bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-Term High-Salt Diet Increases Corin Level to Regulate the Salt–Water Balance in Humans and Rodents
Authors: Zhang Jiao , Yin Yanjun , Chen Lili , Chu Chao , Wang Yang , Lv Yongbo , He Ming , Martin Marcy , Huang Po-Hsun , Mu Jian-Jun , Shyy John Y-J , Yuan Zu-Yi 
Published: August 2017

Abstract

BACKGROUND
Dietary sodium and potassium affect the fluctuation in blood pressure (BP) and renal function. Corin, with its enzymatic activity to convert pro-atrial natriuretic peptide (pro-ANP) to biologically active ANP, regulates BP, cardiac, and renal functions. We investigated whether corin expression responds to a high-salt (HS) diet to regulate salt and water balance.

METHODS
Forty-two volunteers followed 3 sequential diets for 7 days each: a low-salt (LS) diet (3.0 g/day NaCl), a HS diet (18.0 g/day NaCl), followed by an HS diet with K+ supplementation (HS + K+) (18.0 g/day NaCl and 4.5 g/day KCl).

RESULTS
Corin level was higher with the HS diet than the LS and HS + K+ diets and was positively correlated with systolic BP (SBP) and 24-hour urinary Na+ and microalbumin (U-mALB) excretion. In rodents, serum and renal levels of corin were transiently increased with the HS diet and were decreased if the HS diet was continued for up to 7 days. HS loading increased SBP, 24-hour urinary Na+, U-mALB excretion, and the expression of proprotein convertase subtilisin/kexin-6 (PCSK6), a corin activator. Knockdown of PCSK6 or corin in high salt-treated M1-cortical collecting duct (M1-CCD) cells increased the expression of aquaporin 2 (AQP2) and β-epithelial Na+ channel (β-ENaC).

CONCLUSIONS
Short-term HS may induce the PCSK6–corin–ANP–AQP2/β-ENaC pathway in the kidney. Enhanced serum corin level in humans and rodents is positively correlated with HS-induced SBP and 24-hour urinary Na+ and U-mALB excretion, which suggests that corin is involved in the salt-water balance in response to HS intake.

CLINICAL TRIALS REGISTRATION
Public Trials Registry Number NCT02915315
A Computerized Microelectrode Recording to Magnetic Resonance Imaging Mapping System for Subthalamic Nucleus Deep Brain Stimulation Surgery
Authors: Dodani Sunjay S , Lu Charles W , Aldridge J Wayne , Chou Kelvin L , Patil Parag G 
Published: August 2017

Abstract

BACKGROUND
Accurate electrode placement is critical to the success of deep brain stimulation (DBS) surgery. Suboptimal targeting may arise from poor initial target localization, frame-based targeting error, or intraoperative brain shift. These uncertainties can make DBS surgery challenging.

OBJECTIVE
To develop a computerized system to guide subthalamic nucleus (STN) DBS electrode localization and to estimate the trajectory of intraoperative microelectrode recording (MER) on magnetic resonance (MR) images algorithmically during DBS surgery.

METHODS
Our method is based upon the relationship between the high-frequency band (HFB; 500-2000 Hz) signal from MER and voxel intensity on MR images. The HFB profile along an MER trajectory recorded during surgery is compared to voxel intensity profiles along many potential trajectories in the region of the surgically planned trajectory. From these comparisons of HFB recordings and potential trajectories, an estimate of the MER trajectory is calculated. This calculated trajectory is then compared to actual trajectory, as estimated by postoperative high-resolution computed tomography.

RESULTS
We compared 20 planned, calculated, and actual trajectories in 13 patients who underwent STN DBS surgery. Targeting errors for our calculated trajectories (2.33 mm ± 0.2 mm) were significantly less than errors for surgically planned trajectories (2.83 mm ± 0.2 mm; P = .01), improving targeting prediction in 70% of individual cases (14/20). Moreover, in 4 of 4 initial MER trajectories that missed the STN, our method correctly indicated the required direction of targeting adjustment for the DBS lead to intersect the STN.

