bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitric oxide mitigates thalidomide-induced abnormalities during germination and development of fennel seeds
Authors: Swaminathan Akila , Kalyani Koneti Brahma , Sudhagar Senthil Kumar , Bhuvaneswari Srinivasan , Nagalatha S Thupali , Raj T Leon Stephan , Sumantran Venil N , Chatterjee Suvro 
Published: July 2021

Abstract
Thalidomide causes teratogenic effects in several animal species and in humans. Accordingly, the World Health Organization banned thalidomide when mothers who took thalidomide during pregnancy delivered abnormal fetuses. After four decades, thalidomide underwent drug “re-purposing” since its antiangiogenic and immunomodulatory effects were therapeutic for multiple myeloma. There are no reports of thalidomide’s effects on prokaryotes, but it showed teratogenic effects in Arabidopsis thaliana, an ancestor of the plant kingdom. This proof of concept study clearly shows that thalidomide caused a significant and reproducible decrease in germination rate, nitric oxide (NO) production, and chlorophyll content of fennel plantlets. Thalidomide also induced the formation of abnormal fennel plantlets with stunting, wrinkling, and curling of fennel shoots and leaves. Notably, quantitative analysis showed that thalidomide caused a 50% increase in the formation of abnormal fennel plantlets and that these negative effects of thalidomide showed a 2.50- to 4-fold decrease when fennel seeds were co-incubated with an NO donor (Spermine NoNoate) or a stable cGMP analog 8-bromo Guanosine 3′,5′-cyclic monophosphate (8-Bromo-cGMP). This study is important because it confirms that thalidomide’s negative effects on fennel seed germination and growth are mediated by attenuation of NO and disruption of NO signaling. This reproducible model of thalidomide-induced, NO-dependent damage in a plant system can be used to further investigate the molecular mechanisms of thalidomide action in plants. Importantly, this study establishes a link between the evolution of development of higher plants and mammals.
A Rapid In Vitro Phenotypic Assay of Walnut Shoots for Prescreening Resistance to Phytophthora pini
Authors: Zaini Paulo A. , Lee Steven H. , Leslie Charles A. , Walawage Sriema L. , Jiang Cai-Zhong , Browne Gregory T. , Dandekar Abhaya M. , Kasuga Takao 
Published: July 2021

Phytophthora species cause crown, root, and aerial canker diseases in diverse horticultural crops, resulting in a loss of yield, loss of quality, and plant death. Breeding programs are interested in developing genotypes resistant to these and other pathogens, but current screening methods for tree crops are time-consuming, potentially spanning many years. Here we present a rapid in vitro assay in which walnut shoots obtained from tissue culture can be challenged with Phytophthora zoospores and monitored for symptom development within a week. As a proof of concept, two cultivars, scion variety ‘Chandler’ and clonal rootstock ‘RX1’, with known different degrees of crown rot susceptibility, were inoculated in vitro with P. pini (formerly included in P. citricola complex), and results of the assay reproducibly matched the differences in disease susceptibility generally observed for these two walnut selections under greenhouse and orchard conditions. In addition, when the in vitro assay was used for inoculations with P. capsici, which is not pathogenic on walnut, no disease development was observable, indicating that the assay can discriminate between species of Phytophthora that are aggressive on walnut and those not known as walnut pathogens. Our results suggest that this in vitro shoot inoculation procedure may provide rapid assessments useful for prescreening resistance to Phytophthora in walnuts. Further testing of the assay is justified to determine whether it can resolve more subtle differences in resistance and whether it can be useful with other perennial hosts of Phytophthora.
Hyperthermic intraperitoneal chemotherapy for treating ovarian cancer
Authors: Gajarawala Shilpa , Pelkowski Jessica , Dorian Rose , Stanton Amanda , Dinh Tri 
Published: July 2021

