bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of in-utero antiretroviral drug exposure on expression of membrane-associated transporters in mouse placenta and fetal brain
Authors: Gilmore Julian C. , Zhang Guijun , Cameron D. William , Serghides Lena , Bendayan Reina 
Published: June 2021

Objective:
Although antiretroviral therapy (ART) during pregnancy is effective in limiting vertical HIV transmission, adverse outcomes persist amongst uninfected children exposed to antiretroviral drugs in utero. Membrane-associated drug transporters, metabolic enzymes, and tight junction proteins play important roles in adult antiretroviral drug disposition and toxicity; however, the fetal expression of these proteins in the context of ART, and their impact on in-utero antiretroviral drug distribution remain poorly understood. This study aimed to characterize the role of these proteins in modulating in-utero antiretroviral drug exposure.

Methods:
Pregnant mice were exposed to an ART regimen consisting of lamivudine, abacavir, atazanavir, and ritonavir, at clinically relevant doses. Fetal brain, liver, placenta amniotic fluid, and maternal plasma were collected on gestational day 18.5 and concentration of antiretroviral drugs in fetal tissues was measured by LC/MS/MS, whereas transporter expression was assessed by qPCR.

Results:
Abacavir and lamivudine were detected in fetal brain and amniotic fluid, whereas atazanavir and ritonavir were detected in amniotic fluid only. Robust mRNA expression of key transporters was observed in adult and fetal tissues, and sex differences were identified in the expression of Abcc1 and Slc29a1 in the placenta. Antiretroviral drug exposure was associated with a reduction in relative placental Abcg2, Abcc1, and Slc29a1 expression.

Conclusion:
These findings identify a novel effect of fetal sex and antiretroviral drug treatment on the expression of placental transporters in a mouse model, and characterize the penetration of lamivudine and abacavir into fetal brain, uncovering a potential role of transporters in modulating fetal exposure to antiretroviral drugs.
Accreditation of Simulation Fellowships and Training Programs
Authors: Ahmed Rami A. , Wong Ambrose H. , Musits Andrew N. , Cardell Annemarie , Cassara Michael , Wong Nelson L. , Smith Mary Kay , Bajaj Komal , Meguerdichian Michael , Szyld Demian 
Published: June 2021

Summary Statement
As the field of healthcare simulation matures, formal accreditation for simulation fellowships and training programs has become increasingly available and touted as a solution to standardize the education of those specializing in healthcare simulation. Some simulation experts hold opposing views regarding the potential value of simulation fellowship program accreditation. We report on the proceedings of a spirited debate at the 20th International Meeting on Simulation in Healthcare in January 2020. Pro arguments view accreditation as the logical evolution of a maturing profession: improving training quality through standard setting, providing external validation for individual programs, and enhancing the program's return on investment. Con arguments view accreditation as an incompletely formulated construct; burdensome to the “financially strapped” fellowship director, misaligned with simulation fellows' needs and expectations, and confusing to administrators mistakenly equating accreditation with credentialing. In addition, opponents of accreditation postulate that incorporating curricular standards, practice guidelines, and strategies derived and implemented without rigor, supporting evidence and universal consensus is premature. This narrative review of our debate compares and contrasts contemporary perspectives on simulation fellowship program accreditation, concluding with formal recommendations for learners, administrators, sponsors, and accrediting bodies.
Surgical Eligibility Does Not Imply Surgical Equity
Authors: Hester Caitlin A. , Kothari Anai N. , Mason Meredith , Maxwell Jessica , Ikoma Naruhiko , Kim Michael P. , Tzeng Ching-Wei D. , Lee Jeffrey E. , Katz Matthew H. G. , Cao Hop S. Tran 
Published: June 2021

Objective:
We sought to characterize differences in pancreatectomy recommendation rates to surgically eligible patients with pancreatic ductal adenocarcinoma of the pancreatic head across age and racial groups.

Background:
Pancreatectomy is not recommended in almost half of otherwise healthy patients with stage I/II pancreatic ductal adenocarcinoma lacking a surgical contraindication. We characterized differences in pancreatectomy recommendation among surgically eligible patients across age and racial groups.

Methods:
Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) patients were identified in the National Cancer Database with clinical stage I/II pancreatic head adenocarcinoma, Charlson Comorbidity Index of 0 to 1, and age 40 to 89 years. Rates of surgery recommendation and overall survival (OS) by age and race were compared. A Pancreatectomy Recommendation Equivalence Point (PREP) was defined as the age at which the rate of not recommending surgery matched the rate of recommending and completing surgery. Marginal standardization was used to identify association of age and race with recommendation. OS was compared using Kaplan–Meier and Cox regression models.

