bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resveratrol Ameliorates Cardiac Dysfunction by Inhibiting Apoptosis via the PI3K/Akt/FoxO3a Pathway in a Rat Model of Diabetic Cardiomyopathy
Authors: Wu Zhiye , Huang Anqing , Yan Jianyun , Liu Bei , Liu Qicai , Zhang Jianwu , Zhang Xiuli , Ou Caiwen , Chen Minsheng 
Published: July 2017

Abstract:
The aim of this study was to explore the effect and mechanism of action of resveratrol (RSV) on cardiac function in diabetic cardiomyopathy (DCM). Hyperglycemia-induced apoptosis contributes to the pathogenic changes in DCM. RSV treatment inhibited high glucose–induced apoptosis of neonatal rat ventricular myocytes. Additionally, high glucose decreased cell viability, prevented serine–threonine kinase (Akt) and FoxO3a phosphorylation, and suppressed cytoplasmic translocation of FoxO3a. However, these effects of apoptosis were reversed by 10 μM of RSV. The PI3K inhibitor LY294002 abolished the RSV protective effect in vitro. RSV (5 or 50 mg·kg−1·d−1 orally for 8 weeks) prevented the deterioration of cardiac function and structural cardiomyopathy in a streptozotocin-induced rat model of diabetes and reduced apoptosis in diabetic myocardium. Furthermore, it restored streptozotocin-impaired phosphorylation of Akt and FoxO3a (p-Akt and p-FoxO3a) and suppressed nuclear translocation of FoxO3a in vivo. Together, these data indicate that RSV has therapeutic potential against DCM by inhibiting apoptosis via the PI3K/Akt/FoxO3a pathway.
Pelvic denervation procedures for dysmenorrhea
Authors: Ramirez Christina , Donnellan Nicole 
Published: July 2017

Purpose of review
Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis.

Recent findings
Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures.

Summary
Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.
Salvage of Infected Nasal Reconstruction with a Polymethyl Methacrylate Spacer
Authors: Cavadas Pedro C. , Thione Alessandro , Pacheco Yvan D. 
Published: July 2017

Summary:
Total nasal reconstruction is a challenging multistage procedure. Infections can destroy the cartilage framework and seriously compromise the result. The use of polymethyl methacrylate with antibiotics as a spacer has been described in the treatment of skeletal infections. Using this same principle, the use of a polymethyl methacrylate with antibiotics spacer for an infected nasal reconstruction is reported in a clinical case.
Hearing health access in developing countries
Authors: Harris Michael S. , Dodson Edward E. 
Published: July 2017

Purpose of review
The developing world carries a disproportionate burden of hearing loss. Individuals with hearing loss in austere settings worldwide are also potentially impacted by their impairment to a greater extent owing to underdeveloped or nonexistent hearing health infrastructure. The purpose of this review is to examine the state of the literature on hearing health access in developing countries and identify areas for improvement.

Recent findings
Over the last 10 years progress has been made in some areas, whereas other aspects of hearing health in developing countries have changed very little. There has been expansion of efforts to train primary care and local hearing healthcare providers to recognize and appropriately treat preventable causes of hearing loss in the developing world. Applications of telehealth to connect providers and patients in rural locales have grown. Adaptions of newborn hearing screening programs that better fit local resources and customs have been reported. There has been a considerable increase in interest, including cost–benefit analyses, with regard to the use of cochlear implants in the developing world.

Summary
In spite of progress, the developing world still shoulders a disproportionate amount of the world's hearing loss, in particular chronic ear disease, and there is a paucity of well trained local hearing healthcare professionals to deal with the challenge. The role of international humanitarian efforts, telemedicine, and education is highlighted.
Leader Influence, the Professional Practice Environment, and Nurse Engagement in Essential Nursing Practice
Authors: Ducharme Maria P. , Bernhardt Jean M. , Padula Cynthia A. , Adams Jeffrey M. 
Published: July 2017

OBJECTIVE
The purpose of this study was to examine relationships between leaders’ perceived influence over professional practice environments (PPEs) and clinical nurses’ reported engagement in essential professional nursing practice.