ABSTRACT
Hyperthermic intraperitoneal chemotherapy (HIPEC) has been used for decades as a treatment for disseminated abdominal malignancies, including pseudomyxoma peritonei and peritoneal mesothelioma. HIPEC had been used to treat recurrent ovarian cancer only when curative options were lacking, but new data indicate that it may be suitable as a primary treatment for patients with late-stage epithelial ovarian cancer, increasing the recurrence-free time interval and improving quality of life. However, treatment can be challenging because of patient trauma from surgery, combined with the toxicity and high temperature of the chemotherapeutic agents. This article reviews HIPEC and its targeted intraoperative and postoperative management.
Small cell neuroendocrine carcinoma disguised as an external hemorrhoid
Authors: Allmark Amelia , Brubaker Mary L. 
Published: July 2021

ABSTRACT
This article describes a patient who presented to the ED with persistent nausea and vomiting, constipation, weight loss, and a new complaint of an external hemorrhoid and hematochezia with stooling. Comprehensive diagnostic evaluation included imaging studies that showed extensive metastatic disease but did not identify a primary neoplasm. Biopsy of the external hemorrhoid revealed small cell neuroendocrine carcinoma of the anal canal.
Association of deleted in liver cancer-1 gene polymorphism with increased risk of chronicity of disease among Malaysian patients with hepatitis B infection
Authors: Riazalhosseini Behnaz , Mohamed Rosmawati , Devi Apalasamy Yamunah , Mohamed Zahurin 
Published: July 2021

Objective
The aim of this study is to examine the association between genetic variations in deleted in liver cancer 1 (DLC1) gene with progression of the hepatitis B virus (HBV) infection.

Methods
A total of 623 subjects were included in this study, of whom, 423 were chronic hepatitis B (CHB) patients without liver cirrhosis or hepatocellular carcinoma (HCC), 103 CHB with either liver cirrhosis ± HCC and 97 individuals who had resolved HBV. Two single-nucleotide polymorphisms rs3739298 and rs532841 of DLC1 gene were genotyped using the Sequenom MassARRAY platform.

Results
Our results indicated significant differences between the chronic HBV and resolved HBV groups in genotype and allele frequencies of DLC1-rs3739298 [odds ratio (OR) = 2.23; 95% confidence interval (CI): 1.24–3.99; P = 0.007] and (OR = 1.54; 95% CI: 1.07–2.22; P = 0.021), respectively. Moreover, haplotype analysis revealed significant associations between chronicity of HBV with TG and GA haplotypes (P = 0.041 and P = 0.042), respectively.

Conclusion
A significant association exists between the rs3739298 variant and susceptibility to CHB infection.
The effect of participation in accountable care organization on electronic health information exchange practices in U.S. hospitals
Authors: Nwafor Onyi , Johnson Norman A. 
Published: July 2021

Background
Accountable care organizations (ACOs) are a recent incentive program that are designed to address inefficiencies in the U.S. health care sector. To meet their design objectives, ACO participants must engage in greater electronic health information exchange (HIE) practices both internally and externally with care participants, such as patients and other providers.

Purpose
The aim of this study was to examine the relationship between hospital participation in ACOs and electronic HIE practices with different participants of care and how these practices vary differentially across market types.

Approach
Grounding our work in the reward-motivational view of organizational action, we proposed hypotheses that linked hospital participation in ACOs to three dimensions of HIE practices (intraorganizational, interorganizational, and provider–patient HIE practices). We tested our hypotheses by analyzing a sample of 1,926 hospitals.

Results
Hospital participation in ACOs is associated with greater intraorganizational and provider–patient HIE practices, but not interorganizational HIE practices. We also found that whereas the relationship between ACO participation and intra- and interorganizational HIE practices remains unchanged irrespective of the degree of competition in the health care market, the relationship between ACO participation and provider–patient HIE practices holds true only for hospitals operating in noncompetitive markets.

Practice Implications
Our results showed that hospitals participating in ACOs vary in their HIE practices, and attributes of the local market in which ACO participants operate in contribute to this variation. These insights should provide guidance to researchers, policymakers, and hospital administrators who aim to improve the effectiveness of ACOs.
Descemet Stripping Automated Endothelial Keratoplasty in Pediatric Age Group: A Decade of Our Experience
Authors: Ramappa Muralidhar , Mohamed Ashik , Achanta Divya S. Ramya , Tumati Chaitanya S. Kiran , Chaurasia Sunita , Edward Deepak P. 
Published: July 2021

Purpose:
This study was to report the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in managing corneal endothelial disorders in children less than 14 years of age.

