bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Michigan Plan for Appropriate Tailored Health Care in Pregnancy Prenatal Care Recommendations
Authors: Peahl Alex Friedman , Zahn Christopher M. , Turrentine Mark , Barfield Wanda , Blackwell Sean D. , Roberts Suni Jo , Powell Allison R. , Chopra Vineet , Bernstein Steven J. 
Published: August 2021

OBJECTIVE:
To describe MiPATH (the Michigan Plan for Appropriate Tailored Healthcare) in pregnancy panel process and key recommendations for prenatal care delivery.

METHODS:
We conducted an appropriateness study using the RAND Corporation and University of California Los Angeles Appropriateness Method, a modified e-Delphi process, to develop MiPATH recommendations using sequential steps: 1) definition and scope of key terms, 2) literature review and data synthesis, 3) case scenario development, 4) panel selection and scenario revisions, and 5) two rounds of panel appropriateness ratings with deliberation. Recommendations were developed for average-risk pregnant individuals (eg, individuals not requiring care by maternal–fetal medicine specialists). Because prenatal services (eg, laboratory tests, vaccinations) have robust evidence, panelists considered only how services are delivered (eg, visit frequency, telemedicine).

RESULTS:
The appropriateness of key aspects of prenatal care delivery across individuals with and without common medical and pregnancy complications, as well as social and structural determinants of health, was determined by the panel. Panelists agreed that a risk assessment for medical, social, and structural determinants of health should be completed as soon as individuals present for care. Additionally, the panel provided recommendations for: 1) prenatal visit schedules (care initiation, visit timing and frequency, routine pregnancy assessments), 2) integration of telemedicine (virtual visits and home devices), and 3) care individualization. Panelists recognized significant gaps in existing evidence and the need for policy changes to support equitable care with changing practices.

CONCLUSION:
The MiPATH recommendations offer more flexible prenatal care delivery for average-risk individuals.
Fixation at the Inferior Orbital Rim in Medially Rotated Zygomatic Complex Fractures
Authors: Al-Qattan Mohammad M. , Gelidan Adnan 
Published: August 2021

Background:
Zygomatic complex fractures are quadri-pod fractures because of the involvement of the zygomaticotemporal, zygomaticomaxillary, zygomaticofrontal, and zygomaticosphenoid junctions. The need to address one or more fixation points of these four articulations mainly depends on the degree of displacement. In this article, the authors present a series of medially rotated zygomatic complex fractures to demonstrate that one-point fixation at the inferior orbital rim (IOR) is sufficient in most cases.

Methods:
This is a retrospective study of all medially rotated zygomatic complex fractures treated by the authors over the last 4 years.

Results:
The patients were six men with a mean age of 41 years. All patients sustained medially rotated zygomatic complex fractures. Three patients had symptomatic orbital floor defects. One patient had concurrent displaced superior orbital rim fracture. Surgery was done using the transconjunctival approach. A titanium mesh was used to fix the IOR. For orbital floor reconstruction, the same titanium mesh was extended into the floor to cover the defect. The patient with concurrent superior orbital rim fracture required a second point of fixation at the lateral orbital rim.

Conclusions:
Single-point of fixation at the IOR is sufficient in most medially rotated zygomatic complex fractures as long as there is minimal displacement at other fracture points. Some of these patients may have symptomatic orbital floor defects. Simultaneous fixation of the IOR and orbital floor reconstruction may be done via a transconjunctival approach.
Delirium awareness day: a portuguese perspective
Authors: Regueira Patrícia , Firmino Horácio , Cerejeira Joaquim 
Published: August 2021