BACKGROUND
There is little empirical evidence identifying impact of nurse leader influence or why nursing leaders are not perceived, nor do they perceive themselves, as influential in healthcare decision making.

METHODS
A nonexperimental method of prediction was used to examine relationships between engagement in professional practice, measured by Essentials of Magnetism II (EOMII) tool, and nurse leaders' perceived influence, measured by Leadership Influence over Professional Practice Environment Scale (LIPPES). A convenience sample of 30 nurse leaders and 169 clinical nurses, employed in a 247-bed acute care Magnet® hospital, participated.

RESULTS
Findings indicated that leaders perceived their influence presence from “often” to “always,” with mean scores of 3.02 to 3.70 on a 4-point Likert scale, with the lowest subscale as “access to resources” for which a significant relationship was found with clinical nurses’ reported presence of adequate staffing (P < .004). Clinical nurses reported more positive perceptions in adequacy of staffing on the EOMII when nurse leaders perceived themselves to be more influential, as measured by the LIPPES, in collegial administrative approach (P = .014), authority (P = .001), access to resources (P = .004), and leadership expectations of staff (P = .039). Relationships were seen in the outcome measure of the EOMII scale, nurse-assessed quality of patient care (NAQC), where nurse leaders’ perception of their authority (P = .003) and access to resources (P = .022) positively impacted and was predictive of NAQC.

CONCLUSIONS
Findings support assertion that nurse leaders are integral in enhancing PPEs and their influence links structures necessary for an environment that supports outcomes.
Fatal Self-Poisoning With Massive Propranolol Ingestion in a Young Male Physician
Authors: Srettabunjong Supawon 
Published: July 2017

AbstractSuicidal intoxication from massive propranolol ingestion is rare. Surprisingly, no reported cases have involved physicians. The author herein reports a case of self-poisoning death due to ingestion of propranolol by a young male physician. A 31-year-old man with major depressive disorder was found dead in his dormitory room. Fifteen empty packages, each having contained ten 40-mg propranolol tablets, were found without any tablets leftover in his room. A suicide note was also found in his room. He was thus alleged to have ingested 6 g of propranolol for self-poisoning. Autopsy findings revealed approximately 150 mL of pink fluid with some partially dissolved pink tablets in the stomach. No anatomic cause of death was found, except for mild dilatation of cerebral ventricles. Toxicologic analysis revealed propranolol in his blood and gastric contents. The cause of death was attributed to acute cardiac arrest due to severe acute propranolol intoxication from self-poisoning caused by major depressive disorder possibly secondary to organic brain syndrome.
A Scoping Review of Emergency Department Discharge Instructions for Children and Adolescents With Mental Disorders
Authors: Murphy Andrea L. , Curran Janet , Newton Amanda S. , Emberly Debbie , McRae Cecilia , MacPhee Shannon 
Published: July 2017

Background
Although most young people under the age of 25 years with mental health presentations to the emergency department (ED) are discharged home, several studies suggest discharge instructions are inadequate. We conducted a scoping review to characterize and map the literature, identify research gaps, and prioritize targeted areas for future reviews for ED discharge instructions for young people with mental disorders.

Methods
Our review was conducted in an iterative approach with 6 stages including identifying the research question, identifying relevant studies, study selection, data extraction, collaring and summarizing, and stakeholder engagement. We characterized the available information on discharge instruction interventions using the Behavior Change Wheel.

Results
Of the 805 potential publications screened, 25 were included for extraction. Nine of the 25 articles focused on suicide or self-harm, 6 were on mental health in general or mixed groups, and 9 focused on alcohol, tobacco, or substance use in general. Five studies included younger children (ie, less than 12 years) but ages ranged significantly among studies. Education and persuasion were intervention functions most commonly reported in publications (n = 13 and n = 12, respectively). From the policy categories, recommendations regarding service provision were most frequently made from four publications. Descriptions of theory were limited in publications.

