bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of central extracorporeal life support for patients with fulminant myocarditis and cardiogenic shock
Authors: Tadokoro Naoki , Fukushima Satsuki , Minami Kimito , Taguchi Takura , Saito Tetsuya , Kawamoto Naonori , Kakuta Takashi , Seguchi Osamu , Watanabe Takuya , Nakajima Doi Seiko , Kuroda Kensuke , Suzuki Keisuke , Yanase Masanobu , Asaumi Yasuhide , Shimizu Hideyuki , Fukushima Norihide , Fujita Tomoyuki 
Published: May 2021

Abstract

OBJECTIVES
Fulminant myocarditis with cardiogenic shock requires extracorporeal life support (ECLS) and has poor outcomes. To improve outcomes, we have converted patients with severely impaired cardiac and multiorgan function from peripheral to central ECLS. In this study, we reviewed these patients’ clinical outcomes and investigated associated factors.

METHODS
We retrospectively studied 70 consecutive patients with fulminant myocarditis under peripheral support from 2006 to 2020. Forty-eight patients underwent surgical conversion to central support, and the remaining patients continued peripheral support. The end point was survival and ventricular assist device-free survival.

RESULTS
More severe pulmonary congestion and multiorgan failure were present in patients with central than peripheral support. Weaning from ECLS was achieved in 95% and 62% of patients with peripheral and central support, respectively. Five-year survival was not significantly different between patients with central and peripheral support (71.2% vs 87.5%, respectively; P = 0.15). However, the ventricular assist device-free survival rate was significantly higher in patients with central than peripheral support (82.2% vs 52.0%, respectively; P = 0.017). A peak creatine kinase-MB level of &gt;180 IU/l, rhythm disturbance and aortic valve closure were detrimental to functional recovery in patients with central support.

CONCLUSIONS
Conversion to central ECLS is feasible and safe in patients with fulminant myocarditis. Patients with severe myocardial injury as shown by a high creatine kinase-MB level, rhythm disturbance and aortic valve closure should be converted to a durable left ventricular assist device.
Reduction of oral liquid controlled drugs discrepancy in day-to-day practice
Authors: Mohanasundaram Shalini , Rutter Paul , Fox Andrew , Wood Kelly , Roldo Marta 
Published: May 2021

Abstract

Objectives
The storage, use and disposal of controlled drugs (CDs) in hospitals and other healthcare centres are governed by a combination of government legislation and local policy. In the UK, a running balance must be kept for Schedule 2 CDs and when discrepancies arise, they must be investigated and reconciled. Policies on acceptable discrepancies are varied and based on anecdotal evidence. This study was designed to simulate dosing and stock check procedures for oxycodone oral solution, as a sample CD solution, and evaluate where the volume losses that cause discrepancies could arise from.

Methods
Hypromellose solutions were formulated to simulate oxycodone commercial solutions. These were used to simulate dosing and stock check practices. Quantification of volume loss during simulated routine dosing and stock check of viscous oral CD formulations were performed in triplicate.

Key findings
Dosing with enteral syringes via a fitted rubber bung never resulted in volume loss. Volume loss was always observed during stock checks with no statistical difference between methods used.

Conclusions
The findings of this study support the following recommendations. Hospital pharmacy departments should provide oxycodone and other CD liquid formulation bottles pre-fitted with a bung and make sure personnel use enteral syringes that are compatible with the chosen adaptor and of the most appropriate size for the intended dose. Stock checks should be limited to the minimum required by law or local policy.
β-d-N4-hydroxycytidine Inhibits SARS-CoV-2 Through Lethal Mutagenesis But Is Also Mutagenic To Mammalian Cells
Authors: Zhou Shuntai , Hill Collin S , Sarkar Sanjay , Tse Longping V , Woodburn Blaide M D , Schinazi Raymond F , Sheahan Timothy P , Baric Ralph S , Heise Mark T , Swanstrom Ronald 
Published: May 2021