Abstract
Delirium is a syndrome characterized by impairment of awareness and inattention, that represents a change from the patient's baseline cognitive functioning. It is triggered by an underlying medical condition, reaching a prevalence of 24.7% in geriatric wards. However, undiagnosed delirium remains a reality among inpatient individuals, with an estimated frequency of 24.1%. The inappropriate knowledge of diagnostic criteria and standard screening tools was pointed out as a relevant contributing factor to this paradigm.
Liaison Psychiatry Services guarantee psychiatric approach and treatment to patients attending general hospitals. Considering that older adult patient care requires a well-trained and skilled team, the Centro Hospitalar e Universitário de Coimbra has a Geriatric Psychiatry Liaison Service, where delirium is one of the prevailing clinical conditions assessed by this team. The International Delirium Awareness Day is going to be worldwide celebrated on the 11th of March. Given that delirium has been consistently associated with the economic burden and adverse outcomes this symbolic day works as a huge opportunity to raise insight into the preventive strategies that could be implemented among healthcare professionals, patients, and caregivers. Within the Portuguese National Health System there is a need to build a set of systematic epidemiological data about delirium prevalence and incidence in the different settings and it would be essential the employment of a multicomponent intervention package delivered by a multidisciplinary team trained and competent in delirium prevention into routine care.
Comparison of the efficacy and safety indicators of DMARDs for rheumatoid arthritis
Authors: Wang Zunlian , Huang Min , Yu Bin , Huang Yilan , Zheng Silin , Yang Xuping , Ning Hong 
Published: August 2021

Abstract

Objective:
To compare efficacy and safety indicators of disease-modifying antirheumatic drugs, Sarilumab, Sirukumab, Baricitinib, Tocilizumab and Adalimumab in rheumatoid arthritis treatment by a network meta-analysis.

Methods:
Medline, Embase, Web of Science, The Food and Drug Administration web site, and Cochrane library were searched from build to June 1, 2020. Clinical randomized controlled trails of these 5 drugs for rheumatoid arthritis were collected for network meta-analysis.

Results:
A total of 4 randomized controlled trails with 2070 patients were obtained. The results of the network meta-analysis showed that:
The results of the ranked probability plot indicated that Tocilizumab and Sarilumab outperform other drugs in terms of efficacy and safety.

Conclusion:
The results of the ranking of the 5 drugs showed that Tocilizumab and Sarilumab had the best efficacy and safety.
Rational emotive occupational health coaching for quality of work-life among primary school administrators
Authors: Agu Patricia U. , Chigbu Baptista Chinyere , Ede Moses Onyemaechi , Okeke Chinedu Ifedi , Chinweuba Ngozi H. , Amaeze Fidelis E. , Ejionueme Lambart K. , Omeke Faith , Aye Eucharia , Diara Faith Chinwe , Edikpa Edith Chika , Onu Eucheria Amaka , Nwafor Bernadette , Ozioko Agatha , Mezieobi Daniel , Oforka Theresa O. , Vita-Agundu Uche C. , Uwakwe Stephen Iro , Nweze Ukamaka N. , Onah Sebastian O. , Ebeh Jideofor Jeremiah , Ezeaku Patricia 
Published: August 2021

Abstract

Background:
This study aimed at investigating the effect of rational emotive occupational health coaching on quality of work-life among primary school administrators.

Method:
This is a double blinded and randomized control design study. A total of 158 administrators were sampled, half of them were exposed to rational emotive occupational health treatment package that lasted for 12 sessions. Two self-report measures were utilized in assessing the participants using quality of work life scale. Data collected were analyzed using MANOVA statistical tool.

Result:
The results showed that rational emotive occupational health coaching is effective in improving perception of quality of work-life among public administrators. A follow-up result showed that rational emotive occupational health coaching had a significant effect on primary school administrators’ quality of work life.

Conclusion:
This study concluded rational emotive occupation health coaching is useful therapeutic strategy in improving quality of work of primary school administrators, hence, future researchers and clinical practitioners should adopt cognitive-behavioral techniques and principles in helping employers as well as employees. Based on the primary findings and limitations of this study, future studies, occupational psychotherapists should qualitatively explore the clinical relevance of rational emotive occupational health practice across cultures using different populations
Feasibility of therapeutic plasma exchange-based combination therapy in the treatment of acquired hemophilia A
Authors: Wang Lin-Yue , Shen Yan , Zeng Han-Qing , Zhang Ying , Lou Shi-Feng , Deng Jian-Chuan , Luo Yun 
Published: August 2021

