bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modifying influence of polyphenols on hematotoxicity, cardiotoxicity, and hepatotoxicity induced by liquefied petroleum gas in rats
Authors: Akinmoladun Afolabi Clement , Aladesanmi Olayinka Oluwaseun , Ojo Femi Emmanuel , Bello Morenikejimi , Taiwo Bobola Jeremiah , Akindahunsi Afolabi Akintunde 
Published: June 2021

Abstract

Objective
This study was designed to investigate the effects of liquefied petroleum gas (LPG) on hematotoxic, cardiotoxic, and hepatotoxic indices and the modifying influence of selected polyphenols.

Methods
Adult male Wistar rats were exposed to1000 ppm LPG for 10 min at 12-h interval for 30 days with or without cotreatment with 50 mg/kg rutin, quercetin, tannic acid, or gallic acid followed by hematological, biochemical, and histopathological evaluations in animal tissues.

Results
Exposure to LPG induced hematotoxicity, cardiotoxicity, and hepatotoxicity. This is reflected in alterations to levels or activities of blood parameters (hemoglobin, packed cell volume, red blood cells, mean corpuscular volume, mean corpuscular hemoglobin, and platelets), enzymatic and nonenzymatic oxidative stress markers, nitrite, lactate dehydrogenase, creatine kinase-MB, transaminases, γ-glutamyl transpeptidase, bilirubin, and plasma albumin. LPG exposure also caused dyslipidemia and histoarchitectural changes. Treatment with the selected polyphenols effectively attenuated LPG-induced toxicity in rat tissues.

Conclusion
The results indicate that continuous exposure to LPG could lead to blood-, heart-, and liver-related diseases and dietary polyphenols could provide benefits in diseases associated with LPG inhalation toxicity.
Faith-Based Pregnancy Center Education Bridges the Maternal Health Gap
Authors: Walters Colleen P. , Vernon Marlo M. 
Published: June 2021

ABSTRACT:
Routine prenatal care in the United States has not been effective in reducing maternal mortality and preterm birth rates, nor addressing disparities among non-Hispanic Black women. Pregnant women from minority groups are more likely to be of low socioeconomic status and uninsured, and lacking resources to obtain preconception and early prenatal care to manage medical conditions. Faith-based pregnancy resource centers can help to fill the gap in maternal health among vulnerable populations. This article presents the development of an evidence-based prenatal education and social support program developed for those working in pregnancy resource centers to address disparities and improve outcomes in maternal mortality and preterm birth.
Spiritual Health First Aid for Self-Care
Authors: Green Cheryl 
Published: June 2021

ABSTRACT:
Nurses who provided care to patients with coronavirus (COVID-19) and supported patients in their transition from life to death in the absence of patients' families have been especially needful of spiritual self-care. A spiritual first aid kit can help nurses cope with these difficult times. Spiritual self-care is vital for all nurses to renew and preserve the psychological, spiritual, and physical self.
Utility of Insulinoma-Associated Protein 1 (INSM1) and Mucin 2 (MUC2) Immunohistochemistry in the Distinction of Endocrine Mucin-Producing Sweat Gland Carcinoma From Morphologic Mimics
Authors: Quattrochi Brian , Russell-Goldman Eleanor 
Published: June 2021

Abstract:
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare low-grade adnexal malignancy with a predilection for the eyelids of elderly White women, which is associated with invasive mucinous carcinoma with endocrine features in one-third of cases. EMPSGC is characterized by the presence of neuroendocrine differentiation and mucin production. However, EMPSGC displays a variety of architectural patterns including solid, cribriform, papillary, and cystic growth. In addition, EMPSGC may also display nonendocrine cytologic features, such as apocrine change. Because of their variable appearance, EMPSGC can show significant morphologic overlap with certain histologic mimics, namely basal cell carcinoma, hidrocystoma, apocrine hidradenoma, and tubular adenoma. In addition, the often limited sampling of this anatomically delicate area can make the diagnosis of EMPSGC challenging. EMPSGC expresses neuroendocrine markers, including synaptophysin and chromogranin, often in a focal distribution. However, insulinoma-associated protein 1 (INSM1) has been found to be a more sensitive marker for EMPSGC. Recent studies have also demonstrated the expression of the gel-forming mucin 2 (MUC2) in EMPSGC, possibly signifying a lacrimal or conjunctival origin of these neoplasms. In this article, we discuss EMPSGC in the context of its histologic mimics (BCC, hidrocystoma, apocrine hidradenoma, and tubular adenoma) and we investigate the utility of the immunohistochemical expression of INSM1 and MUC2 in the distinction of EMPSGC from them. We demonstrate that INSM1 and MUC2 can reliably distinguish EMPSGC from these histologic mimics.
Fetal Growth Trajectories Among Small for Gestational Age Babies and Child Neurodevelopment
Authors: Ferguson Kelly K. , Sammallahti Sara , Rosen Emma , van den Dries Michiel , Pronk Anjoeka , Spaan Suzanne , Guxens Mònica , Tiemeier Henning , Gaillard Romy , Jaddoe Vincent W.V. 
Published: June 2021

