bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrathecal catheter use after accidental dural puncture in obstetric patients: literature review and clinical management recommendations
Authors: Orbach‐Zinger S. , Jadon A. , Lucas D. N. , Sia A. T. , Tsen L. C. , Van de Velde M. , Heesen M. 
Published: January 2021

SummaryIf an accidental dural puncture occurs, one option is to insert a catheter and use it as an intrathecal catheter. This avoids the need for a further injection and can rapidly provide labour analgesia and anaesthesia for caesarean section. However, there are no recommendations for managing intrathecal catheters and, therefore, significant variation in clinical practice exists. Mismanagement of the intrathecal catheter can lead to increased motor block, high spinal anaesthesia, drug error, hypotension and fetal bradycardia. Care must be taken with an intrathecal catheter to adhere to strict aseptic technique, meticulous labelling, cautious administration of medications and good communication with the patient and other staff. Every institution considering the use of intrathecal catheters should establish a protocol. For labour analgesia, we recommend the use of dilute local anaesthetic agents and opioids. For caesarean section anaesthesia, gradual titration to the level of the fourth thoracic dermatome, with full monitoring, in a facility equipped to manage complications, should be performed using local anaesthetics combined with lipophilic opioids and morphine or diamorphine. Although evidence of the presence and duration of intrathecal catheters on the development of post‐dural puncture headache and need for epidural blood patch is limited, we suggest considering leaving the intrathecal catheter in for 24 hours to reduce the chance of developing a post‐dural puncture headache while maintaining precautions to avoid drug error and cerebrospinal fluid leakage. Injection of sterile normal saline into the intrathecal catheter may reduce post‐dural puncture headache. The level of evidence for these recommendations was low.
Emergency hernia surgery at a high‐volume tertiary centre: a 3‐year experience
Authors: Russell Thomas B. , Elberm Hassan 
Published: January 2021

AbstractBackgroundHernia surgery is often considered minor. However, emergency abdominal wall hernia (AWH) surgery is associated with significant morbidity. This study reviews a high‐volume centre's experience.MethodsThis is a retrospective review of all emergency AWH operations performed between 2014 and 2017. The following were analysed: patient demographics, ASA grade, type of hernia, time from admission to surgery, use of pre‐operative imaging, sac content, details of bowel resection, rate of admission to high dependency unit (HDU)/intensive care unit (ICU), length of stay and morbidity/mortality.ResultsA total of 198 cases were included. Median age was 67.4 years (range 19–95). 52.2% of patients were ASA III or above. Median time from admission to surgery was 13 h (range 1–341) and median length of stay was 4 days (range 1–75). The sac contained bowel in 93 cases (47.0%). These patients had longer length of stay (P < 0.01) and were more frequently admitted to HDU/ICU (P < 0.01). Thirty‐one patients underwent bowel resection (33.3% of those with bowel involvement and 15.7% of the total). Twenty‐seven patients (13.6%) were admitted to HDU/ICU post‐operatively. Six patients (3.0%) had an unplanned return to theatre and 66 patients (33.3%) had a post‐operative complication. Inpatient mortality was three (1.51%).ConclusionsPatients who undergo emergency AWH surgery represent a relatively aged and co‐morbid group. This surgery is associated with significant morbidity and consumes considerable hospital resources. Efforts should be made to identify the higher risk subgroup with bowel involvement. Elderly and co‐morbid patients should be listed for timely elective surgery wherever suitable.
The Significance of the Insignificant: Borders, Urban Space, Everyday Life
Authors: Lafazani Olga 
Published: January 2021

AbstractThis paper can be read as a film sequence, as each scene is based on the narration of a different everyday encounter in the city. The aim of the paper is to start a discussion on the multiple ways borders proliferate in the urban: not only through laws, institutions or policing practices, but also through deeds, words, and feelings. Rather than analyse migration and borders by focusing only on the borderzones, this paper captures the multiple relations that connect the camp to the city square, the deportation regime to the train carriage, the newspaper headlines to the housing tenements in an attempt to work towards framing a broader theory of borders in geographical terms. Focusing on everyday encounters generates more complicated and nuanced understandings of subjectivity and power, while it brings to the fore the multiple borders that are simultaneously embodied and transcended, performed and challenged, established and subverted.
Prenatal origins of neuropsychiatric diseases
Authors: Amgalan Ariunzaya , Andescavage Nickie , Limperopoulos Catherine 
Published: January 2021

