bluuebunny/crossref_metadata_2025_split huggingface dataset:
Active bayerite underpinned Ag2O/Ag: an efficient antibacterial nanohybrid combating microbial contamination
Authors: Aazem Irthasa , Rathinam Prasanth , Pillai Saju , Honey Gopinathan , Vengellur Ajith , Bhat Sarita G , Sailaja G S 
Published: August 2021

Abstract
Active surfaces with bactericidal properties are of paramount importance in health care sector as a judicious approach to confront prevalent challenges presented by disastrous pathogenic infections and antibiotic-resistant microbes. Herein, we present Bayerite underpinned Ag2O/Ag (ALD), a nanohybrid with excellent antibacterial and antibiofilm functionalities against tested standard strains and clinical isolates. The multicomponent system coexists and complement each other with respect to phase and functionalities, demonstrated by XRD, XPS, and TEM analyses. In situ reduction of Ag+ ions to Ag0 over Bayerite as a stable bound phase is favoured by pH of the reaction, yielding 60–80% bound Ag protruding outwards facilitating active surface for interaction with microbes. ALD has a minimum inhibitory concentration (MIC) of 0.068 mg/ml against clinical isolates: Pseudomonas aeruginosa RRLP1, RRLP2, Acinetobactor baumannii C78 and C80. Disc diffusion assay demonstrated excellent antibacterial activity against standard strains (positive control: standard antibiotic disc, Amikacin). ALD incorporated PMMA films (5 and 10 wt%; PALD-5 and PALD-10) exhibited significant contact killing (99.9%) of clinical isolates in drop-test besides strong antibacterial activity (disc diffusion assay) comparable to that of ALD. ALD exemplified a dose (0.034 and 0.017 mg/ml) dependent biofilm inhibition (P &lt; 0.001) and significant eradication of pre-formed biofilms (P &lt; 0.001) by clinical isolates. PALD 5 and PALD 10 significantly declined the number of viable biofilm associated bacteria (99.9%) compared to control. Both ALD and PALD samples are proposed as green antibacterial materials with antibiofilm properties. Results also present ample opportunity to explore PALD as antibacterial and/or antibiofilm coating formulations.
ELTD1 deletion reduces vascular abnormality and improves T-cell recruitment after PD-1 blockade in glioma
Authors: Huang Hua , Georganaki Maria , Conze Lei Liu , Laviña Bàrbara , van Hooren Luuk , Vemuri Kalyani , van de Walle Tiarne , Ramachandran Mohanraj , Zhang Lei , Pontén Fredrik , Bergqvist Michael , Smits Anja , Betsholtz Christer , Dejana Elisabetta , Magnusson Peetra U , He Liqun , Lugano Roberta , Dimberg Anna 
Published: August 2021

Abstract

Background
Tumor vessels in glioma are molecularly and functionally abnormal, contributing to treatment resistance. Proteins differentially expressed in glioma vessels can change vessel phenotype and be targeted for therapy. ELTD1 (Adgrl4) is an orphan member of the adhesion G-protein-coupled receptor family upregulated in glioma vessels and has been suggested as a potential therapeutic target. However, the role of ELTD1 in regulating vessel function in glioblastoma is poorly understood.

Methods
ELTD1 expression in human gliomas and its association with patient survival was determined using tissue microarrays and public databases. The role of ELTD1 in regulating tumor vessel phenotype was analyzed using orthotopic glioma models and ELTD1−/− mice. Endothelial cells isolated from murine gliomas were transcriptionally profiled to determine differentially expressed genes and pathways. The consequence of ELTD1 deletion on glioma immunity was determined by treating tumor-bearing mice with PD-1-blocking antibodies.

Results
ELTD1 levels were upregulated in human glioma vessels, increased with tumor malignancy, and were associated with poor patient survival. Progression of orthotopic gliomas was not affected by ELTD1 deletion, however, tumor vascular function was improved in ELTD1−/− mice. Bioinformatic analysis of differentially expressed genes indicated increased inflammatory response and decreased proliferation in tumor endothelium in ELTD1−/− mice. Consistent with an enhanced inflammatory response, ELTD1 deletion improved T-cell infiltration in GL261-bearing mice after PD-1 checkpoint blockade.