Methods:
Medical records of 180 DSAEK performed, between 2008 and 2020, on 167 eyes of 111 children who had a visually significant endothelial dysfunction were retrospectively reviewed for the primary etiology of corneal decompensation, time of the onset and duration of cloudiness, preoperative visual acuity, the technique of endothelial keratoplasty, surgical modifications, and reintervention.

Results:
Median age at surgical intervention was 7.9 years (interquartile range, 5.2–11.2 years). At a median postinterventional follow-up of 2.5 years (interquartile range, 0.9–3.4 years), 86.2% (144 of 167 eyes, 95% confidence interval 79.9%–90.1%) maintained a clear graft. Median best-corrected visual acuity (logarithm of the minimum angle of resolution) improved from 1.45 ± 0.70 preoperatively to 0.90 ± 0.06 at the last follow-up visit (P < 0.0001). The cumulative overall long-term graft survival was 92.7%, 86.5%, and 77.7% at 1, 3, and 7 years, respectively. Cox proportional hazards regression analysis showed that the indication for DSAEK (P = 0.007; hazards ratio: 2.17 ± 0.62), age at surgery (P = 0.02; hazards ratio: 0.87 ± 0.05), and any subsequent intervention after DSAEK (P = 0.003; hazards ratio: 0.11 ± 0.08) were significant risk factors for DSAEK failure. The endothelial cell loss was 40.1% at 6 months, 45.4% at 1 year, 55.2% at 5 years, and 61.9% at 7 years.

Conclusions:
DSAEK is a safe and effective surgical strategy in managing endothelial disorders among the pediatric age group.
Lipids and cardiovascular calcification: contributions to plaque vulnerability
Authors: Hsu Jeffrey J. , Tintut Yin , Demer Linda L. 
Published: July 2021

Purpose of review
Cardiovascular calcification, a common feature of atherosclerotic lesions, has long been known to associate with cardiovascular risk. The roles of lipoproteins in atherosclerosis are also established, and lipid-modifying therapies have shown capacity for plaque regression. However, the association of lipid-modifying therapies with calcification is more complex, and currently no medical therapies have been found to reverse or attenuate calcification in patients. In this review, we summarize recent developments in our understanding of the interplay between lipids and cardiovascular calcification, as well as new imaging modalities for assessing calcified atherosclerotic plaque vulnerability.

Recent findings
Recent clinical studies have highlighted the associations of lipoprotein subtypes, such as low-density and high-density lipoprotein particles, as well as lipoprotein (a) [Lp(a)], with coronary calcification and calcific aortic valve disease. Further, evidence continues to emerge for the utility of fused 18F-sodium fluoride positron-emission tomographic and computed tomographic (18F-NaF PET/CT) imaging in characterizing the microarchitecture and vulnerability of atherosclerotic plaque, in both humans and animal models.

Summary
The relationship between lipids and cardiovascular calcification is complex, and new imaging techniques, such as 18F-NaF PET/CT imaging, may allow for better identification of disease-modifying therapies and prediction of calcified plaque progression and stability to help guide clinical management.
Handling Errors in the Use of Inhalation Devices
Authors: Neininger Martina Patrizia , Kaune Almuth , Musiol Juliane , Kiess Wieland , Bertsche Astrid , Prenzel Freerk , Bertsche Thilo 
Published: July 2021

Background:
Children suffering from bronchial diseases need assistance from nurses in the use of inhalation devices.

Purpose:
We aimed to assess nurses' skills and knowledge concerning drug administration with inhalation devices in hospitalized pediatric patients.

Methods:
An expert panel defined medication errors in drug administration with inhalation devices in children. We monitored 241 inhalation procedures to investigate nurses' inhalation technique skills. Twenty-nine nurses completed a questionnaire to assess nurses' knowledge.

