bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Procedural sedation and analgesia in Italian pediatric emergency departments: a subgroup analysis in italian hospitals"
Authors: Bevacqua Martina , Sforzi Idanna , Bressan Silvia , Barbi Egidio , Sahyoun Cyril 
Published: February 2023

AbstractTo date, pain and anxiety are the most common symptoms reported by children who refer to pediatric emergency department. Despite it is well known that the undertreatment of this condition has some negative consequences in a short term and long term of time, gaps in the management of pain in this setting still persist. This subgroup analysis aims to describe the current state of art of pediatric sedation and analgesia in Italian emergency departments and to identify existing gaps to solve. This is a subgroup analysis of a cross-sectional European survey of pediatric emergency departments sedation and analgesia practice undertaken between November 2019 and March 2020. The survey proposed a case vignette and questions addressing several domains, like the management of pain, availability of medications, protocols and safety aspects, staff training and availability of human resources around procedural sedation and analgesia. Italian sites responding to the survey were identified and their data were isolated and checked for completeness. Eighteen Italian sites participated to the study, the 66% of which was represented University Hospitals and/or Tertiary Care Centers. The most concerning results were an inadequate sedation to 27% of patients, lack of availability of certain medications like nitrous oxide, the lack of use of intranasal fentanyl and topical anesthetics at the triage, the rare use of safety protocols and preprocedural checklists, lack of staff training and lack of space. Furthermore, the unavailability of Child Life Specialists and hypnosis emerged. Despite procedural sedation and analgesia in Italian pediatric emergency departments is progressively more used than previously, several aspects still require an implementation. Our subgroup analysis could be a starter point for further studies and to improve and make the current Italian recommendations more homogeneous.
Mismatch negativity as an early biomarker of cognitive impairment in schizophrenia
Authors: Mahmoud Abeer Mamdouh Ali , Eissa Mai Abd-Elraoof , Kolkaila Enaas Ahmad , Amer Reham Abdel Rahman , Kotait Mona Ahmed 
Published: February 2023

Abstract
Background
Due to its disturbance in schizophrenic patients, mismatch negativity (MMN) generation is believed to be a potential biomarker for recognizing primary impairments in auditory sensory processing during the course of the disease. However, great controversy exists regarding the type and onset of MMN-related impairments, with the deficits to frequency deviants is more debatable. This cross-sectional, case–control study was conducted to assess the cognitive functions among 33 eligible Egyptian schizophrenics (15 early and 18 chronic), and 30 matched healthy controls by assessing their psychometric tests and correlating them to the coexisting frequency deviant MMN responses (using both tone and speech stimuli).

Results
Deficits in frequency MMN and neuropsychological tests were evident among early and chronic schizophrenics compared to their matched control counterparts, and also between early versus chronic schizophrenia in favor of the later. MMN deficits to speech stimuli were more elicited than tone stimuli among schizophrenics. Moreover, significant correlations were identified between MMN parameters and the results of psychiatric cognitive scales.

Conclusions
We demonstrated that frequency-deviant MMN deficits are evident feature among the enrolled Egyptian schizophrenics. The cognitive functions as indexed by MMN seem affected early, with the striking decrease of MMN amplitude and delay of latency point towards the progression of the illness. The normal lateralization of MMN was absent in chronic schizophrenia. These findings could be helpful in using the MMN as an additional objective tool for confirming cognitive impairments among schizophrenics and to differentiate between early- and chronic-schizophrenic patients for medico-legal purposes and clinical implication for medications.
Identification of biomarkers for vascular dementia: a literature review
Authors: Jamali Qutub , Akinfala Akinloye , Upendram Amulya 
Published: February 2023

SUMMARYAlzheimer's disease and vascular dementia are the two most common types of dementia. It becomes difficult to distinguish between the two, especially when there are no specific genetic causes or vascular changes apparent. The aim of this review was to identify specific biomarkers supporting the diagnosis of vascular dementia by conducting a literature search for systematic reviews and observational studies. We found seven studies meeting our inclusion/exclusion criteria, and from these we identified four specific biomarkers supporting the diagnosis of vascular dementia: high levels of thyroid-stimulating hormone, lipoprotein(a), homocysteine and N-terminal prosomatostatin. However, the studies were small and a well-conducted study with larger populations is recommended to strengthen the evidence base.
Measuring recovery-oriented rehabilitation language in clinical documentation to enhance recovery-oriented practice
Authors: De Monte Veronica , Veitch Angus , Dark Frances , Meurk Carla , Wyder Marianne , Wheeler Maddison , Carney Kylie , Parker Stephen , Kisely Steve , Siskind Dan 
Published: February 2023

Background
Mental health services are encouraged to use language consistent with principles of recovery-oriented practice. This study presents a novel approach for identifying whether clinical documentation contains recovery-oriented rehabilitation language, and evaluates an intervention to improve the language used within a community-based rehabilitation team.