Conclusion
Our data demonstrate that ELTD1 participates in inducing vascular dysfunction in glioma, and suggest that targeting of ELTD1 may normalize the vessels and improve the response to immunotherapy.
Improving perinatal depression screening and management: results from a federally qualified health center
Authors: Bruney Talitha L , Zhang Xueting 
Published: August 2021

Abstract

Introduction
Perinatal depression affects 8.5–20% of women. In a systematic review 22% of women with a positive depression screen use mental health services. The objective of this study was to examine the effectiveness of on-site management in the perinatal setting and barriers to care.

Methods
This is a retrospective chart review of 1042 women who received perinatal care between 1 January to 31 December 2019. Primary outcome was percentage of patients who were assessed after a positive depression screen. The secondary outcome was to determine factors affecting patients’ receptiveness to assessment/treatment.

Results
9.52% of women screened positive. Sixty-two (63.9%) met with an on-site social worker for assessment, 6 (6.2%) misunderstood the screening questions, and 33 (34.0%) met criteria for depression. Of those, 9 (27.3%) attended at least one follow-up, 8 (24.2%) were referred to or already in care, 7 (21.2%) no-showed, and 9 (27.3%) declined further care. English speaking patients were more likely to meet with a social worker for diagnostic assessment (69.9% versus 45.8%, P = 0.033).

Conclusion
On-site management of a positive depression screen yielded a follow-up rate of 64% versus 49% in other studies. Non-English language may be a barrier to accessing mental health car.
GROUNDWATER AND DRINKING WATER RADON CONCENTRATIONS IN THE COASTAL AND INTERIOR AREAS OF CHENNAI METRO CITY AND ITS IMPACT ON PUBLIC HEALTH
Authors: Banerjee Kakolee , Saravanan C , Fernandes Maria C , Kannan Vaidyanathan , Purvaja Ramachandran , Ramesh R 
Published: August 2021

Abstract
One hundred forty-eight water samples were collected from in and around Chennai and 222Rn concentrations were measured using radon emanometry method. The average 222Rn concentration was estimated to be 6.88, 2.01, 1.17, 0.19 and 0.10 Bq L−1 for borewell water, openwell water, tank water, metro water and lake water, respectively, which were within the U.S. Environmental Protection Agency’s (USEPA) Standard limit of 11.1 Bq L−1 and World Health Organization (WHO) global average 10 Bq L−1. The total effective dose obtained has varied from 0 to 157.57 μSv y−1 with ±10% standard deviation. The mean values were 19.608, 8.092, 4.692, 0.761 and 0.423 μSv y−1 for closed borewell, open well water, tank water, metro water and for lake water, respectively. All these values were below the reference point 0.1 mSv y−1 (100 μSv y−1) set by WHO.
Delusional infestation
Authors: Windbiel-Rojas Karey , Matuskey Rachel , Parilo Denise Wall 
Published: August 2021

Abstract:
Patients with delusional infestation, a rare psychiatric disorder, have a false and fixed belief that insects or other organisms are crawling in or on their skin. This article describes signs and symptoms, available treatments, and appropriate nursing interventions for patients with primary delusional infestation.
Validity Evidence Supporting the Comunicación y Habilidades Interpersonales (CAI) Scale for Medical Spanish Communication and Interpersonal Skills Assessment
Authors: Ortega Pilar , Moxon Nathaniel R. , Chokshi Anuj K. , Pérez-Cordón Cristina , Park Yoon Soo 
Published: August 2021

Purpose
While many schools teach medical Spanish to improve communication with the growing Spanish-speaking population, a standardized assessment methodology is lacking. This study evaluates validity evidence for a newly developed Spanish Communication and Interpersonal Skills (CIS) scale.

Method
The authors developed the Comunicación y Habilidades Interpersonales (CAI, pronounced /kī/) scale by culturally and linguistically adapting a 14-item validated English CIS scale. Sources of validity evidence were gathered targeting content, response process, internal structure, relations to other variables, and consequences. The CAI was administered as part of an objective structured clinical examination at 2 medical schools from April to June 2020.

Results
The authors mapped CAI items onto USMLE Step 2 CIS behavioral functions and medical Spanish learner competencies to examine content validity. The mean item difficulty and item discrimination estimates are 2.86 (SD = 0.34) and 0.81 (SD = 0.08), respectively, demonstrating good psychometric properties at the item level. Internal-consistency reliability for a single case was 0.96. Learner variance accounted for 12% of total variance, demonstrating ability to differentiate higher and lower performing learners; the person–case interaction accounted for 44% of total variance, indicating strong case specificity.