Abstract
Poor availability and a lack of affordability of bypassing agents (recombinant activated factor VII and activated prothrombin complex concentrate) in west China prompted us to investigate an alternative cost-effective combination therapy. We aimed to explore the feasibility of therapeutic plasma exchange (TPE)-based combination therapy in the treatment of acquired hemophilia A (AHA).
We retrospectively investigated the clinical features of AHA in 6 patients who were treated with a combination of TPE, corticosteroids, and rituximab in our department for 9 years between January, 2011 and December, 2019.
We examined 1 male and 5 female patients. The median age at diagnosis of AHA was 51 years (18–66 years). In all patients, FVIII activity levels were low (median: 1.5%; 1–3%), FVIII inhibitor titers were high (median: 24.5 BU/mL; 13.2–48.6 BU/mL), and activated partial thromboplastin time was markedly prolonged (median: 99.4 s; 60.9–110.1 s). They underwent 2 to 8 cycles of plasma exchange and were given varying combinations of dexamethasone, methylprednisolone, prednisone, and rituximab. After TPE bleeding gradually stopped, and activated partial thromboplastin time decreased. After 3 months of treatment, FVIII inhibitors completely disappeared.
TPE when combined with corticosteroids and rituximab, as adjunctive immunosuppressive agents, may be an effective and reliable treatment for AHA. When there is no alternative, intensive first-line treatment including TPE may be lifesaving.
Changes in tapered endotracheal tube cuff pressure after changing position to hyperextension of neck
Authors: Park Ji-Hoon , Lee Hyo-Jin , Lee Sou Hyun , Kim Ji Seob 
Published: August 2021

Abstract

Background:
Endotracheal tube (ETT) with a tapered-shaped cuff had an improved sealing effect when compared to ETTs with a conventional cylindrical-shaped cuff. Positional change and neck movement typically displace an ETT and change the intracuff pressure. The aim of the current study was to compare the ETT cuff pressure in the TaperGuard ETT vs the conventional ETT after a change from the supine, neutral position to the extension of the neck and semi-Fowler position for thyroid surgery.

Methods:
This prospective, randomized clinical trial included 50 patients undergoing thyroidectomy. Patients were randomly allocated into one of the 2 groups: tracheal intubation with the TaperGuard ETT or with a conventional ETT. The ETT cuff was inflated with air and the ETT cuff pressure was set initially at 20 cmH2O using a calibrated cuff manometer. ETT cuff pressure and distance from carina to ETT tip were measured at supine and semi-Fowler positions with neck extension.

Results:
After the position change, the ETT tip migrated cephalad and cuff pressure increased in the majority of cases. ETT cuff pressure was significantly higher in the TaperGuard group than the conventional group (28.0 ± 6.6 cmH2O and 22.8 ± 4.5 cmH2O, respectively, P = .001). The degree of cephalad displacement of the ETT tip was comparable between the 2 groups (19.4 ± 6.31 mm in TaperGuard group and 21.9 ± 6.9 mm in conventional group, P = .12).

Conclusions:
After the position change from supine to hyperextension of the neck, the ETT cuff pressure was higher in the TaperGuard ETT than in the conventional ETT, although the extent of displacement of the ETT was comparable between the 2 groups.
Survival of health workers infected by SARS-CoV-2 in the context of vaccination against COVID-19 in Peru
Authors: Escobar-Agreda Stefan , Silva-Valencia Javier , Rojas-Mezarina Leonardo , Vargas-Herrera Javier 
Published: August 2021

ABSTRACTObjectivesTo evaluate the survival of health workers infected by SARS-CoV-2 in the context of the vaccination process against COVID-19 in Peru.MethodsA survival analysis was performed using data from national health databases. Data from people between 18 and 59 years old infected with SARS-CoV-2 as evidenced by molecular or antigenic tests were included. Kaplan Meier graphs were produced to compare the survival of health workers and the rest of the population during 2021 and health workers during the first and second wave of mortality in Peru in 2020 and 2021, respectively.ResultsData from 998,295 people were included. The average age was 41.2 years (SD 15.8) and 485,167 (48.6%) were women. A higher level of survival of health workers after vaccination was found compared to the general population and to the population of health workers before vaccination. It was evidenced that, at the beginning of the second wave, the risk of dying for health workers was twice that of the first wave (HR = 2). After vaccination (in the sixth month of the second wave), the risk of dying decreased to 87.5% less than in the first wave (HR = 0.125).ConclusionsA positive change has been evidenced in the level of survival of health workers infected by SARS-CoV-2 during the context of vaccination against COVID-19 in Peru.
Impaired SARS-CoV-2 mRNA vaccine antibody response in chronic medical conditions: a real-world data analysis
Authors: Liao Shu-Yi , Gerber Anthony N. , Zelarney Pearlanne , Make Barry , Wechsler Michael E. 
Published: August 2021

