bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local anesthetic systemic toxicity in children: a review of recent case reports and current literature
Authors: Singaravelu Ramesh Archana , Boretsky Karen 
Published: June 2021

BackgroundLocal anesthetic systemic toxicity (LAST) in children occurs at an estimated rate of 8 per 100 000 blocks (95% CI 0.3 to 1.6). Due to the potential lethality of this iatrogenic complication, a better clarity of risk factors, clinical presentation, and prognosis may be clinically useful for contemporary treatment and prevention.MethodsAn extensive literature search and detailed analysis of reported cases of LAST in patients less than 18 years of age published between April 2014 and August 2019 was performed. Clinical patterns were summarized.ResultsThirty-two cases of LAST were described in 17 published articles and 2 additional cases reported to lipidrescue.org, for a total of 34 cases. Three patients did not meet the inclusion criteria. Thirty-one cases were included in the analysis.DiscussionInfants represented a disproportionately large number of reports of LAST. The majority of local anesthetic doses were within currently published guidelines. Among the reported cases, penile and caudal blocks were the most commonly associated with LAST. Needle aspiration and test dosing with epinephrine failed to predict LAST with certainty. When LAST presented with severe cardiac compromise, intravenous lipid emulsion was given within 10 min in 43% of cases (13 of 30 reported cases). The vast majority of children were under general anesthesia when local anesthetic medications were administered. In children under general anesthesia, LAST presented with cardiac manifestations in 90% of cases (19 of 21 cases). There were no deaths or long-term morbidity reported.
Influence of weather and day length on intra-seasonal growth of Norway spruce (Picea abies) and European beech (Fagus sylvatica) in a natural montane forest
Authors: Ježík Marek , Blaženec Miroslav , Mezei Pavel , Sedmáková Denisa , Sedmák Róbert , Fleischer Peter , Fleischer Peter , Bošeľa Michal , Kurjak Daniel , Střelcová Katarína , Ditmarová Ľubica 
Published: June 2021

Intra-seasonal growth responses of co-occurring European beech (Fagus sylvatica L.) and Norway spruce (Picea abies (L.) Karst.) to weather variability in montane forests can provide useful information on their future growth trends. To improve growth predictions, we aimed to identify (i) the main seasonal windows during which weather variability influences tree-ring growth, (ii) species-specific differences in the response to weather fluctuations, and (iii) teleconnections to remote sites in the Western Carpathians. We monitored intra-seasonal growth dynamics based on proxies extracted growth signals detected by high-resolution dendrometers in the transition zone between the beech and spruce altitudinal belt. Over 12 consecutive seasons in the natural montane forest (1350 m a.s.l.), the main part of spruce (68% to 10 July) and beech (95% to 26 August) annual increment was under the prevailing influence of temperature. After this, precipitation pattern (regarding spruce) and day length became the most influential variables during deceleration and cessation of growth. In addition, synchronous patterns with remote sites in the Western Carpathians were found. The results emphasize the importance of studying the influence of shorter-term weather fluctuations during the season. Our findings suggest that montane spruce tends to be less temperature-demanding and more drought-sensitive than beech, which may favor beech over the spruce under the future climate.
Topological preons from algebraic spinors
Authors: Gresnigt Niels G. 
Published: June 2021

AbstractIt is demonstrated that many of the assumed rules that govern the structure of a previously proposed topological preon model, in which simple non-trivial braids consisting of three twisted ribbons are mapped to the first generation of leptons and quarks, are automatically adhered to when the algebraic spinors of two complex Clifford algebras are identified with braids via a suitable map. Much of the assumed topological architecture of this model can therefore be interpreted as a direct consequence of the deeper algebraic structures upon which the minimal ideals of these Clifford algebras are constructed. This result deepens the understanding of how these two complementary descriptions, one topological and one algebraic, of Standard Model symmetries are intimately connected despite originating from very different perspectives.
Greybody radiation and quasinormal modes of Kerr-like black hole in Bumblebee gravity model
Authors: Kanzi Sara , Sakallı İzzet 
Published: June 2021