AbstractAimThe main objective is to review the available evidence in the literature for developmental origins of neuropsychiatric diseases and their underlying mechanisms. We also probe emerging cutting‐edge prenatal MR imaging tools and their future role in advancing our understanding the prenatal footprints of neuropsychiatric disorders.ObservationsBoth human and animal studies support early intrauterine origins of neuropsychiatric disease, particularly autism spectrum disorders (ASD), attention and hyperactivity disorders, schizophrenia, depression, anxiety and mood disorders. Specific mechanisms of intrauterine injury include infection, inflammation, hypoxia, hypoperfusion, ischaemia polysubstance use/abuse, maternal mental health and placental dysfunction.Conclusions and RelevanceThere is ample evidence to suggest developmental vulnerability of the foetal brain to intrauterine exposures that increases and individual's risk for neuropsychiatric disease, especially the risk of ASD, depression and anxiety. Elucidating the exact timing and mechanisms of injury can be difficult and require novel, non‐invasive approaches to the study emerging structural and functional brain development of the foetus. Clinical care should both emphasise maternal health during pregnancy, as well as close, continued monitoring for at risk offspring throughout young adulthood for the early identification and treatment of neuropsychiatric diseases.
Impact of pharmacist‐led medication therapy management in ambulatory elderly patients with chronic diseases
Authors: Wang Xin , Wang Shihui , Yu Xiaojia , Ma Zhuo , Wang Huaguang , Yang Jing , Liu Lihong 
Published: January 2021

AimsThis study aimed to assess the impact of pharmacist‐led medication therapy management (MTM) performed on ambulatory elderly patients with chronic diseases.MethodsPatients who came to a pharmacist‐led outpatient clinic between January 2016 and June 2018 were enrolled in this study. Eligible subjects received MTM services from the pharmacists at least twice a year and the clinical data of these patients were complete. Drug‐related problems (DRPs) and recommendations were evaluated using The Pharmaceutical Care Network Europe Classification for Drug related problems V8.03.ResultsA total of 525 DRPs were identified during the study period. Treatment effectiveness (53.71%) was the most common DRP. The most frequently recommended intervention was changing the drug (48.76%). There were 92.38% patients accepting the interventions and 90.48% patients completely implemented. The number of drugs taken was the significant associated factor for DRPs. Postintervention data collection showed lower levels in systolic blood pressure (BP) and diastolic BP compared to the preintervention data collection. There were statistically significant changes in total cholesterol, low‐density lipoprotein cholesterol and triglycerides between the pre‐ and postintervention data collections. The average cost of medications per patient for every month decreased from 387.72 to 355.17 renminbi (P = .009).ConclusionWe confirmed that pharmacists had a valuable role to perform MTM services for ambulatory elderly patients, not only in identifying and solving the DRPs, but also in improving clinical outcomes (BP and lipid level) and cost‐saving effect.
The role of school‐based relationships for school well‐being: How different are high‐ and average‐ability students?
Authors: Weyns Tessa , Colpin Hilde , Verschueren Karine 
Published: January 2021

BackgroundRelationships with peers and teachers are keys for children’s psychosocial development. However, it is unclear whether this also applies for high‐ability children. This study adds to the literature by longitudinally examining the role of interpersonal relationships in the educational context for high‐ and average‐ability students.AimsIn this study, we examined whether high‐ and average‐ability students differ in terms of peer acceptance, teacher conflict, and school well‐being. Further, we studied the potential bi‐directional effects between school well‐being, teacher conflict, and peer acceptance in late childhood and examined whether the relations between these concepts differ between high‐ and average‐ability students.SampleThe total sample consisted of 3,101 Belgian students (49.9% boys, Mage = 9.76 years), with 348 high‐ability and 2,753 average‐ability students.MethodsCognitive ability was assessed in Grade 3 with two cognitive ability tests (for crystallized intelligence and fluid intelligence, respectively). The students were followed for three years (Grades 4, 5, and 6), and each year their current teacher filled out questionnaires regarding teacher–child conflict, peer acceptance, and school well‐being.ResultsHigh‐ability students showed lower teacher conflict, higher peer acceptance, and better school well‐being than average‐ability students. Cross‐lagged analyses showed that peer acceptance consistently predicted school well‐being over time, while Grade 4 school well‐being impacted Grade 5 teacher conflict. Also, better peer acceptance in Grade 5 predicted lower teacher–student conflict in Grade 6. Multigroup analyses revealed similar associations for both groups.ConclusionsOur results show that high‐ability students in general display more positive school‐based social relationships and school well‐being than average‐ability students. We found no differences in the links between these variables for both groups (i.e., high‐ability students and average‐ability students).
Compartmentation of β2‐adrenoceptor stimulated cAMP responses by phosphodiesterase types 2 and 3 in cardiac ventricular myocytes
Authors: Rudokas Michael W. , Post John P. , Sataray‐Rodriguez Alejandra , Sherpa Rinzhin T. , Moshal Karni S. , Agarwal Shailesh R. , Harvey Robert D. 
Published: January 2021