Background:
Being born small for gestational age (SGA, <10th percentile) is a risk factor for worse neurodevelopmental outcomes. However, this group is a heterogeneous mix of healthy and growth-restricted babies, and not all will experience poor outcomes. We sought to determine whether fetal growth trajectories can distinguish who will have the worst neurodevelopmental outcomes in childhood among babies born SGA.

Methods:
The present analysis was conducted in Generation R, a population-based cohort in Rotterdam, the Netherlands (N = 5,487). Using group-based trajectory modeling, we identified fetal growth trajectories for weight among babies born SGA. These were based on standard deviation scores of ultrasound measures from mid-pregnancy and late pregnancy in combination with birth weight. We compared child nonverbal intelligence quotient (IQ) and attention deficit hyperactivity disorder (ADHD) symptoms at age 6 between SGA babies within each growth trajectory to babies born non-SGA.

Results:
Among SGA individuals (n = 656), we identified three distinct fetal growth trajectories for weight. Children who were consistently small from mid-pregnancy (n = 64) had the lowest IQ (7 points lower compared to non-SGA babies, 95% confidence interval [CI] = −11.0, −3.5) and slightly more ADHD symptoms. Children from the trajectory that started larger but were smaller at birth showed no differences in outcomes compared to children born non-SGA.

Conclusions:
Among SGA children, those who were smaller beginning in mid-pregnancy exhibited the worst neurodevelopmental outcomes at age 6. Fetal growth trajectories may help identify SGA babies who go on to have poor neurodevelopmental outcomes.
Efficacy of Trabeculectomy Combined With Limited Deep Sclerectomy Versus Trabeculectomy Alone: A Randomized-controlled Trial
Authors: Dada Tanuj , Sharma Arpit , Midha Neha , Angmo Dewang , Gupta Shikha , Sihota Ramanjit 
Published: June 2021

Précis:
The addition of limited deep sclerectomy (LDS) to conventional trabeculectomy increases the success rate, especially in pseudophakic eyes.

Purpose:
This study aimed to evaluate the efficacy of LDS in enhancing the intraocular pressure (IOP)-lowering outcomes of trabeculectomy.

Design:
This was a parallel-arm, single-masked, randomized-controlled trial.

Methods:
A total of 68 patients (68 eyes) with moderate to advanced primary open-angle glaucoma or primary angle-closure glaucoma with pseudophakia were recruited at a tertiary eye care center in Northern India and randomized into 2 groups. Thirty-five eyes in group 1 were subjected to trabeculectomy alone and 33 eyes in group 2 were subjected to trabeculectomy with LDS. All cases were supplemented with low-dose subconjunctival mitomycin-C (0.1 mg/mL for 1 min) in both groups. The primary outcome measure was IOP, and success rates were calculated for IOP ≤18/15/12 and ≥5 mm Hg. The secondary outcome measures included evaluation of bleb morphology, presence of an intrascleral aqueous lake, and supraciliary flow on ultrasound biomicroscopy.

Results:
The mean postoperative IOP at 12 months was 13.4±1.83 mm Hg in group 1 and 12.5±1.67 mm Hg in group 2 (P=0.04). For IOP cutoff ≤15 mm Hg, absolute success was noted in 11 (31.4%) and 22 eyes (66.6%) in groups 1 and 2, respectively (P=0.004). At 12 months, the intrascleral lake was detected in 2 (6%) eyes in group 1 and in 9 (29%) eyes in group 2 (P=0.02). Supraciliary flow was detected in 2 eyes (6.2%) in group 2 and none in group 1 at 12 months (P=0.02). In the Cox proportional hazard model, trabeculectomy with LDS was associated with a lower rate of failure (hazard ratio: 0.32, 95% confidence interval: 0.13-0.75, P=0.009).