AbstractIn the framework of the Lorentz symmetry breaking (LSB), we investigate the quasinormal modes (QNMs) and the greybody factors (GFs) of the Kerr-like black hole spacetime obtained from the bumblebee gravity model. In particular, we analyze the scalar and fermionic perturbations of the black hole within the framework of both semi-analytic WKB method and the time domain approach. The impacts of the LSB on the bosonic/fermionic QNMs and GFs of the Kerr-like black hole are investigated in detail. The obtained results are graphically depicted and discussed.
Valosin-Containing Protein Stabilizes Mutant p53 to Promote Pancreatic Cancer Growth
Authors: Wang Jieqiong , Chen Yajie , Huang Canhua , Hao Qian , Zeng Shelya X. , Omari Sara , Zhang Yu , Zhou Xiang , Lu Hua 
Published: June 2021

Abstract

Approximately 80% of human pancreatic ductal adenocarcinomas (PDAC) harbor TP53 mutations, among which, R273H is the most frequent. Although p53-R273H is known to possess gain-of-function properties, how it is regulated in PDAC has not been extensively explored. Here we identify valosin-containing protein (VCP) as a regulator of p53-R273H by conducting immunoprecipitation-tandem mass spectrometry analysis. VCP bound p53-R273H at its DNA binding domain. Ectopic or endogenous VCP stabilized p53-R273H by binding to MDM2 and disrupting its association with mutant p53. Inhibition of VCP either by genetic depletion or the pharmacologic inhibitor CB-5083 increased ubiquitination and degradation of p53-R273H, leading to cell death. Consistently, ablation of VCP markedly retarded growth of cultured PDAC cells and xenograft PDAC tumors. Together, these results unveil VCP as a novel partner of p53-R273H in promoting PDAC growth and as a potential target for developing anti-PDAC therapy.

Significance:
These findings identify valosin-containing protein (VCP) as a novel regulator of p53-R273H stability and suggest VCP as a potential target for development of pancreatic cancer therapy.
Five-Year Clinical and Quality of Life Outcomes From the CoreValve US Pivotal Extreme Risk Trial
Authors: Arnold Suzanne V. , Petrossian George , Reardon Michael J. , Kleiman Neal S. , Yakubov Steven J. , Wang Kaijun , Hermiller James , Harrison J. Kevin , Deeb G. Michael , Huang Jian , Cohen David J. ,   on behalf of the US CoreValve Investigators
Published: June 2021

Background:
Older adults with comorbidities who are at extreme risk for surgical aortic valve replacement may be appropriate candidates for transcatheter aortic valve replacement (TAVR). We present the 5-year clinical, echocardiographic, and health status outcomes of such patients treated with CoreValve self-expanding supra-annular TAVR.

Methods:
The CoreValve US Extreme Risk Pivotal Trial was a prospective, nonrandomized, single-arm clinical trial of TAVR at 41 sites in the United States. The primary outcome was all-cause mortality or major stroke. Secondary outcomes included echocardiographic parameters and patient-reported health status, assessed with the Kansas City Cardiomyopathy Questionnaire.

Results:
Between February 2011 and August 2012, 639 patients with severe aortic stenosis at extreme surgical risk underwent attempted TAVR (mean age 82.8±8.4 years, 53% women, mean Society of Thoracic Surgeons Predicted Risk of Mortality 10.4±5.6%, 77% iliofemoral access). The 5-year Kaplan-Meier rate of death or major stroke was 72.6% ([95% CI, 68.4%–76.7%]; death 71.6%, major stroke 11.5%), with no significant differences according to access site. Among patients who survived 5 years, mean transvalvular gradient was 7.5±5.9 mm Hg, and 3.1% had moderate or severe aortic regurgitation. Health status measures improved significantly by 1 month after TAVR through 1 year (mean change in Kansas City Cardiomyopathy Questionnaire–Overall Summary score 24.8 points [95% CI, 22.4–27.2]). Beyond 1 year, the Kansas City Cardiomyopathy Questionnaire–Overall Summary score decreased gradually but remained significantly improved from pre-TAVR through 5 years of follow-up among surviving patients (mean change from baseline, 14.3 points [95% CI, 10.7–17.9]).

