bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phylogeny and generic classification of the Anthidiini bees from the Neotropical region (Hymenoptera: Apidae)
Authors: Parizotto Daniele R , Urban Danúncia , Melo Gabriel Ar 
Published: January 2021

AbstractThe Anthidiini is a highly diverse tribe of bees with approximately 700 described species worldwide, of which about 350 occur in the Neotropical region. However, the phylogenetic relationships within the Neotropical lineage are poorly understood and the generic limits of these clades are still controversial, with different proposals of classification. Therefore, we carried out a phylogenetic study to investigate the monophyly of Neotropical taxa, to understand the relationships among Neotropical genera, and to propose a classification congruent with the evolution of the group. We performed parsimony-based morphological analyses using a matrix of 204 characters from adults of 83 species (79 terminal taxa of Anthidiini and four outgroup taxa). The results provide strong support for the monophyly of the tribe, despite a representation biased towards the Neotropical taxa. The monophyly of a large group containing only species from Neotropical genera is also supported. The latter group is divided into six main clades, one of them composed of only cleptoparasitic taxa (Austrostelis, Hoplostelis, Melostelis and Rhynostelis). The morphological characters assembled here allowed scrutiny of the genus-level classification of the Neotropical clade and may be useful for future phylogenetic studies involving the Anthidiini from other biogeographic regions.
Brain metastasis in a patient with multiple malignancies
Authors: Robinson Kevlin , Zerfoss Cindy , Nicholas Joyce , Rolfs Jenna 
Published: January 2021

ABSTRACT
Brain metastases originate from other primary cancers within the body, most commonly lung, breast, and melanoma. Because patients with brain metastasis, stroke, or intracranial hemorrhage may present with similar acute neurologic symptoms, clinicians must have a high suspicion for brain metastasis and perform an immediate workup to rule out life-threatening conditions. This case report focuses on the clinical symptoms, diagnostics, and treatment options for brain metastasis in a patient with multiple malignancies.
Managing obesity in adults as a chronic condition
Authors: Jrolf Cheri Wilder 
Published: January 2021

ABSTRACT
Despite extensive evidence-based guidelines, clinicians still face many barriers to reducing the incidence of obesity. Recognizing that obesity is a chronic disease will allow clinicians to properly treat patients and bill for reimbursement. With enhanced education, knowledge of reimbursement, and a push for legislation, physician assistants can pave the way to reducing rates of obesity in adults.
Original Research: Concussions at School: The Experiences and Knowledge of School Nurses
Authors: Pietz Katy , Graves Janessa , Weybright Elizabeth , Pinkleton Bruce , Klein Tracy 
Published: January 2021

ABSTRACT

Background:
School nurses' knowledge about and confidence in managing concussions are important to ensure continuity of care between a student's school and home environments. This mixed-methods study explored concussion-related knowledge, confidence, and management experiences among urban and rural school nurses in Washington State.

Methods:
Public school nurses, identified via state educational service district websites and recruited by e-mail, completed an online survey assessing their concussion knowledge and confidence levels. Following the survey, a subset of respondents participated in semistructured interviews aimed at exploring their confidence in managing concussions.

Results:
Of the 945 school nurses to whom the survey was sent, 315 responded (33% response rate). Most survey respondents held an RN license (89.6%) and were from urban areas (90.8%). Overall, the respondents exhibited accurate concussion knowledge; only one significant difference was noted based on rural–urban status. Correct responses were given for most questions (67.4% to 98.7% correct responses). In interviews with a subset of six school nurses, emergent themes pertained to communication, assessment, and monitoring, and the nurse's role in postconcussion management. Barriers can include a lack of relevant school policies, low concussion awareness among teachers and parents, and limited resources.