Conclusion:
The addition of LDS to trabeculectomy led to lower mean IOP and higher success rates at 12 months, compared with trabeculectomy alone.
Presurgical distress about bodily sensations predicts chronic postsurgical pain intensity and disability 6 months after cardiothoracic surgery
Authors: Aternali Andrea , Slepian P. Maxwell , Clarke Hance , Ladha Karim S. , Katznelson Rita , McRae Karen , Seltzer Ze'ev , Katz Joel 
Published: June 2021

Abstract
Chronic postsurgical pain (CPSP) and disability after cardiothoracic surgery are highly prevalent and difficult to treat. Researchers have explored a variety of presurgical risk factors for CPSP and disability after cardiothoracic surgery, including one study that examined distress from bodily sensations. The current prospective, longitudinal study sought to extend previous research by investigating presurgical distress about bodily sensations as a risk factor for CPSP and disability after cardiothoracic surgery while controlling for several other potential psychosocial predictors. Participants included 543 adults undergoing nonemergency cardiac or thoracic surgery who were followed over 6 months postsurgically. Before surgery, participants completed demographic, clinical, and psychological questionnaires. Six months after surgery, participants reported the intensity of CPSP on a 0 to 10 numeric rating scale and pain disability, measured by the Pain Disability Index. Multinomial logistic regression analyses were conducted to evaluate the degree to which presurgical measures predicted pain outcomes 6 months after surgery. The results showed that CPSP intensity was significantly predicted by age and presurgical scores on the Symptom Checklist-90-Revised Somatization subscale (Nagelkerke R
2 = 0.27, P < 0.001), whereas chronic pain disability was only predicted by presurgical Symptom Checklist-90-Revised Somatization scores (Nagelkerke R
2 = 0.29, P < 0.001). These findings demonstrate that presurgical distress over bodily sensations predicts greater chronic pain intensity and disability 6 months after cardiothoracic surgery and suggest that presurgical treatment to diminish such distress may prevent or minimize CPSP intensity and disability.
Parent-Reported PEDI-CAT Mobility and Gross Motor Function in Infants With Cerebral Palsy
Authors: Scott Kimberley , Lewis Jessica , Pan Xueliang , Heathcock Jill 
Published: June 2021

Purpose:
The purpose of this study is to determine the relationship between the Pediatric Evaluation of Disability Index—Computer Adapted Test (PEDI-CAT), a parent-reported outcome measure, and therapist-administered measures of motor function for infants with cerebral palsy (CP) with moderate to severe motor impairments.

Methods:
A prospective, cohort study included 54 infants, ages 6 to 24 months, with CP or high risk of CP, Gross Motor Function Classification System (GMFCS) levels III to V. Measures included the Gross Motor Function Measure (GMFM) and the mobility domain of the PEDI-CAT (PEDI-mob).

Results:
A significant correlation was found between PEDI-mob and GMFM scores. Significant differences were found in PEDI-mob scores as a function of GMFCS level.

Conclusions:
The PEDI-mob adds value to motor evaluations of infants with CP. Parents can accurately contribute information about daily motor performance for goal setting and treatment planning. The PEDI-mob offers a practical solution when longer assessments cannot be completed.
Psychometric Testing of the Activity Measure for Post-Acute Care (AM-PAC) in the Pediatric Acute Care Setting
Authors: Denlinger Katherine , Young Daniel L. , Beier Meghan , Friedman Michael , Quinn Julie , Hoyer Erik H. , Kudchadkar Sapna R. 
Published: June 2021

Purpose:
To determine interrater reliability and construct validity of the Activity Measure for Post-Acute Care (AM-PAC) Inpatient “6-clicks” Short Forms for children in acute care.

Methods:
Eight physical therapists (PTs) scored the AM-PAC Basic Mobility, 30-second walk test (30SWT), and Timed Up and Go (TUG) for 54 patients (4-17 years); 6 occupational therapists (OTs) scored the AM-PAC Daily Activity and handgrip dynamometry for 50 patients (5-17 years). Correlations between the AM-PAC Basic Mobility, 30SWT, and TUG and between the Daily Activity AM-PAC and handgrip dynamometry were calculated for evidence of construct validity.

Results:
Interrater reliability for the AM-PAC was excellent for PTs and OTs. Validity was strong to moderate for Basic Mobility when compared with the 30SWT and TUG. Daily Activity had weak correlation with mean left handgrip strength and no correlation with mean right handgrip strength.