Conclusions:
Patients with severe aortic stenosis at extreme surgical risk who are treated with self-expanding supra-annular TAVR have high 5-year mortality. However, the short-term benefits of TAVR in terms of valve hemodynamics and quality of life are mostly preserved among surviving patients at 5 years, thereby supporting the continued use of TAVR in these challenging patients.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01240902.
Correlations Between Physician and Hospital Stroke Thrombectomy Volumes and Outcomes: A Nationwide Analysis
Authors: Stein Laura K. , Mocco J , Fifi Johanna , Jette Nathalie , Tuhrim Stanley , Dhamoon Mandip S. 
Published: June 2021

Background and Purpose:
Despite the Joint Commission’s certification requirement of ≥15 stroke thrombectomy (ST) cases per center and proceduralist annually, the relationship between ST case volumes and outcomes is uncertain. We sought to determine whether a proceduralist or hospital volume threshold exists that is associated with better outcomes among Medicare beneficiaries.

Methods:

Retrospective cohort study using validated
International Classification of Diseases, Tenth Revision
, Clinical Modification codes to identify admissions with acute ischemic stroke and treatment with ST. We used de-identified, national 100% inpatient Medicare data sets from January 1, 2016, to December 31, 2017 for US individuals aged ≥65 years. We calculated total procedures by proceduralist and hospital. We performed adjusted logistic regression of total cases as a predictor of inpatient mortality, good outcome (defined by dichotomized discharge disposition of inpatient rehabilitation or better), and 30-day readmission. We adjusted for sex, age, Charlson Comorbidity Index, availability of neurocritical care, teaching hospital status, socioeconomic status, 2-year stroke volume, and urban versus rural hospital location. We dichotomized case numbers incrementally to determine a volume threshold for better outcomes.

Results:

Thirteen thousand three hundred thirty-five patients were treated with ST by 2754 proceduralists at 641 hospitals. For every 10 more proceduralist cases, patients had 4% lower adjusted odds of inpatient mortality (adjusted odds ratio, 0.96 [95% CI, 0.95–0.98],
P
<0.0001) and 3% greater adjusted odds of good outcome (adjusted odds ratio, 1.03 [95% CI, 1.02–1.04],
P
<0.0001). For every 10 more hospital cases, patients had 2% lower odds of inpatient mortality (adjusted odds ratio, 0.98 [95% CI, 0.98–0.99],
P
=0.0003) and 2% greater odds of good outcome (adjusted odds ratio, 1.02 [95% CI, 1.01–1.02],
P
<0.0001). With increasing volumes, there were higher odds of better outcomes.

Conclusions:
Nationally, higher proceduralist and hospital ST case volumes were associated with reduced inpatient mortality and better outcome. These data support volume requirements in guidelines for ST training and certification.
Teaching Women to Write: Weaponizing Ḥadīth Against Colonialism
Authors: Wright Brian 
Published: June 2021

Abstract
This article traces the use of a ḥadīth prohibiting women’s literacy during the colonial period. Although rejected by most ḥadīth scholars and ignored by jurists, it gained prominence in the second half of the nineteenth century through the works of scholars who weaponized it as a response to colonial education projects. As debates on the religious permissibility of modern education spread, the ḥadīth accompanied them, empowering scholars who attempted to push back against modernizing national education projects. Through an analysis of the debate around this ḥadīth in British India and Egypt, I highlight the importance of the ḥadīth as a pragmatic – and not simply normative – source within Islamic legal discussions as they articulated responses to colonialism.
Does workplace spirituality enhance motivation of hospitals social workers? The scrutiny in Iran
Authors: Pouragha Behrooz , Sheikhbardsiri Hojjat , Asgharnezhad Masoomeh , Abdolahi Mahdieh , Sahebi Ali , Amiri Hadis 
Published: June 2021