Results:

Skills: In 93 of 241 (39%) inhalation procedures, the mask/mouthpiece did not fit airtight. In none of the 11 inhalations administering a glucocorticoid, the patient's mouth was thoroughly cleaned afterward. Knowledge: Ten of 29 nurses (34%) thought a distance between mask and the patient's face was acceptable. Only 16 of 29 (55%) knew that it is necessary to thoroughly clean the patient's mouth after the inhalation of budesonide.

Conclusions:
We found that education on inhalation procedures including practical training is required to increase patient safety.
Improving Compliance with a Rounding Checklist through Low- and High-technology Interventions: A Quality Improvement Initiative
Authors: Carr Leah H. , Padula Michael , Chuo John , Cunningham Megan , Flibotte John , O’Connor Theresa , Thomas Beth , Nawab Ursula 
Published: July 2021

Introduction:
Checklists aid in ensuring consistency and completeness in medical care delivery. However, using an improvement and safety checklist during rounds was variable in our neonatology intensive care unit (NICU), and completion was not tracked sustainably. This quality improvement (QI) initiative’s primary aim was to increase compliance with checklist completion from 31% to >75% within 1 year.

Methods:
A multidisciplinary QI team identified barriers to checklist completion and implemented a human factors-focused low-technology intervention (redesign of a hard-copy checklist) and later a high-technology clinical decision support tool within the electronic health record. The primary outcome measure was percent compliance with the use of the checklist. Process metrics included the duration of checklist completion. Balancing measures included staff perceptions of work burden and question relevance.

Results:
Major barriers to checklist utilization were inability to remember, rounding interruptions, and perceived lack of question relevance to patients. Average biweekly checklist compliance improved from 31% before interventions to 80% after interventions. Average checklist completion time decreased from 46 to 11 seconds. Follow-up surveys demonstrated more respondents found questions “completely relevant” (34% pre versus 43% post) but perceived increased work burden (26% pre versus 31% post).

Conclusions:
Using QI methodology, human factors-based interventions, and a novel clinical decision support tool, we significantly improved efficiency and checklist compliance and created an automated, sustainable method for monitoring completion and responses. This foundational project provides an infrastructure broadly applicable to QI work in other healthcare settings.
Implementing PDSA Methodology for Pediatric Appendicitis Increases Care Value for a Tertiary Children's Hospital
Authors: Ingram Martha-Conley E. , Studer Abbey , Schechter Jamie , Martin Sarah A. , Patel Manisha , Roben Emily C.Z. , Burjek Nicholas E. , Birmingham Patrick K. , Raval Mehul V. 
Published: July 2021

Introduction:
We used the plan-do-study-act (PDSA) framework to develop and implement an evidence-based clinical practice guideline (CPG) within an urban, tertiary children’s referral center.

Methods:
We developed an evidence-based CPG for appendicitis using iterative PDSA cycles. Similar CPGs from other centers were reviewed and modified for local implementation. Adjuncts included guideline-specific order sets and operative notes in the electronic medical record system. Outcomes included length of stay (LOS), 30-day readmissions, hospital costs, and patient and family experience (PFE) scores. Our team tracked outcome, process, and balancing measures using Statistical Process Charts. Outcome measures were compared over 2 fiscal quarters preimplementation and 3 fiscal quarters postimplementation, using interrupted time series, student t test, and chi-square tests when appropriate.

Results:
LOS for simple (uncomplicated) appendicitis decreased to 0.87 days (interquartile range [IQR] 0.87–0.94 days) from 1.1 days (IQR 0.97–1.42 days). LOS for complicated appendicitis decreased to 4.96 days (IQR 4.95–6.15) from 5.58 days (IQR 5.16–6.09). This reduction equated to an average cost-savings of $1,122/patient. Thirty-day readmission rates have remained unchanged. PFE scores increased across all categories and have remained higher than national benchmarks.

