bluuebunny/crossref_metadata_2025_split huggingface dataset:
Viral Micro-RNAs Are Detected in the Early Systemic Response to Injury and Are Associated With Outcomes in Polytrauma Patients
Authors: Vicente Diego , Schobel Seth A. , Anfossi Simone , Hensman Hannah , Lisboa Felipe , Robertson Henry , Khatri Vivek , Bradley Matthew J. , Shimizu Masayoshi , Buchman Timothy G. , Davis Thomas A. , Dente Christopher J. , Kirk Allan D. , Calin George A. , Elster Eric A. 
Published: July 2021

OBJECTIVES:
To evaluate early activation of latent viruses in polytrauma patients and consider prognostic value of viral micro-RNAs in these patients.

DESIGN:
This was a subset analysis from a prospectively collected multicenter trauma database. Blood samples were obtained upon admission to the trauma bay (T0), and trauma metrics and recovery data were collected.

SETTING:
Two civilian Level 1 Trauma Centers and one Military Treatment Facility.

PATIENTS:
Adult polytrauma patients with Injury Severity Scores greater than or equal to 16 and available T0 plasma samples were included in this study. Patients with ICU admission greater than 14 days, mechanical ventilation greater than 7 days, or mortality within 28 days were considered to have a complicated recovery.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Polytrauma patients (n = 180) were identified, and complicated recovery was noted in 33%. Plasma samples from T0 underwent reverse transcriptase-quantitative polymerase chain reaction analysis for Kaposi’s sarcoma–associated herpesvirus micro-RNAs (miR-K12_10b and miRK-12-12) and Epstein-Barr virus–associated micro-RNA (miR-BHRF-1), as well as Luminex multiplex array analysis for established mediators of inflammation. Ninety-eight percent of polytrauma patients were found to have detectable Kaposi’s sarcoma–associated herpesvirus and Epstein-Barr virus micro-RNAs at T0, whereas healthy controls demonstrated 0% and 100% detection rate for Kaposi’s sarcoma–associated herpesvirus and Epstein-Barr virus, respectively. Univariate analysis revealed associations between viral micro-RNAs and polytrauma patients’ age, race, and postinjury complications. Multivariate least absolute shrinkage and selection operator analysis of clinical variables and systemic biomarkers at T0 revealed that interleukin-10 was the strongest predictor of all viral micro-RNAs. Multivariate least absolute shrinkage and selection operator analysis of systemic biomarkers as predictors of complicated recovery at T0 demonstrated that miR-BHRF-1, miR-K12-12, monocyte chemoattractant protein-1, and hepatocyte growth factor were independent predictors of complicated recovery with a model complicated recovery prediction area under the curve of 0.81.

CONCLUSIONS:
Viral micro-RNAs were detected within hours of injury and correlated with poor outcomes in polytrauma patients. Our findings suggest that transcription of viral micro-RNAs occurs early in the response to trauma and may be associated with the biological processes involved in polytrauma-induced complicated recovery.
Reading Aloud, Self-Regulation, and Early Language and Cognitive Development in Northern Brazil
Authors: Piccolo Luciane da Rosa , Weisleder Adriana , Oliveira João B. A. , Mazzuchelli Denise S. R. , Lopez Aline Sá , Neto Walfrido D. , Cates Carolyn B. , Mendelsohn Alan L. 
Published: July 2021

ABSTRACT:

Objectives:
In this study, we examined (1) whether a reading aloud intervention, Universidade do Bebê (UBB), had impacts on self-regulation; (2) whether effects on child outcomes were mediated by self-regulation; and (3) whether effects of UBB were explained through a sequential pathway of impact, including cognitive stimulation in the home, parent-child interactive reading, and self-regulation.

Methods:
We performed a cluster randomized controlled trial of UBB in child care centers serving low-income children (mean age 37.4 months; SD = 6.5) in Northern Brazil. The child care centers were randomized to receive UBB or standard care (control). Families in UBB could borrow children's books weekly and participate in monthly workshops focused on reading aloud. Parent-child dyads (n = 484, intervention = 232, control = 252) were evaluated at baseline and 9 months later on: child self-regulation, vocabulary, intelligence quotient (IQ), working memory, and phonological memory and measures of cognitive stimulation in the home and parent-child interactive reading. Multilevel analyses accounted for baseline performance, sociodemographics, and clustering within centers and sites.

