bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pecan pericarp extract protects against carbon tetrachloride-induced liver injury through oxidative mechanism in rats
Authors: Dorsaf Hallegue , Sabrine Moujahed , Houda Ben Lamine , Khémais Ben Rhouma , Mohsen Sakly , Olfa Tebourbi 
Published: August 2020

AbstractThe purpose of this study was to quantify the proanthocyanidin content of pecan (Carya illinoinensis) pericarp extract (PPE) and to assess its useful impacts against carbon tetrachloride (CCl4)-induced hepatotoxicity. Rats were randomly divided into four groups: Group 1: received intraperitoneal injection of saline solution, Group 2: was injected with PPE (25 mg/kg body weight) for 10 consecutive days, Group 3: received CCl4 (0.5 ml/kg, subcutaneous injection), Group 4: was coadministred with PPE + CCl4. The CCl4 was administered every 3 days during 10 days. Results revealed the presence of a high amount of total proanthocyanidins in the PPE (81.01 ± 0.21 mg TAE.g−1DW). CCl4 injection induced significant reductions in hepatic antioxidants but increased hepatic lipid peroxidation (LPO) as well as serum injury biomarkers. However, cotreatment with PPE significantly (P &lt; 0.05) inverted CCl4-induced increase in plasma alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase activities, respectively to 74%, 77%, 60%, and 82% compared with CCl4 group. No significant toxic effects were observed following treatment with plant extract alone. PPE cotreatment also decreased significant (P &lt; 0.05) the hepatic malondialdehyde formation (21%) and enhanced the liver catalase activity (107%) in CCl4-intoxicated rats. The histopathological examination showed inflammatory infiltration and degenerative changes in the hepatic tissue following CCl4 injection. The hepatoprotective activity of PPE against CCl4 exposure was supported by the maintenance of structural integrity of liver histopathology. In conclusion, the current study illustrated that PPE pretreatment significantly improved all examined parameters, restored the hepatic architecture and successfully alleviates oxidative damage induced by CCl4 intoxication.
Applicability of hiPSC-Derived Neuronal Cocultures and Rodent Primary Cortical Cultures for In Vitro Seizure Liability Assessment
Authors: Tukker Anke M , Wijnolts Fiona M J , de Groot Aart , Westerink Remco H S 
Published: August 2020

Abstract
Seizures are life-threatening adverse drug reactions which are investigated late in drug development using rodent models. Consequently, if seizures are detected, a lot of time, money and animals have been used. Thus, there is a need for in vitro screening models using human cells to circumvent interspecies translation. We assessed the suitability of cocultures of human-induced pluripotent stem cell (hiPSC)-derived neurons and astrocytes compared with rodent primary cortical cultures for in vitro seizure liability assessment using microelectrode arrays. hiPSC-derived and rodent primary cortical neuronal cocultures were exposed to 9 known (non)seizurogenic compounds (pentylenetetrazole, amoxapine, enoxacin, amoxicillin, linopirdine, pilocarpine, chlorpromazine, phenytoin, and acetaminophen) to assess effects on neuronal network activity using microelectrode array recordings. All compounds affect activity in hiPSC-derived cocultures. In rodent primary cultures all compounds, except amoxicillin changed activity. Changes in activity patterns for both cell models differ for different classes of compounds. Both models had a comparable sensitivity for exposure to amoxapine (lowest observed effect concentration [LOEC] 0.03 µM), linopirdine (LOEC 1 µM), and pilocarpine (LOEC 0.3 µM). However, hiPSC-derived cultures were about 3 times more sensitive for exposure to pentylenetetrazole (LOEC 30 µM) than rodent primary cortical cultures (LOEC 100 µM). Sensitivity of hiPSC-derived cultures for chlorpromazine, phenytoin, and enoxacin was 10-30 times higher (LOECs 0.1, 0.3, and 0.1 µM, respectively) than in rodent cultures (LOECs 10, 3, and 3 µM, respectively). Our data indicate that hiPSC-derived neuronal cocultures may outperform rodent primary cortical cultures with respect to detecting seizures, thereby paving the way towards animal-free seizure assessment.
Problem-Based Learning and Case Scenarios: An Interprofessional Pharmacology Experience
Authors: Rosenbloom Sylvie , Nemec Eric C. 
Published: August 2020