Results:
Among 40,866 patients, 36,133 (88%) were NHW and 4733 (12%) were NHB. For the entire cohort, PREP was 79 years. PREP was 5 years younger in NHB patients than in NHW patients (75 vs 80 years). Adjusted rates of not recommending surgery were significantly higher for NHB than for NHW patients in each age group. After adjusting for surgery recommendation, we found no difference in OS between NHW and NHB patients (hazard ratio 0.98 [95% CI 0.94–1.02]).

Conclusions:
PREP of NHB patients was 5 years younger than NHW patients, and in every age group, the rate of not recommending pancreatectomy was higher in NHB patients. Age and race disparities in treatment recommendations may contribute to shorter longevity of NHB patients.
Clinical and Microbiological Outcomes Associated With Use of Platelet-Rich Plasma in Chronic Venous Leg Uclers
Authors: Pires Bruna Maiara Ferreira Barreto , Baptista de Oliveira Beatriz Guitton Renaud , Bokehi Luciana Castilho , Luiz Ronir Raggio , Carvalho Bernadete Teixeira Ferreira , Santana Rosimere Ferreira , Alfradique de Souza Priscilla , Renato de Paula Geraldo , Teixeira Lenise Arneiro 
Published: June 2021

PURPOSE:
To evaluate the susceptibility profiles of Staphylococcus aureus and Pseudomonas aeruginosa strains identified in chronic venous ulcers treated with platelet-rich plasma (PRP) and petrolatum gauze or petrolatum gauze alone and to quantitatively evaluate the bacterial load and biofilm-forming capacities of the detected S. aureus and P. aeruginosa strains.

DESIGN:
Randomized controlled trial.

SUBJECTS AND SETTING:
The convenience sample included 36 participants; 18 were allocated to the PRP combined with the petrolatum gauze group, and 18 were allocated to the control group, which was treated with petrolatum gauze alone.

METHODS:
Thirty-six patients presenting with chronic venous ulcers were consecutively randomized to the PRP group (n = 18) or the petrolatum gauze control group (n = 18). We followed participants for 3 months during treatment and collected swab cultures from their wounds during weeks 1, 6, and 12 or until the wounds healed. The samples were analyzed using mass spectrometry. Antimicrobial susceptibility tests were performed using disk diffusion.

RESULTS:

P. aeruginosa was identified in 39 (39%) of 100 samples, and S. aureus was detected in only 10 (10%) samples collected over the study period. At the end of the 12-week treatment period, the wound infections reduced in both the PRP (P = .0078) and control groups (P = .01). The microorganisms were susceptible to most of the tested antimicrobials. The PRP did not increase the bacterial load in the wounds. All S. aureus strains identified showed biofilm-forming capacities and were classified as weak biofilm producers. All P. aeruginosa strains produced biofilm, with 17 strains being classified as weak, 14 as moderate, and 8 as strong biofilm producers.

CONCLUSIONS:
The PRP plus petrolatum gauze did not increase bacteriological growth or the microbial load in chronic venous ulcers compared with petrolatum gauze alone and could be a considered as an advanced treatment option for these types of chronic wounds.
Development and Implementation of a Simple Wound Care Guideline for Minor Skin Lesions
Authors: Bates Alexandra Nicole , Ercolano Elizabeth 
Published: June 2021

PURPOSE:
The purpose of this quality improvement project was to use the best available evidence and expert opinion to develop and implement a simple inpatient nursing care guideline (“The Guideline”) for patients with minor skin lesions, including candidiasis, skin tears, incontinence-associated dermatitis, and stage 1 and stage 2 pressure injuries that would not require a WOC nurse consultation.

PARTICIPANTS AND SETTING:
The Guideline was developed for nurses working on inpatient adult acute care units in a large community hospital in southwest Minnesota.

APPROACH:
The Guideline was validated for its clarity and appropriateness by internal and external hospital-based wound care nurses and implemented through in-person rounding on the nursing units and distribution of badge cards and required completing an online education module. Surveys and wound documentation audits were conducted to measure changes in knowledge and skin care pre- and postimplementation of The Guideline.