CONCLUSION
A computer-based algorithm simultaneously utilizing MER and MR information potentially eases electrode localization during STN DBS surgery.
The Surgical White Matter Chassis: A Practical 3-Dimensional Atlas for Planning Subcortical Surgical Trajectories
Authors: Jennings Jonathan E , Kassam Amin B , Fukui Melanie B , Monroy-Sosa Alejandro , Chakravarthi Srikant , Kojis Nathan , Rovin Richard A 
Published: August 2017

Abstract

BACKGROUND
The imperative role of white matter preservation in improving surgical functional outcomes is now recognized. Understanding the fundamental white matter framework is essential for translating the anatomic and functional literature into practical strategies for surgical planning and neuronavigation.

OBJECTIVE
To present a 3-dimensional (3-D) atlas of the structural and functional scaffolding of human white matter—ie, a “Surgical White Matter Chassis (SWMC)”—that can be used as an organizational tool in designing precise and individualized trajectory-based neurosurgical corridors.

METHODS
Preoperative diffusion tensor imaging magnetic resonance images were obtained prior to each of our last 100 awake subcortical resections, using a clinically available 3.0 Tesla system. Tractography was generated using a semiautomated deterministic global seeding algorithm. Tract data were conceptualized as a 3-D modular chassis based on the 3 major fiber types, organized along median and paramedian planes, with special attention to limbic and neocortical association tracts and their interconnections.

RESULTS
We discuss practical implementation of the SWMC concept, and highlight its use in planning select illustrative cases. Emphasis has been given to developing practical understanding of the arcuate fasciculus, uncinate fasciculus, and vertical rami of the superior longitudinal fasciculus, which are often-neglected fibers in surgical planning.

CONCLUSION
A working knowledge of white matter anatomy, as embodied in the SWMC, is of paramount importance to the planning of parafascicular surgical trajectories, and can serve as a basis for developing reliable safe corridors, or modules, toward the goal of “zero-footprint” transsulcal access to the subcortical space.
Early identification of idiopathic sudden sensorineural hearing loss
Authors: Jensen Elizabeth Ann H. , Harmon Elizabeth D. , Smith Whitney 
Published: August 2017

Abstract:
This article discusses the physiology of normal hearing, the pathophysiology and differential diagnoses of sudden sensorineural hearing loss, and an approach for definitive diagnosis and treatment. A focus is placed on idiopathic sudden sensorineural hearing loss in the adult population in a primary care setting.
Infant Resuscitation Practices of Midwives in a Developing Country
Authors: Khriesat Wadah , Kassab Manal , Hamadneh Shereen , Mohammad Khitam , Hamadneh Jehan , Khader Yousef S. 
Published: August 2017

Background:
Effective basic newborn resuscitation is an important strategy to reduce the incidence of birth asphyxia and associated newborn outcomes. Outcomes for newborns can be markedly improved if health providers have appropriate newborn resuscitation skills.

Purpose:
To evaluate the skills of midwives in newborn resuscitation in delivery rooms in Jordan.

Methods:
Data were collected from observation of 118 midwives from National Health Service hospitals in the north of Jordan who performed basic newborn resuscitation for full-term neonates. A structured checklist of 14 items of basic skills of resuscitation was used. Descriptive statistics were used to analyze the data.

Results:
The results highlighted the lack of appropriate performance of the 8 necessary skills at birth by midwives. About 17.8% of midwives had performed the core competencies at birth (ie, assessing breathing pattern/crying, cleaning airways) appropriately and met the standard sequence. Less than half of midwives assessed skin color (40.7%) and breathing pattern or crying (41.5%) appropriately with or without minor deviations from standard sequences. Of the 6 skills that had to be performed by midwives at 30 seconds up to 5 minutes after birth, 4 skills were not performed by about one-quarter of midwives.

Implications for Practice and Research:
The midwives' practices at the 2 hospitals of this study were not supported by best practice international guidelines. The study showed that a high proportion of midwives had imperfect basic newborn resuscitation skills despite a mean experience of 8 years. This highlights the critical need for continuing medical education in the area of basic newborn resuscitation. The results highlight the need for formal assessment of midwives' competence in basic newborn resuscitation. National evidence-based policies and quality assurance are needed to reflect contemporary practice.
Healthcare Professionals' Attitudes and Practices in Supporting and Promoting the Breastfeeding of Preterm Infants in NICUs
Authors: Shattnawi Khulood Kayed 
Published: August 2017

Background:
Breastfeeding preterm infants is shown to have important health benefits for both infants and mothers. A positive relationship between mothers and healthcare teams and supportive practices tend to facilitate maternal competence and promote early initiation of breastfeeding within neonatal intensive care units (NICUs).

