bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Social Media to Exchange Critical Care Practice Evidence During the Pandemic
Authors: Bourgault Annette M. , Davis Jean W. , Peach Brian C. , Ahmed Rohina , Wheeler Megan 
Published: November 2021

Background
The evidence-based practice (EBP) process was challenged during the early phase of the COVID-19 pandemic by factors such as a novel disease, rapidly changing guidelines, shortage of personal protective equipment, and other health care supplies.

Objectives
Our aims were to (1) explore sources of evidence sought by critical care nurses during a pandemic and (2) explore nurses' perceptions of EBP.

Methods
A qualitative exploratory study was conducted using deidentified data from the American Association of Critical-Care Nurses (ACCN) open-access Facebook page, January 28 to April 30, 2020.

Results
Two major themes were identified: (1) “sharing and seeking evidence,” that is, nurses used both formal and informal sources to explore evidence supporting evolving clinical practices, and (2) “concerns about evidence,” that is, nurses expressed concerns about lack of evidence and mistrust of evolving evidence.

Discussion
Initially, there was a mismatch in nurses' expectations of the American Association of Critical-Care Nurses Facebook page. A major limitation of Facebook is the lack of a repository for quick retrieval of information. Despite these limitations, and fear and mistrust of changing guidelines, social media was used to communicate, collaborate, and share evidence to support clinical practice. Critical care nurses seemed to value evidence to support patient management and their personal safety during this evolving health crisis.

Conclusions
Social media played a large role in dissemination of timely evidence-based information during the early pandemic. Our results show that current EBP models should be revised to prepare for future crises and include direction for dealing with limited health care resources, and lack of and/or rapidly changing evidence.
Integration Process With a Donated Heart
Authors: Bahramnezhad Fatemeh , Dehghan Nayeri Nahid , Asgari Parvaneh 
Published: November 2021

Background
In the posttransplant period, recipients face a complex phenomenon called the new heart, which is a symbol of physical and emotional life. They use different methods to get used to the new heart.

Objective
The aim of this study was to explore the integration process with a donated heart in heart transplant patients.

Methods
A qualitative study design with a grounded theory approach following Corbin and Strauss was used. Purposive and then theoretical sampling led to the inclusion of 15 heart transplant patients with diverse characteristics. Observations and semistructured interviews were conducted during a 1-year period in 2019 to 2020. Data collection and analysis occurred simultaneously.

Results
The process of integration with the new heart in the transplant patients or the core category in this study was “rebirth.” The process involved thre3 sequential and overlapping phases, which over time led to toleration and management of the situation. Religious issues, emotional chaos, additional worries, and sense of duality in the early stages after transplantation form a cycle, and the person is moving in this cycle.

Discussion
The results of this study indicated that the patients experienced several emotional and psychological changes after heart transplantation. It was also shown that the participants experienced a change in the emotions and feelings over time. On the basis of the findings of this study, it can be suggested that health care providers need to improve their knowledge about posttransplant changes, recipients' feelings, and adaptation strategies.
Polidocanol Sclerotherapy in Pyogenic Granulomas
Authors: Khurana Ananta , Mathachan Sinu Rose 
Published: November 2021

BACKGROUND
Polidocanol is a safe sclerosing agent with anesthetic properties and minimal skin toxicity.

OBJECTIVE
To evaluate the efficacy, safety, and recurrence rates with polidocanol sclerotherapy in the treatment of pyogenic granulomas (PGs).

METHODS AND METHODS
Thirty-nine patients with PG were injected with polidocanol 1% solution. Repeat injections were given weekly in case of incomplete clinical/dermoscopic resolution, until a maximum of 3 sittings. A higher strength (3%) was used for subsequent sessions in those with a minimal response to 1% solution. A final assessment for relapses was performed at 3, 6, and 12 months.

RESULTS
All 39 patients achieved complete resolution (100% clearance rate), with most (n = 26) lesions resolving after the first sitting. Side effects noted were postprocedure pain (22), erythema (2), superficial ulceration (2), paresthesias (1), prominent edema (4), thrombophlebitis (1), cyanotic discoloration (1), purpuric staining around injection site (4), and mild local pruritus (1). The procedure was well tolerated across the age spectrum (4–63 years) included.