Conclusions
The CAI has higher case specificity than previously reported in English, suggesting that the nuanced contextual elements of individual cases may matter even more when learners are using limited language skills. Implementing the CAI more widely may promote inclusion of patient-centered communication skills as part of curricular content and activities. This study’s validity evidence may inform the development of a future medical Spanish certification examination.
Supported Independence: The Role of Supervision to Help Trainees Manage Uncertainty
Authors: Ilgen Jonathan S. , de Bruin Anique B.H. , Teunissen Pim W. , Sherbino Jonathan , Regehr Glenn 
Published: August 2021

Purpose
Safe and effective supervised practice requires a negotiated partnership between trainees and their supervisors. Substantial work has explored how supervisors make judgments about trainees’ readiness to safely engage in critical professional activities, yet less is known about how trainees leverage the support of supervisors when they perceive themselves to be at the limits of their abilities. The purpose of this study is to explore how trainees use supervisory support to navigate experiences of clinical uncertainty.

Method
Using a constructivist grounded theory approach, the authors explored how novice emergency medicine trainees conceptualized the role of their supervisors during experiences of clinical uncertainty. They employed a critical incident technique to elicit stories from participants immediately following clinical shifts between July and September 2020, and asked participants to describe their experiences of uncertainty within the context of supervised practice. Using constant comparison, 2 investigators coded line-by-line and organized these stories into focused codes. The relationships between these codes were discussed by the research team, and this enabled them to theorize about the relationships between the emergent themes.

Results
Participants reported a strong desire for supported independence, where predictable and accessible supervisory structures enabled them to work semiautonomously through challenging clinical situations. They described a process of borrowing their supervisors’ comfort during moments of uncertainty and mechanisms to strategically broadcast their evolving understanding of a situation to implicitly invoke (the right level of) support from their supervisors. They also highlighted challenges they faced when they felt insufficiently supported.

Conclusions
By borrowing comfort from—or deliberately projecting their thinking to—supervisors, trainees aimed to strike the appropriate balance between independence for the purposes of learning and support to ensure safety. Understanding these strategic efforts could help educators to better support trainees in their growth toward self-regulation.
No Difference in Reoperation Rates for Adjacent Segment Disease (Operative Adjacent Segment Disease) in Posterior Cervical Fusions Stopping at C7 Versus T1/T2
Authors: Guppy Kern H. , Royse Kathryn E. , Fennessy Jacob , Norheim Elizabeth P. , Harris Jessica E. , Brara Harsimran S. 
Published: August 2021

Study Design.
A retrospective cohort study with chart review.

Objective.
To determine whether there is a difference in reoperation rates for adjacent segment disease ([ASD] operative ASD) in posterior cervical fusions (PCFs) that stop at –C7 versus –T1/T2.

Summary of Background Data.
There are surgical treatment challenges to the anatomical complexities of the cervicothoracic junction. Current posterior cervical spine surgery is based on the belief that ASD occurs if fusions are stopped at C7 although there is varying evidence to support this assumption.

Methods.
Patients were followed until validated reoperations for ASD, membership termination, death, or March 31, 2020. Descriptive statistics and 5-year crude incidence rates and 95% confidence intervals for operative ASD for PCF ending at –C7 or –T1/T2 were reported. Time-dependent crude and adjusted multivariable Cox-Proportional Hazards models were used to evaluate operative ASD rates with adjustment for covariates or risk change estimates more than 10%.

Results.
We identified 875 patients with PCFs (beginning at C3 or C4 or C5 or C6) stopping at either –C7 (n = 470) or –T1/T2 (n = 405) with average follow-up time of 4.6 (±3.3) years and average time to operative ASD of 2.7 (±2.8) years. Crude overall incidence rates for stopping at –C7 (2.12% [1.02%–3.86%]) and –T1/T2 (2.48% [1.25%–4.40%]) were comparable with no statistical difference in risk (adjusted hazard ratio = 1.47, 95% confidence interval = 0.61–3.53, P = 0.39). In addition, we observed no differences in the probability of operative ASD in competing risk time-dependent models (Grey test P
= 0.448).

Conclusion.
A large cohort of 875 patients with PCFs stopping at –C7 or –T1/T2 with an average follow-up of more than 4 years found no statistical difference in reoperation rates for ASD (operative ASD).