OUTCOMES:
We conducted wound documentation audits of approximately 491 records that assessed whether patients received appropriate treatment and found an improvement from 45% (104 of 231) to 80% (209 of 260). Nurses' self-rating of their knowledge about which dressings and topical treatment to use improved from 18% (16 of 89) agreement to 57% (55 of 96). Nurses' self-rating of their knowledge about when to change dressings and reapply topical treatments improved from 27% (24 of 89) agreement to 65% (62 of 96).

IMPLICATIONS FOR PRACTICE:
Although there is evidence for a variety of dressings or products to treat wounds, this quality improvement project demonstrated increased adherence with providing appropriate care when fewer treatment options were recommended to nursing staff through our structured guideline. The Guideline continues to be used at the project site and is now being implemented at affiliate hospitals.
GWAS meta-analysis and gene expression data link reproductive tract development, immune response and cellular proliferation/apoptosis with cervical cancer and clarify overlap with other cervical phenotypes
Authors: Koel Mariann , Võsa Urmo , Lepamets Maarja , Läll Kristi , Pujol-Gualdo Natàlia , Laivuori Hannele , Lemmelä Susanna , Daly Mark ,   Estonian Biobank Research Team,   FinnGen, Palta Priit , Mägi Reedik , Laisk Triin 
Published: June 2021

AbstractGenome-wide association studies (GWAS) have successfully identified associations for cervical cancer, but the underlying mechanisms of cervical biology and pathology remain uncharacterised. Our GWAS meta-analyses fill this gap, as we characterise the genetic architecture of cervical phenotypes, including up to 9,229 cases and 490,304 controls for cervical cancer from diverse ancestries. We prioritisePAX8/PAX8-AS1,LINC00339,CDC42,CLPTM1L,HLA-DRB1, andGSDMBas the most likely candidate genes for cervical cancer signals, providing insights into cervical cancer pathogenesis and supporting the involvement of reproductive tract development, immune response, and cellular proliferation/apoptosis. We construct a GRS that associates with cervical cancer (HR=3.7 for top 5% vs lowest 5%), and with other HPV- and immune-system related diagnoses in a PheWAS analysis. Our results propose valuable leads for further functional studies and the presented GRS offers an additional opportunity for risk stratification together with conventional screening strategies.
Seroconversion panels demonstrate anti-SARS-CoV-2 antibody development after administration of the mRNA-1273 vaccine
Authors: Belda Francisco , Mora Oscar , Lopez-Martinez Monica , Torres Nerea , Vivanco Ana , Christie Rebecca , Crowley Michael 
Published: June 2021

AbstractSeroconversion panels are an important tool for investigating antibody responses in acute and chronic phases of disease and development of serological assays for viral diseases including COVID-19. Globally it is anticipated that vaccines against SARS-CoV-2 will facilitate control of the current pandemic. The two COVID-19 seroconversion panels analyzed in this study were obtained from consenting donors with samples collected before vaccination with the mRNA-1273 vaccine (Moderna) and after the first and second doses of the vaccine. Panel samples were tested for antibodies to SARS-CoV-2 (IgG). Individual subjects with a positive response for anti-SARS-CoV2 IgG in their pre-vaccination samples showed a significantly enhanced response to the first vaccination. In older subjects, weaker immunological responses to the first injection were observed, which were overcome by the second injection. All subjects in the study were positive for anti-SARS-CoV-2 IgG after the second dose of vaccine.
A randomized crossover trial of short versus conventional pulse width DBS in Parkinson’s Disease
Authors: Petry-Schmelzer Jan Niklas , Schwarz Lisa M , Jergas Hannah , Reker Paul , Steffen Julia K. , Dafsari Haidar S. , Baldermann Juan Carlos , Fink Gereon R. , Visser-Vandewalle Veerle , Dembek Till A. , Barbe Michael T. 
Published: June 2021