Purpose:
The aim of this study was to understand attitudes and behaviors of healthcare professionals toward breastfeeding practices and supporting mothers of preterm infants.

Methods:
This study adopted an ethnographic research design that involved 135 hours of participant observation over a 6-month period and semistructured interviews of 10 nurses and 5 physicians.

Results:
Data analysis suggests that while staff members agree with the benefits of breastfeeding for preterm infants, the actual implementation of a breastfeeding policy within NICUs is problematic. Three key themes emerged. The first described the contradiction that exists between the staff beliefs and behaviors in relation to breastfeeding and supporting mothers. The second theme was related to staff working conditions, which described the lack of institutional support and barriers to supporting breastfeeding. The final theme of controlling relationships captured the essence of the practitioner to mother association. Together, these elements revealed a situation whereby the staff appeared more preoccupied with addressing the task of caring for the babies than with supporting mothers in feeding and subsequently caring for their preterm children.

Implications for Practice:
The institutional barriers to breastfeeding promotion within NICUs should be addressed by healthcare providers. Actions that provide a supportive environment within NICUs for both mothers and nurses are essential to improve the overall quality of care.

Implications for Research:
Future research may include an examination of hospital policies and practices of promoting breastfeeding for preterm infants.
Cadaveric Analysis of Proximal Humerus Locking Plate Fit: Contour Mismatch May Lead to Malreduction
Authors: Ravindra Amy , Roebke Austin , Goyal Kanu S. 
Published: August 2017

Objectives:
To investigate proximal humerus locking plate fit in a large sample of human proximal humeri.

Methods:
A total of 97 cadaveric human humeri were selected. Humerus length, head diameter, and neck–shaft angle were measured. Three-hole and 5-hole 3.5-mm proximal humerus locking compression plates were affixed. A digital caliper was used to measure the maximum gap distance from the plate to the bone. Analysis of variance and student's t tests were conducted to evaluate differences in plate–bone distance between the 2 plate lengths, gender, race, age, and laterality. Correlation between plate–bone distance and humerus length, head diameter, and neck–shaft angle were determined.

Results:
Mean plate–bone distance for the 3-hole plate was 1.5 ± 0.6 mm (range 0.3–2.9 mm), and for the 5-hole plate was 2.5 ± 0.9 mm (range 0.7–5.0 mm) (P = 0.01). Female and right-sided humeri were shown to have significantly larger plate–bone gap distance when compared with counterparts (P = 0.01). No correlation was found between plate–bone gap distance and humeral length (R2 = 0.03), head diameter (R2 = 0.05), or neck–shaft angle (R2 = 0.08).

Conclusion:
The proximal humerus locking plate was under-contoured and spanned all 97 specimens. Greater plate–bone distance was observed with the 5-hole plate versus the 3-hole plate. Applying the plate flush to bone may lead to medial displacement of the humeral head at the calcar increasing risk of loss of fracture fixation. In fractures with any metaphyseal comminution, malreduction will be more pronounced. Caution should be exercised when using the proximal humerus locking plate as a reduction aide.
PROMIS Physical Function Correlation With NDI and mJOA in the Surgical Cervical Myelopathy Patient Population
Authors: Owen Robert J. , Zebala Lukas P. , Peters Colleen , McAnany Steven 
Published: August 2017

Study Design.
Retrospective review.

Objective.
To determine the correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) physical function with Neck Disability Index (NDI) and Modified Japanese Orthopedic Association (mJOA) scores in the surgical cervical myelopathy patient population.

Summary of Background Data.
Outcome measures such as NDI and mJOA are essential for analyzing treatments for cervical myelopathy. Administrative burdens impose limits on completion of these measures. The PROMIS group developed an outcome measure to improve reporting of patient symptoms and function and to reduce administrative burden. Despite early success, NDI and mJOA have not been compared with PROMIS in patients with cervical myelopathy. This study determines the correlation of NDI and mJOA with PROMIS in surgical patients with cervical myelopathy.