Background: In today’s world as the globe of organizations, employees tend to show endeavor and more involvement in organizational goals and mission by creating workplace spirituality. Aim: The present study aimed to investigate the role of workplace spirituality in improving hospital social worker’s motivation. Methods: The study employed a cross-sectional design and was conducted in 19 private and governmental hospitals in Karaj city, Alborz province, north Iran in 2019. The statistical population included all 302 hospital social workers who were selected as the sample population according to Cochran’s formula. Using two standard questionnaires of workplace spirituality and employee motivation, we assessed the role of workplace spirituality in improving the hospital’ social workers’ motivation. Results: According to research findings, there were significant relationships between workplace spirituality, meaningful working, sense of community, forgiveness, and honesty with hospital social workers motivation p ⩽ .05. There was a significant difference between age group, gender, level of education and workplace spirituality, and motivation of hospital social workers p ⩽ .05. Conclusion: Findings suggest that health planners and authorities may need to examine factors that contribute to the promotion of workplace spirituality to increase the motivation of hospital social workers for improved performance of health organizations.
Racial/Ethnic Disparities in Intensive Care Admissions in a Pregnant and Postpartum Population, Hawai‘i, 2012-2017
Authors: Estrada Pamela , Ahn Hyeong Jun , Harvey Scott A. 
Published: June 2021

Objective Maternal morbidity and mortality is a global concern despite advances in medical care and technology and improved economic resources of nations worldwide. The primary objective of our study was to describe racial/ethnic disparities in severe maternal morbidity by using admission to an intensive care unit (ICU) as a marker. The secondary objective was to evaluate associations between patient characteristics, including obstetric outcomes, and severe maternal morbidity. Methods This retrospective cohort study used a large inpatient database to identify pregnancy and postpartum hospitalizations in Hawai‘i from January 2012 through September 2017. We evaluated associations between sociodemographic and clinical characteristics and race/ethnicity by using χ2 tests. We used multivariable logistic regression to assess associations between race/ethnicity and ICU admission. We used a post hoc analysis to assess associations between ICU admission and obstetric outcomes by race/ethnicity. Results After adjustment, we found a significantly higher ICU admission rate among Asian (adjusted odds ratio [aOR] = 1.30; 95% CI, 1.04-1.62; P = .02), Filipino (aOR = 1.45; 95% CI, 1.17-1.79; P < .001), and Native Hawaiian/Other Pacific Islander (aOR = 1.39; 95% CI, 1.15-1.68; P < .001) women compared with non-Hispanic White women. Multiple clinical characteristics and outcomes were associated with ICU admission, such as preexisting chronic conditions and pregnancy-induced hypertensive disorders. Conclusion We found that severe maternal morbidity represented by ICU admission is higher among Asian, Filipino, and Native Hawaiian/Other Pacific Islander women than among non-Hispanic White women in Hawai’i. Our findings reemphasize the need for health care providers to be vigilant in caring for members of racial/ethnic minority groups and managing their comorbidities.
Ultrasound-guided local corticosteroid injection for carpal tunnel syndrome: A meta-analysis of randomized controlled trials
Authors: Wang Hongchen , Zhu Yuting , Wei Hongyu , Dong Chunke 
Published: June 2021

Objective: This meta-analysis aimed to compare the efficacy and safety of ultrasound-guided (US-guided) versus landmark-guided (LM-guided) local corticosteroid injection for carpal tunnel syndrome (CTS). Methods: Database including Pubmed, Embase, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs). The outcomes mainly included Boston Carpal Tunnel Questionnaire (BCTQ): Symptom Severity Scale (BCTQs), Functional Status Scale (BCTQf); and electrophysiological indexes: distal motor latency (DML), sensory distal latency (SDL), compound muscle action potential (CAMP), sensory nerve action potential amplitude (SNAP), and sensory nerve conduction velocity (SNCV). Adverse events were also recorded. Results: Overall, nine RCTs were finally screened out with 469 patients (596 injected hands). Pooled analysis showed that US-guided injection was more effective in BCTQs (SMD, −0.69; 95% CI, −1.08 to −0.31; P = 0.0005), BCTQf (SMD, −0.23; 95% CI, −0.39 to −0.07; P = 0.005), CAMP (MD, 0.64; 95% CI, 0.35−0.94; P < 0.0001) improvement, and a lower rate of adverse events (RR, 0.34; 95% CI, 0.22−0.52; P < 0.00001). Subgroup analysis revealed that the US-guided injection had significantly better CMAP than the LM-guided for the in-plane approach (MD, 0.69; 95% CI, 0.36−1.01; P < 0.0001) but not for the out-plane approach (MD, 0.39; 95% CI, −0.39 to 1.17; P = 0.33). Conclusions: US-guided injection was superior to LM-guided injection in symptom severity, functional status, electrodiagnostic, and adverse events improvement for CTS. To some extent, the in-plane approach yields better results compared with the out-plane process under US guidance.
Hidden Tales of Ebola: Airing the Forgotten Voices of Ugandan “Ebola Nurses”
Authors: Okello Wonyima Isaac , Fowler-Kerry Susan , Nambozi Grace , Barry Charlotte , Wills Jeanie , Palmer-Clarke Yolanda , Locsin Rozzano C. 
Published: June 2021