Conclusions
The available literature regarding discharge instructions in the ED for youth with mental disorders is focused on certain content areas (eg, self injurious behaviors, substance use) with more work required in chronic mental disorders that make up a significant proportion of ED visits. Research that extends beyond education and with theoretical underpinnings to explain how and why various interventions work would be useful for clinicians, policy-makers, and other researchers.
Pediatric Emergency Department and Primary Care Provider Attitudes on Assessing Childhood Adversity
Authors: Schilling Samantha , Murray Ashlee , Mollen Cynthia J. , Wedin Tara , Fein Joel A. , Scribano Philip V. 
Published: July 2017

Objective
The purpose of this study was to understand pediatric emergency department (ED) and primary care (PC) health care provider attitudes and beliefs regarding the intersection between childhood adversities and health care.

Methods
We conducted in-depth, semistructured interviews in 2 settings (ED and PC) within an urban health care system. Purposive sampling was used to balance the sample among 3 health care provider roles. Interview questions were based on a modified health beliefs model exploring the “readiness to act” among providers. Interviews were recorded, transcribed, and coded. Interviews continued until theme saturation was reached.

Results
Saturation was achieved after 26 ED and 19 PC interviews. Emergency department/primary care providers were similar in their perception of patient susceptibility to childhood adversity. Childhood mental health problems were the most frequently referenced adverse outcome, followed by poor childhood physical health. Adult health outcomes because of childhood adversity were rarely mentioned. Many providers felt that knowing about childhood adversity in the medical setting was important because it relates to provision of tangible resources. There were mixed opinions about whether or not pediatric health care providers should be identifying childhood adversities at all.

Conclusions
Although providers exhibited knowledge about childhood adversity, the perceived effect on health was only immediate and tangible. The effect of childhood adversity on lifelong health and the responsibility and potential accountability health systems have in addressing these important health determinants was not recognized by many respondents in our study. Addressing these provider perspectives will be a critical component of successful transformation toward more accountable health care delivery systems.
Methodology and Demographics of a Brief Adolescent Alcohol Screen Validation Study
Authors: Bromberg Julie R. , Spirito Anthony , Chun Thomas , Mello Michael J. , Casper T. Charles , Ahmad Fahd , Bajaj Lalit , Brown Kathleen M. , Chernick Lauren S. , Cohen Daniel M. , Fein Joel , Horeczko Tim , Levas Michael N. , McAninch Brett , Monuteaux Michael , Mull Colette C. , Grupp-Phelan Jackie , Powell Elizabeth C. , Rogers Alexander , Shenoi Rohit P. , Suffoletto Brian , Vance Cheryl , Linakis James G. 
Published: July 2017

Objective
The aim of this study was to determine the psychometric properties of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within 16 Pediatric Emergency Care Applied Research Network pediatric emergency departments. This article describes the study methodology, sample characteristics, and baseline outcomes of the NIAAA 2-question screen.

Methods
Participants included 12- to 17-year-olds treated in one of the participating pediatric emergency departments across the United States. After enrollment, a criterion assessment battery including the NIAAA 2-question screen and other measures of alcohol, drug use, and risk behavior was self-administered by participants on a tablet computer. Two subsamples were derived from the sample. The first subsample was readministered the NIAAA 2-question screen 1 week after their initial visit to assess test-retest reliability. The second subsample is being reassessed at 12 and 24 months to examine predictive validity of the NIAAA 2-question screen.

Results
There were 4834 participants enrolled into the study who completed baseline assessments. Participants were equally distributed across sex and age. Forty-six percent of the participants identified as white, and 26% identified as black. Approximately one quarter identified as Hispanic. Using the NIAAA 2-question screen algorithm, approximately 8% were classified as low risk, 12% were classified as moderate risk, and 4% were classified as highest risk. Alcohol use was less likely to be reported by black participants, non-Hispanic participants, and those younger than 16 years.