AbstractMutagenic ribonucleosides can act as broad-based antiviral agents. They are metabolized to the active ribonucleoside triphosphate form and concentrate in genomes of RNA viruses during viral replication. β-d-N4-hydroxycytidine (NHC, initial metabolite of molnupiravir) is &gt;100-fold more active than ribavirin or favipiravir against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with antiviral activity correlated to the level of mutagenesis in virion RNA. However, NHC also displays host mutational activity in an animal cell culture assay, consistent with RNA and DNA precursors sharing a common intermediate of a ribonucleoside diphosphate. These results indicate highly active mutagenic ribonucleosides may hold risk for the host.
Optimization of the rapid carbapenem inactivation method for use with AmpC hyperproducers
Authors: Muntean Mădălina Maria , Muntean Andrei-Alexandru , Guerin François , Cattoir Vincent , Creton Elodie , Cotellon Garance , Oueslati Saoussen , Popa Mircea Ioan , Girlich Delphine , Iorga Bogdan I. , Bonnin Rémy A. , Naas Thierry 
Published: May 2021

Abstract

Objectives
Detection of carbapenemase-producing Enterobacterales (CPEs) is sometimes difficult with AmpC-hyperproducing Enterobacterales (AHEs), as they may falsely be classified as CPEs. Here, we present a rapid Carbapenem Inactivation Method (rCIM) optimized for AmpC producers (rCIM-A) that allows rapid and easy discrimination between AHEs and CPEs.

Methods
Enterobacterales (n = 249), including natural AmpC producers, AHEs, CPEs and non-carbapenemase-producing carbapenem-resistant control strains were evaluated, using Carba NP, rCIM and rCIM-A. The rCIM-A differs from the rCIM by the addition of cloxacillin (400 μg/mL) to the initial antibiotic incubation step.

Results
The rCIM-A yielded a sensitivity and specificity of 84.26% (95% CI: 76.00%–90.55%) and 99.29% (95% CI: 96.11%–99.98%), respectively, while those of the rCIM were 86.11% (95% CI: 78.13%–92.01%) and 80.85% (95% CI: 73.38%–86.99%), respectively; those of Carba NP were lower at 84.04% (95% CI: 75.05%–90.78%) and 91.37% (95% CI: 85.41%–95.46%), respectively, due to indeterminate results. The rCIM-A was capable of discriminating between AHEs and true CPEs, but still failed to identify OXA-23-producing Proteus mirabilis isolates and remained only partially reliable for identifying IMI-like producers and a few MBL (2 NDM-1, 1 LMB-1, 1 TMB-1 and 1 IMP-13) producers. One chromosomally encoded AmpC variant, MIR-10, gave repeatedly positive results using all three tests and was thus considered a false positive.

Conclusions
Specificity for AHEs greatly improved with the rCIM-A without altering the test performance for the other resistance mechanisms. It may replace the rCIM as a cheap, easy, rapid and accurate CPE detection test.
Development of Three Molecular Diagnostic Tools for the Identification of the False Codling Moth (Lepidoptera: Tortricidae)
Authors: Rizzo D , Da Lio D , Bartolini L , Cappellini G , Bruscoli T , Salemi C , Aronadio A , Del Nista D , Pennacchio F , Boersma N , Rossi E , Sacchetti P 
Published: May 2021

Abstract
Three molecular protocols using qPCR TaqMan probe, SYBR Green, and loop-mediated isothermal amplification (LAMP) methods were set up for the identification of larvae and adults of an African invasive moth, Thaumatotibia leucotreta (Meyrick, 1913) (Lepidoptera: Tortricidae). The DNA extracts from larval and adult samples of T. leucotreta were perfectly amplified with an average Ct value of 19.47 ± 2.63. All assays were demonstrated to be inclusive for T. leucotreta and exclusive for the nontarget species tested; the absence of false positives for nontarget species showed a 100% of diagnostic specificity and diagnostic sensitivity for all assays. With the SYBR Green protocol, the Cq values were only considered for values less than 22 (cutoff value) to prevent false-positive results caused by the late amplification of nonspecific amplicons. The limit of detection (LoD) for the qPCR probe protocol was equal to 0.02 pg/µl while a value equal to 0.128 pg/µl for the qPCR SYBR Green assay and LAMP method were established, respectively. The intrarun variabilities of reproducibility and repeatability in all the assays evaluated as CV%, ranged between 0.21 and 6.14, and between 0.33 and 9.52, respectively; the LAMP values were slightly higher than other assays, indicating a very low interrun variability. In order for an operator to choose the most desirable method, several parameters were considered and discussed. For future development of these assays, it is possible to hypothesize the setup of a diagnostic kit including all the three methods combined, to empower the test reliability and robustness.
Transnational Experts Wanted: Nigerian Oil Spills before the Dutch Courts
Authors: Bertram Daniel 
Published: May 2021