Methods.
A total of 60 patients with cervical myelopathy undergoing surgery were included. PROMIS, NDI, and mJOA were collected preoperatively, and in the first 6 months postoperatively. Correlations between NDI, mJOA, and PROMIS were quantified using Pearson correlation coefficients. Students t tests were used to test significance.

Results.
All 60 (100%) of patients completed preoperative questionnaires. Fifty-five (92%) of patients completed initial follow-up questionnaires within the first 6 months. PROMIS physical function and NDI demonstrated a strong negative correlation at baseline and in initial follow-up (R = −0.69, −0.76). PROMIS and mJOA demonstrated a strong positive correlation at baseline and in initial follow-up (R = 0.61, 0.72).

Conclusion.
PROMIS physical function has a strong negative correlation with NDI and a strong positive correlation with mJOA at baseline and in the early postoperative course in patients undergoing surgery for cervical myelopathy. Surgeons may factor these outcomes into the delivery and interpretation of patient-reported outcome measures in this population. Use of PROMIS may improve completion of outcome measures in the office and reduce administrative burden while still providing reliable outcomes data.

Level of Evidence: 3
Worldwide Survey of the “Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment” (ABCDEF) Bundle
Authors: Morandi Alessandro , Piva Simone , Ely E. Wesley , Myatra Sheila Nainan , Salluh Jorge I.F. , Amare Dawit , Azoulay Elie , Bellelli Giuseppe , Csomos Akos , Fan Eddy , Fagoni Nazzareno , Girard Timothy D. , Heras La Calle Gabriel , Inoue Shigeaki , Lim Chae-Man , Kaps Rafael , Kotfis Katarzyna , Koh Younsuck , Misango David , Pandharipande Pratik P. , Permpikul Chairat , Cheng Tan Cheng , Wang Dong-Xin , Sharshar Tarek , Shehabi Yahya , Skrobik Yoanna , Singh Jeffrey M. , Slooter Arjen , Smith Martin , Tsuruta Ryosuke , Latronico Nicola 
Published: August 2017

Objectives:
To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines.

Design:
Worldwide online survey.

Setting:
Intensive care.

Intervention:
A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle.

Measurement and Main Results:
There were 1,521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. Spontaneous awakening trials and spontaneous breathing trials are performed in 66% and 67% of the responder ICUs, respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was “prescribed” by most, but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU-acquired weakness. Family members were actively involved in 67% of ICUs; however, only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hr/d for family visits.

Conclusions:
The current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines.
Oxygen Thresholds and Mortality During Extracorporeal Life Support in Adult Patients*
Authors: Munshi Laveena , Kiss Alex , Cypel Marcelo , Keshavjee Shaf , Ferguson Niall D. , Fan Eddy 
Published: August 2017

Objectives:
Extracorporeal life support can lead to rapid reversal of hypoxemia and shock; however, it can also result in varying degrees of hyperoxia. Recent data have suggested an association between hyperoxia and mortality; however, this conclusion has not been consistent across the literature. We evaluated the association between oxygenation thresholds and mortality in three cohorts of extracorporeal life support patients.

Design:
We performed a retrospective cohort study using the Extracorporeal Life Support Organization Registry.

Setting:
We evaluated the relationship between oxygenation measured 24 hours after extracorporeal membrane oxygenation onset and mortality (2010–2015).

Patients:
The extracorporeal life support cohorts were as follows: 1) veno-venous extracorporeal membrane oxygenation for respiratory failure, 2) veno-arterial extracorporeal membrane oxygenation for cardiogenic shock, and 3) extracorporeal cardiopulmonary resuscitation.

Interventions:
The relationships between hypoxemia (Pao
2 < 60mm Hg), normoxia (Pao
2 60–100mm Hg), moderate hyperoxia (Pao
2 101–300mm Hg), extreme hyperoxia (Pao
2 > 300 mm Hg), and mortality were evaluated across three extracorporeal life support cohorts.