CONCLUSION
We report polidocanol to be a highly effective, safe, and cost-effective sclerosant for treatment of PGs with no recurrences or need for special postprocedure care.
Neonatal outcomes following prophylactic administration of phenylephrine or noradrenaline in women undergoing scheduled caesarean delivery
Authors: Singh Apoorva , Jain Kajal , Goel Nitika , Arora Aashima , Kumar Praveen 
Published: November 2021

BACKGROUND
There is limited evidence to support the use of noradrenaline over phenylephrine during elective caesarean section with regards to its impact on foetal acidosis. Concerns regarding a deleterious effect of noradrenaline on foetal blood gas analysis because of its β-mimetic activity cannot currently be ruled out by data from randomised controlled trials.

OBJECTIVE
We hypothesised that noradrenaline would be associated with higher umbilical artery base excess values and less foetal acidosis compared with phenylephrine. This study aimed to observe the effect of prophylactic infusions of phenylephrine or noradrenaline in low-risk elective caesarean delivery on umbilical artery blood gas analysis.

DESIGN
A prospective, randomised, double-blind trial.

SETTING
Labour room operating theatre of tertiary care hospital in Northern India from April 2020 to November 2020.

PATIENTS
Full-term, nonlabouring pregnant women, scheduled for elective caesarean delivery under spinal anaesthesia.

INTERVENTION
Equipotent prophylactic infusions of either phenylephrine 100 μg min−1 or noradrenaline 5 μg min−1 were administered to maintain maternal SBP between 90 and 110% of baseline using a predefined algorithm.

MAIN OUTCOME MEASURE
The primary outcome was umbilical artery base excess in noradrenaline versus the phenylephrine group. The incidence of foetal acidosis defined as umbilical artery base excess less than −6 mmol l−1 was also assessed for noradrenaline versus phenylephrine.

RESULTS
Median [IQR] umbilical artery base excess was significantly higher in the noradrenaline group: −5.4 [−6.6 to −4.03] versus −6.95 [−9.02 to −4.53] in the phenylephrine group (P = 0.014). No significant difference in the incidence of foetal acidosis was observed between noradrenaline and phenylephrine groups: 36 versus 54% (P 0.07); difference 18% (95% CI, −1.4 to 35.6%).

CONCLUSION
Prophylactic noradrenaline 5 μg min−1 infusion resulted in higher base excess values compared with phenylephrine 100 μg min−1 infusion. A comparable incidence of foetal acidosis was observed in women receiving either noradrenaline or phenylephrine. Maternal bradycardia was more pronounced with phenylephrine while targeting blood pressure goals.

CTRI
CTRI/2020/03/023986.
Lip Reshaping with LOVE Approach: A Prospective Analysis Based on Two Hyaluronic Acid Fillers
Authors: Bertossi Dario , Nocini Riccardo , van der Lei Berend , Magistretti Philippe , Gualdi Alessandro , Pirayesh Ali , Marchetti Alberto 
Published: November 2021

Background:
Aesthetic improvement of the lips with hyaluronic acid fillers is a popular procedure. A comprehensive, modular, and highly individualizable method has been developed: the Lip Omnicomprehensive Volume Enhancement (LOVE) approach. The present study assessed the safety and effectiveness of LOVE across different patient age groups.

Methods:
This was a prospective, single-center study of women aged 20–70 years seeking nonsurgical lip enhancement or asymmetry correction. Three equally sized groups were formed based on patient age: 20–34, 35–45, and 46 years or older. Individualized treatment plans were developed taking into account patient preferences expressed in a pre-injection questionnaire. Treatment used one or more of the three modules of LOVE: lip shape [vermilion border, Vycross (VYC)-17.5]; volume (vermilion body, VYC-17.5); and hydration (submucosal area, VYC-12). Follow-up lasted 6 months.

Results:
Sixty patients were enrolled (mean age: 41.3 ± 13.3 years; n = 20 per age group), all of whom were White. Most were treated with all three LOVE modules. Mean filler quantities increased with age: 20–34 years, 1.1 ± 0.1 mL; 35–45 years, 1.5 ± 0.1 mL; 46 years or older, 1.6 mL ± 0.2 mL. Mean patient satisfaction at 4 weeks [on a seven-point scale from 0 (extremely dissatisfied) to 6 (extremely satisfied)] was 4.8–4.9 in each age group. Apart from minor and transient edema/bruising, there was only one complication: a case of lumps that resolved with home massage.