Abstract
This analysis recapitulates the Hague Court of Appeal’s decisions in a series of lawsuits brought by Nigerian farmers against Dutch oil giant Shell. The ruling upholds Shell’s civil liability for the pollution ensuing from several oil spills and has been widely hailed as a blueprint for similar claims before European courts. Beyond these headlines, the judgment charters unexplored legal territories and elicits burning questions about judicial and environmental expertise in complex transnational settings. I propose a three-pronged analysis to cut through this complexity. First, the case deals with the international ‘anchor’ jurisdiction of Dutch courts over claims against foreign defendants. Secondly, the ruling marks a significant contribution to the jurisprudence on tort liability across corporate structures. Finally, the verdict sheds a new light on the interplay between environmental rights and tort actions. The confluence of these three perspectives projects a kaleidoscopic vision of environmental liability across borders.
Policy-Specific Expertise and the Importance of Organizational Leadership in Shared Administrative Governance: Evidence from US Federal Cooperative Agreements
Authors: Krause George A , Zarit Matthew 
Published: May 2021

Abstract
This study analyzes US federal cooperative agreements (CAs) that reflect federal agencies’ willingness to invest in shared administrative governance with third-party organizations. A logic anchored in organizational economics predicts that US federal agency investments to collaborate with other non-federal organizations is positively related to an agency head’s policy-specific expertise, and that this relationship will take on greater importance when collaborating with nonprofits and private firms. These propositions are tested analyzing a novel database of 241,730 US federal CA decisions awarded by 31 federal agencies between 1988 and 2008. The statistical findings reveal support for this logic, especially for larger, more complex CAs with non-governmental organizations. The evidence also reveals that federal agencies’ CA award decisions generally have little, if any, discernible statistical association; other agency level factors such as an agency leader’s managerial skills, agency politicization, agency staff professionalism, and the loyalty of agency heads to appointing presidents (JEL H11, H57, H83, L33, & M59).
Impact of COVID-19 on Families of Pediatric Solid Organ Transplant Recipients
Authors: Forner-Puntonet Mireia , Castell-Panisello Eudald , Quintero Jesús , Ariceta Gema , Gran Ferran , Iglesias-Serrano Ignacio , Gisbert-Gustemps Laura , Daigre Constanza , Ibañez-Jimenez Pol , Delgado Mercedes , Español-Martín Gemma , Parramon Gemma , Pont Teresa , Ramos-Quiroga Josep Antoni 
Published: May 2021

Abstract

Objective
The COVID-19 pandemic and lockdown measures have had a clear psychological impact on families, and specifically those with children with chronic illnesses have reported greater overloads and exhaustion. The objective of this study was to evaluate the exposure, impact and experience of the pandemic on families of pediatric solid organ transplant (SOT) recipients compared to families of healthy children and adolescents.

Methods
We recruited 96 families, 48 with a pediatric SOT recipient and 48 healthy controls, matched by child age and gender. A primary caregiver from each family responded to an online sociodemographic questionnaire and the COVID-19 Exposure and Family Impact Survey (CEFIS), which explores the exposure, impact and experience of the pandemic and lockdown on families.

Results
Exposure to the pandemic was greater in families of healthy children and adolescents. The impact was mostly negative in both groups: caregivers reported increased anxiety (76%) and mood disturbances (71.9%) and hindered quality of sleep (64.6%) and health habits (58.3%). On the positive side, family relationships improved. Qualitatively, the SOT group positively perceived isolation and established hygienic measures as protective and destigmatizing, although they reported fear of virus transmission to their child.

Conclusions
The psychological impact of the pandemic has been similar in both groups, although families of transplant recipients have protected themselves more, probably because they are used to prevention measures and they see contagion as a graver risk. Additionally, SOT recipients’ families presented some idiosyncratic elements, especially a decrease in their perception of stigma associated with the medical condition.
Simultaneous aortic and pulmonary valve replacement in a young patient after intracardiac repair for tetralogy of Fallot: mechanical or biological valve? A case report
Authors: Okubo Ryo , Kimura Fumiaki , Harada Hideyuki , Kobayashi Daita , Shirasaka Tomonori , Kamiya Hiroyuki 
Published: May 2021

