bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of caffeine on brain antioxidant status and mitochondrial respiration in acetaminophen-intoxicated mice
Authors: Gonçalves Débora F , Tassi Cintia C , Amaral Guilherme P , Stefanello Silvio T , Dalla Corte Cristiane L , Soares Félix A , Posser Thais , Franco, Jeferson L , Carvalho Nélson R 
Published: September 2020

AbstractHepatic encephalopathy is a pathophysiological complication of acute liver failure, which may be triggered by hepatotoxic drugs such as acetaminophen (APAP). Although APAP is safe in therapeutic concentration, APAP overdose may induce neurotoxicity, which is mainly associated with oxidative stress. Caffeine is a compound widely found in numerous natural beverages. However, the neuroprotective effect of caffeine remains unclear during APAP intoxication. The present study aimed to investigate the possible modulatory effects of caffeine on brain after APAP intoxication. Mice received intraperitoneal injections of APAP (250 mg/kg) and/or caffeine (20 mg/kg) and, 4 h after APAP administration, samples of brain and blood were collected for the biochemical analysis. APAP enhanced the transaminase activity levels in plasma, increased oxidative stress biomarkers (lipid peroxidation and reactive oxygen species), promoted an imbalance in endogenous antioxidant system in brain homogenate and increased the mortality. In contrast, APAP did not induce dysfunction of the mitochondrial bioenergetics. Co-treatment with caffeine modulated the biomarkers of oxidative stress as well as antioxidant system in brain. Besides, survival assays demonstrated that caffeine protective effects could be dose- and time-dependent. In addition, caffeine promoted an increase of mitochondrial bioenergetics response in brain by the enhancement of the oxidative phosphorylation, which could promote a better energy supply necessary for brain recovery. In conclusion, caffeine prevented APAP-induced biochemical alterations in brain and reduced lethality in APAP-intoxicated mice, these effects may relate to the preservation of the cellular antioxidant status, and these therapeutic properties could be useful in the treatment of hepatic encephalopathy induced by APAP intoxication.
Bisphenol AF and Bisphenol F Induce Similar Feminizing Effects in Chicken Embryo Testis as Bisphenol A
Authors: Mentor Anna , Wänn Mimmi , Brunström Björn , Jönsson Maria , Mattsson Anna 
Published: September 2020

Abstract
The plastic component bisphenol A (BPA) impairs reproductive organ development in various experimental animal species. In birds, effects are similar to those caused by other xenoestrogens. Because of its endocrine disrupting activity, BPA is being substituted with other bisphenols in many applications. Using the chicken embryo model, we explored whether the BPA alternatives bisphenol AF (BPAF), bisphenol F (BPF), and bisphenol S (BPS) can induce effects on reproductive organ development similar to those induced by BPA. Embryos were exposed in ovo from embryonic day 4 (E4) to vehicle, BPAF at 2.1, 21, 210, and 520 nmol/g egg, or to BPA, BPF, or BPS at 210 nmol/g egg and were dissected on embryonic day 19. Similar to BPA, BPAF and BPF induced testis feminization, manifested as eg testis-size asymmetry and ovarian-like cortex in the left testis. In the BPS-group, too few males were alive on day 19 to evaluate any effects on testis development. We found no effects by any treatment on ovaries or Müllerian ducts. BPAF and BPS increased the gallbladder-somatic index and BPAF, BPF and BPS caused increased embryo mortality. The overall lowest-observed-adverse-effect level for BPAF was 210 nmol/g egg based on increased mortality, increased gallbladder-somatic index, and various signs of testis feminization. This study demonstrates that the BPA replacements BPAF, BPF, and BPS are embryotoxic and suggests that BPAF is at least as potent as BPA in inducing estrogen-like effects in chicken embryos. Our results support the notion that these bisphenols are not safe alternatives to BPA.
Community-associated MRSA among Indigenous children in remote settings
Authors: Campbell Rhonda , Martin Donna , Pierce Darlene , Nweze Sochimaobi 
Published: September 2020

Abstract:
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a major public health concern for Indigenous pediatric populations worldwide. It is the leading cause of skin and soft tissue infections in this demographic. This article reviews the literature and presents an evidence-based algorithm for the assessment and management of CA-MRSA among Indigenous children in remote settings.
Medium-Term Patient-Reported Quality of Life and Activities of Daily Living in Surgically Treated Trauma Patients With Pelvic, Acetabular or Combined Pelvic and Acetabular Fractures in a Retrospective Single-Center Study
Authors: de Krom Maartje A. P. , Kalmet Pishtiwan H. S. , Jagtenberg Eline M. , Jansen Joey J. R. , Versteegh Viktor E. , Verbruggen Jan P. A. M , Seelen Henk A.M. , Poeze Martijn 
Published: September 2020

Objective:
To gain more insights in the medium-term patient-reported quality of life (QoL), activities of daily living (ADL), and number of complications in trauma patients with an acetabular fracture (AF), a pelvic fracture (PF), and those with a surgically combined pelvic and AF (PAF).