Conclusion:
The LOVE approach is safe and effective across a range of ages, with high levels of patient satisfaction.
The prevalence of chronic pain in young adults: a systematic review and meta-analysis
Authors: Murray Caitlin B. , de la Vega Rocío , Murphy Lexa K. , Kashikar-Zuck Susmita , Palermo Tonya M. 
Published: November 2021

Abstract
Previous systematic reviews have summarized the prevalence and impact of chronic pain in “average” pediatric (ie, school-age children) and adult (ie, middle-aged individuals) age groups. To the best of our knowledge, this is the first study to describe the prevalence of chronic pain in the subgroup of individuals who fall in between established boundaries of “childhood” and “adulthood”—known as young adulthood. The goal of this research was to meta-analyze prevalence data on pain in young adults based on available data published between 2008 and 2020. Searches were identified with MEDLINE, Embase, and PsycINFO. We included general population and university-based studies presenting prevalence estimates of chronic pain (pain lasting ≥3 months) in young adults. We identified 43 articles providing prevalence estimates across a combined population of 97,437 young adult respondents (age range: 15-34 years), with studies undertaken in 22 countries. Available data allowed for stratification of prevalence according to pain condition. The overall pooled random-effect prevalence rate of chronic pain in young adults was 11.6%, suggesting that 1 in every 9 young adults experience chronic pain worldwide. Prevalence rates varied considerably according to pain condition. Estimates did not vary according to sex, geographic location, and several study methodological characteristics (ie, population type, sampling area, sampling year, investigation period, and assessment method). Overall, young adult chronic pain is common and should be recognized as a major public health concern. Considering the difficulties young adults face accessing adult health care, greater attention is needed to develop transition programs and evidence-based treatments tailored to the unique needs of this age group.
Accuracy of the Simplified HOSPITAL Score in Predicting COVID-19 Readmissions—Exploring Outcomes from a Hospital-at-Home Program
Authors: Gavin Warren , Rager Joshua , Russ Jason , Subramoney Kavitha , Kara Areeba 
Published: November 2021

SUMMARY

Goal:
As strategies emerge to off-load hospital systems and prevent readmissions amid the COVID-19 pandemic, pragmatic assessments of readmission risk become increasingly important. The simplified HOSPITAL score is an extensively validated tool that predicts 30-day potentially avoidable readmission (PAR). Scores of 0 to 4 predict a 30-day PAR risk of 6.4%, while scores ≥ 5 predict a 30-day PAR risk of 17.3%. Its role in patients with COVID-19 is unknown. Our goal was to assess the simplified HOSPITAL score’s accuracy in patients with COVID-19 and explore outcomes related to a hospital-at-home program.

Methods:
Patients discharged following an admission for clinically symptomatic COVID-19 from two hospitals belonging to the same healthcare system in the Midwest were included. Those who died, discharged to hospice or an acute care hospital, whose length of stay was < 1 day, or who discharged against medical advice were excluded. The simplified HOSPITAL score was tabulated for included patients to predict their 30-day PAR risk. The Brier score was calculated to compare the observed rates of 30-day readmission with rates predicted by the simplified HOSPITAL score. Prediction models with a Brier score <.25 are considered useful.

Principal Findings:
Among 612 patients, the overall 30-day PAR rate was 10.1%. Most patients (n = 522 [85.3%]) had simplified HOSPITAL scores of 0 to 4, and 41 (7.8%) of these patients were readmitted. Among the 90 patients (14.7%) with scores ≥5, 21 (23.3%) were readmitted. The Brier score was 0.088, indicating very good accuracy between the predicted readmission risk and observed readmissions. In patients with scores 0 to 4, readmissions were highest in those discharged to acute or subacute rehabilitation (10.4% [8/77]), intermediate in those discharged home (8.1% [32/394]), and lowest in those discharged to hospital at home (1.9% [1/51]). However, these differences did not reach statistical significance.