Results:
The UBB group showed significantly higher self-regulation (Cohen's d = 0.25), compared with the control group, particularly in the subdomains of Attention (d = 0.24) and Impulse Control (d = 0.21). Previously shown impacts of UBB on receptive vocabulary, IQ, and working memory were mediated by self-regulation. Effects of UBB on self-regulation and child outcomes were partially explained through cognitive stimulation in the home and parent-child interactive reading.

Conclusion:
Self-regulation represents an important mechanism by which reading aloud interventions affect language and cognitive outcomes. Investigators should consider the role of self-regulation when refining interventions, seeking to prevent poverty-related disparities.
Agreement and repeatability of corneal tomography in healthy eyes using a new swept-source OCT, a rotating Scheimpflug camera, and a dual Scheimpflug–Placido system
Authors: Herber Robert , Lenk Janine , Pillunat Lutz E. , Raiskup Frederik 
Published: July 2021

Purpose:
To investigate the accordance and repeatability of tomographic parameters measured by a new swept-source optical coherence tomographer (SS-OCT, ANTERION), a rotating Scheimpflug camera (RSC, Pentacam), and a dual Scheimpflug-Placido system (DSP, Galilei G6).

Setting:
Department of Ophthalmology of University of Hospital Carl Gustav Carus, Dresden, Germany.

Design:
Prospective reliability analysis.

Methods:
Normal tomography was ensured by bilaterally evaluating appropriated parameters using RSC. All subjects received 3 consecutive measurements on each device by the same operator and in the uniform order RSC, SS-OCT, and DSP. Anterior (ACP) and posterior (PCP) corneal parameters such as flat and steep keratometry and corneal thickness were analyzed. Repeatability was assessed by using a coefficient of repeatability (CoR) and a coefficient of variation. Agreement between RSC and SS-OCT and between RSC and DSP were shown by Bland-Altman plots.

Results:
This study included 30 randomly selected eyes of 30 healthy participants. CoR of ACP did not exceed 0.5 diopters. There were no statistically significant differences in repeatability of ACP obtained from the 3 devices (P > .05). For PCP and corneal thickness, there was statistically significant higher repeatability mostly found for SS-OCT as opposed to RSC and DSP (P < .05). For a wide range of analyzed parameters, there were large limits of agreement (95% LoA) found between the devices.

Conclusions:
The SS-OCT showed highly repeatable measurements in healthy subjects regarding anterior, posterior, and corneal thickness parameters. Repeatability of ACP did not differ between the devices. A mostly wide range of 95% LoA prevents interchangeability between the devices.
Shifts in Attitudes and Intentions to Practice Following Medication-Assisted Treatment Training
Authors: Phelps Paula , Domenech Rodríguez Melanie M. , Alvarez María de la Caridad , Johnson Jeffrey L. 
Published: July 2021

Purpose
The Idaho State University Physician Assistant (PA) program was one of the first PA programs in the country to incorporate medication-assisted treatment (MAT) into its curriculum. This manuscript documents the impact of the course.

Methods
In the spring and summer of 2018, 61 students and 12 local providers enrolled in an elective MAT course developed by Idaho State University. All completed the training. At the end of the course, only the students submitted reflective essays.

Results
A review and coding of the essays indicated that MAT education increased knowledge about addiction and resulted in self-reported decreases in negative attitudes towards people with addictions.

Conclusion
PA programs can support communities' increased capacity to offer MAT. A widely available course appears to result in important gains in both knowledge and attitude.
Use of a Knee Orthosis to Advance Motor Control in a 3-Year-Old with Achondroplasia: A Case Report
Authors: Parent-Nichols Jennifer , Chamberlain Deborah 
Published: July 2021

ABSTRACT

Introduction
Children with achondroplasia experience numerous impairments in body structure and function, including hypotonicity, weakness, joint laxity/hypermobility, skeletal malalignment, and delays in gross motor development. Atypical patterns of movement are often used to compensate for short limbs, weakness, laxity at the joints, and bony malalignment. As a result of these atypical patterns, pain and self-restricted movement frequently begin at a young age. Surgical interventions are the general recommendation to address progressive deformity and resultant pain. Lower-limb bracing to address alignment and motor control in children with other diagnoses that include hypotonia has had positive results, including improved alignment and gross motor skills, but has not been explored in children with achondroplasia.