Background and PurposeIn cardiac myocytes, cyclic AMP (cAMP) produced by both β1‐ and β2‐adrenoceptors increases L‐type Ca2+ channel activity and myocyte contraction. However, only cAMP produced by β1‐adrenoceptors enhances myocyte relaxation through phospholamban‐dependent regulation of the sarco/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2). Here we have tested the hypothesis that stimulation of β2‐adrenoceptors produces a cAMP signal that is unable to reach SERCA2 and determine what role, if any, phosphodiesterase (PDE) activity plays in this compartmentation.Experimental ApproachThe cAMP responses produced by β1‐and β2‐adrenoceptor stimulation were studied in adult rat ventricular myocytes using two different fluorescence resonance energy transfer (FRET)‐based biosensors, the Epac2‐camps, which is expressed uniformly throughout the cytoplasm of the entire cell and the Epac2‐αKAP, which is targeted to the SERCA2 signalling complex.Key ResultsSelective activation of β1‐ or β2‐adrenoceptors produced cAMP responses detected by Epac2‐camps. However, only stimulation of β1‐adrenoceptors produced a cAMP response detected by Epac2‐αKAP. Yet, stimulation of β2‐adrenoceptors was able to produce a cAMP signal detected by Epac2‐αKAP in the presence of selective inhibitors of PDE2 or PDE3, but not PDE4.Conclusion and ImplicationsThese results support the conclusion that cAMP produced by β2‐adrenoceptor stimulation was not able to reach subcellular locations where the SERCA2 pump is located. Furthermore, this compartmentalized response is due at least in part to PDE2 and PDE3 activity. This discovery could lead to novel PDE‐based therapeutic treatments aimed at correcting cardiac relaxation defects associated with certain forms of heart failure.
Parkinson‐like early autonomic dysfunction induced by vagal application of DOPAL in rats
Authors: Sun Jie , He Chao , Yan Qiu‐Xin , Wang Hong‐Dan , Li Ke‐Xin , Sun Xun , Feng Yan , Zha Rong‐Rong , Cui Chang‐Peng , Xiong Xue , Gao Shan , Wang Xue , Yin Rui‐Xue , Qiao Guo‐Fen , Li Bai‐Yan 
Published: January 2021

AbstractAimTo understand why autonomic failures, a common non‐motor symptom of Parkinson's disease (PD), occur earlier than typical motor disorders.MethodsVagal application of DOPAL (3,4‐dihydroxyphenylacetaldehyde) to simulate PD‐like autonomic dysfunction and understand the connection between PD and cardiovascular dysfunction. Molecular and morphological approaches were employed to test the time‐dependent alternation of α‐synuclein aggregation and the ultrastructure changes in the heart and nodose (NG)/nucleus tractus solitarius (NTS).ResultsBlood pressure (BP) and baroreflex sensitivity of DOPAL‐treated rats were significantly reduced accompanied with a time‐dependent change in orthostatic BP, consistent with altered echocardiography and cardiomyocyte mitochondrial ultrastructure. Notably, time‐dependent and collaborated changes in Mon‐/Tri‐α‐synuclein were paralleled with morphological alternation in the NG and NTS.ConclusionThese all demonstrate that early autonomic dysfunction mediated by vagal application of DOPAL highly suggests the plausible etiology of PD initiated from peripheral, rather than central site. It will provide a scientific basis for the prevention and early diagnosis of PD.
Cardiac transplantation in adult congenital heart disease with prior sternotomy
Authors: Kainuma Atsushi , Ning Yuming , Kurlansky Paul A. , Axsom Kelly , Farr Maryjane , Sayer Gabriel , Uriel Nir , Lewis Matthew J. , Rosenbaum Marlon S. , Kalfa David , LaPar Damien J. , Bacha Emile A. , Takayama Hiroo , Naka Yoshifumi , Takeda Koji 
Published: January 2021