Application to Practice:
The simplified HOSPITAL score was accurate in patients with COVID-19 and can be used to direct resources toward those predicted to be at increased risk for readmission and to assess outcomes from readmission reduction strategies. Hospitals at home may be a promising strategy to decrease readmissions in patients with COVID-19.
Association Between Long Working Hours and Chronic Kidney Disease According to Diabetic Status
Authors: Kim Ki Duk , Jang Suk-Yong 
Published: November 2021

Objective:
This study aimed to investigate the relationship between long working hours and chronic kidney disease (CKD) according to diabetic status.

Methods:
Twelve thousand seven hundred three full-time employees without diabetes and 2136 with diabetes were included in this study. Participants were grouped according to working hours: ≤40, 41 to 52, and >52 h/week. Multiple logistic regression was used to evaluate the association between working hours and CKD prevalence.

Results:
Participants with diabetes who worked 41 to 52 h/week showed 1.85 times higher odds of CKD (95% CI 1.15–2.96; P = 0.0112) compared with those who worked ≤40 h/week after adjusting for covariates. An interaction between diabetes and long working hours was observed (P for interaction = 0.0212) in the model.

Conclusion:
Long working hours are associated with CKD in participants with diabetes. An interaction between long working hours and diabetes leading to CKD development may exist.
Physician Assistant Education Community Assumptions About an Entry-level Doctoral Degree
Authors: Brown Darwin , Quincy Brenda , Snyder Jennifer 
Published: November 2021

Purpose
This study described the assumptions that PA educators hold regarding the option and/or transition to a doctoral entry-level degree for PA graduates.

Methods
A cross-sectional electronic survey of all members of accredited PA programs was administered. The survey comprised 32 Likert-type statements that measured respondents' level of agreement ranging from strongly disagree to strongly agree and general demographic information. Mean scores are reported for each Likert statement and then compared with analysis of variance and post hoc testing for subgroups of baseline variables.

Results
Responses indicate wide-ranging opinions regarding the adoption of an entry-level doctoral degree for PAs. However, the preponderance of responses appeared more neutral or in opposition to an entry-level doctoral degree. The statement with the strongest level of agreement was that “consideration of the entry-level doctoral degree was really about competing with advanced practice nurses.” Educators who were PAs and those who were physicians differed significantly in their responses for 17 of 32 statements.

Conclusion
Most respondents believed that the master's degree is “enough for clinical practice.” If there is not a deliberate discussion informing the transition to a doctoral entry-level degree, then the change is likely to occur at the individual program level as it did with the transition from a certificate to a bachelor's degree and then to a master's degree. If the PA profession moves to the acceptance of an entry-level doctoral degree, the PA professional organizations should continue to be involved in developing a measured plan forward.
The relationship between brain glucose metabolism and insulin resistance in subjects with normal cognition – a study based on 18F-FDG PET
Authors: Chen Yuqi , Qiu Chun , Yu Wenji , Shao Xiaonan , Zhou Mingge , Wang Yuetao , Shao Xiaoliang 
Published: November 2021

Objective
Insulin resistance can increase the risk of cognitive dysfunction and dementia. Our purpose is to use 18F-FDG PET imaging to explore the effect of insulin resistance on brain glucose metabolism in cognitively normal subjects.

Methods
A total of 189 cognitively normal subjects who underwent PET examinations were enrolled. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to evaluate the presence of insulin resistance. Multivariate linear regression and generalized additive models were used to analyze the association between HOMA-IR and glucose metabolism in the whole brain and evaluate the effects of various covariates. The SPM12 software was used to evaluate the regional effect of insulin resistance on brain glucose metabolism.

Results
After being fully adjusted for confounding factors, HOMA-IR showed an approximately linear negative correlation with brain glucose metabolism (β = −0.219, T = −3.331, P = 0.021). Compared with normal subjects, insulin-resistant subjects had reduced glucose metabolism in bilateral middle temporal gyrus, bilateral middle frontal gyrus, right precentral gyrus, right inferior frontal gyrus, right cuneiform lobe and bilateral cerebellar regions. In cognitively normal subjects, systemic insulin resistance has a significant effect on brain glucose metabolism.