Materials and Methods
A 3-year-old child with achondroplasia participated in an intervention using a neoprene knee orthosis with hyperextension resistance at the knee combined with a play-based, proprioceptive-intensive home exercise program. We hypothesized that the knee orthosis would increase proprioceptive input, improve alignment, and have a positive effect on gross motor skill acquisition and refinement. Early training may also have a positive impact on potential future pain and disability.

Results
Improvements in alignment and motor control were seen in this child after 12 weeks of this intervention but were not initially sustained. After an additional 6 weeks of intervention, significant progress was demonstrated in lower-limb alignment and motor control, as evidenced by independent use of proper movement patterns. Delay in gross motor skill was reduced from 27% to 22%.

Discussion
Motor skills training in proper alignment with aid of neoprene knee orthosis resulted in positive gains for a 3-year old with achondroplasia.

Conclusion
This intervention may be helpful for other children with achondroplasia who experience hypotonia, malalignment, and atypical movement patterns. Sufficient amounts of practice and intensity are recommended for permanent motor learning to occur.
Sleep and quality of life in lung cancer patients and survivors
Authors: Martin Rachel E. , Loomis Dianne M. , Dean Grace E. 
Published: July 2021

ABSTRACT

Background:
Lung cancer patients and survivors are vulnerable to disturbed sleep and impaired quality of life (QOL) across the continuum of illness. Few studies have sought to identify predictors of QOL using well-validated measures of both sleep quality and QOL in this population.

Purpose:
The purpose of this study was to examine factors associated with lung cancer that are predictive of QOL in adult lung cancer patients and survivors in the outpatient setting.

Method:
Cross-sectional data collected exclusively in the outpatient setting from three lung cancer clinics in the Northeastern United States were pooled and analyzed. The pooled sample (N = 103) data included cancer type and stage, body mass index, Pittsburgh Sleep Quality Index, and Functional Assessment of Cancer Treatment-Lung information.

Results:
Significant correlations between sleep quality, lung cancer symptom severity, and QOL were observed. Sleep quality and lung cancer symptoms were found to be statistically significant predictors of QOL. No significant differences in QOL were found based on cancer type or recruitment source. Demographic factors and cancer stage were also not predictive of overall QOL.

Conclusions:
Lung cancer symptoms and sleep quality were important determinants of QOL in this pooled sample of lung cancer patients and survivors.

Implications for practice:
Patients and survivors of lung cancer require routine screening for sleep disturbance, lung cancer symptoms, and QOL needs. Nurse practitioners can help improve QOL in this population by screening for and treating sleep disturbance and lung cancer symptoms.
The different facets of sickle cell disease-related pulmonary hypertension
Authors: Prohaska Clare C. , Machado Roberto F. 
Published: July 2021

Purpose of review
Sickle cell disease (SCD), one of the most common genetic diseases in the world, is characterized by repeated episodes of hemolysis and vaso-occlusion. Hemolytic anemia is a risk factor for the development of pulmonary hypertension, and currently SCD-related pulmonary hypertension is classified as World Health Organization group 5 pulmonary hypertension. Patients with SCD-related pulmonary hypertension have unique hemodynamics, multiple comorbidities, and distinct phenotypes that may contribute to the development of pulmonary hypertension.

Recent findings
SCD-related pulmonary hypertension is defined as a mean pulmonary artery pressure >20 mmHg, a pulmonary artery occlusion pressure ≤15 mmHg and relatively low pulmonary vascular resistance (>2 Wood units) rather than the traditional definition of ≥3 Wood units, an important distinction due to a baseline high-cardiac output state in the setting of chronic anemia and low vascular resistance. Diastolic dysfunction is frequently identified in this patient population and right heart catheterization is essential to determine if combined pre- and postcapillary pulmonary hypertension is present. Thromboembolism is common among patients with SCD, and screening for chronic thromboembolic pulmonary hypertension is essential. Data regarding advanced therapies are limited. Primary treatment options include targeting correction of their primary hemoglobinopathy as well as aggressive management of underlying comorbid conditions.