Abstract
Interprofessional education (IPE) is a required component of the nursing curriculum as it can foster students’ abilities to become integral members of the health care team. To facilitate this requirement, an IPE experience focusing on cardiovascular pharmacology was created for nurse practitioner and physician assistant students. The authors developed and utilized a problem-based learning activity and two minicase scenarios. The Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education-Revised was administered before and after the activity to assess students’ attitudes toward IPE. This article reviews the planning, development, and implementation of this IPE experience and discusses its challenges.
Trajectories of Disability and Low Back Pain Impact
Authors: Dutmer Alisa L. , Schiphorst Preuper Henrica R. , Stewart Roy E. , Soer Remko , Reneman Michiel F. , Wolff André P. 
Published: August 2020

Study Design.
Prospective cohort study.

Objective.
The aim of this study was to identify treatment response trajectories in patients with low back pain (LBP) during and after multidisciplinary care in a tertiary spine center, and to examine baseline patient characteristics that can distinguish trajectories.

Summary of Background Data.
Treatment response is often heterogeneous between patients with LBP. Knowledge on key characteristics that are associated with courses of disability could identify patients at risk for less favorable outcome. This knowledge will help improve shared decision-making.

Methods.
Adult patients with LBP completed questionnaires on disability (Pain Disability Index) and LBP impact (Impact Stratification of the National Institutes of Health minimal dataset) at baseline, 6, 12, 18, and 24 months’ follow-up. Latent class analyses were applied to identify trajectories of disability and LBP impact. Baseline sociodemographic and clinical patient characteristics were compared between trajectory subgroups.

Results.
Follow-up was available for 996 patients on disability and 707 patients on LBP impact. Six trajectories were identified for both outcome measures. Three disability trajectories remained stable at distinct levels of severity (68% of patients) and three trajectories showed patterns of recovery (32%). For LBP impact there was one stable trajectory (17%), two slightly improving (59%), two recovering (15%), and one with a pattern of recovery and relapse (15%). Significant differences between trajectories were observed for almost all baseline patient characteristics.

Conclusion.
On average, patients show moderate improvements in disability and LBP impact 2 years after visiting a multidisciplinary tertiary spine center. However, latent class analyses revealed that most patients belong to subgroups experiencing stable levels of disability and LBP impact. Differences in baseline patient characteristics were mostly associated with baseline levels of functioning, instead of (un)favorable outcome during follow-up.

Level of Evidence: 2
Adjacent Level Ossification Development Following Anterior Cervical Fusion
Authors: Lee Dong-Ho , Park Sehan , Park Jae-Woo , Hwang Chang-Ju , Cho Jae Hwan , Lee Choon Sung , Riew K. Daniel 
Published: August 2020

Study Design.
Retrospective matched cohort analysis.

Objective.
The aim of this study was to investigate the impact of adjacent level ossification development (ALOD) on the affected as well as the next-level discs with regards to range of motion (ROM) and degenerative changes.

Summary of Background Data.
Although ALOD is not a rare condition in patients who undergo anterior cervical fusion procedures, there has been little discussion to date about its clinical implications.

Methods.
Patients who underwent anterior cervical instrumented fusion with a minimum 2-year follow-up were reviewed. Twelve patients with each respective ossification grade (totally 48 patients) were matched based on age, sex, and number of fusion levels. On the preoperative and final follow-up x-rays, disc height, osteophytes, ROM, and maximal listhesis were assessed at the segments which were one- (the adjacent segment) and two-level cranial (the next segment) to the uppermost fused disc. Then, the patients were divided into two groups according to ALOD degree: group 1 (grade 0–1, N = 24) versus group 2 (grade 2–3, N = 24). The changes of all variables were compared between the two groups.

Results.
The mean ROM of the adjacent segment increased by 3.6 degree in group 1 and conversely decreased by 2.8 degree in group 2 (P = 0.002). The mean ROM increase of the next segment was significantly greater in group 2 than in group 1 (4.5 vs. 1.2 degree, P = 0.016). The osteophyte growth and the progression of listhesis at the next segment were significantly greater in group 2 (P < 0.05). Disc height of the next segment significantly decreased in group 2, but did not change in group 1.

Conclusion.
Severe ALOD (grade 2–3) following anterior cervical fusion significantly reduced ROM at the affected segment and conversely increased motion at the next segment. This increased motion probably accelerated the degeneration of the next-level disc.