Conclusions

18F-FDG brain PET imaging could be helpful for the early diagnosis and treatment of changes in brain glucose metabolism caused by insulin resistance.
Adherence to Best Practice Advice for Diagnosis of Pulmonary Embolism
Authors: Prentice Donna , Wipke-Tevis Deidre D. 
Published: November 2021

Purpose
This study evaluated clinician adherence to the American College of Physicians Best Practice Advice for diagnosis of pulmonary embolism.

Design
A prospective, single-center, descriptive design was utilized.

Methods
A heterogeneous sample of 111 hemodynamically stable adult inpatients with a computed tomography pulmonary angiogram ordered was consented. Electronic medical records were reviewed for demographic and clinical variables to determine adherence. The 6 individual best practice statements and the overall adherence were evaluated by taking the sum of “yes” answers divided by the sample size.

Results
Overall adherence was 0%. Partial adherence was observed with clinician-recorded clinical decisions rules and obtaining d-dimer (3.6% [4/111] and 10.2% [9/88], respectively) of low/intermediate probability scorers. Age adjustment of d-dimer was not recorded. Computed tomography pulmonary angiogram was the first diagnostic test in 89.7% (79/88) in low/intermediate probability patients.

Conclusion
In hemodynamically stable, hospitalized adults, adherence to best practice guidelines for diagnosis of pulmonary embolism was minimal. Clinical utility of the guidelines in hospitalized adults needs further evaluation. Systems problems (eg, lack of standardized orders, age-adjusted d-dimer values, information technology support) likely contributed to poor guideline adherence.
Identification of a promiscuous conserved CTL epitope within the SARS-CoV-2 spike protein
Authors: Jiang Sheng , Wu Shuting , Zhao Gan , He Yue , Guo Xinrong , Zhang Zhiyu , Hou Jiawang , Ding Yuan , Cheng Alex , Wang Bin 
Published: November 2021

ABSTRACTThe COVID-19 disease caused by infection with SARS-CoV-2 and its variants is devastating to the global public health and economy. To date, over a hundred COVID-19 vaccines are known to be under development and the few that have been approved to fight the disease are using the spike protein as the primary target antigen. Although virus neutralizing epitopes are mainly located within the RBD of the spike protein, the presence of T cell epitopes, particularly the CTL epitopes that are likely to be needed for killing infected cells, has received comparatively little attention. In this study, we predicted several potential T cell epitopes with web-based analytic tools, and narrowed them down from several potential MHC-I and MHC-II epitopes by ELIspot and cytolytic assays to a conserved MHC-I epitope. The epitope is highly conserved in current viral variants including the most recent Omicron and compatible with presentation by most HLA alleles worldwide. In conclusion, we identified a CTL epitope suitable for evaluating the CD8+ T cell-mediated cellular response and potentially for addition into future COVID-19 vaccine candidates to maximize CTL responses against SARS-CoV-2.
Impaired astrocytic Ca2+ signalling in awake Alzheimer’s disease transgenic mice
Authors: Åbjørsbråten Knut Sindre , Syverstad Skaaraas Gry H. E. , Cunen Céline , Bjørnstad Daniel M. , Gullestad Binder Kristin M. , Jensen Vidar , Nilsson Lars N.G. , Rao Shreyas B. , Tang Wannan , Hermansen Gudmund Horn , Nagelhus Erlend A. , Ottersen Ole Petter , Torp Reidun , Enger Rune 
Published: November 2021

AbstractIncreased astrocytic Ca2+ signaling related to amyloid plaques has been shown in Alzheimer’s disease mouse models, but to date no reports have characterized behaviorally induced astrocytic Ca2+ signalling in such mice without the confounding effects of anesthesia. Here, we employ an event-based algorithm to assess astrocytic Ca2+ signals in the neocortex of awake-behaving tg-ArcSwe mice and non-transgenic wildtype littermates while monitoring pupil responses and behavior. We demonstrate an attenuated astrocytic Ca2+ response to locomotion and an uncoupling of pupil responses and astrocytic Ca2+ signalling in 15-months old plaque-bearing mice. This points to a potential decoupling of neuromodulatory activation and astrocytic Ca2+ activity, which may account for some of the cognitive dysfunctions observed in Alzheimer’s disease.