Discussion
This study successfully recruited a large, demographically diverse sample to establish rates of the NIAAA screen risk categories across age, sex, ethnicity, and race within pediatric emergency departments.
Primary Omental Torsion in a Pediatric Patient
Authors: Madha Emad S. , Kane Timothy D. , Manole Mioara D. 
Published: July 2017

Abstract
Primary omental torsion is a rare cause of acute abdominal pain with a clinical presentation resembling acute appendicitis. Here, we report the case of a 7-year-old child presenting with right lower quadrant pain. Primary omental torsion was discovered upon laparoscopy, and the torsed omentum was excised without postoperative complications. Potential causes, contributing factors, diagnosis, and treatment are discussed.
Ovarian Torsion in a Pediatric Patient
Authors: Skappak Christopher , Thurston Jackie L. , Kam April J. 
Published: July 2017

Abstract
A previously healthy 10-year-old girl presented to the emergency department with a 1-day history of abdominal pain. She was afebrile with an elevated white blood cell count and a negative pelvic ultrasound. The pain resolved while in hospital, and the patient was discharged home. The patient returned 10 days later, and the pain now migrated from the left flank to the subumbilical region. The patient now had an elevated white blood cell count and C-reactive protein. On pelvic ultrasound, the patient had a large midline mass and a normal right ovary. The patient was taken to the operating room where she was found to have a torted and necrotic left ovary and fallopian tube, which were removed. There are few instances where pediatric ovarian torsion presents as intermittent episodes of abdominal pain. Emergency physicians should always have a high index of suspicion for ovarian torsion in any case of abdominal/pelvic pain in young girls with previous negative imaging.
Protection Against Lipopolysaccharide-Induced Immunosuppression by IgG and IgM
Authors: Kyvelidou Christiana , Sotiriou Dimitris , Zerva Ioanna , Athanassakis Irene 
Published: July 2017

ABSTRACT
Lipopolysaccharide (LPS) is commonly used in murine sepsis models, which are largely associated with immunosuppression and collapse of the immune system. After adapting the LPS treatment to the needs of locally bred BALB/c mice, the present study explored the potential role of IgG and IgM in reversing LPS endotoxemia. The established protocol consisted of five daily intraperitoneal injections of 0.2 μg/g LPS, which was tolerable by half of the manipulated animals. Such a protocol allowed longer survival, necessary in the prospect of therapeutic treatment application. This treatment significantly decreased CD4+, CD8+, CD3z+, and CD19+ cells, while increasing myeloid-derived suppressor cells (MDSCs; CD11b+Gr1+), CD25+ and Foxp3+ cells. These results were accompanied by increased arginase-1 activity in spleen cell lysates and production of IL-6, TNF-α, IL-18, and C-reactive protein (CRP) in the serum. The applied LPS protocol did not alter serum procalcitonin levels. MDSCs isolated from the spleen of LPS-treated animals (LPS-MDSCs) decreased proliferation of naive T cells in coculture experiments. The application of IgG and IgM to the naive T cell/LPS-MDSCs cocultures significantly decreased CD25+, Foxp3+, and CD3z+ cells, indicating an anti-suppressive effect of immunoglobulins. The in vivo application of IgG and IgM significantly decreased the percent of CD11b+Gr1+, CD25+, Foxp3+ cells, and arginase-1 activity in the spleen of LPS-treated animals, while decreasing IL-6, TNF-α, and CRP levels in the serum, allowing survival to all animals tested. In conclusion, these results reveal a novel mode of action of IgG/IgM in LPS endotoxemia, strengthening thus the use of immunoglobulin treatment is septic patients.
Reduction in Mortality Rates of Postinjury Multiple Organ Dysfunction Syndrome: A Shifting Paradigm? A Prospective Population-Based Cohort Study
Authors: van Wessem Karlijn J.P. , Leenen Luke P.H. 
Published: July 2017

ABSTRACT

Introduction:
The incidence of multiple organ dysfunction syndrome (MODS) has decreased in the last decade by improvement in trauma care. However, it still remains a major cause of morbidity and mortality. This study investigated the current incidence and mortality of MODS in polytrauma patients.