Level of Evidence: 3
Design and Validation of a Spinal Surgical Navigation System Based on Spatial Augmented Reality
Authors: Xu Bin , Yang Zhiyong , Jiang Shan , Zhou Zeyang , Jiang Bowen , Yin Shiwu 
Published: August 2020

Study Design.
Prospective observational study.

Objective.
This article aims to develop a spatial augmented reality-based surgical navigation system to assist in the placement of pedicle screws in minimally invasive spine surgery and to verify the accuracy of this method.

Summary of Background Data.
Due to their high accuracy and good visualization ability, augmented reality surgical navigation systems have been used in minimally invasive surgeries. However, augmented reality does not allow information to be shared and restricts doctors.

Methods.
A surgical navigation system that implements augmented reality based on a projector can be used to realize the external visualization of virtual organs and surgical information through an improved multiple information fusion method. Using fiducial markers and imaging technology, the patient's spatial position is tracked and registered in real time. All the information is accurately fused with the patient's back skin, and the surgeon can see surgical information such as the preoperative plan and bones. Phantom experiments were used to verify the accuracy and effectiveness of the system.

Results.
In the phantom experiments, the accuracy of the pedicle screw insertion point on the dummy's skin was 0.441 ± 0.214 mm, the average location error into the dummy's body was 1.645 ± 0.355 mm, and the average axial and sagittal angulation errors were <0.9°.

Conclusion.
This article introduces and verifies the design of a new surgical navigation system based on spatial augmented reality for lumbar pedicle screw implantation. The system passed a series of phantom accuracy experiments. Compared with the traditional augmented reality navigation system, this system avoids the use of glasses and truly realizes the effect of naked-eye 3D, which is more convenient for doctors to use for communication during an operation.

Level of Evidence: N/A
Perioperative ADministration of Dexamethasone And blood Glucose concentrations in patients undergoing elective non-cardiac surgery – the randomised controlled PADDAG trial
Authors: Corcoran Tomás B. , O’Loughlin Edmond , Chan Matthew T.V. , Ho Kwok M. 
Published: August 2020

BACKGROUND
The hyperglycaemic effect of dexamethasone in diabetic and nondiabetic patients in the peri-operative period is unknown.

OBJECTIVE
To assess the effect of a single dose of intra-operative dexamethasone on peri-operative blood glucose.

DESIGN
Multicentre, stratified, randomised trial.

SETTING
University hospitals in Australia and Hong Kong.

PATIENTS
A total of 302 adults scheduled for elective, noncardiac and nonobstetric surgical procedures under general anaesthesia, stratified by diabetes mellitus status, were randomised to receive placebo, 4 or 8 mg dexamethasone administered intravenously after induction of anaesthesia.

MAIN OUTCOME MEASURES
Maximum blood glucose within 24 h of surgery, and the interaction between glycated haemoglobin (HbA1c) and dexamethasone were the primary and secondary outcomes.

RESULTS
The median [IQR] baseline blood glucose in the nondiabetes stratum in the placebo (n=81), 4 mg (n=81) and 8 mg dexamethasone (n=77) trial arms were respectively 5.3 [4.6 to 5.8], 5.0 [4.7 to 5.4] and 5.0 [4.2 to 5.9] mmol l−1. In the diabetes stratum these values were 6.6 [6.0 to 8.3]; (n=22), 6.1 [5.5 to 10.4]; (n=22) and 6.7 [5.6 to 8.3]; (n=19) mmol l−1. The median [IQR] maximum peri-operative blood glucose values in the nondiabetes stratum were 6.0 [5.3 to 6.8], 6.3 [5.5 to 7.3] and 6.3 [5.8 to 7.4] mmol l−1 in the control, dexamethasone 4 mg and dexamethasone 8 mg arms, respectively. In the diabetes stratum these values were 10.3 [8.1 to 12.4], 12.6 [10.3 to 18.3] and 13.6 [11.2 to 20.1] mmol l−1. There was a significant interaction between pre-operative HbA1c value and 8 mg dexamethasone: every 1% increment in HbA1c produced a 4.0 mmol l−1 elevation in maximal peri-operative glucose concentration.