Conclusions:
The study findings suggest that school nurses possess high levels of concussion knowledge and confidence in managing concussions. Continuing education remains important to ensure that current research and evidence inform practice regarding ongoing concussion management among school-age children.
Accuracy of Bladder Scanner for the Assessment of Postvoid Residual Volumes in Women With Pelvic Organ Prolapse
Authors: Taylor Danielle Lynn , Sierra Tania , Duenas-Garcia Omar Felipe , Kim Youngwu , Leung Katherine , Hall Cynthia , Flynn Michael K. 
Published: January 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2020;26:640–643)
There is an increased risk of developing voiding dysfunction in patients with advanced pelvic organ prolapse (POP). An important component of evaluating these patients is assessment of postvoid residual (PVR) volumes.
Application of exhaled nitric oxide (FeNO) in pediatric asthma
Authors: Di Cicco Maria , Peroni Diego Giampietro , Ragazzo Vincenzo , Comberiati Pasquale 
Published: January 2021

Purpose of review
Fractional concentration of Nitric Oxide in the exhaled air (FeNO) is a moderately good biomarker of type-2 airway inflammation, and its measurement is feasible also in children. The available evidence is still not enough to support the routine use of FeNO to diagnose or manage asthma in every patient in clinical practice. However, its role in identifying asthma with eosinophilic inflammation is of particular interest in the management of severe asthma.

Recent findings
In healthy subjects, FeNO levels increase with age and height, particularly in males, and are also influenced by ethnicity. FeNO measurement can support asthma diagnosis and help in predicting asthma development later in life in young children with recurrent wheezing. FeNO-guided asthma management is effective in reducing asthma exacerbations but may result in a higher daily dose of inhaled corticosteroids. FeNO can also be used as a marker to evaluate adherence to asthma treatment and predict response to different biologicals, especially Omalizumab and Dupilumab.

Summary
This review outlines recent data on the application of FeNO in childhood-onset asthma diagnosis and management, as well as in phenotyping subjects with severe asthma who may benefit from monoclonal antibodies administration.
Small-airway dysfunction in paediatric asthma
Authors: Cottini Marcello , Lombardi Carlo , Berti Alvise , Comberiati Pasquale 
Published: January 2021

Purpose of review
Asthma is a chronic inflammatory airway disorder that can involve the entire bronchial tree. Increasing evidence shows that ventilation heterogeneity and small airway dysfunction are relevant factors in the pathogenesis of asthma and represent a hallmark in adults with persistent asthma. Little is known about the contribution of peripheral airway impairment in paediatric asthma, mainly due to the inaccessibility to evaluation by noninvasive techniques, which have only been widely available in recent years.

Recent findings
Emerging evidence suggests that small airways are affected from the early stages of the disease in childhood-onset asthma. Conventional lung function measurement, using spirometry, is unable to sensitively evaluate small airway function and may become abnormal only once there is a significant burden of disease. Recent studies suggest that chronic inflammation and dysfunction in the small airways, as detected with new advanced techniques, are risk factors for asthma persistence, asthma severity, worse asthma control and loss of pulmonary function with age, both in adults and children. Knowing the extent of central and peripheral airway involvement is clinically relevant to achieve asthma control, reduce bronchial hyper-responsiveness and monitor response to asthma treatment.

Summary
This review outlines the recent evidence on the role of small airway dysfunction in paediatric asthma development and control, and addresses how the use of new diagnostic techniques available in outpatient clinical settings, namely impulse oscillometry and multiple breath washout, could help in the early detection of small airway impairment in children with preschool wheezing and school-age asthma and potentially guide asthma treatment.
Gelatin–Poly (γ-Glutamic Acid) Hydrogel as a Potential Adhesive for Repair of Intervertebral Disc Annulus Fibrosus
Authors: Yang Jui-Jung , Lin Yu-Yang , Chao Kuo-Hua , Wang Jaw-Lin 
Published: January 2021

Study Design.
An in vitro experimental study testing a Gelatin–poly (γ-glutamic acid) hydrogel for disc repair.

Objective.
To evaluate the cytocompatibility and degradability of the above mentioned hydrogel for intervertebral disc annular fibrosis (AF) repair.

Summary of Background Data.
No repair strategies for correcting annular defects in lumbar discectomy have been clinically well recognized. Exogenous supplementation of regenerative materials to fill defects is a minimally invasive way to restore compromised mechanical properties. The injected materials, most commonly gelatin-based materials with cross-linking agents, serve as sealants and as a scaffold for incorporating biomaterials for augmentation. However, cytotoxicity of hydrogel crosslinking agents is of concern in developing viable materials.