Design:
Retrospective single-center study.

Setting:
Level I academic trauma center.

Patients/Participants:
51 trauma patients with PF, AF, or PAF who were surgically treated between 2014 and 2017.

Intervention:
Open reduction and internal fixation.

Main Outcome Measurements:
Primary outcome measures are patient-reported outcome questionnaire, which includes 2 items, the QoL, as measured with the Short Form-12, and the ADL, as measured with the Lower Extremity Functional Scale. The secondary outcome parameter was the occurrence of complications during a follow-up of at least 2 years.

Results:
The mean physical component score (PCS) of the QoL (P = 0.03) and the ADL (P = 0.03) were significantly higher in patients with AF compared with patients with PF. The incidence of the overall postoperative complications did not significantly differ between the PF, AF, and PAF groups (P = 0.28).

Conclusions:
This study found that the PCS of the QoL and the ADL in surgically treated trauma patients with PF were significantly lower compared with patients with AF. No significant differences were found in overall complication rate between the PF, AF, and PAF groups.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Effect of a 6 am–9 am Dedicated Orthopaedic Trauma Room on Hip Fracture Outcomes in a Community Level II Trauma Center
Authors: McDonald Michael , Ward Lawrence , Wortham Heather , Sorenson Breanna , Jarski Robert , El-Yussif Eddie 
Published: September 2020

Objective:
To assess the outcomes of elderly hip fracture surgeries performed 12 months before and 12 months after the implementation of a daily 6 am–9 am dedicated orthopaedic trauma room (DOTR) at a Level II community trauma center.

Design:
Retrospective cohort study.

Setting:
Level II academic trauma center.

Patients:
A total of 431 consecutive trauma patients undergoing surgical management of isolated low-energy hip fractures from January 1, 2018, to December 31, 2019.

Intervention:
Implementation of a 6 am–9 am DOTR Monday through Friday.

Main Outcome Measures:
Time to surgery, number of cases performed after hours, surgical time, 90-day morbidity and mortality, and time to therapy.

Results:
Retrospective analysis showed that despite a 24% increase in surgical hip fracture volume, implementation of a part-time DOTR led to a decrease in after-hours surgery (32.4% vs. 19.6%; P = 0.008) and patients requiring the intensive care unit postoperatively (7% vs. 3.8%; P = 0.036). Surgeries performed after hours were longer than that of surgeries performed during the daytime (82.0 vs. 68 minutes; P = 0.003) and had more complications (pneumonia, pulmonary embolism, and surgical site infection; P = 0.002, 0.047, 0.024, respectively).

Conclusions:
Our results show that a part-time DOTR in a community Level II hospital is associated with improvement in patient care.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Protocolized Tracheal and Thoracic Ultrasound for Confirmation of Endotracheal Intubation and Positioning: A Multicenter Observational Study
Authors: Senussi Mourad H. , Kantamneni Phani C. , Latifi Mani , Omranian Ali P. , Krveshi Lirim , Barakat Amr F. , Masri Ahmad , Schmidhofer Mark 
Published: September 2020

Objectives:
To determine the feasibility of a combination of tracheal and thoracic ultrasonography to confirm adequate positioning of endotracheal tube placement in a cohort of critically ill patients.

Design:
Prospective, multicenter, observational study from January 2019 to May 2020.

Setting:
Multicenter study conducted in multiple ICUs across four different academic tertiary and community hospitals.

Patients:
Eligible patients were adults (≥ 18 yr) requiring endotracheal intubation and intensive care.

Intervention:
Tracheal and thoracic ultrasonography were performed during intubation attempts to rule out esophageal intubations, to detect mainstem intubations, and to confirm and adjust endotracheal tube position.

