bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulse Oximetry Saturation (Spo 2) Monitoring in the Neonatal Intensive Care Unit (NICU): The Challenge for Providers
Authors: Falsaperla Raffaele , Giacchi Valentina , Saporito Marco Andrea Nicola , Pavone Piero , Puglisi Federica , Ruggieri Martino 
Published: August 2021

Background:
In the neonatal intensive care unit (NICU), maintaining an oxygenation level that avoids both hypoxemia and hyperoxemia is challenging. Pulse oximetry has become fundamental for noninvasive monitoring of saturation of peripheral oxygen (Spo
2) in preterm newborns.

Purpose:
The aim of this systematic review is to determine Spo
2 target values in order to avoid hypoxemia or hyperoxemia and complications arising from these.

Method and Search Strategy:
For this systematic review, articles were audited from 2010 to 2020 using the PRISMA guidelines. PubMed, MEDLINE, Google Scholar, and Scopus databases were used, and search terms were related to use of pulse oximetry in the NICU.

Results:
The result showed that 12 of 20 (60%) studies focused on target values but without a unanimous agreement on values, although 5 of 12 studies (41.66%) suggested a lower value target of 85% and 4 of 12 studies (33.33%) recommended 95% as the higher target value. Other authors showed no difference in the incidence of adverse events comparing different target values and focused the importance more on the fluctuation of the value than on the target value itself.

Implication for Practice:
Reaching a balance in the oxygen administration so as to avoid potential complications associated with hypoxemia or hyperoxemia is a challenge for the clinicians.

Implication for Research:
Further studies on fluctuation of Spo
2 comparing different starting targets could better clarify the role of fluctuations and the absolute target values.

Video Abstract available at:
https://journals.na.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=49
The Effect of Vibration on Pain During Heel Lance Procedures in Newborns
Authors: Avan Antepli Nihal , Bilsin Kocamaz Elif , Güngörmüş Zeynep 
Published: August 2021

Background/Significance:The pain-reducing effect of applying vibration, which is used as a nonpharmacological method in pain management, is explained by the gate control theory developed by Melzack and Wall. Studies that are based on this theory have shown similar results to those of Melzack and Wall, indicating that pain-transmitting nerves are suppressed by vibrations, leading to higher pain thresholds.Purpose:The study aimed to evaluate the effect of applying vibration to manage pain during heel lance procedures in newborns.Methods:This is a randomized, controlled experimental study. The study sample included 56 newborns determined using power analysis (vibration group = 28; control group = 28). For those in the vibration group, a vibrating device was used for approximately 30 seconds before the heel lance procedure and then continued throughout the procedure. No interventions were provided to the newborns in the control group. Pain in the newborns was evaluated by the nurse who performed the heel lance procedures, before the procedures and 15 to 20 seconds and 5 minutes after procedures, and by 2 specialists who viewed the video footage and conducted the Neonatal Infant Pain Scale examination.Results:The pain scores were significantly lower at 15 to 20 seconds and 5 minutes after the heel lance procedures in the group that received vibrations than in the control group (P< .05).Implications for Practice:The application of vibration, which is effective, nonpharmacological, and noninvasive, could help nurses manage pain in newborns as a nonpharmacological method.Implications for Research:The number of studies that examine the effect that vibration has on pain associated with heel lance procedures in newborns is very limited, and it is recommended that further studies be conducted with larger sample sizes.
Using a Bundle Approach to Prevent Bronchopulmonary Dysplasia in Very Premature Infants
Authors: Ratliff-Crain Devon , Wallingford Brenda , Jorgenson Lisa 
Published: August 2021

Background:
Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects about 20% to 30% of infants born at less than 32 weeks of gestation. Diagnosis is made if an infant requires oxygen therapy at 36 weeks' corrected age or discharge home. BPD increases healthcare costs, mortality rates, and risk of long-term respiratory complications and neurosensory impairments.

Purpose:
The purpose of this project was to improve rates and severity of BPD in very premature infants without increasing length of hospitalization.