Abstract
Pulmonary valve stenosis and regurgitation can occur in the distant stages after intracardiac repair of tetralogy of Fallot (TOF). Aortic regurgitation (AR) can also occur, although it is rare in postoperative patients. However, there are few reports of simultaneous replacement of the pulmonary and aortic valves in young patients after intracardiac repair of TOF, and there are no clear guidelines for selecting a valve prosthesis in such patients. We report a case of severe pulmonary valve stenosis and regurgitation with severe AR 38 years after the TOF operation, in which urgent double valve replacement and right ventricular outflow tract patching were performed with a mechanical valve in the aortic valve position and a bioprosthetic valve in the pulmonary valve position, with a successful outcome.
An extraordinary rare anastomotic band causing food bolus obstruction following uneventful minimally invasive esophagectomy: endoscopic treatment
Authors: Baili Efstratia , Davakis Spyridon , Syllaios Athanasios , Boura Maria , Meropouli Antonia , Charalabopoulos Alexandros 
Published: May 2021

Abstract
The most common long-term complication post esophagectomy implicating the esophagogastric anastomosis is stricture-induced stenosis leading to late postoperative dysphagia. Herein, we present a case of a male patient readmitted to our Upper Gastrointestinal Department due to a food bolus obstruction through an anastomotic epithelial band arisen from a prior esophagogastric anastomosis performed 5 months earlier. A band transection in between two hemostatic clips placed on both sides of the band, followed by a release and fragmentation of the foreign body into several pieces led to its final transoral removal endoscopically. The patient experienced a direct resolution of his dysphagia and discharged on the same day. At 6 months follow-up, he remains symptom-free. In conclusion, endoscopic state-of-the-art techniques when combined with standard hemostatic surgical principles in a minimally invasive manner are excellent tools for the management of post-esophagectomy syndromes.
Incarceration of transplanted kidney through incisional hernia
Authors: Nawabi Atta , Marlor Derek , Camarata Christopher , King Clay D , Nawabi Perwaiz 
Published: May 2021

Abstract
Transplanted allograft kidney herniation through an incisional hernia resulting in incarceration is a rare condition with only one other similar case reported in the literature. The primary imaging modalities used to diagnose kidney herniation are graft ultrasound, abdominal computed tomography and abdominal magnetic resonance imaging [Sugi et al. (Imaging of renal transplant complications throughout the life of the allograft: comprehensive multimodality review. Radiographics 2019;39:1327-1355)]. Treatment should be based on patient’s symptoms. This case report highlights the initial presentation of hematuria in a 57-year-old male that eventually led to the diagnosis of a right-sided incarcerated grafted kidney through an incisional hernia. Subsequently, the patient underwent transplant nephrectomy.
A Call to Thaw the Shoulder
Authors: Al-Rashid Mamun 
Published: May 2021

Abstract
The shoulder joint is an intrinsically unstable joint with a very wide range of multidirectional motions that allow positioning of the arm in a variety of functional planes. Complaints of gradual and spontaneous limitation of shoulder range of motion require prompt attention due to their functional consequences. Adhesive capsulitis is a common shoulder condition that can be painful and functionally disabling. Most cases are idiopathic, with a smaller number of individuals developing it secondary to previous trauma or surgery. Adhesive capsulitis is a clinical diagnosis of painful shoulder with global loss of passive and active range of motion and normal radiological findings. This chapter reviews the clinical signs, differential diagnoses, and treatment options for adhesive capsulitis.
A “Spooky” Shoulder Blade
Authors: Sharma Joyti , Melendez-Benabe John 
Published: May 2021

Abstract
Disorders affecting the scapula can lead to significant limitations in arm movement and pain. Scapular winging is a rare, painful, and debilitating condition that leads to limited functional abilities of the upper limb. This condition can be caused by multiple etiologies, most commonly lesions to the long thoracic nerve (serratus anterior weakness) and spinal accessory nerve (trapezius weakness). Other less common types may be caused by lesions affecting the dorsal scapular nerve. These neurological lesions produce characteristic and distinct types of scapular winging or dyskinesis. This chapter reviews the various types of scapular winging and discusses their evaluation, diagnosis, and management options.
A Construction Worker Sidelined by Elbow Pain
Authors: Subbarao Bruno 
Published: May 2021