Measurements and Main Results:
Among 118 patients, median age was 66 years (interquartile range 56–73 yr), body mass index 28 (interquartile range 25–34), and 63.6 % were males. Using the ultrasound protocol, one esophageal (0.9%) and five main stem intubations (4.2%) were detected. 97.5% of final endotracheal tube positions confirmed by ultrasound were in concordance with the next occurring chest radiograph, with only three (2.5%) requiring minor post-chest radiograph adjustments.

Conclusions:
A protocolized, systematic approach using tracheal and thoracic ultrasonography can be used to confirm endotracheal intubation, detect main stem intubations, and guide tube positioning in the critically ill. This ultrasonographic approach is easily applicable, safe, and comparable to chest radiography. This approach may serve as a potential alternative or adjunct when chest radiography is not available or ideal. This has the potential to be used for routine intensive care, out-of-hospital or resource-poor settings, or situations which require isolation precautions to mitigate the use of chest radiography.
Different distributions of nerve demyelination in chronic acquired multifocal polyneuropathies
Authors: Zhou Xia-Jun , Zhu Ying , Zhu De-Sheng , Han Lu , Liu Qian-Yun , Liang Xiao-Niu , Hao Yong , Li Ze-Zhi , Guan Yang-Tai 
Published: September 2020

AbstractBackgroundMultifocal motor neuropathy (MMN), Lewis-Sumner syndrome (LSS), and many chronic inflammatory demyelinating polyradiculoneuropathies (CIDPs) are representative of acquired multifocal polyneuropathy and are characterized by conduction block (CB). This retrospective study aimed to investigate the demyelinating distribution and the selective vulnerability of MMN, LSS, and CIDP with CB (CIDP-CB) in nerves.MethodsFifteen LSS subjects (107 nerves), 24 MMN subjects (176 nerves), and 17 CIDP-CB subjects (110 nerves) were included. Their clinical information was recorded, blood and cerebrospinal fluid tests were conducted, and nerve conductions of the median, ulnar, radial, peroneal, and tibial nerves were evaluated. CB, temporal dispersion, distal motor latency (DML), and F-wave latency were recorded, and nerve conduction velocity, terminal latency index, and modified F-wave ratio were calculated.ResultsCB was more likely to occur around the elbow in CIDP-CB than in MMN (78.6%vs. 6.8%,P < 0.01) but less likely to occur between the wrist and the elbow than in LSS (10.7%vs. 39.3%,P < 0.05). Tibial nerve CB was most frequently observed in MMN (47.4%,P < 0.05). CIDP-CB was characterized by a prolonged DML in all nerves, and slow motor nerve velocity of the upper limb was significant when CB nerves were excluded (P < 0.05).ConclusionsWe report the different distributions of segmental and diffuse demyelination of the ulnar and tibial nerves in LSS, MMN, and CIDP-CB. These distinct distributions could help in differentiating among these conditions.
Cancer of the Vulva: A Review
Authors: Michalski Basia M. , Pfeifer John D. , Mutch David , Council M. Laurin 
Published: September 2020

BACKGROUND
Vulvar cancers, although rare, are becoming an increasingly serious threat to women's health. Cancer of the vulva accounted for 0.3% of all new cancers in the United States in 2019, with 6,070 newly diagnosed cases. This review details the epidemiology, pathogenesis, diagnosis, staging, and treatment of vulvar malignancies.

OBJECTIVE
To review cancer entities of the vulva, including vulvar intraepithelial neoplasms, squamous cell carcinoma (SCC), malignant melanoma, basal cell carcinoma, neuroendocrine tumors, and adenocarcinomas.

MATERIALS AND METHODS
Literature review using PubMed search for articles related to cancer of the vulva.

RESULTS
Vulvar intraepithelial neoplasms represent premalignant precursors to SCC of the vulva. There are several different histopathologic subtypes of SCC, and treatment is dependent on characteristics of primary tumor and lymph node involvement. Melanoma is the second most common cancer to affect the vulva, and staging is based on tumor, node, and metastatic spread.

CONCLUSION
Vulvar malignancies are rare, and diagnosis is dependent on biopsy and pathologic evaluation. Treatment for vulvar malignancies depends on histopathologic diagnosis but ranges from wide local excision with or without lymph node biopsy or dissection to radiation therapy with chemo- or immunotherapy. Overall survival varies by diagnosis.
State-Level Numbers and Rates of Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths by Age, 2014
Authors: Sarmiento Kelly , Thomas Karen , Daugherty Jill , Haarbauer-Krupa Juliet , Waltzman Dana 
Published: September 2020

Objective:
To provide state-level traumatic brain injury (TBI)-related emergency department (ED) visit, hospitalization, and death estimates by age group for 2014.