Conclusion:
Development and Implementation of a CPG for pediatric appendicitis using the PDSA framework adds value to care provided within a large tertiary center.
Papillary Thyroid Carcinoma in Ectopic Thyroid Tissue Within a Suspected Cervical Paraganglioma
Authors: Sambo Salas Marcel Ernesto , Muñoz Moreno Diego , Fernandez Laura Gonzalez , Nuñez Ramos Patricia , Cebollero Presmanes Maria 
Published: July 2021

Abstract
Ectopic differentiated thyroid carcinoma represents less than 1% of all thyroid carcinoma cases, which usually arises along the cervical midline, and (delving into literature) there are scarce reports of such entity in nuclear medicine imaging studies. We present a rare case of a confirmed synchronous, orthotopic, and heterotopic (in lateral ectopic thyroid tissue) differentiated thyroid carcinoma in a patient who was previously misdiagnosed as having a cervical paraganglioma, based on compatible clinical, analytical, and imagenological (both structural and functional) findings.
Outcome Measurement of Beauty and Attractiveness of Facial Aesthetic Rejuvenation Surgery
Authors: Atiyeh Bishara S. , Chahine Fadl 
Published: July 2021

Abstract
Aesthetic plastic surgery is a most unusual and unique subspecialty. Unlike other medical and surgical specialties driven primarily by objective medical diagnosis and outcome, aesthetic surgery is patient driven; it represents a special exercise in professional competence by adapting objective medical standards to a mostly subjective field. Given the subjectivity of facial beauty and of the projected aesthetic intervention outcome, in addition to be able to determine beauty of the final result as precisely and objectively as possible, it is also essential to be able to assess patient's satisfaction. However, lack of standardized facial measurements and clear definition of aesthetic outcome and beauty are still major obstacles preventing real change in the consultation dynamics to help better serve patients’ expectations. Because of the tremendous increase in demand for all types of facial aesthetic procedures, an objective understanding of aesthetics and beauty is becoming of utmost importance. Recognition of the importance of science and evidence-based medicine is long overdue in our specialty. This study aims at identifying the most recently available evidence-based measures to quantitatively assess beauty and measure outcome of rhytidoplasty that can be useful in everyday aesthetic practice.
Fully Guided Zygomatic Implant Surgery
Authors: Rigo Leone , Tollardo James , Giammarinaro Enrica , Covani Ugo , Caso Guerino 
Published: July 2021

Introduction:
Rehabilitating a severely atrophic maxilla is a complex procedure. In case of severe resorption, zygomatic implants are indicated and loading of the implants at the end of the surgery is desirable. We present a new method by means of guided surgery for the placement of zygomatic implants, using specially designed metal templates that should be supported by bone.

Methods:
The treatment planning for completely guided prosthetic rehabilitation of the maxilla with zygomatic implants was digitally performed. A radiographic template was designed for the prosthetic treatment planning. A surgical template was used to replicate the digitally planned steps in vivo.

Results:
The procedure ended with the positioning of a custom-made temporary prosthesis. This method can reduce the surgery duration, simplify the procedure, and optimize the outcome. It requires equal cooperation among technicians, prosthodontists, and surgeons. Nineteen out of twenty patients included in the study presented successful implants and prosthesis at the moment of analysis.

Conclusions:
The present approach addressed the needs for zygomatic-implant surgery. The surgical and prosthetic plan, position, emergence, the shape of the implants, the position of the temporary prosthesis, the inter-arch relationships, and surgical templates were designed in a completely virtual environment and performed by the surgeon on stereolithographic models beforehand. Consequently, the surgical procedure was considerably simplified.
Distance Learning During COVID-19 Mitigates Learning Loss for Interprofessional Education
Authors: Arciaga Peregrina L. , Calmes Daphne , Windokun Adejare , Pan Deyu , Dev Parvati , Ruff Henry , Bazargan-Hejazi Shahrzad 
Published: July 2021

Summary Statement
On-site interprofessional education (IPE) simulation is primarily used to teach students teamwork, communication, and crisis resource management. Participants view it as an educational environment in which to acquire and consolidate skills. Virtual IPE simulation is traditionally seen as an opportunity to supplement, complement, and reinforce on-site IPE (OI). We used VI as the sole simulation method during the COVID-19 pandemic to provide IPE because of constraints of social distancing. The VI resulted in substantially achieving similar learning outcomes to OI. This suggests that VI, which has the advantage of being cheaper and more easily scalable than OI, may be an effective remote learning modality for IPE.