Methods:
A multidisciplinary care bundle involving respiratory support and medication use guidelines was created and implemented along with a noninvasive ventilation algorithm for the delivery room. This bundle was utilized for infants born in a Midwest hospital in 2019 at less than 32 weeks of gestation and the outcomes were compared to infants born in 2017.

Results:
Implementation of this BPD prevention bundle contributed to a decrease in the use of oxygen at discharge for very premature infants without increasing length of hospitalization. Use of invasive mechanical ventilation and the severity of BPD also decreased.

Implications for Practice and Research:
A multidisciplinary bundle approach can be successful in decreasing the rates of BPD for very premature infants. Future quality improvement projects should focus on improving delivery room management of extremely premature infants, with an emphasis on optimizing noninvasive ventilation strategies. More research is still needed to determine the best method of ventilation for premature infants and the best utilization of surfactant and corticosteroids.
Incidence and Risk Factors of Ocular Hypertension and Glaucoma in Patients With Acanthamoeba Keratitis
Authors: Al Owaifeer Adi Mohammed , Al-Omair Sarah , Alrefaie Shaimaa , Alenezi Saad H. , Al-Shahwan Sami 
Published: August 2021

Objectives:
To determine the incidence of ocular hypertension (OHT) and glaucoma in patients with acanthamoeba keratitis (AK) and to outline the risk factors for the development of glaucoma.

Methods:
A retrospective review of patients diagnosed with AK at our institute during the period from 2000 to 2018. The main outcome measures were the incidence of OHT and glaucoma, and risk factors for the development of glaucoma.

Results:
Fifty-two eyes diagnosed with AK were included. The incidence of OHT and glaucoma was 51.9% and 32.7%, respectively. The mean duration from disease onset to the first attack of elevated intraocular pressure was 8.4±16.6 months. The use of corticosteroids in the treatment regimen was significantly associated with the development of glaucoma (odds ratio, 3.93; 95% confidence interval, 0.96–16.15; P=0.049). At the last follow-up visit, both patients with glaucoma and nonglaucoma patients had improved visual acuity without a difference in the mean amount of logarithm of the minimum angle of resolution acuity improvement among them (0.56±0.91 vs. 0.67±0.87, P=0.686).

Conclusion:
Our findings confirm that OHT and glaucoma are frequent complications in AK. Patients treated with a regimen containing corticosteroids are at a higher risk; thus, they should receive close intraocular pressure monitoring.
Botanical Medicines With Activity Against Stationary Phase Bartonella henselae
Authors: Ma Xiao , Leone Jacob , Schweig Sunjya , Zhang Ying 
Published: August 2021

Abstract

Bartonella henselae is a Gram-negative bacterium and is the causative agent of cat scratch disease. In humans, infections with B. henselae can result in acute or chronic systemic infections with diverse clinical symptoms. The current treatment for Bartonella infections with antibiotics such as doxycycline and rifampin is not always effective, presumably due in part to bacterial persistence. There are various anecdotal reports of herbal extracts used for treating patients with persistent Bartonella infections but their activity on B. henselae is unknown. In order to identify more effective therapies for persistent Bartonella infections, in this study, we tested the antimicrobial activity of botanical and herbal medicines and screened an herbal product collection against stationary phase B. henselae in vitro using a SYBR Green I/propidium iodide viability assay. We identified five herbal product extracts (at 1.67 mg/mL or 2.5 mg/mL), including Cryptolepis sanguinolenta, Juglans nigra, Polygonum cuspidatum, Scutellaria baicalensis, and Scutellaria barbata, that had high activity against stationary phase B. henselae. Among them, C. sanguinolenta, J. nigra, and P. cuspidatum could eradicate all stationary phase B. henselae cells within 7 days at 0.83 mg/mL or 1.25 mg/mL in drug exposure time-kill assays, whereas S. baicalensis and S. barbata showed relatively poor activity. These top hits were active against both stationary phase non-growing B. henselae and log phase growing B. henselae in minimum inhibitory concentration testing. These findings may have implications for improved treatment of persistent Bartonella infections.
Is there a role for immune-enhancing therapies for acutely ill patients with coronavirus disease 2019?
Authors: Wittebole Xavier , Montiel Virginie , Mesland Jean-Baptiste 
Published: August 2021

Purpose of review
Although the so-called cytokine storm has been early described and related to a dramatic evolution in severe COVID-19 patients, it soon became clear that those patients display clinical and biological evidence of an immunosuppressive state characterized, among other, by a profound lymphopenia. The negative role of this immune suppression on the outcome raises the question on immune therapies that might improve patient's condition.