AbstractBackgroundAdult congenital heart disease (ACHD) patients who require orthotopic heart transplantation are surgically complex due to anatomical abnormalities and multiple prior surgeries. In this study, we investigated these patients’ outcomes using our institutional database.MethodsACHD patients who had prior intracardiac repair and subsequent heart transplant were included (2008–2018). Adult patients without ACHD were extracted as a control. A comparison of patients with functional single ventricular (SV) and biventricular (BV) hearts was performed.ResultsThere were 9 SV and 24 BV patients. The SV group had higher central venous pressure/pulmonary capillary wedge pressure (P = .028), hemoglobin concentration (P = .010), alkaline phosphatase (P = .022), and were more likely to have liver congestion (P = .006). Major complications included infection in 16 (48.5%), temporary dialysis in 12 (36.4%), and graft dysfunction requiring perioperative mechanical support in 7 (21.2%). Overall in‐hospital mortality was 15.2%. Kaplan‐Meier analysis showed a higher, but not statistically significant, survival after 10 years between the ACHD and control groups (ACHD 84.9% vs. control 67.5%, P = .429). There was no significant difference in 10‐year survival between SV and BV groups (78% vs. 88%, P = .467).ConclusionsComplex ACHD cardiac transplant recipients have a high incidence of early morbidities after transplantation. However, long‐term outcomes were acceptable.
Critical need for pharmacologic treatment options in NAFLD: A pediatric perspective
Authors: Friesen Chance S. , Chan Sherwin S. , Wagner Jonathan B. , Hosey‐Cojocari Chelsea , Csanaky Iván L. , Shakhnovich Valentina 
Published: January 2021

AbstractNonalcoholic fatty liver disease (NAFLD) affects up to 70% of children with obesity and has become the number one etiology for liver transplant in the United States. Early, effective intervention is critical to prevent disease progression into adulthood. Yet, it is seldom achieved through lifestyle modification alone. Thus, children must be included in NAFLD pharmacology trials, which, to date, continue to focus primarily on adult populations. This commentary serves as a call to action.
Foreign body reaction toward hydrophilic polymer at the site of endovascular procedure: A report of two cases
Authors: Shah Nirav , Javeed Masi , Patel Nishit , Rodriguez‐Waitkus Paul , Chen Wei‐Shen 
Published: January 2021

AbstractHydrophilic polymer‐coated devices have been increasingly utilized for various endovascular procedures, however not been without adverse effects. We report two cases of subacute cutaneous lesions on the neck encountered in our dermatology clinic. Histopathologic findings were significant for a nodular aggregate of epithelioid histiocytes and lymphocytes with numerous foreign body giant cells in the dermis. The granulomatous infiltrate was associated with an amorphous basophilic non‐polarizable material. Further chart review reveals both patients receiving a central venous procedure in the past, thus attributing the hydrophilic polymers as the likely source of the foreign material found at the insertion site. Our cases contrast to the more commonly reported distal embolization by these hydrophilic polymer layers. We suspect the incidence of retained hydrophilic polymer at the site of prior endovascular procedures may be underreported in the literature with the more inconspicuous presentations. Therefore, retained foreign material should be considered by both treating physicians and dermatopathologists in presenting cases of lesions that occur at common sites of endovascular procedures.
Efficacy and safety of oral sulfate solution for bowel preparation in Japanese patients undergoing colonoscopy: Noninferiority‐based, randomized, controlled study
Authors: Saito Yutaka , Oka Shiro , Tamai Naoto , Kudo Toyoki , Kuniyoshi Nobutoshi , Shirakura Tatsuya , Omae Yoshio , Hamahata Yukihiro , Arai Takehiro , Tanaka Shinji , Uedo Noriya , Shimizu Seiji , Fukuzawa Masakatsu , Uraoka Toshio , Ichinose Shiori , Ogata Haruhiko , Kobayashi Kiyonori , Saito Shoichi , Tajiri Hisao 
Published: January 2021