Summary
SCD-related pulmonary hypertension is common among patients with SCD and is associated with increased mortality. A high index of suspicion is warranted during evaluation to identify all potential factors that may be contributing to disease.
Effects of Provocative Testing on Phase III Migrating Motor Complex in Children
Authors: Damrongmanee Alisara , El-Chammas Khalil , Fei Lin , Liu Chunyan , Santucci Neha , Kaul Ajay 
Published: July 2021

ABSTRACT

Objectives:
Antroduodenal manometry (ADM) is used to evaluate antral and small intestinal motility, with the presence of phase III migrating motor complexes (MMCs) indicating an intact enteric neuromuscular system. The lack of evidence-based or consensus-driven established norms for MMC in fasting phase and after provocative testing marks a major limitation in the interpretation of ADM studies. We aimed to determine the characteristics of MMC in fasting and post-provocative phase in children.

Methods:
Data from subjects ages <20 years with ADM results evaluated at neuro-gastroenterology and Motility Disorders Center, Cincinnati Children's Hospital Medical Center from January 2018 to March 2019 were analyzed.

Results:
Forty-eight ADM tracings that did not demonstrate abnormal patterns were included; the mean age was 10.00 ± 5.72 years and 50% were male. Indications for ADM included: vomiting (27.1%), feeding intolerance (27.1%), abdominal pain (16.6%), nausea (14.6%), and abdominal distension (14.6%). Thirty-seven percent of subjects had enteral access for feeds. During fasting, one-third of all MMC originated in the antrum. Azithromycin-induced MMC occurred in 28% of subjects and two-thirds of these originated in the antrum with antral contractions of significantly higher frequency and amplitude compared to fasting. Octreotide significantly increased frequency, amplitude, and duration of MMC compared to fasting, with 76% originating in the antrum. Both azithromycin and octreotide induced more than one MMC in a third of subjects.

Conclusions:
We describe the characteristics of antral and small intestinal motility during fasting and after provocative testing in children. These values will help standardize our interpretation of pediatric ADM studies.
Creation of a Pediatric Choledocholithiasis Prediction Model
Authors: Cohen Reuven Zev , Tian Hongzhen , Sauer Cary G. , Willingham Field F. , Santore Matthew T. , Mei Yajun , Freeman A. Jay 
Published: July 2021

ABSTRACTBackground:Definitive non‐invasive detection of pediatric choledocholithiasis could allow more efficient identification of those patients who are most likely to benefit from therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction.Objective:To craft a pediatric choledocholithiasis prediction model using a combination of commonly available serum laboratory values and ultrasound results.Methods:A retrospective review of laboratory and imaging results from 316 pediatric patients who underwent intraoperative cholangiogram or ERCP due to suspicion of choledocholithiasis were collected and compared to presence of common bile duct stones on cholangiography. Multivariate logistic regression with supervised machine learning was used to create a predictive scoring model. Monte‐Carlo cross‐validation was used to validate the scoring model and a score threshold that would provide at least 90% specificity for choledocholithiasis was determined in an effort to minimize non‐therapeutic ERCP.Results:Alanine aminotransferase (ALT), total bilirubin, alkaline phosphatase, and common bile duct diameter via ultrasound were found to be the key clinical variables to determine the likelihood of choledocholithiasis. The dictated specificity threshold of 90.3% yielded a sensitivity of 40.8% and overall accuracy of 71.5% in detecting choledocholithiasis. Positive predictive value was 71.4% and negative predictive value was 72.1%.Conclusion:Our novel pediatric choledocholithiasis predictive model is a highly specific tool to suggest ERCP in the setting of likely choledocholithiasis.
Skull Base Vagal Schwannoma
Authors: Xiong Lei , Wang Chong , Liu Huan , Feng Zhien 
Published: July 2021

