up. Transition from intermediate Fib-4 levels to those compatible with no or limited fibrosis was higher in NAFLD/PBC patients.

Conclusion
These findings suggest PBC does not adversely affect the severity or course of NAFLD.
The Malnutrition Universal Screening Tool can predict malnutrition in patients with esophageal achalasia
Authors: Milito Pamela , Aquilino Krizia , Lazzari Veronica , Boveri Sara , Munizio Nadia , Ogliari Cristina , Asti Emanuele , Bonavina Luigi 
Published: June 2020

Background:
At present, little research has been done to clarify why some achalasia patients do not lose weight or are even obese and to investigate their nutritional status. The aim of this study was to identify predictive factors of malnutrition in these patients and to assess their response to treatment.

Methods:
We conducted a retrospective cohort study on consecutive patients referred to a tertiary-care center for laparoscopic or endoscopic treatment of achalasia. Demographics, anthropometric variables, presenting symptoms, and results of the objective investigation were recorded on a prospectively collected database. The severity of symptoms and the nutritional risk were assessed by the Eckardt score and the Malnutrition Universal Screening Tool (MUST), respectively, before and after treatment.

Results.
Between 2013 and 2019, 171 patients met the study inclusion criteria. There were 87 (50.9%) male and the median age was 53.0 (39–66) years. The median Eckardt score was 6 (interquartile range 3). Based on the MUST score, 121 (70.8%) patients were classified at moderate/high risk of malnutrition. Of these, 93 (76.9%) were overweight or obese. Compared to low-risk group, predictive factors of moderate/high risk of malnutrition were higher Eckardt score [odds ratio (OR) 1.63; 95% CI, 1.35–1.99], more severe dysphagia (OR 2.68, 95% CI, 1.66–4.30), and greater absolute weight loss (OR 2.37; 95% CI, 1.77–3.17). The latter was the only independent predictive factor of malnutrition (OR 2.54; 95% CI, 1.69–3.82). After treatment, the measured MUST score was 0 in 96% of patients.

Conclusions:
Over 70% of achalasia patients were at moderate/high risk of malnutrition. These individuals may benefit from a perioperative multidisciplinary approach including dietary intervention to stabilize weight and improve their nutritional status.
The burden of Clostridioides difficile infection in patients with history of liver transplant and during index admission
Authors: Wijarnpreecha Karn , Aby Elizabeth S. , Kim Donghee , Ungprasert Patompong , Cheungpasitporn Wisit , Thongprayoon Charat , Lukens Frank J. , Harnois Denise M. , Kröner Paul T. 
Published: June 2020

Background/objectives
Liver transplant recipients have an increased risk of Clostridioides difficile infection (CDI) which associated with higher morbidity and mortality. CDI in liver transplant has been argued to increase hospital costs, charges, and length of stay (LOS) in small studies. However, no recent nationwide analysis determines these outcomes.

Methods
This is a retrospective cohort study using the National Inpatient Sample 2016. All patients with ICD10CM diagnostic codes for CDI were included. The cohort was stratified for the history of liver transplant and liver transplant index admission. The primary outcome was the odds of CDI in both patient cohorts to patients without liver transplant. Secondary outcomes were inpatient morbidity, mortality, resource utilization, colectomy rates, LOS, and total hospital costs and charges.

Results
A total of 360 364 patients with CDI were identified, 1665 had a history of liver transplant and 155 had liver transplant during that admission. Patients with a history of liver transplant had increased odds of CDI compared to patients with no history of liver transplant (adjusted odds ratio 2.78; 95% confidence interval, 2.44–3.16). Patients with CDI had greater odds of shock, acute kidney injury, ICU stay, organ failure and significantly higher costs, charges and LOS.

Conclusions
Patients with a history of liver transplant increased odds of CDI. CDI with history of liver transplant and the index admission for liver transplant had higher odds of morbidity and resource utilization. Clinicians must maintain a high index of suspicion for CDI for early diagnosis and appropriate initiation of treatment.
Nomogram for Estimating Overall Survival in Patients With Metastatic Pancreatic Cancer
Authors: Goldstein David , Von Hoff Daniel D. , Chiorean E. Gabriela , Reni Michele , Tabernero Josep , Ramanathan Ramesh K. , Botteman Marc , Aly Abdalla , Margunato-Debay Sandra , Lu Brian , Louis Chrystal U. , McGovern Desmond , Lee Chee Khoon 
Published: June 2020

Objectives
This analysis investigated nomogram use to evaluate metastatic pancreatic cancer prognosis.

Methods
Thirty-four baseline factors were examined in the Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT) (nab-paclitaxel plus gemcitabine vs gemcitabine) data set. Factors significantly (P < 0.1) associated with overall survival (OS) in a univariable model or with known clinical relevance were tested further. In a multivariable model, factors associated with OS (P < 0.1) were selected to generate the primary nomogram, which was internally validated using bootstrapping, a concordance index, and calibration plots.

Results
Using data from 861 patients, 6 factors were retained (multivariable analysis): neutrophil-lymphocyte ratio, albumin level, Karnofsky performance status, sum of longest diameter of target lesions, presence of liver metastases, and previous Whipple procedure. The nomogram distinguished low-, medium-, and high-risk groups (concordance index, 0.67; 95% confidence interval, 0.65–0.69; median OS, 11.7, 8.0, and 3.3 months, respectively).

Conclusions
This nomogram may guide estimates of the range of OS outcomes and contribute to patient stratification in future prospective metastatic pancreatic cancer trials; however, external validation is required to improve estimate reliability and applicability to a general patient population. Caution should be exercised in interpreting these results for treatment decisions: patient characteristics could differ from those included in the nomogram development.
Serum Anti-p53 Antibody Can Serve as a Predictive Marker for Histological Grade of Intraductal Papillary Mucinous Neoplasms of the Pancreas
Authors: Hata Tatsuo , Mizuma Masamichi , Motoi Fuyuhiko , Iseki Masahiro , Omori Yuko , Hayashi Hiroki , Nakagawa Kei , Morikawa Takanori , Kamei Takashi , Naitoh Takeshi , Furukawa Toru , Unno Michiaki 
Published: June 2020

Objective
The aim of the study was to clarify the diagnostic impact of measuring serum anti-p53 antibody (S-p53Ab) in predicting the histological grades of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.

Methods
We compared the measured values and positive prevalence of S-p53Ab across the different histological grades of 111 resected IPMN cases. We also evaluated the TP53 alterations using immunohistochemistry and next-generation sequencing.

Results
Serum anti-p53 antibody were detected in 6 of 111 cases, all of their histological grades were high-grade dysplasia (HGD) and invasive carcinoma (INV). Positive prevalence of S-p53Ab was higher in cases with INV (4/35 cases, 11.4%) than those with HGD (2/38 cases, 5.3%), whereas S-p53Abs were undetectable in cases with low-grade dysplasia. Measured S-p53Ab values were not correlated with either carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA 19-9). In 4 of 6 S-p53Ab-positive cases, the TP53 alterations—somatic pathogenic mutations or aberrant immunoreactivity—were identified in their IPMN lesions. A combination assay of S-p53Ab, CEA, and CA 19-9 revealed a 38.4% sensitivity and 81.6% specificity for predicting HGD/INV.

Conclusions
Serum anti-p53 antibody can serve as a surrogate marker for TP53 alterations and help predict the presence of HGD/INV in cases with IPMN, in combination with CEA and CA 19-9.