CONCLUSION
Dexamethasone 4 mg or 8 mg did not induce greater hyperglycaemia compared with placebo for nondiabetic and well controlled diabetic patients. Maximal peri-operative blood glucose concentrations in patients with diabetes were related to baseline HbA1c values in a concentration-dependent fashion after 8 mg of dexamethasone.

TRIAL REGISTRATION
Australia and New Zealand Clinical Trials Registry (ACTRN12614001145695): URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367272.
Ultrasound-guided interscalene block combined with intermediate or superficial cervical plexus block for clavicle surgery
Authors: Arjun B. Krishna , Vinod Chinnamaregowda N. , Puneeth Jayanna , Narendrababu Madappa C. 
Published: August 2020

BACKGROUND
The complex innervation of the clavicle makes general anaesthesia a preferred technique for clavicular surgeries in current practice. The role and approach of regional anaesthesia remains unanswered.

OBJECTIVES
This study aims to delineate the relative effectiveness between interscalene brachial plexus block with either intermediate cervical plexus or superficial cervical plexus block (CPB) as the anaesthetics for clavicular surgery.

DESIGN
A randomised, double-blind prospective study.

SETTING
Single-centre, tertiary care medical college and research institute.

PATIENTS
Fifty patients with American Society of Anesthesiologist's (ASA) grade I to III, aged 18 to 70 years, scheduled for clavicular surgery, during May 2018 to April 2019 were enrolled in this study.

INTERVENTION
All patients received interscalene block with 10 ml of 0.5% bupivacaine. Patients were randomised to undergo additional ultrasound-guided intermediate CPB (Group-1) or superficial CPB (Group-2) with 10 ml of 0.5% bupivacaine.

MAIN OUTCOME MEASURES
The block success rate, sensory block onset time, haemodynamic parameters, duration of postoperative analgesia and complications were noted. Categorical data were analysed using the chi-square test and Fisher's exact test. Continuous data were analysed using Student's t-test.

RESULT
In Group 1, block success was 100%. In Group 2, five patients failed to achieve adequate surgical anaesthesia (P = 0.02). The average sensory block onset time in Group 1 was 2.5 ± 0.4 min and was longer in Group 2, 4.3 ± 0.5 min (P < 0.001). There was no difference between the groups with respect to haemodynamic parameters and complications. The mean duration of postoperative analgesia was longer in Group 1 (7.5 ± 0.8 h) as compared with Group 2 (5.7 ± 0.4 h, P < 0.001).

CONCLUSION
Ultrasound-guided combined interscalene and intermediate CPB had a better success rate, with faster sensory block onset time and prolonged postoperative analgesia as compared with interscalene and superficial CPB in patients undergoing clavicle surgery.

TRIAL REGISTRATION
Clinical trial registry of India (www.ctri.nic.in) - CTRI/2018/05/013785
What to do after a mid-urethral sling fails
Authors: Speed Jacqueline M. , Mishra Kavita 
Published: August 2020

Purpose of review
After the Food and Drug Administration Public Health Notification in 2011 regarding transvaginal mesh, there has been a decline in the use of mid-urethral slings (MUS). However, they are an effective treatment option for stress urinary incontinence (SUI) with minimal complications. The management of recurrent SUI after sling continues to be debated.

Recent findings
Long-term follow-up after primary MUS confirms its efficacy and safety. There remains no level 1 evidence for the best next step after a failed MUS. Preferred treatment strategies include placing a repeat MUS with more recent evidence demonstrating no difference in cure rates between transobturator tape and retropubic approach. Pubovaginal slings (PVS) and urethral bulking agents are also acceptable treatment options. A newer bulking agent, polyacrylamide hydrogel, demonstrated excellent short-term success rates in patients after a failed sling.

Summary
MUS is an effective treatment option for SUI. Patients who develop recurrent urinary incontinence are a heterogeneous population who must be evaluated for detrusor overactivity, misplaced sling, unrecognized ISD. Patients with ISD are more likely to benefit by a PVS. Other patients with demonstrated recurrent SUI will likely do well with a repeat MUS.
Ultrasound in the investigation of pelvic floor disorders
Authors: Dietz Hans Peter 
Published: August 2020

Purpose of review
Translabial ultrasound with systems designed for obstetric imaging is now the commonest diagnostic modality in pelvic floor medicine. This review will outline current clinical utility and introduce recent research in the investigation of pelvic floor disorders, such as urinary and anal incontinence, pelvic organ prolapse, obstructed defecation and of complications after sling and mesh surgery.