Recent findings
Important positive effects of active immune therapies, such as IL-7 or thymosin-α are already described and warrant confirmation in larger prospective trials. For other therapies, such as interferons, firm conclusions for critically ill COVID-19 patients are lacking as those patients were often excluded from the published trials. Treatment with immunoglobulins or convalescent plasma is a passive strategy to provide specific immunity. Unfortunately, results from large RCTs do not support their use presently.

Summary
In this article, we provide a review on active and passive immune boosting strategies that might help treating the most severe COVID-19 patients. We mainly focus on active strategies that include IL-7, thymosin-α, interferons, and vitamin D. Although some positive effects are described, they certainly warrant confirmation in large randomized controlled trials.
Rectal Evacuation Disorders are Associated With Poor Bowel Preparation in Patients With Chronic Constipation
Authors: Pathipati Mythili P. , Silvernale Casey J. , Barshop Kenneth G. , Ha Jasmine B. , Richter James M. , Staller Kyle D. 
Published: August 2021

Introduction:
We evaluated factors that can predict the adequacy of bowel preparation in patients with chronic constipation undergoing colonoscopy.

Materials and Methods:
We identified patients with chronic constipation who underwent anorectal manometry and at least 1 colonoscopy at 2 tertiary referral centers from 2003 to 2019. We also identified a subgroup of patients who underwent colonic transit testing through radiopaque marker testing. We determined demographic, medical, and constipation-related factors associated with poor bowel preparation and their effect on standardized quality metrics using univariate and multivariate analyses.

Results:
We identified 274 patients with chronic constipation who underwent anorectal manometry testing. Both outlet dysfunction (prolonged balloon expulsion) and slow-transit constipation were associated with suboptimal bowel preparation. Outlet dysfunction was also associated with decreased cecal intubation rates, adenoma detection rates, and sessile serrated polyp detection rates. In multivariable analyses controlling for demographics and known factors associated with poor bowel preparation, outlet dysfunction was associated with an almost 3-fold odds of suboptimal bowel preparation [odds ratio (OR): 2.9; 95% confidence interval (CI): 1.6-5.1] and a 3-fold reduction in cecal intubation rates (OR: 0.3; 95% CI: 0.1-0.8). Among those with radiopaque marker colonic transit testing available, slow-transit constipation was associated with a >2-fold odds of suboptimal bowel preparation (OR: 2.2; 95% CI: 1.1-4.4).

Conclusions:
Among a cohort of patients with chronic constipation undergoing colonoscopy, outlet dysfunction was associated with suboptimal bowel preparation and other quality metrics. Constipated patients with a rectal evacuation disorder may represent a subgroup of patients that could benefit from individualized strategies for better bowel preparation.
Effects of coronavirus disease 2019 on the digestive system and its nutritional implications
Authors: Aguila Enrik John T. , Cua Ian Homer Y. , Singh Rajvinder 
Published: August 2021

Purpose of review
There has been a deluge of scientific data since coronavirus disease 2019 (COVID-19) was first reported. The effects of COVID-19 on the digestive system are now increasingly well understood. This article aims to review the current data on the effects of COVID-19 on the digestive system with particular emphasis on preexisting digestive diseases and its implications on nutrition practices.

Recent findings
Evidence has shown that Severe acute respiratory syndrome coronavirus 2 virus affects the gastrointestinal (GI) tract, pancreas and hepatobiliary system resulting in different GI manifestations. Several preexisting digestive diseases have been investigated. These studies have revealed that these special patient population groups are generally not at an increased risk to contract COVID-19, but are susceptible to develop increasing severity of disease. Aside from medical therapy, optimizing nutritional care has a beneficial role in this group of patients.