Level of Evidence: 3
Nuclear Dbf2-related Kinase 1 functions as tumor suppressor in glioblastoma by phosphorylation of Yes-associated protein
Authors: Chen Bin , Liu Bin , Yu Tao , Han Yun-Feng , Wu Chao , Wang Zhen-Yu 
Published: August 2021

Abstract

Background:
The Nuclear Dbf2-related (NDR1) kinase is a member of the NDR/LATS family, which was a supplementary of Hippo pathway. However, whether NDR1 could inhibit glioblastoma (GBM) growth by phosphorylating Yes-associated protein (YAP) remains unknown. Meanwhile, the role of NDR1 in GBM was not clear. This study aimed to investigate the role of NDR1-YAP pathway in GBM.

Methods:
Bioinformation analysis and immunohistochemistry (IHC) were performed to identify the expression of NDR1 in GBM. The effect of NDR1 on cell proliferation and cell cycle was analyzed utilizing CCK-8, clone formation, immunofluorescence and flow cytometry, respectively. In addition, the xenograft tumor model was established as well. Protein interaction was examined by Co-immunoprecipitation and immunofluorescence to observe co-localization.

Results:
Bioinformation analysis and IHC of our patients’ tumor tissues showed that expression of NDR1 in tumor tissue was relatively lower than that in normal tissues and was positively related to a lower survival rate. NDR1 could markedly reduce the proliferation and colony formation of U87 and U251. Furthermore, the results of flow cytometry showed that NDR1 led to cell cycle arrest at the G1 phase. Tumor growth was also inhibited in xenograft nude mouse models in NDR1-overexpression group. Western blotting and immunofluorescence showed that NDR1 could integrate with and phosphorylate YAP at S127 site. Meanwhile, NDR1 could mediate apoptosis process.

Conclusion:
In summary, our findings point out that NDR1 functions as a tumor suppressor in GBM. NDR1 is identified as a novel regulator of YAP, which gives us an in-depth comprehension of the Hippo signaling pathway.
Cyanoacrylate Granuloma After Cyanoacrylate Closure of Incompetent Saphenous Veins
Authors: Sermsathanasawadi Nuttawut , Pruekprasert Kanin , Chinsakchai Khamin , Wongwanit Chumpol , Ruangsetakit Chanean 
Published: August 2021

BACKGROUND
Cyanoacrylate closure (CAC) is a minimally invasive surgery to treat incompetent saphenous veins.

OBJECTIVE
To evaluate the incidence, the risk factors for, and the management of cyanoacrylate granuloma (CAG) after CAC of incompetent saphenous veins in patients with chronic venous disease.

MATERIALS AND METHODS
Data specific to incompetent saphenous veins, including great saphenous veins, anterior accessory saphenous veins, and small saphenous veins, that were treated with CAC were retrospectively evaluated.

RESULTS
A total of 126 saphenous veins from 101 patients were included. Recapture of the delivery catheter before withdrawal was not performed in all patients. Cyanoacrylate granuloma occurred in 3 of 101 (2.9%) patients, and in 3 of 126 (2.3%) treated saphenous veins. All patients with CAG presented with granuloma and abscess at the puncture site 3 to 5 months after CAC. All patients were treated with incision, drainage, and removal of the glue foreign body. No recurrent granuloma was observed during the study period. No patient or procedural predictive factor for CAG was identified.

CONCLUSION
Cyanoacrylate granuloma is not a rare complication after CAC when recapture of the delivery catheter is not performed. Patients should be advised of the possibility of CAG after CAC.
Role of the Pedicled Mentalis Muscle Flap in Closure of Chin Implants in Genioplasty
Authors: Mrad Mohamed Amir , Kattan Abdullah E. , Shah Mardan Qutaiba N. M. , Almarghoub Mohammed A. , Yaremchuk Michael J. 
Published: August 2021

Summary:
With the purpose of obtaining an aesthetically pleasing chin appearance, genioplasty or chin augmentation can be performed through osteotomy or chin implantation, with the latter available in different sizes and materials such as silicone and porous polyethylene. The implants are traditionally placed in a subperiosteal or supraperiosteal plane with different advantages and disadvantages to each. This procedure has evolved through time with many techniques and modifications; and this article is an addition to this ongoing refinement by advocating for closure of the mentalis muscle (a paired chin muscle originating from the incisor fossa to the chin skin) over the implant after securing its position with screws (in the case of porous polyethylene) or creating a snug pocket (in the case of silicone). In this retrospective analysis, 15 patients underwent this procedure with an excellent outcome. A single patient developed numbness in the mandibular nerve territory, while another one developed a fistulating radicular cyst that was unrelated to this technique. In addition to the simple learning curve, the potential advantages of this technique include less chances of fistula formation, implant exposure, infection, extrusion, or malpositioning. Prospective studies with more subjects are required to cement our findings.
The Effectiveness of Immediate Triamcinolone Acetonide Injection after Auricular Keloid Surgery: A Prospective Randomized Controlled Trial
Authors: Burusapat Chairat , Wanichjaroen Nutthapong , Wongprakob Nuttadon , Sapruangthong Rapeepat 
Published: August 2021