Conclusions:
AM-PAC Short Forms have acceptable psychometrics for use among children in acute care.
The implementation of a pathway and care bundle for the management of acute occlusive arterial mesenteric ischemia reduced mortality
Authors: Tolonen Matti , Lemma Aurora , Vikatmaa Pirkka , Peltola Erno , Mentula Panu , Björkman Patrick , Leppäniemi Ari , Sallinen Ville 
Published: June 2021

BACKGROUND
Acute mesenteric ischemia (AMI) is a disease with high mortality and requires a multidisciplinary approach for effective management. A pathway and care bundle were developed and implemented with the objective to reduce mortality. The aim of this retrospective comparative study was to analyze the effects of the pathway on patient management and outcome.

METHODS
All consecutive patients operated in a secondary and tertiary referral center because of occlusive arterial AMI were identified between 2014 and April 2020. The pathway aimed to increase overall awareness, and hasten and improve diagnostics and management. Patients treated before implementation of the pathway (pregroup, years 2014–2017) were compared with patients treated using the pathway (postgroup, May 2018 to April 2020). Univariate and multivariate analyses were used to compare the groups.

RESULTS
There were 78 patients in the pregroup and 67 patients in the postgroup with comparable baseline characteristics and disease acuity. The postgroup was more often diagnosed with contrast-enhanced computed tomography (58 [74%] vs. 63 [94%], p = 0.001) and had shorter mean in-hospital delay to operating room (7 hours [interquartile range, 3.5–12.5] vs. 3 hours [interquartile range, 2–11], p = 0.023). Revascularization was done more often in the postgroup (53 [68%] vs. 56 [84%], p = 0.030) especially using endovascular treatment (26 [33%] vs. 43 [64%], p < 0.001). Thirty-day mortality was lower in the postgroup (23 [51%] vs. 17 [25%], p = 0.001). Being managed in the postgroup remained as a protective factor (odds ratio, 0.32; 95% confidence interval, 0.14–0.75; p = 0.008) for 30-day mortality in the multivariate analysis.

CONCLUSION
Implementing a pathway and care bundle resulted in enhanced regional and in-hospital awareness of AMI, more appropriate computed tomography imaging, shorter in-hospital delays, increased number of revascularizations, and, hence, lower mortality.

LEVEL OF EVIDENCE
Therapeutic/Care Management, level IV.
Predicting success of resuscitative endovascular occlusion of the aorta: Timing supersedes variable techniques in predicting patient survival
Authors: Cralley Alexis L. , Moore Ernest E. , Scalea Thomas M. , Inaba Kenji , Bulger Eileen M. , Meyer David E. , Fox Charles J. , Sauaia Angela 
Published: June 2021

BACKGROUND
Resuscitative endovascular occlusion of the aorta (REBOA) is used for temporary aortic occlusion of trauma patients in the management of noncompressible hemorrhage. Previous studies have focused on how to properly perform REBOA in the trauma environment to improve survival rates, but high-grade evidence defining the ideal patient population does not yet exist. This post hoc analysis of the Emergent Truncal Hemorrhage Control Study seeks to identify the most important clinical factors for physicians to consider when selecting for REBOA candidates and their potential survival following REBOA.

METHODS
Post hoc analysis of a large, multicenter, prospective observational study conducted at six level 1 trauma centers, 2017 to 2018, was performed. An onsite data collector documented all time points for REBOA patients since admission. Candidate predictors were demographics; injury severity; physiology preprocedure, during procedure, and postprocedure; cardiopulmonary resuscitation; and REBOA-specific variables (time to procedure, procedure-related time intervals, access site, technique, sheath size, catheter length, balloon volume, deployment zone). Predictive models for survival at three different time points along the trauma triage and REBOA process timeline (“Admission,” “REBOA Initiation,” and “Postaortic Occlusion”) were devised by logistic regression.

RESULTS
Eighty-eight patients had REBOA placement. The Admission model selected age, Glasgow Coma Scale, and admission systolic blood pressure as significant predictors of survival (area under the receiver operating characteristic curve [AUROC], 0.86; 95% CI, 0.77–0.94). The REBOA Initiation and Postaortic Occlusion models selected age, Glasgow Coma Scale, and the systolic blood pressure measured just before balloon inflation as predictors for survival (AUROC, 0.87 [95% CI, 0.78–0.97] and AUROC, 0.90 [95% CI, 0.81–0.99], respectively). No REBOA procedural variables were identified as predictors of patient survival.

CONCLUSION
Only patient-specific criteria of age, neurologic status, and severity of shock predicted survival. The hemodynamic stability of the patient at the time REBOA is initiated is more important than how REBOA is initiated. These findings suggest that earlier preparation for REBOA placement may be a key to improved survival.