ObjectivesTo compare the efficacy and safety of oral sulfate solution administered using the same‐day dose and the split‐dose regimens with those of polyethylene glycol plus ascorbate solution, used for bowel preparation in Japanese patients undergoing colonoscopy.MethodsThis multicenter (n = 13), randomized, active‐controlled, colonoscopist‐ and image evaluator‐blinded, noninferiority study with parallel‐group comparison recruited 632 patients from December 2018 to June 2019. Of these, 602 patients were divided into the oral sulfate solution same‐day dose group (n = 200); oral sulfate solution split‐dose group (n = 202); and polyethylene glycol plus ascorbate same‐day dose group (n = 200). Differences in the efficacy rates between the polyethylene glycol plus ascorbate group and each oral sulfate solution group were calculated using the asymptotic method. The safety of the oral sulfate solution was evaluated, based on the occurrence of adverse events and reactions.ResultsBoth oral sulfate solution protocols were confirmed as noninferior to the polyethylene glycol plus ascorbate protocol for bowel‐cleansing. The occurrence of adverse reactions was significantly lower in the oral sulfate solution same‐day dose group than in the polyethylene glycol plus ascorbate group (P = 0.010). The occurrence of adverse reactions was not significantly different between the oral sulfate solution split‐dose and the polyethylene glycol plus ascorbate group.ConclusionsOral sulfate solution is not only safe and efficacious but also not inferior to polyethylene glycol plus ascorbate solution (active control). It could be used for bowel preparation in Japanese patients scheduled for colonoscopy (Clinical trial registration number: NCT03794310).
Early childhood poverty and adult executive functioning: Distinct, mediating pathways for different domains of executive functioning
Authors: Evans Gary W. , Farah Martha J. , Hackman Daniel A. 
Published: January 2021

AbstractExecutive functioning in adulthood is associated with early‐in‐life disadvantage. Furthermore, distinct and independent underlying processes account for differences in specific domains of adult executive functioning. The duration of poverty from birth to age 9 is associated with reduced adult inhibitory control assessed by the Flanker task (n = 233, M = 23.52 years). This effect is largely explained by lower levels of maternal responsiveness in adolescence. Early poverty also related to worse working memory in adulthood, and this effect is partially explained by elevated allostatic load during adolescence, an index of chronic physiological stress.
Students’ learning environment perception and the transition to clinical training in dentistry
Authors: Serrano Carlos M. , Lagerweij Maxim D. , de Boer Ilse R. , Bakker Dirk R. , Koopman Pepijn , Wesselink Paul R. , Vervoorn Johanna M. 
Published: January 2021

AbstractIntroductionThe learning environment (LE) influences students’ behaviour, and predicts academic achievement, satisfaction and success. Measuring students’ perception of the LE provides relevant information for curricular quality assurance. In this study, a LE assessment was used to observe variations in students’ LE perception throughout the curriculum, to illustrate the possible influence that preclinical training (Pt) and clinical training (Ct) have on students’ learning experience.Materials and MethodsAll students in the six‐year undergraduate dental programme (n = 849) at the Academic Centre for Dentistry Amsterdam (ACTA) were approached and divided into Pt and Ct groups according to their training phase in the curriculum. The LE was assessed using the Dundee Ready Educational Environment Measure (DREEM), and the results were evaluated using the Statistical Package for the Social Sciences (SPSS) software for distribution (Kolmogorov‐Smirnov normality test), internal reliability (Cronbach's alpha) and comparative analysis (one‐way ANOVA).ResultsThe questionnaire was completed by 216 (response rate=65%) Pt students and by 379 (response rate=75%) Ct students. With a general DREEM score of 124.3, significantly higher scores were found during Pt (DREEM=133.4) in comparison with the Ct phase of the curriculum (DREEM=119.2). DREEM scores steadily decreased throughout the 6‐year curriculum, with the highest drops in LE perception observed in the second and third years of the programme. Significant differences in all DREEM domains were observed, with lower scores for Ct.ConclusionStudents’ LE perception deteriorates throughout the curriculum, especially within the Pt‐Ct transition, during the second and third years of the programme. An inferior LE perception was observed in every domain of the LE questionnaire within this transition showing a learning experience, which requires an educational intervention. Further research is required to better understand the educational needs of the Pt‐Ct transition at this school.