Methods.
This in vitro experimental study evaluated a newly developed gelatin-based hydrogel for intervertebral disc AF repair. Mechanical strength was augmented by γ-PGA, and 1-(3-dimethylaminopropyl)-3-ethyl-carbodiimide hydrochloride (EDC) was used for material crosslinking. Isolated bovine tail intervertebral discs (IVDs) were used to test the hydrogel, and hydrogel surface monolayer AF cell culture was used to investigate efficacy in hydrogel constructs of different EDC concentrations. Cell metabolic activity was evaluated with Alamar blue assay, cell viability assay with live/dead stain, and sulfated glycosaminoglycan (GAG) and double strain DNA were quantified to evaluate proliferation of implanted cells and synthesis of extracellular matrix (ECM) proteins.

Results.
EDC concentrations from 10 to 40 mM resulted in significant decreases in AF cell proliferation without obvious influence on cell viability. Higher EDC concentrations resulted in decreased percentage of Alamar blue reduction and GAG and DNA concentration, but did not affect GAG/DNA and live–dead ratios. Degradation tests revealed that higher EDC concentrations decreased the hydrogel degradation rate.

Conclusion.
The developed gelatin–poly (γ-PGA) hydrogel with 20 mM EDC concentration provides an effective gap-filling biomaterial with good cytocompatibility, suggesting substantial promise for use as a sealant for small AF defects.

Level of Evidence: N/A
Unilateral Biportal Endoscopy Versus Tubular Microendoscopy in Management of Single Level Degenerative Lumbar Canal Stenosis
Authors: Aygun Hayati , Abdulshafi Khaled 
Published: January 2021

Study Design:
Prospective clinical study.

Summary of Background Data:
To the authors knowledge, there are no previous prospective studies to test the feasibility of the unilateral biportal endoscopic (UBE) technique in management of lumbar canal stenosis.

Purpose:
The study was conducted to compare clinical results of the UBE technique with the tubular microendoscopic (TME) surgery for management of degenerative lumbar canal stenosis.

Methods:
One hundred fifty-four cases of single level degenerative lumbar canal stenosis were randomly divided into 2 groups. Each group consisted of 77 cases: one group underwent UBE and the other TME. Clinical outcome was assessed periodically: early postoperative, at 1, 3, and every 6 months for 2 years. Clinical outcome assessment operatives included the Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and patient satisfaction using Modified Macnab Criteria (MMC). In addition, the admission period, operative time, and estimated blood loss were compared.

Results:
In UBE cases, ODI and ZCQ were statistically superior to TME for all periods (P<0.05). For both approaches, values presented progressive improvement until the 24th month. Regarding ODI, UBE and TME had an 84% and 79% success rate, respectively. In ZCQ, UBE and TME had a 79% and 73% success rate, respectively, at the end of the 24th month. Regarding the MMC, UBE and TME had 63% and 29% excellent results, respectively. UBE also has shorter admission period (days: 1.11 vs. 1.28), operative time (minutes: 57.74 vs. 65.31), and less estimated blood loss (mL: 49.47 vs. 53.57).

Conclusions:
Given its demanding learning curve, UBE is considered an effective alternative to TME with a higher clinical success rate.
Controversies in Limb Salvage in Patients With Diabetes Mellitus
Authors: Louis-Ugbo John 
Published: January 2021

Diabetic foot ulcers are the most feared complications among patients with diabetes mellitus because these are frequently a harbinger to major lower extremity amputation after failed attempts at treatment or limb salvage. Though most of these ulcers go on to heal, there is a sizeable proportion that goes on to develop gangrene, deep infections, osteomyelitis, and unstable deformities. These cohorts of patients often require repeated, costly, and controversial attempts at limb salvage surgery. Considering the growing cost of care of these patients worldwide, controversies abound in the literature regarding the best approach for limb salvage that will provide the best possible outcomes. There are no clear guidelines regarding what limbs with diabetic ulcers to salvage and those that require immediate major amputation in the orthopedic literature. However, many reports have shown that aggressive efforts at salvage with partial foot amputations should be entertained before higher-level amputations because of the increased morbidity and mortality associated with major amputation.Level of Evidence:Level IV.
Respite Care for Families of Children with Disabilities
Authors: Bigham Amy , Cunningham Jill , Johnston Kristen 
Published: January 2021