Summary
GI manifestations of COVID-19 in addition to preexisting digestive diseases have an impact on patient's nutrition. Digestion, absorption and transport of nutrients may be impaired. To date, there are no existing guidelines on the nutritional management of patients for this particular at-risk group. Most nutrition practices are based only on observations and clinical experience. Basic prepandemic nutrition care principles are primarily followed but often individualized based on clinical judgment.
The cepstral spectral index of dysphonia, the acoustic voice quality index and the acoustic breathiness index as novel multiparametric indices for acoustic assessment of voice quality
Authors: Barsties v. Latoszek Ben , Mathmann Philipp , Neumann Katrin 
Published: August 2021

Purpose of review
The objective assessment of voice quality using acoustic measures is an important pillar of voice diagnostics. This article reviews three recent acoustic measures and their clinical use in phoniatrics and laryngology.

Recent findings
Two acoustic parameters, the cepstral spectral index of dysphonia (CSID) and the acoustic voice quality index (AVQI), have gained importance as validated multiparametric indices in the objective assessment of hoarseness because they include both continuous speech and sustained vowels. The acoustic breathiness index (ABI), another multiparametric index, assesses breathiness admixture during phonation and identifies it robustly, unaffected by other characteristics of dysphonia such as roughness.

Summary
Acoustic measurements are useful diagnostic tools when used correctly with an appropriate recording system, consideration of environment and use of software programs. CSID, AVQI and ABI objectively improve the detection of voice quality abnormalities. In addition to their proven validity, their application is simple and their usability for clinicians is high.
Global health security as it pertains to Zika, Ebola, and COVID-19
Authors: Pannu Jaspreet , Barry Michele 
Published: August 2021

Purpose of review
Due to the impact of the COVID-19 pandemic this past year, we have witnessed a significant acceleration in the science, technology, and policy of global health security. This review highlights important progress made toward the mitigation of Zika, Ebola, and COVID-19 outbreaks. These epidemics and their shared features suggest a unified policy and technology agenda that could broadly improve global health security.

Recent findings
Molecular epidemiology is not yet in widespread use, but shows promise toward informing on-the-ground decision-making during outbreaks. Point-of-care (POC) diagnostics have been achieved for each of these threats; however, deployment of Zika and Ebola diagnostics lags behind those for COVID-19. POC metagenomics offers the possibility of identifying novel viruses. Vaccines have been successfully approved for Ebola and COVID-19, due in large part to public-private partnerships and advance purchase commitments. Therapeutics trials conducted during ongoing epidemics have identified effective antibody therapeutics for Ebola, as well as steroids (both inhaled and oral) and a broad-spectrum antiviral for COVID-19.

Summary
Achieving global health security remains a challenge, though headway has been made over the past years. Promising policy and technology strategies that would increase resilience across emerging viral pathogens should be pursued.
Prospective Trial of Near-Infrared Spectroscopy for Continuous Noninvasive Monitoring of Free Fibular Flaps
Authors: Ouyang Si-Yuan , Cai Zhi-Gang , Shan Xiao Feng , Li Yue 
Published: August 2021

Introduction
Some free flaps develop postoperative vessel thrombosis, which influences the flap survival rate. Early discovery and identification of vascular crisis are critical to the success rate of flap salvage. The primary aims of this study were to determine the features of postoperative blood supply changes in fibular flaps with normal and abnormal blood flow, using near-infrared spectroscopy (NIRS), to monitor oxygenation and blood flow, and to characterize the probable risk factors for vascular crisis.

Methods
Sixty-three consecutive patients undergoing reconstruction of unilateral mandibular defects with free fibular flaps at the Peking University School of Stomatology were included. Patients were divided into 2 groups, A (n = 38) and B (n = 25); fibular flaps in group A underwent continuous NIRS monitoring from immediately postoperatively until 7 days postoperatively (approximately 150 hours), whereas fibular flaps and opposite mandibles in group B underwent intermittent monitoring: once every 4 hours during the first 24 hours postoperatively and once every 12 hours from 24 to 168 hours postoperatively.