Measurements and Main Results:
Seven hundred sixty-five patients underwent veno-venous extracorporeal membrane oxygenation, 775 patients underwent veno-arterial extracorporeal membrane oxygenation, and 412 underwent extracorporeal cardiopulmonary resuscitation. During veno-venous extracorporeal membrane oxygenation, hypoxemia (odds ratio, 1.68; 95% CI, 1.09–2.57) and moderate hyperoxia (odds ratio, 1.66; 95% CI, 1.11–2.50) were associated with increased mortality compared with normoxia. There was no association between oxygenation and mortality for veno-arterial extracorporeal membrane oxygenation. Moderate hyperoxia was associated with increased mortality during extracorporeal cardiopulmonary resuscitation compared with normoxia (odds ratio, 1.77; 95% CI, 1.03–3.30). An exploratory analysis did not find more specific Pao
2 thresholds associated with mortality within moderate hyperoxia.

Conclusions:
Moderate hyperoxia was associated with increased mortality in patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure and extracorporeal cardiopulmonary resuscitation. Hypoxemia was associated with an increased mortality in veno-venous extracorporeal membrane oxygenation. No association was seen between oxygenation and mortality in veno-arterial extracorporeal membrane oxygenation which may be due to early death driven by the underlying disease.
Prioritization for Plastic Surgery Procedures Aimed to Improve Quality of Life: Moral Considerations
Authors: Selvaggi Gennaro , Kolby Lars , Elander Anna 
Published: August 2017

Background:
Different health conditions are treated in a Plastic Surgery unit, including those cases whose main goal is to enable patients to feel and integrate better within society and therefore improving quality of life, rather then physical functions.

Methods:
We discuss moral principles that can be used as a guide for health professionals to revise and create policies for plastic surgery patients presenting with non–life-threatening conditions.

Results:
A specific anatomical feature is not always an indicator of patient’s well-being and quality of life, and therefore it cannot be used as the sole parameter to identify the worst-off and prioritize the provision of health care. A policy should identify who preoperatively are the worst-off and come to some plausible measure of how much they can be expected to benefit from an operation. Policies that do not track these principles in any reliable way can cause discrimination.

Conclusions:
A patient-centered operating system and patient’s informed preferences might be implemented in the process of prioritizing health. In circumstances when the effectiveness of a specific treatment is unproven, professionals should not make assumptions based on their own values.
Cardiac Auscultation for Noncardiologists: Application in Cardiac Rehabilitation Programs
Authors: Compostella Leonida , Compostella Caterina , Russo Nicola , Setzu Tiziana , Iliceto Sabino , Bellotto Fabio 
Published: August 2017

During outpatient cardiac rehabilitation after an acute coronary syndrome or after an episode of congestive heart failure, a careful, periodic evaluation of patients' clinical and hemodynamic status is essential. Simple and traditional cardiac auscultation could play a role in providing useful prognostic information.
Reduced intensity of the first heart sound (S1), especially when associated with prolonged apical impulse and the appearance of added sounds, may help identify left ventricular (LV) dysfunction or conduction disturbances, sometimes associated with transient myocardial ischemia. If both S1 and second heart sound (S2) are reduced in intensity, a pericardial effusion may be suspected, whereas an increased intensity of S2 may indicate increased pulmonary artery pressure. The persistence of a protodiastolic sound (S3) after an acute coronary syndrome is an indicator of severe LV dysfunction and a poor prognosis. In patients with congestive heart failure, the association of an S3 and elevated heart rate may indicate impending decompensation. A presystolic sound (S4) is often associated with S3 in patients with LV failure, although it could also be present in hypertensive patients and in patients with an LV aneurysm. Careful evaluation of apical systolic murmurs could help identifying possible LV dysfunction or mitral valve pathology, and differentiate them from a ruptured papillary muscle or ventricular septal rupture. Friction rubs after an acute myocardial infarction, due to reactive pericarditis or Dressler syndrome, are often associated with a complicated clinical course.
During cardiac rehabilitation, periodic cardiac auscultation may provide useful information about the clinical-hemodynamic status of patients and allow timely detection of signs, heralding possible complications in an efficient and low-cost manner.