LEVEL OF EVIDENCE
Therapeutic, level IV.
Evolving Trends in Risk Profiles and Outcomes in Older Adults Undergoing Kidney Retransplantation
Authors: Sandal Shaifali , Ahn JiYoon B. , Cantarovich Marcelo , Chu Nadia M. , Segev Dorry L. , McAdams-DeMarco Mara A. 
Published: June 2021

Background.
In older adults (≥65), access to and outcomes following kidney transplantation (KT) have improved over the past 3 decades. It is unknown if there were parallel trends in re-KT. We characterized the trends, changing landscape, and outcomes of re-KT in older adults.

Methods.
Among the 44,149 older kidney-only recipients (1995–2016) in the Scientific Registry of Transplant Recipients, we identified 1743 who underwent re-KT. We analyzed trends and outcomes (mortality, death-censored graft failure [DCGF]) by eras (1995–2002, 2003–2014, and 2015–2016) that were defined by changes to the expanded criteria donors and Kidney Donor Profile Index policies.

Results.
Among all older kidney-only recipients during 1995–2002, 2003–2014, 2015–2016 the proportion that were re-KTs increased from 2.7% to 4.2% to 5.7%, P < 0.001, respectively. Median age at re-KT (67–68–68, P = 0.04), years on dialysis after graft failure (1.4–1.5–2.2, P = 0.003), donor age (40.0–43.0–43.5, P = 0.04), proportion with panel reactive antibody 80–100 (22.0%–32.7%–48.7%, P < 0.001), and donation after circulatory death (1.1%–13.4%–19.5%, P < 0.001) have increased. Despite this, the 3-y cumulative incidence for mortality (22.3%–19.1%–11.5%, P = 0.002) and DCGF (13.3%–10.0%–5.1%, P = 0.01) decreased over time. Compared with deceased donor retransplant recipients during 1995–2002, those during 2003–2014 and 2015–2016 had lower mortality hazard (aHR = 0.78, 95% confidence interval, 0.63-0.86 and aHR = 0.55, 95% confidence interval, 0.35-0.86, respectively). These declines were noted but not significant for DCGF and in living donor re-KTs.

Conclusions.
In older retransplant recipients, outcomes have improved significantly over time despite higher risk profiles; yet they represent a fraction of the KTs performed. Our results support increasing access to re-KT in older adults; however, approaches to guide the selection and management in those with graft failure need to be explored.
Implementing Mandatory Testing and a Public Health Commitment to Control COVID-19 on a College Campus
Authors: Liu Cindy , Vyas Amita , Castel Amanda D. , McDonnell Karen A. , Goldman Lynn R 
Published: June 2021

ABSTRACTThe COVID-19 pandemic has greatly impacted US colleges and universities. As The George Washington University (GWU), a large urban university, prepared to reopen for the Fall 2020 semester, GWU established protocols to protect the health and wellness of all members of campus community. Reopening efforts included a cadre of COVID-19 surveillance systems including development of a public health COVID-19 laboratory, weekly and symptomatic SARS-CoV-2 testing and daily risk screening and symptom monitoring. Other activities included completion of a mandatory COVID-19 training and influenza vaccination for the on-campus population, quarantining of students returning to campus, campus-focused case investigations and quarantining of suspected close contacts, clinical follow-up of infected persons, and regular communication and monitoring. A smaller on-campus population of 4,435 students, faculty and staff returned to campus with later expansion of testing to accommodate GWU students living in the surrounding area. Between August 17 and December 4, 2020, 38,288 tests were performed; 220 were positive. The surveillance program demonstrated a relatively low positivity rate, with temporal clustering of infected persons mirroring community spread, and little evidence for transmission among the GWU on-campus population. These efforts demonstrate the feasibility of safely partially reopening a large urban college campus by applying core principles of public health surveillance, infectious disease epidemiology, behavioral measures, and increased testing capacity, while continuing to promote educational and research opportunities. GWU will continue to monitor the program as the pandemic evolves and periodically reassess to determine if these strategies will be successful upon a full return to in-person learning.Summary BoxWhat is the current understanding of this subject? When the COVID-19 pandemic began, generally universities were not prepared and it was unclear how to safely reopen colleges and universities given the uncertain risks of transmission among students, faculty and staff.What does this report add to the literature? This case report highlights the successful approaches employed, including applying the core principles of public health surveillance and increasing testing capacity, to mitigate the spread of SARS-CoV-2 on a densely populated urban college campus resulting in a safe reopening.What are the implications for public health practice? This experience can provide a roadmap for other universities to consider as they plan for the safe reopening of their campuses.