Setting and Participants:
Centers for Disease Control and Prevention's Core Violence and Injury Prevention Program and State Injury Indicators-participating states.

Design:
Cross-sectional.

Main Measures:
Number and population-based incidence rates of TBI-related ED visits, hospitalizations, and deaths by age group—children and young adults (0-24 years), adults (25-64 years), and older adults (≥65 years)—in 36 states.

Results:
South Dakota had the lowest rates of TBI-related ED visits for all age groups—children and young adults: 566.2 (95% CI: 539.2-593.3) per 100 000; adults: 269.2 (95% CI: 253.0-285.4) per 100 000; and older adults: 324.3 (95% CI: 293.4-355.2) per 100 000. Rhode Island had the lowest rate of TBI-related hospitalizations for children and young adults—25.9 (95% CI: 20.7-32.0) per 100 000. The lowest rate of TBI-related hospitalizations among adults and older adults was in Virginia—39.6 (95% CI: 37.7-41.4) per 100 000—and Ohio—129.3 (95% CI: 124.0-134.6) per 100 000—respectively. Maryland had the lowest rate of TBI-related deaths for children and young adults—3.1 (95% CI: 2.3-3.9) per 100 000. Rhode Island had the lowest rate of TBI-related deaths for adults—7.2 (95% CI: 5.2-9.8) per 100 000—and New Jersey had the lowest rate of TBI-related deaths for older adults—29.4 (95% CI: 26.5-32.4) per 100 000.

Conclusion:
This analysis demonstrated that there are variations in TBI-related ED visits, hospitalizations, and deaths by age. State public health professionals may use these findings to develop state-based strategies to address TBI.
State-Level Numbers and Rates of Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths by Sex, 2014
Authors: Waltzman Dana , Haarbauer-Krupa Juliet , Daugherty Jill , Thomas Karen , Sarmiento Kelly 
Published: September 2020

Objective:
To provide state-level traumatic brain injury (TBI)-related emergency department (ED) visit, hospitalization, and death estimates by sex for 2014.

Setting and Participants:
Centers for Disease Control and Prevention's Core Violence and Injury Prevention Program and State Injury Indicators-participating states.

Design:
Cross-sectional.

Main Measures:
Number and rate of TBI-related ED visits, hospitalizations, and deaths (indicators) by sex in over 25 states.

Results:
Across all states that supplied data, males had higher rates of TBI-related ED visits, hospitalizations, and deaths than females. However, for some indicators, high rates for both sexes and low rates for both sexes appeared clustered in a specific region of the United States. There was also within-state variability in TBI rates by indicator and sex. For example, within-state variability between sexes ranged from as low as 2.8% for ED visits and as high as 335% for deaths.

Conclusion:
TBI-related ED visits, hospitalizations, and deaths varied by state and by sex, and evidence was found for within-state variability in TBI rates by indicator and sex in 2014. Differences in TBI indicators by sex may have important implications for public health professionals implementing TBI prevention and care strategies at the state level.
Effects of Terpinen-4-ol on Meibomian Gland Epithelial Cells In Vitro
Authors: Chen Di , Wang Jingyi , Sullivan David A. , Kam Wendy R. , Liu Yang 
Published: September 2020

Purpose:
Infestation with demodex mites has been linked to the development of chalazion, meibomian gland dysfunction, and blepharitis. An effective treatment is the eyelid application of terpinen-4-ol (T4O), a tea tree oil component. However, T4O is also known to be toxic to nonocular epithelial cells. We hypothesize that T4O toxicity also extends to human meibomian gland epithelial cells (HMGECs).

Methods:
Immortalized (I) HMGECs were cultured with varying concentrations (1.0%–0.001%) of T4O under proliferating or differentiating conditions up to 5 days. Experimental procedures included analyses of cell appearance, survival, P-Akt signaling, lysosome accumulation, and neutral lipid content.

Results:
Our findings show that T4O causes a dose- and time-dependent decrease in the cell survival of IHMGECs. After 15 minutes of exposure to 1% T4O, IHMGECs exhibited rounding, atrophy, and poor adherence. Within 90 minutes of such treatment, almost all cells died. Reducing the T4O concentration to 0.1% also led to a marked decrease in P-Akt signaling and cell survival of IHMGECs. Decreasing the T4O amount to 0.01% caused a slight, but significant, reduction in the IHMGEC number after 5 days of culture and did not influence the ability of these cells to differentiate.