Patients and Methods:
A 3-year prospective study included consecutive trauma patients admitted to a Level-1 Trauma Center Intensive Care Unit (ICU). Isolated head injuries, drowning, asphyxiation, and burns were excluded. Demographics, Injury Severity Score (ISS), physiologic parameters, resuscitation parameters, and Denver multiple organ failure (MOF) scores were prospectively collected. Data are presented as median (interquartile range [IQR]), P < 0.05 was considered significant.

Results:
One hundred fifty-seven patients were included. Median age was 45 (26–61) years, 118 males (75%), ISS was 29 (22–37), 151 (96%) patients had blunt injuries. Thirty-one patients developed MODS (20%). Twenty-seven patients (17%) died, 24 due to brain and/or spinal cord injuries (89%). Only one patient (3%) died of MODS. Median highest Denver MOF score was 4 (4–5). Median time to MODS onset was 3 (3–4) days after injury with a length of 2 (1–3) days. Only seven patients (23%) had MODS for more than 3 consecutive days. Patients who developed MODS were older, needed more blood products in the emergency department, more platelets  < 8 h and <24 h, stayed longer on the ventilator, longer in ICU and developed more often adult respiratory distress syndrome. There was however no difference in mortality between both groups.

Conclusions:
In this polytrauma population mortality was predominantly caused by brain injury. Even though MODS was still present in severely injured polytrauma patients, its presentation was only early onset, less severe during a shorter time period, and accompanied by lower mortality.
Improving Patient Selection for Refractory Out of Hospital Cardiac Arrest Treated with Extracorporeal Life Support
Authors: Chouihed Tahar , Kimmoun Antoine , Lauvray Adrien , Laithier Francois-Xavier , Jaeger Deborah , Lemoine Simon , Maureira Juan Pablo , Nace Lionel , Duarte Kevin , Albizzati Stéphane , Girerd Nicolas , Levy Bruno 
Published: July 2017

ABSTRACT

Background:
Despite recent management improvement, including Extracorporeal Life Support (ECLS), refractory out of hospital cardiac arrest (ROHCA) survival remains dramatically low.

Methods:
We assessed an innovative strategy (Out of hoSpital Cardiac ARrest–ExtraCorporeal Life Support—“OSCAR-ECLS”) to optimize access to ECLS of ROHCA patients and reduce the delay between recognition and ECLS implantation.

Methods:
This study, conducted in a tertiary teaching hospital, compared the survival and delay times of ROHCA patients treated by ECLS before and after OSCAR-ECLS implementation. This procedure included an early recognition of ROHCA 10 min after initiation of advanced cardiopulmonary resuscitation; the optimization of patient selection and reduction in time from collapse to ECLS initiation.

Results:
Fourteen patients before and 32 patients after OSCAR-ECLS implementation were identified between 2013 and 2016. Time to ECLS initiation was 99 (90–107) min before OSCAR-ECLS vs. 80 (65–94) min during the OSCAR-ECLS period (P = 0.0007), mostly due to a reduction in time spent on site: 48 (40.0–54.0) min vs. 24 (20.0–28.0) min (P = 0.0001). Survival at hospital discharge was 7% (1/14) before OSCAR-ECLS and 25% (8/32) during the OSCAR-ECLS period (P = 0.20). Only one patient survived with a Glasgow Pittsburgh Cerebral Performance Category (CPC) score = 1 before the OSCAR-ECLS procedure while during the OSCAR-ECLS procedure, eight patients (25%) survived, six with a CPC score = 1, one with a CPC score = 2, and one with a CPC score = 3.

Conclusions:
The use of a new paradigm of ROHCA dramatically shortened the time to ECLS initiation by reducing the time spent on site by more than 20 min. Survival improved from 7% to 25% after implementation of OSCAR-ECLS.