ABSTRACT:
Families of children with disabilities or special healthcare needs report respite care as a great need, yet availability of such care is scarce. A partnership developed between a nursing school in the Southeast and a faith community, to provide respite care and summer camps, resulted in a win-win situation for families, children, interprofessional students and educators, the faith community, and volunteers. This article explains the need for respite, how schools of nursing and faith communities can partner, and the benefits to all stakeholders.
CSOG MFM Committee Guideline: Management of Hepatitis B During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020)
Authors: Zhou Yi-Hua , Hu Yali , Liu Xinghui , Yang Huixia 
Published: January 2021

Abstract
Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the main cause of chronic hepatitis B. The prevention of MTCT plays a critical role in control chronic hepatitis B. The main purpose of the present clinical guidelines is to aid healthcare providers in managing pregnant women with positive HBsAg and in preventing MTCT of HBV. We recommend: (1) all pregnant women require prenatal screen for hepatitis B serological markers; (2) newborn infants of mothers with negative hepatitis B surface (HBsAg) require administration of hepatitis B vaccine on a 0, 1, and 6 month-schedule; (3) newborn infants of mothers with positive HBsAg need hepatitis B immunoglobulin (HBIG) and birth dose vaccine within 12 hours (the sooner the better) after birth, followed by injection of the second and third dose of hepatitis B vaccine at the age of one and six months respectively; (4) in preterm neonates or neonates with poor health conditions born to HBsAg-positive mothers, the immunoprophylaxis measures should be appropriately taken; (5) to further reduce MTCT of HBV, pregnant women with HBV DNA levels >2 × 105 IU/mL or positive hepatitis B e antigen may receive oral antivirals, starting from 28 to 32 weeks of gestation and discontinuing the drug on the delivery day; (6) cesarean section is not recommended to reduce MTCT of HBV; (7) breastfeeding is recommended in infants of HBsAg-positive mothers, regardless of maternally positive hepatitis B e antigen, maternal nipple injury or bleeding, oral mucosal injury in neonates or infants; (8) breastfeeding is recommended in infants born to HBsAg-positive mothers who require continuation of antiviral therapy after delivery, and the infants should be followed up to observe whether adverse effects develop; and (9) the infants born to HBsAg-positive mothers should be tested for hepatitis B serological markers at the age of 7–12 months, and those who are negative for HBsAg and anti-HBs should receive three doses of hepatitis B vaccine on the 0, 1, and 6 month-schedule as soon as possible.
ASSOCIATIONS WITH RECURRENCE OF MACULAR EDEMA IN BRANCH RETINAL VEIN OCCLUSION AFTER THE DISCONTINUATION OF ANTI VASCULAR ENDOTHELIAL GROWTH FACTOR
Authors: Lee Geun Woo , Kang Se Woong , Kang Min Chae , Kim Sang Jin , Kim Yoon Young 
Published: January 2021

Purpose:
To identify factors predicting the recurrence of macular edema after the discontinuation of intravitreal antivascular endothelial growth factor injection in patients with branch retinal vein occlusion.

Methods:
This retrospective study included only subjects who had discontinued injections at 3 months after the final bevacizumab injection due to fully resolved macular edema. Fifty-two eyes meeting the criteria were included in the study and divided into two groups (recurrence and no recurrence). Clinical features and measurements of retinal thickness at the time of the diagnosis and when the decision to stop injections was made (stopping point) were analyzed.

Results:
At the stopping point, the no recurrence group showed a thinner parafoveal inner retina, better best-corrected visual acuity, and lower incidence of ellipsoid zone disruption in multivariate logistic regression analysis (all P < 0.05). Similarly, parafoveal inner retinal thinning of more than 30 µm, when compared with the corresponding region of the fellow eye or the unaffected region of the affected eye, was significantly related to less recurrence of macular edema.

Conclusion:
Thinning of the parafoveal inner retina as well as better vision and intact outer retinal layers are associated with a lack of recurrence of macular edema. These findings suggest that inner retinal atrophy after branch retinal vein occlusion may result in a reduction in oxygen demand in the affected retinal tissue and less production of vascular endothelial growth factor.
Effect of Body Refrigeration Time on Cornea Donor Tissue
Authors: Munir Wuqaas M. , Brown Clayton H. , Munir Saleha Z. , Hoover Caroline K. 
Published: January 2021

Purpose:
To determine how early body refrigeration affects corneal donor transplant suitability and endothelial cell density.