Conclusions:
T4O, even at levels 10-fold to 100-fold lower than demodicidal concentrations, is toxic to HMGECs in vitro.
Tuck In Femtosecond Laser Assisted Anterior Lamellar Keratoplasty (T-FALK) for the Management of Superficial Anterior Corneal Scars—A Modified Technique
Authors: Sharma Vijay K. , Sati Alok , Kaushik Jaya , Kumar Santosh , Agarwal Manisha 
Published: September 2020

Purpose:
To report a modified sutureless and glue-less technique, termed tuck in femtosecond laser assisted anterior lamellar keratoplasty (T-FALK), and to achieve a good graft–host junction apposition.

Methods:
This is a prospective interventional case series of 15 eyes of 15 patients who underwent T-FALK. Depth of the anterior corneal scar was assessed using anterior segment optical coherence tomography (ASOCT). The donor and recipient lenticules were prepared using femtosecond laser. After removing the recipient anterior scarred lenticule, the transparent donor lenticule was positioned on the recipient bed and margins tucked in under the recipient cornea. A bandage contact lens was applied for 3 weeks. Postoperatively, topical antibiotic and steroid combination eye drops were given, and the assessment of healing of the graft-host junction was done using ASOCT.

Results:
A total of 15 patients (8 men and 7 women) underwent T-FALK. Six patients had superficial corneal opacities after healed microbial keratitis, 5 patients had spheroidal corneal degeneration, 3 patients had Salzman nodular degeneration, and 1 patient had vortex keratopathy. No intraoperative or postoperative complications were noted during T-FALK. All patients had good graft–host junction apposition postoperatively, as demonstrated by ASOCT.

Conclusions:
Sutureless and glue-less T-FALK can be the best way ahead for management of superficial anterior corneal scars with good visual outcome.
Successful Treatment of a Pediatric Neurotrophic Keratopathy With Cenegermin
Authors: Papadopoulos Kosmas , Besgen Volker , Sekundo Walter 
Published: September 2020

Purpose:
We present a challenging case of a 9-year-old patient with refractory neurotrophic keratopathy (NK) who was successfully treated with cenegermin eye drops.

Methods:
A 7-year-old boy developed an ocular infection after a visit to a public swimming pool. After having been unsuccessfully treated for 2 years with antibiotics, steroids, and artificial tears, the patient presented to our clinic with a therapy-refractory NK. We initiated treatment with autologous serum eye drops that showed only weak response. Therefore, treatment with cenegermin eye drops was started.

Results:
After cenegermin therapy, a complete restoration of the corneal surface and an increase in visual acuity were achieved.

Conclusions:
The use of cenegermin is effective in treating pediatric NK.
Mini-Scleral Lenses Improve Vision-Related Quality of Life in Keratoconus
Authors: Kreps Elke O. , Pesudovs Konrad , Claerhout Ilse , Koppen Carina 
Published: September 2020

Purpose:
To evaluate the effects of mini-scleral lenses on visual acuity (VA) and visual functioning in patients with keratoconus.

Methods:
This prospective, interventional study examined the effects of mini-scleral lenses on VA and visual functioning in patients with keratoconus. Patients younger than 18 years or with a history of refractive surgery or corneal graft surgery were excluded. Patients were fitted with mini-Misa lenses, Senso mini-scleral lenses, or Zenlens mini-scleral lenses. Outcome measures were scleral lens–corrected VA and vision-related quality of life as assessed with the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-39).

Results:
Eighty-nine eyes of 50 keratoconus patients were included in the study. Median baseline logarithm of the minimal angle of resolution VA with habitual correction was 0.22 (range 0.02–1.04). Mini-scleral lens fitting resulted in a statistically significant visual improvement (median 0; P < 0.0001). At the 6-month follow-up, 11 patients (22%) had abandoned mini-scleral lens wear, primarily because of difficulties with lens handling (7 patients). Of the 39 patients with continued wear, 33 patients (84.6%) wore their lenses for a daily average of 12 hours. NEI-VFQ scoring in these patients showed significantly improved results for both visual functioning and socioemotional scales after scleral lens fitting (P < 0.0001).

Conclusions:
Mini-scleral lenses significantly improve VA and visual functioning on NEI-VFQ in patients with keratoconus. Difficulties with lens insertion and removal are the principal reason for lens dropout.