Recent findings
There has been significant progress in standardization of imaging methods, and the International Urogynecology Association has developed an online course encouraging this standardization. Tomographic methods are increasingly used for imaging of the levator ani and anal canal. Several comparative studies have investigated concordance between tomographic translabial imaging and competing methods, and the widespread availability of equipment has facilitated interethnic comparative studies. Several meta- analyses have investigated risk factors for major pelvic floor trauma and the role of pelvic floor abnormalities in prolapse recurrence after surgery.

Summary
The widespread use of imaging has the potential to change the management of pelvic floor morbidity, such as urinary and anal incontinence, pelvic organ prolapse and related conditions. Even in units and locations where the required systems are not easily accessible, the insights provided by real-time imaging will enhance diagnostic and therapeutic capabilities.
Serum 25-Hydroxy Vitamin D, Vitamin B12, and Folic Acid Levels in Progressive and Nonprogressive Keratoconus
Authors: Aslan Mehmet Gökhan , Fındık Hüseyin , Okutucu Murat , Aydın Emre , Oruç Yavuz , Arpa Medeni , Uzun Feyzahan 
Published: August 2020

Purpose:
To evaluate the serum 25-hydroxy vitamin D, vitamin B12, and folic acid (FA) levels in progressive and nonprogressive patients with keratoconus (KCN).

Methods:
Fifty-five patients with KCN (28 progressive and 27 nonprogressive) who were followed up for at least 12 months were recruited and separated into 2 groups according to corneal topographic progression criteria. Age- and sex-matched 30 healthy individuals formed the control group. Serum vitamin D, B12, FA, and Ca levels were compared among control, nonprogressive, and progressive groups. The effect of gender, age, vitamin D, B12, and FA parameters on KCN progression was investigated.

Results:
Serum vitamin D levels were 12.77 ± 5.52, 11.78 ± 4.32, and 17.40 ± 5.12 ng/mL in nonprogressive, progressive, and control groups, respectively. The serum vitamin D levels in KCN groups (nonprogressive and progressive) were significantly lower than the control group (P = 0.002 and P < 0.001, respectively). There was no significant difference between all groups in serum vitamin B12, FA, and Ca levels (P > 0.05). Decreased vitamin D levels significantly increased nonprogressive KCN probability 1.23 times and progressive KCN probability 1.29 times more than the control group (P = 0.002, 95% confidence interval, 0.708–0.925; P < 0.001, 95% confidence interval, 0.668–0.888, respectively).

Conclusions:
Serum vitamin D levels were significantly decreased in both KCN groups. However, serum vitamin B12, FA, and Ca levels were similar in all groups. Serum vitamin D evaluation of patients with KCN at onset and follow-up examinations may help to predict the course of the disease.
Chromoblastomycosis
Authors: Joseph Joel Joby , Paul Aby , Sebastian Stelvin , Saijan Sanjo , Vilapurathu Jobin Kunjumon 
Published: August 2020

Abstract
Chromoblastomycosis (CBM) is a chronic progressive cutaneous fungal infection caused by several naturally pigmented fungi which are commonly seen in tropical and subtropical climates. The infection is secondary to trauma or autoinoculation. A majority of the cases from India are reported from the sub-Himalayan belt and South India. Fungal diseases other than mycetoma are considered neglected diseases by the World Health Organization. The global burden of CBM could be even greater than mycetoma and can lead to potential incapacity for labor. Here, we present a case of cutaneous CBM from Kerala, India. A 57-year-old male farmer presented with a history of itching and warty growth over the posterior aspect of the right ankle. Histopathology revealed the occurrence of hyperkeratosis papillomatosis, acanthosis, pseudoepitheliomatous hyperplasia, and chronic granulomatous dermatitis with medlar bodies. The patient was managed with a combination of itraconazole and terbinafine for 6 months. After 6 months of follow-up, lesions showed significant improvement.
Severe Rhabdomyolysis Due to SARS CoV-2 Infection in a Young Adult
Authors: Johns Christina B. , Zimmerman Chloe O. , Rowan Cherise , Grossman Matthew R. 
Published: August 2020

Abstract
This report describes a case of severe rhabdomyolysis secondary to severe acute respiratory syndrome coronavirus 2 infection in an otherwise healthy young adult with few other manifestations of the infection.