Background:
The earlobe and helix are common sites for keloids following ear piercing. First-line therapy involves intra-keloidal excision followed by triamcinolone acetonide (TA) injection. Yet, the optimal timing for TA injection after keloid excision remains debated. The objective of this study was to compare outcomes between immediate and delayed TA injection after auricular keloid excision.

Methods:
This was a prospective, controlled trial with patients randomized into immediate or delayed groups. The Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) were used to evaluate scar quality. The number of recurrent keloid cases was recorded, defined as a VSS height of 3, POSAS thickness greater than 5, or an increase in VSS height or POSAS thickness after keloid excision. Overall complications were recorded. A P value less than 0.05 was considered statistically significant.

Results:
The immediate group contained 18 patients, and the delayed group had 16 patients. The mean age of patients was 25.52 years, and the mean maximum keloid diameter was 14.49 mm (7–32.5 mm). The immediate group reported a statistically significant lower recurrence rate than did the delayed group at 5 months (P = 0.042). No significant differences were noted between VSS and POSAS scores at 3 months, and no complications were recorded during the study.

Conclusions:
Immediate TA injection is an acceptable option for auricular keloid treatment. Here, it was associated with a lower recurrence rate than with delayed injection and resulted in no complications. The immediate and delayed groups had similar outcomes for VSS and POSAS.
Inaccuracy of brachial blood pressure and its potential impact on treatment and aortic blood pressure estimation
Authors: Kowalski Cédric , Yang Katie , Charron Thierry , Doucet Michel , Hatem Raja , Kouz Rémi , Palisaitis Donald , Schampaert Erick , Terriault Paul , Tessier Pierre , Agharazii Mohsen , Goupil Rémi 
Published: August 2021

Objective:
Although brachial cuff SBP is universally used to guide hypertension management, it can differ significantly from intraarterial SBP. We examine the potential impacts of cuff-to-intraarterial brachial SBP (bSBP) mismatch on hypertension treatment and accuracy towards central SBP.

Methods:
In 303 individuals, cuff bSBP (CUFF-bSBP) and central SBP were measured using a Mobil-o-Graph simultaneously to intraarterial bSBP (IA-bSBP) and aortic SBP. According to the difference between CUFF-bSBP and IA-bSBP, we identified three phenotypes: Underestimation (CUFF-bSBP < IA-bSBP by >10 mmHg); No Mismatch (CUFF-bSBP within 10 mmHg of IA-bSBP); Overestimation (CUFF-bSBP > IA-bSBP by >10 mmHg) phenotypes. Risk of overtreatment and undertreatment, and accuracy (ARTERY society criteria: mean difference ≤5 ± 8 mmHg) were determined. A multiple linear regression model was used to assess variables associated with the bSBP difference.

Results:
Underestimation (n = 142), No Mismatch (n = 136) and Overestimation (n = 25) phenotypes had relatively similar characteristics and CUFF-bSBP (124 ± 17, 122 ± 14, 127 ± 19 mmHg, P = 0.19) but different aortic SBP (133 ± 21, 120 ± 16, 112 ± 18 mmHg, P < 0.001). In the underestimation phenotype, 59% were at risk of undertreatment (14% in No Mismatch), whereas 50% in the Overestimation phenotype were at risk of overtreatment (17% in No Mismatch). CUFF-bSBP accurately estimated aortic SBP only in the No Mismatch Group (mean difference 1.6 ± 8.2 mmHg) whereas central BP never met the accuracy criteria. Male sex, higher height and active smoking were associated with lesser underestimation of bSBP difference.

Conclusion:
The brachial cuff lacks accuracy towards intraarterial BP in a significant proportion of patients, potentially leading to increased risks of BP mismanagement and inaccurate determination of central BP. This illustrates the need to improve the accuracy of cuff-based BP monitors.