AbstractBackgroundSubthalamic nucleus deep brain stimulation is a well-established treatment for patients with Parkinson’s disease. Previous acute challenge studies suggested that short pulse widths might increase the therapeutic window while maintaining motor symptom control.ObjectivesTo investigate in patients with Parkinson’s disease and nucleus subthalamicus deep brain stimulation (STN-DBS) whether short pulse width stimulation with 30µs maintains equal motor control as conventional 60µs stimulation over a period of 4 weeks.MethodsIn this monocentric, double-blinded, randomized crossover trial, 30 patients with Parkinson’s disease and STN-DBS were enrolled and assigned to 4 weeks of stimulation with 30µs and 4 weeks of stimulation with 60µs in randomized order (German Clinical Trials Register No. DRKS00017528). The primary outcome was the difference in motor symptom control as assessed by a motor diary. Secondary outcomes included energy consumption measures, non-motor effects, side-effects, and quality of life.ResultsA total of 24 patients were included in the final analysis. There was no difference in motor symptom control between the two treatment conditions. Concerning secondary outcomes there was no difference in energy consumption, non-motor symptoms, side-effects, or quality of life. On the individual level, patients preferring 30µs tended to be more dyskinetic in the 60µs setting, whereas patients preferring 60µs experienced more off-time in the 30µs setting.ConclusionsShort pulse width settings (30µs) provide equal motor symptom control as conventional (60µs) stimulation without significant differences in energy consumption. Future studies are warranted to evaluate a potential benefit of short pulse width settings in patients with pronounced dyskinesia.
Risk of dementia after hospitalization due to traumatic brain injury: a longitudinal, population-based study
Authors: Raj Rahul , Kaprio Jaakko , Jousilahti Pekka , Korja Miikka , Siironen Jari 
Published: June 2021

ABSTRACTObjectiveTraumatic brain injury (TBI) is considered a potential modifiable dementia risk factor. We aimed to determine whether TBI actually increases the risk of dementia when adjusting for other relevant dementia risk factors.MethodsNational prospective longitudinal cohort study that included 32,385 participants aged 25–64 during 1992–2012. Of these, 288 suffered from a major TBI (diagnosis of traumatic intracranial hemorrhage and hospital length of stay (LOS) ≥3 days) and 406 from a minor TBI (concussion diagnosis and hospital LOS ≤1 day). Dementia was defined as any first hospital contact with a diagnosis of dementia; first use of an anti-dementia drug; and dementia as an underlying or contributing cause of death. Follow-up until the end of 2017 yielded a total of 1,010 incident dementia cases.ResultsAfter adjusting for age and sex, hospitalization due to major TBI (hazard ratio [HR] 1.51, 95% CI 1.03–2.22), but not minor TBI, increased the risk of dementia. After additional adjustment for educational status, smoking status, alcohol consumption, physical activity, and hypertension, the association between major TBI and dementia weakened (HR 1.30, 95% CI 0.86–1.97). The risk factors most strongly attenuating the association between major TBI and dementia were alcohol consumption and physical activity.ConclusionThere was an association between major TBI and incident dementia. The association was attenuated after adjusting for confounders, especially alcohol consumption and physical activity. Minor TBI was not associated with an increased risk of dementia.
Effectiveness of Face Masks in Blocking the Transmission of SARS-CoV-2: a Preliminary Evaluation of Masks Used by SARS-CoV-2-Infected Individuals
Authors: Mello Vinicius M. , Eller Cristiane M. , Salvio Andreza L. , Nascimento Felipe F. , Figueiredo Camila M. , Silva Emanuelle S. R. F. , Sousa Paulo S. F. , Costa Pamela F. , Paiva Anne A. P. , Mares-Guias Maria A. M. M. , Lemos Elba R. S. , Horta Marco A. P. 
Published: June 2021

AbstractIn 2019, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is transmitted via airborne route, caused a new pandemic namely, “coronavirus disease 2019” (COVID-19). Although it is still debated whether the use of masks can prevent the transmission of SARS-CoV-2, no study has evaluated the virus-blocking efficacy of masks used by patients. We aimed to evaluate this efficacy of masks used by SARS-CoV-2-infected individuals. Data, masks used, and nasopharyngeal swab samples were obtained from these patients. Forty-five paired samples of nasopharyngeal swabs and masks were obtained and processed; the majority of masks were woven. Viral RNAs were amplified using quantitative reverse-transcription polymerase chain reaction and detected only on the inner parts of masks. Median cycle threshold (Ct) values of swabs and masks were 28.41 and 37.95, respectively. Statistically, there was a difference of approximately 10 Ct values between swabs and masks and no significant difference in Ct values among different types of masks. There were statistically significant differences in Ct values between men and women and symptomatic and asymptomatic patients. Our findings suggest the blocking of the transmission of viruses by different types of masks and reinforce the use of masks by both infected and non-infected individuals.
Taiwan on track to end third COVID-19 community outbreak
Authors: Nordling Torbjörn E. M. , Wu Yu-Heng 
Published: June 2021