Abstract
Lateral epicondylitis is an enthesopathy, a disorder involving the attachment of a tendon to a bone. It is a painful condition caused by chronic repetitive microtrauma and inflammation of and around the common extensor tendon attachment located at the lateral epicondyle of the humerus. Also known as “tennis elbow,” lateral epicondylitis is often due to repetitive motions and therefore can be managed conservatively by addressing any improper biomechanics that may have led to undue stress or tension on the tendons. Pain and inflammation can otherwise be managed in a similar manner as other inflammatory conditions—through a multimodal approach of therapies, bracing, pharmaceuticals, injections, and, if necessary, surgery. This chapter will provide the key components of the evaluation and stepwise management of this condition.
The Case of the Burning Pinky
Authors: Pham Quynh Giao 
Published: May 2021

Abstract
Pain and paresthesias affecting the fifth digit may be caused by lesions affecting the lower cervical spine roots, brachial plexus, or the ulnar nerve. Cubital tunnel syndrome is the most common compression neuropathy affecting the ulnar nerve. Cubital tunnel syndrome commonly presents with sensation abnormalities in the fourth and fifth digits with positive Tinel’s sign at the elbow. Cubital tunnel syndrome can arise from ulnar nerve compression at the ulnar groove or between two heads of the flexor carpi ulnaris muscle proximally. This chapter reviews the signs and symptoms of cubital tunnel syndrome and discusses its evaluation and diagnosis. It also discusses treatment considerations.
Ghostly White Hands That Come and Go
Authors: Cruz-Jimenez Maricarmen , Cuevas-Trisan Ramon 
Published: May 2021

Abstract
The evaluation of hand pallor and discoloration requires immediate attention to assess vascular compromise and ischemia. Raynaud’s is a rare condition that affects approximately 5% of the U.S. population. It is a vascular condition that may be idiopathic (primary) or a manifestation of a systemic disease (secondary). It affects arteries, particularly at their most distal segments of the fingers and to a lesser degree the toes. The vessels suffer severe vasospasm that leads to ischemia and pain. The diagnosis is made by triggering the vasospasm using tests such as the cold stimulation test. Raynaud’s can be very disabling and painful, leading to finger and toe amputations in severe cases. The condition has no cure, and treatment modalities include some pharmacological and interventional analgesic procedures, with overarching goals centered around patient education, their awareness on how to protect their hands from attacks, and lifestyle modifications. Secondary Raynaud’s is primarily managed by treating the underlying cause and avoiding triggers.
Physiological Changes During Pregnancy
Authors: Missouri Shairko , Miller Trevor , Mueller Taylor 
Published: May 2021

Abstract
Pregnancy is a normal maternal physiological state that is developed to accommodate and nurture the fetus and enable the mother during labor. Pregnancy engenders multiple systemic changes—whether it be hormonal, mechanical, or circulatory. The gravid uterus and the increase in progesterone and estrogen levels attributes to the multisystemic changes. The increase in peptide hormones alters connective tissue characteristics, leading to structural changes to the kidneys, ureters, rib cage, diaphragm, and abdominal compartments. Cardiac output, pulmonary blood flow, and circulating blood volume are all increased in response to rising metabolic demands. There are additional significant changes in many biochemical laboratory results in comparison to the nonpregnant women. Awareness of those changes will not only enable clinicians to navigate normal pregnancy but also to identify critical pathological values that assist in further management.
The Placenta
Authors: Gonzalez Sandra N. , Patel Easha , Riley Christa L. 
Published: May 2021

Abstract
The human placenta is the interface between the mother and the fetus, allowing for the transfer of nutrients and gases and the removal of waste products from the fetal metabolism, which are processes necessary for optimal fetal growth and development. Increasingly, many parturients receive various medications during pregnancy and many parturients require surgery during pregnancy and are therefore exposed to anesthesia. It is important to understand what medications administered to the mother reach the fetus and how those medications affect the fetus. Placental functions also include endocrine and metabolic functions that are involved in the regulation of both maternal metabolism as well as fetal growth and development. These functions evolve throughout the duration of the pregnancy, and as the placenta develops, its features adjust to provide the support needed for a successful outcome. The anatomy and physiology of the placenta change dynamically, resulting in a large surface area for transfer of substances and for increasing blood flow that supports the high metabolic demands of the growing fetus. Abnormalities in any of its functions can compromise the viability of the pregnancy or result in poor perinatal outcomes such as intrauterine growth retardation.