AbstractThis study is to investigate whether certain medical conditions may impair antibody response to the mRNA vaccines. In this unique study, participants were drawn from patients in National Jewish Health, a pulmonary specialty outpatient clinic.Our study highlights fact that 26% of our patients (n=226) who had spike protein ab measured at least 14 days post 2nd vaccine had negative spike protein ab testing. We found interstitial lung disease (ILD) to be an independent risk factor for impaired antibody response. While the exact antibody level that confers protection against SARS-CoV-2 is unknown and there may be other non-B cell-mediated protection (e.g. T cell-mediated), our study raises concerns that SARS-CoV-2 vaccination may not result in protective immunity in all populations and may have implications for some as masking and distancing strategies are abandoned.
Concentration-dependent change in hypothalamic neuronal transcriptome by the dietary fatty acids: oleic and palmitic acids
Authors: Valencia Fabiola Pacheco , Marino Amanda F. , Noutsos Christos , Poon Kinning 
Published: August 2021

AbstractPrenatal high-fat diet exposure increases hypothalamic neurogenesis events in embryos and programs offspring to be obesity-prone. The molecular mechanism involved in these dietary effects of neurogenesis are unknown. This study investigated the effects of oleic and palmitic acids, which are abundant in a high-fat diet, on the hypothalamic neuronal transcriptome and how these changes impact neurogenesis events. The results show differential effects of low and high concentrations of oleic or palmitic acid treatment on differential gene transcription. Gene ontology analysis uncovered significant gene enrichment in several cellular pathways involved in gene regulation and protein production, particularly with proliferation, migration, and cell survival. The enriched signaling pathways include Wnt, integrin, PDGF, and apoptosis, in addition endocrine function signaling pathways CCKR and GnRH. Further examination of proliferation and migration show low concentrations of oleic acid to stimulate proliferation and high concentrations of both oleic and palmitic acid to stimulate apoptosis. Oleic acid also reduced hypothalamic neuronal migration, with little effects by palmitic acid. The results show direct impact of the two most abundant fatty acids in a high fat diet to directly impact hypothalamic neuronal proliferation and migration. The results also uncovered signaling pathways affected by oleic and palmitic acid and suggest a mechanism of prenatal high-fat diet induced neurogenesis events is through these two abundant fatty acids.
Predictive Functions of H3K27me3 and H4K20me3 in Primate Hippocampal Stem and Progenitor Cells
Authors: Rhodes Christopher T. , Lin Chin-Hsing Annie 
Published: August 2021

ABSTRACTEpigenetic regulations play important roles in cell fate determination during neurogenesis, a process by which different types of neurons are generated from neural stem and progenitor cells (NSPCs). Although some epigenetic changes are part of developmental and aging processes, the role of tri-methylation on histone 3 lysine 27 (H3K27me3) and histone 4 lysine 20 (H4K20me3) in primate hippocampal NSPCs remains elusive. This task is best assessed within a context resembling the human brain. As more studies emerge, the baboon represents an excellent model of human central nervous system in addition to their genomic similarity. With a focus on H3K27me3 and H4K20me3, the overarching goal of this work is to reveal their respective epigenetic landscapes in NSPCs of non-human primate baboon hippocampus. We identified putative targets of H3K27me3 and H4K20me3 that suggests a protective mechanism by dual H3K27me3/H4K20me3-mediated repression of specific-lineage gene activation important for differentiation processes while controlling the progression of the cell cycle.
The role of actin and myosin II in the cell cortex of adhered and suspended cells
Authors: Flormann D.A.D. , Kaub K.H. , Vesperini D. , Schu M. , Anton C. , Pohland M.O. , Kainka L. , Montalvo Bereau G. , Janshoff A. , Hawkins R.J. , Terriac E. , Lautenschläger F. 
Published: August 2021