Introduction According to the Centers for Disease Control and Prevention, Ebola has affected the lives of thousands, including health care workers. With few studies describing the experience of nurses who survived Ebola, the study aimed to describe Ugandan nurses’ experiences. Method Using a phenomenological design, in-depth interviews were conducted among five Ugandan nurses who contracted Ebola and survived. Result Thematic analysis revealed themes of expectations of dying, hopelessness, loneliness, and betrayal by family, community, and the health system. Discussion Results support the need for policies targeting holistic practice protocols to protect all health care professionals during future outbreaks. Last, nursing survivors should have access to government-guaranteed support programs, including free health care and financial stipends. These results and recommendations transcend to the current reality of living with COVID-19 (coronavirus disease 2019). Efficient practice protocols could protect all rights and privileges and contribute to access to treatment and stigma removal.
Effects of March of Dimes Supportive Pregnancy Care on Social Support and Postpartum Depression
Authors: Kettrey Heather Hensman , Steinka-Fry Katarzyna T. 
Published: June 2021

Purpose Group prenatal care, which integrates medical care with patient education and empowerment in a group setting, has the potential to build social support among pregnant women and reduce the risk of postpartum depression (PPD). Past research on group care’s effects on social support or PPD has produced inconsistent findings. Studies have tended to (1) examine direct effects on social support or PPD and (2) treat group care participation as a dichotomous variable. This study tests the hypothesis that group care has an indirect effect on PPD through its effect on social support. It uses both a dichotomous measure of group care participation and an ordinal measure of social contact with group members. Method This study used survey data from 199 women at two Tennessee health care sites who participated in traditional care (TC) or Supportive Pregnancy Care (SPC), a new group program developed by March of Dimes. Path analysis was employed, estimating standardized path coefficients with propensity score weighted multilevel modeling. Results The study found no evidence of an indirect relationship between SPC and PPD symptoms when modeling the dichotomous measure. Modeling the ordinal measure revealed more favorable PPD outcomes among women reporting high group member contact (compared with TC) and adverse outcomes among women reporting low group member contact. Conclusion SPC may be useful for preventing PPD symptoms among women socially engaged with other group care patients. Given the adverse effect among women who do not engage with other group members, group facilitators should encourage women to interact outside of scheduled sessions.
Outcomes of selective laser trabeculoplasty in corticosteroid-induced ocular hypertension and glaucoma
Authors: AlObaida Ibrahim , Al Owaifeer Adi Mohammed , Alotaibi Hajar , Alsafi Aisha , Ali Aljasim Leyla 
Published: June 2021

Purpose: To report the outcomes of selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in patients with steroid-induced ocular hypertension and glaucoma. Methods: A retrospective chart review of patients who underwent SLT for steroid-induced ocular hypertension or glaucoma between January 2014 and October 2018. Success of SLT was defined as ⩾20% IOP reduction from baseline without further medical or surgical intervention and/or a reduction in the number of glaucoma medications by ⩾1 from baseline while maintaining the target IOP. Main outcome measures were change in IOP from baseline and reduction in the number of medications post-laser. Results: A total of 25 eyes of 17 patients were included in the study. The mean duration of follow-up was 18.8 ± 4.5 months. IOP decreased from 23.7 ± 6.7 mmHg pre-laser to 14.4 ± 3.2 mmHg post-laser, at the last follow-up visit ( p < 0.001). The mean number of medications was 1.8 ± 1.6 medications pre-laser and 1.4 ± 1.3 medications post-laser ( p = 0.262). The overall success rate at 12 months was 72%. No visually significant complications were encountered during the whole duration of follow-up. Conclusion: SLT is a safe and effective procedure that can result in well-controlled IOP in patients with steroid-induced ocular hypertension and glaucoma.