Abstract
Skull base vagal nerve schwannoma (VNS) is relatively uncommon and poses a challenge to surgeons. Although schwannomas are benign and slowly growing neoplasms arising from Schwann cells, they may cause significant dysfunction by causing the surrounding structures compression or infiltrating vital structures such as the skull base, the orbit, and the cranial nerves. These tumors are resistant to radiotherapy and chemotherapy. Complete surgical removal is the optimal treatment modality, with recurrence being rare. The authors report a case of a 58-year-old man with an extensive VNS involving the left jugular foramen and parapharyngeal space. The clinical presentation, surgical management, and outcomes of VNS are discussed.
Single Segment Neo-Bandeau Fronto-Orbital Advancement in Children With Craniosynostosis: Technique Adaptation and Craniometric Analysis
Authors: Zapatero Zachary D. , Zimmerman Carrie E. , Kosyk Mychajlo S. , Kalmar Christopher L. , Carlson Anna R. , Humphries Laura S. , Lang Shih-Shan , Swanson Jordan W. 
Published: July 2021

Abstract
Fronto-orbital advancement (FOA) of the anterior skull and orbital bandeau is standard of care for craniosynostosis with anterior morphology. Fronto-orbital retrusion, temporal hollowing, and bony contour irregularities are commonly seen in long-term follow-up. In this study, we report several technical adaptations of a new FOA technique described in Fearon et al that help facilitate adaptation of the single-segment neo-bandeau FOA technique in preparation of use in younger patients, and perform a craniometric analysis of the technique. Five consecutive patients who underwent the single-segment neo-bandeau FOA in 2020 with available pre- and post-operative three-dimensional head computed tomography scans were studied. Using Materialise Mimics (Materialise, Ghent, Belgium), cranial length, cranial height, cranial widths, and intracranial volume were measured. Two (40%) patients were male and all were non-Hispanic White with a median age at surgery of 18.6 months (interquartile range 10.4–45.7). Three patients (60%) had bicoronal or other multi-suture craniosynostosis, and 1 each had metopic and sagittal craniosynostosis. Intraoperatively measured intracranial pressure decreased from 17.8 mmHg (R 13.0–20.0) before craniectomy to 4.8 mmHg (R 2.0–11.0; P = 0.038) after craniectomy. Anterior cranial width increased postoperatively (mean 92.6 mm; R 74.9–111.5 versus 117.6 mm; R 109.8–135.2, P = 0.005). Intracranial volume increased from preoperative (mean 1211 cm3; R 782–1949 cm3) to postoperative (1387 cm3; R 1022–2108 cm3; P = 0.009). The authors find in this small sample that a single-segment neo-bandeau FOA demonstrates volumetric expansion similar to conventional FOA techniques and is feasible in infants under 1 year of age.
The Role of Extracellular Vesicles Secreted From Thermal Stress-Induced Adipose-Derived Stem Cells on Bone Regeneration
Authors: Akdeniz-Dogan Zeynep , Sendur Samet , Karademir-Yilmaz Betul , Bugdayci Onur , Cilingir-Kaya Ozlem Tugce , Yilmaz-Goler Ayse M. , Gunduz Oguzhan , Celebiler Ozhan B. 
Published: July 2021

Purpose:
Extracellular vesicles (EVs) are responsible for intercellular communication. Mesenchymal stem cell-derived vesicles have been shown to have similar properties as functional mesenchymal stem cells. The aim of this study was to compare the therapeutic benefit of EVs obtained from adipose tissue-derived stem cells (ADSC) on bone repair whereas using ß-tricalcium phosphate (ß-TCP) biomaterial as a carrier.

Materials and Method:
A single critical size bone defect of 8 mm in diameter was created on the right side of rat calvarium using a custom-made punch needle. Animals were randomly divided into 5 groups: group 1 (no treatment), group 2 (bone graft), group 3 (ß-TCP + ADSC), group 4 (ß-TCP + EV), group 5 (ß-TCP). Eight weeks later, animals were sacrificed and histologic and radiologic evaluation was performed.

Results:
Semiquantitative histologic scoring demonstrated significantly higher bone regeneration scores for groups 2, 3, and 4 compared to group 1. Radiologic imaging showed significantly higher bone mineral density for groups 2, 3, and 5 compared to group 1. There were no significant differences between treatment groups in either histologic or radiologic scoring.

Conclusions:
Our data showed that EVs provided from thermally induced ADSCs did not show any significant difference in bone regeneration when compared to ADSCs themselves. Future studies should focus on determining the optimum amount and content of EV application since these vary significantly depending on the microenvironment.