AbstractAdhesion induces dramatic morphological and mechanical changes to cells, which are reflected by changes to the actin cortex. Among the many different proteins involved in this sub-membranous layer, motor proteins (e.g., nonmuscle myosin II [NMII]) and actin nucleators (e.g., Arp2/3, formins) are known to have significant influences on its dynamics and structure. The different roles of NMII, Arp2/3, and formins in the dynamics, structure, and mechanics of the actin cortex depend on the adhesion state of the cell. In this study, we unravel the interplay between the dynamics, structure, and mechanics of the actin cortex in adhered cells and in cells in suspension. We show that treatments with extrinsic cellular perturbants lead to alterations of all three properties that are correlated. However, intrinsic actin cortex variations between different cell adhesion states lead to unexpected correlations. Surprisingly, we find that NMII minifilaments have a minor influence on the actin cortex. Using new microscopy techniques, we show that NMII minifilaments are not localized within the actin cortex, as previously thought, but concentrated in a layer beneath it. Our treatments affecting Arp2/3 and formin reveal correlations between the actin cortex characteristics. Our data build towards a comprehensive understanding of the actin cortex. This understanding allows the prediction and control of cortical changes, which is essential for the study of general cellular processes, such as cell migration, metastasis, and differentiation.
Complementing Tissue Testing with Plasma mutation Profiling Improves Therapeutic Decision Making for Lung Cancer Patients
Authors: Choudhury Yukti , Tan Min-Han , Shi Jun Li , Tee Augustine , Ngeow Kao Chin , Poh Jonathan , Goh Ruth Rosalyn , Mong Jamie 
Published: August 2021

ABSTRACTBackgroundTissue biopsy is an integral part of the diagnostic approach to lung cancer. It is however invasive and associated with limitations of tissue heterogeneity. Liquid biopsies may complement tissue testing by providing additional molecular information and may be particularly helpful in patients from whom obtaining sufficient tissue for genomic profiling is challenging.MethodsPatients with suspected lung cancer (n=71) were prospectively recruited. Blood and diagnostic tissue samples were collected within 48 hrs of each other. Plasma cell-free DNA (cfDNA) testing was done using an ultrasensitive amplicon-based next-generation sequencing (NGS) panel (plasma NGS testing). For cases diagnosed as non-small cell lung carcinoma (NSCLC) via histology or cytology, targeted testing for epidermal growth factor receptor (EGFR) mutations was performed using tissue biopsy samples, where available (tissueEGFRtesting). Concordance of clinically actionable mutations between methods and sample types were assessed.ResultsFor confirmed NSCLC cases (n = 54), tissueEGFRtest results were available only for 70.3% (38/54) due to sample inadequacies, compared to blood samples for 98.1% (53/54) cases. TissueEGFRtesting identified sensitizingEGFR(L858R or exon 19 deletion) mutation in 31.6% (12/38) of cases. Plasma NGS identified clinically actionable mutations in 37.7% (20/53) of cases, includingEGFRmutations in two cases with no tissue EGFR results, and mutations inKRAS, BRAFandMET. Overall sensitivity ofEGFRsensitizing mutation detection by plasma NGS was 75% (9/12), and specificity was 100% (25/25) in patients tested in both tissueEGFRand plasma NGS (n=37). In this cohort of patients, tissueEGFRtesting alone informed clinical decisions in 22.2% (12/54) of cases. Adding plasma NGS to tissueEGFRtesting increased the detection rate of actionable mutations to 42.6% (23/54), representing a near doubling (1.9-fold increase) of clinically relevant findings. The average turnaround time (TAT) of plasma NGS was shorter than standard tissue testing (10 days vs. 29.9 days, p-value <0.05).ConclusionsIn the first-line setting, plasma NGS was highly concordant with tissueEGFRtesting. Plasma NGS increases the detection of actionable findings with shorter time to results. This study outlines the clinical utility of a complementary plasma mutation profiling in the routine management of lung cancer patients.