AbstractSince the start of the COVID-19 pandemic on December 31st, 2019, with the World Health Organization being notified of pneumonia of unknown cause in Wuhan (China), Taiwan has successfully ended two COVID-19 community outbreaks. For 19 days, the third community outbreak has now been successfully suppressed, putting Taiwan on path to end it too around Aug. 16th based on our forecast using an exponential model. Since May 28th the 7-day average of reported confirmed infected, which peaked at 593, has been falling to 204 on June 16th and the 7-day average of reported suspected and excluded cases increased to above 25 000. Resulting in a decrease in the ratio of the 7-day average of local & unknown confirmed to suspected cases–the identified control variable–to less than one third of its peak value. The later is a hallmark of working contact tracing, which together with testing and isolation of infected are the keys to ending the community outbreak.
Association between preference and e-learning readiness among the Bangladeshi female nursing students in the COVID-19 pandemic: a cross-sectional study
Authors: Kabir Humayun , Tonmon Tajrin Tahrin , Hasan Md. Kamrul , Biswas Lila , Hasnat Chowdhury Md. Abul , Islam Muhammad Didarul , Rahman Mamunur , Mitra Dipak Kumar 
Published: June 2021

AbstractBackgroundThe COVID-19 pandemic jeopardized the traditional academic learning calendars due to the closing of all educational institutions across the globe. To keep up with the flow of learning, most of the educational institutions shifted toward e-learning. However, the students’ e-learning preference for various subdomains of e-learning readiness did not identify, particularly among the female nursing students’ for a developing country like Bangladesh, where those domains pose serious challenges.ResultsA cross-sectional study was conducted among the female nursing students’ perceived e-learning readiness in subdomains of readiness; availability, technology use, self-confidence, and acceptance. The findings of the study revealed that the prevalence of preference for e-learning was 43.46%. The students did not prefer e-learning compared to ‘prefer group’ has significantly less availability of technology (β = -3.01, 95% CI: -4.46, -1.56), less use of technology (β = - 3.08, 95% CI: -5.11, -1.06), less self-confidence (β = -4.50, 95% CI: -7.02, -1.98), less acceptance (β = -5.96, 95% CI: -7.76, -4.16) and less training need (β = -1.86, 95% CI: -2.67, - 1.06). The age, degree, residence, parents’ highest education, having a single room, having any eye problems were significantly associated with the variation of availability of technology, use of technology, self-confidence, acceptance, and training need of e-learning.ConclusionsThe outcomes of the study could be helpful while developing an effective and productive e-learning infrastructure regarding the preparedness of nursing colleges for the continuation of academia in any adverse circumstances like the COVID-19 pandemic.
More complaints than findings - Long-term pulmonary function in children and adolescents after COVID-19
Authors: Knoke Leona , Schlegtendal Anne , Maier Christoph , Eitner Lynn , Lücke Thomas , Brinkmann Folke 
Published: June 2021

ABSTRACTBackgroundThe frequency of persistent symptoms after coronavirus disease 2019 (COVID-19) in adults varies from 4.5% to 87%. Pulmonary function can also show long-term impairment in adults: 10% of hospitalised adults had reduced spirometry values, and 24% had decreased diffusion capacity. To date, only preliminary evidence is available on persistent respiratory sequelae in children and adolescents, therefore our objective was to examine the long-term effects of COVID-19 on pulmonary function in this age group.MethodsMultiple-breath washout, body plethysmography, and diffusion capacity testing were performed after an average of 2.6 months (range 0.4–6.0) following COVID-19 in 73 children and adolescents (age 5–18 years) with different disease severity. Cases were compared to 45 controls with and without infection within six months prior to assessment after exclusion of severe acute respiratory coronavirus-2 infection (SARS-CoV-2).ResultsOf the 19 patients (27.1%) who complained about persistent or newly emerged symptoms since COVID-19, 8 (11.4%) reported respiratory symptoms. Comparing patients with COVID-19 to controls, no significant differences were detected in frequency of abnormal pulmonary function (COVID-19: 12, 16.4%; controls: 12, 27.7%; OR 0.54, 95% CI 0.22–1.34). Only two patients with persistent respiratory symptoms showed abnormal pulmonary function. Multivariate analysis revealed reduced forced vital capacity (p=0.045) in patients with severe infection regardless of SARS-CoV-2 infection.DiscussionPulmonary function is rarely impaired in children and adolescents after COVID-19, except of those with severe infection. The discrepancy between persistent respiratory symptoms and normal pulmonary function suggests a different underlying pathology such as dysfunctional breathing.