Results
Six fibular flaps developed vascular thromboses: 4 were venous thromboses and 2 were arterial thromboses; 5 were rescued after exploration. Of 6 regional oxygen saturation (rSO2) values in the continuous monitoring group, 4 showed no significant differences at any time point compared with the intermittent monitoring group (P > 0.05). The rSO2 of the fibular flap was significantly different from that in the opposite mandible in the first 36 hours postoperatively (P < 0.05). This difference decreased over time. During the initial period of venous thrombosis, rSO2, deoxyhemoglobin, and oxygenated hemoglobin all rose slightly, then showed simultaneous rapid reduction. However, the magnitude of reduction was smaller for deoxyhemoglobin than for oxygenated hemoglobin.

Conclusions
Near-infrared spectroscopy can be used for noninvasive and reliable assessment of oxygenation and blood flow in free flaps through continuous, real-time monitoring. It is also portable, inexpensive, and simple to operate. In addition, the detection depth of NIRS is up to 2.0 cm, so it can be used to monitor buried flaps with depths <2.0 cm.
Mechanical Embolectomy for Superior Cerebellar Artery Embolism
Authors: Yin Chun , Ding Yasuo , Sun Bing , Zhang Bo , Chang Hao 
Published: August 2021

Abstract
Acute embolism of the superior cerebellar artery is rarely reported. The treatment is mainly medication, decompressive craniectomy is performed when necessary, and mechanical thrombus removal is not recommended. This article describes the admission of a 69-year-old man with acute superior cerebellar artery embolization. Compared with the imaging data of the patient 2 weeks before the onset of the disease, cerebral angiography revealed that there was a mural thrombus covering the opening of the superior cerebellar artery. it is also a bold attempt for this patient to undergo mechanical thrombectomy. The patient finally recovered well from neurological symptoms. This case report details the causes of the rare mural thrombosis leading to superior cerebellar artery embolism, and also has a new understanding of arterial embolism in acute stroke.
Long-term Normothermic Machine Preservation of Partial Livers: First Experience With 21 Human Hemi-livers
Authors: Mueller Matteo , Hefti Max , Eshmuminov Dilmurodjon , Schuler Martin J. , Sousa Da Silva Richard X. , Petrowsky Henrik , De Oliveira Michelle L. , Oberkofler Christian E. , Hagedorn Catherine , Mancina Leandro , Weber Achim , Burg Brian , Tibbitt Mark W. , Rudolf von Rohr Philipp , Dutkowski Philipp , Becker Dustin , Bautista Borrego Lucia , Clavien Pierre-Alain 
Published: August 2021

Objective:
The aim of this study was to maintain long-term full function and viability of partial livers perfused ex situ for sufficient duration to enable ex situ treatment, repair, and regeneration.

Background:
Organ shortage remains the single most important factor limiting the success of transplantation. Autotransplantation in patients with nonresectable liver tumors is rarely feasible due to insufficient tumor-free remnant tissue. This limitation could be solved by the availability of long-term preservation of partial livers that enables functional regeneration and subsequent transplantation.

Methods:
Partial swine livers were perfused with autologous blood after being procured from healthy pigs following 70% in-vivo resection, leaving only the right lateral lobe. Partial human livers were recovered from patients undergoing anatomic right or left hepatectomies and perfused with a blood based perfusate together with various medical additives. Assessment of physiologic function during perfusion was based on markers of hepatocyte, cholangiocyte, vascular and immune compartments, as well as histology.

Results:
Following the development phase with partial swine livers, 21 partial human livers (14 right and 7 left hemi-livers) were perfused, eventually reaching the targeted perfusion duration of 1 week with the final protocol. These partial livers disclosed a stable perfusion with normal hepatic function including bile production (5–10 mL/h), lactate clearance, and maintenance of energy exhibited by normal of adenosine triphosphate (ATP) and glycogen levels, and preserved liver architecture for up to 1 week.

Conclusion:
This pioneering research presents the inaugural evidence for long-term machine perfusion of partial livers and provides a pathway for innovative and relevant clinical applications to increase the availability of organs and provide novel approaches in hepatic oncology.