Methods:
Donor information was obtained from the CorneaGen Eye Bank including demographics, time of death to preservation, and body refrigeration status, for donors between 2012 and 2016. The death to preservation interval was classified into 3 categories: 0 to 10, 10 to 20, and 20+ hours. Two primary logistic method models were fit using a main effects model and an interaction model to determine the association of body refrigeration on unsuitability of transplantation and endothelial cell density.

Results:
Analysis was from 42,929 donor eyes, with a mean (standard deviation) endothelial cell count of 2743 (415) cells/mm2. Fifty-nine percent of donor eyes were from male donors in the eye bank data set, and the mean death to preservation interval was 11.0 (5.6) hours for all eyes. Unsuitability for transplantation demonstrated a reduced adjusted odds ratio by 22% (OR = 0.78, P = 0.009) when the body was refrigerated during the death to preservation interval versus when the body was not refrigerated. Eyes that were refrigerated, however, exhibited no statistically significant difference in endothelial cell count from eyes that were not refrigerated (P = 0.12).

Conclusions:
We demonstrate an appreciable effect of early body refrigeration on transplant suitability in this large cohort of eye bank eyes. There was no beneficial effect of body refrigeration on endothelial cell count.
CRISPR-Cas9 System: A Revolutionary Tool in the Fight Against Antimicrobial Resistance: Retracted
Authors: Ekwebelem Osmond C. , Aleke Job , Ofielu Ekenedirichukwu , Nnorom-Dike Obinna 
Published: January 2021

Abstract
The rapidly evolving world of antimicrobial resistance has not only made it difficult to combat infectious diseases, but during the last decades also brought the discovery of novel antimicrobials to a standstill. In recent years, researchers discovered the potential of the clustered regularly interspaced short palindromic repeats (CRISPR)-associated (CRISPR-Cas) system as an alternative therapeutic. Since the unearthing of CRISPR-Cas9 as an “adaptive immune system” of bacteria, the CRISPR-Cas9 system has been improved into a state-of-the-art genetic engineering tool, with an impressive ability to cause specific gene insertions and/or gene deletions, in almost all microorganisms. The emerging picture suggests that the CRISPR-Cas9 system can be exploited in a sequence-specific manner to selectively eliminate individual bacterial strains in a mixed microbial population, and/or re-sensitize bacteria to antibiotics. These findings have not only revolutionized biomedical research, but might also prove to be pivotal in creating novel alternative treatments for multidrug-resistant infections. Here, we discussed the up-to-date findings reported in this area, as well as the approaches involved in the utilization of CRISPR-Cas9 as a novel technology in the fight against antimicrobial resistance. We also highlighted recent studies that have exploited the CRISPR-Cas9 system in the context of targeting pathogenic and drug-resistant bacteria.
Evaluating the Benefits of Early Intensive Rehabilitation for Patients With Sepsis in the Medical Intensive Care Unit: A Retrospective Study
Authors: Uthup Bahitha R. , Myszenski Adele , Saigh Nora , Samuel Preethy S. 
Published: January 2021

Purpose:
To evaluate the benefits of early rehabilitation intervention for patients with sepsis in a medical intensive care unit (MICU) and to identify the factors associated with positive outcomes at discharge.

Methods:
A retrospective review of 97 electronic medical records of patients with sepsis admitted to 2 similar-sized MICU pods of an urban tertiary care hospital was conducted. Bivariate analyses were conducted to compare the sociodemographics, length of stay, mobility level, and discharge disposition of 47 patients who received early rehabilitation intervention in MICU pod 1, with 46 patients who received standard rehabilitation intervention in MICU pod 2. In addition, multivariate analysis of the entire sample was conducted to identify the factors associated with positive discharge outcomes.

Results:
Patients in pod 1 had significantly higher level of mobility at discharge (mean difference = 0.80, P = .009) and a better discharge disposition (λ2 = 25.05, df = 7, P < .001) than those in pod 2. The positive outcomes of increased mobility and return to home at discharge were associated with rehabilitation intensity (F
1,91 = 52.30; P < .001, b = 0.82) and rehabilitation initiation (adjusted odds ratio: 0.85, P = .039), respectively.

Conclusion:
These findings provide empirical support for the safety and benefits of providing early intensive rehabilitation for patients in the MICU with sepsis using a therapist-driven model of care.