Aims
This is a pilot study of training to enhance recovery-oriented rehabilitation language written in care review summaries, as measured through a text-based analysis of language used in mental health clinical documentation.

Method
Eleven case managers participated in a programme that included instruction in recovery-oriented rehabilitation principles. Outcomes were measured with automated textual analysis of clinical documentation, using a custom-built dictionary of rehabilitation-consistent, person-centred and pejorative terms. Automated analyses were run on Konstanz Information Miner (KNIME), an open-source data analytics platform. Differences in the frequency of term categories in 50 pre-training and 77 post-training documents were analysed with inferential statistics.

Results
The average percentage of sentences with recovery-oriented rehabilitation terms increased from 37% before the intervention to 48% afterward, a relative increase of 28% (P < 0.001). There was no significant change in use of person-centred or pejorative terms, possibly because of a relatively high frequency of person-centred language (22% of sentences) and low use of pejorative language (2.3% of sentences) at baseline.

Conclusions
This computer-driven textual analysis method identified improvements in recovery-oriented rehabilitation language following training. Our study suggests that brief interventions can affect the language of clinical documentation, and that automated text-analysis may represent a promising approach for rapidly assessing recovery-oriented rehabilitation language in mental health services.
Sexually Dimorphic Regulation of Gonadotrope Cell Hyperplasia in Medaka Pituitary via Mitosis and Transdifferentiation
Authors: Royan Muhammad Rahmad , Kayo Daichi , Weltzien Finn-Arne , Fontaine Romain 
Published: February 2023

AbstractThe 2 pituitary gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), regulate the reproductive function in all vertebrates. While many studies have investigated the regulation of gonadotropin production and release by sex steroid feedback, its role on the regulation of gonadotrope cell number remains unclear. Using medaka as a model and an optimized protocol to restore physiological sex steroids levels following gonadectomy, we show that gonadal sex steroids not only decrease fshb transcript levels, but also Fsh cell number in both sexes. We then investigated the origin of Fsh cell hyperplasia induced by gonadectomy. In both sexes, bromodeoxyuridine incubation shows that this is achieved via Fsh cell mitosis. In situ hybridization reveals that new Fsh cells also originate from transdifferentiating Tsh cells in females, but not in males. Both phenomena are inhibited by sex steroid supplementation via feeding. In males (but not females), gonadectomy (without recovery with sex steroid supplementation) also reduces sox2 transcript levels and Sox2-immunopositive population size, suggesting that Sox2 progenitors may be recruited to produce new Fsh cells. Opposite to Fsh cells, gonadectomy decreases lhb levels in both sexes, and levels are not restored by sex steroid supplementation. In addition, the regulation of Lh cell number also seems to be sex dependent. Removal of gonadal sex steroids stimulates Lh cell mitosis in male (like Fsh cells) but not in females. To conclude, our study provides the first evidence on sexually dimorphic mechanisms used in the fish pituitary to remodel gonadotrope populations in response to sex steroids.
LGR4: A New Receptor Member in Endocrine and Metabolic Diseases
Authors: Zhang Ningning , Yuan Mingyang , Wang Jiqiu 
Published: February 2023

AbstractClassic hormone membrane receptors, such as leucine-rich repeat-containing G protein–coupled receptor (LGR) 1 (follicle-stimulating hormone receptor), LGR2 (luteinizing hormone receptor), and LGR3 (thyrotropin receptor), are crucial in endocrinology and metabolism, and the identification of new receptors can advance this field. LGR4 is a new member of this G protein–coupled receptor family and shows ways of expression and function similar to those of LGR1/2/3. Several recent studies have reported that, unlike LGR5/6, LGR4 plays essential roles in endocrine and metabolic diseases, including hypothalamic–gonadal axis defects, mammary gland dysplasia, osteoporosis, cardiometabolic diseases, and obesity. An inactivating mutation p.R126X in LGR4 leads to osteoporosis, electrolyte disturbance, abnormal sex hormone levels, and weight loss, whereas an activating mutation p.A750T is associated with bone mineral density, insulin resistance, and adiposity. Though several paracrine ligands are known to act on LGR4, the endocrine ligands of LGR4 remain poorly defined. In this review, we highlight LGR4 dysfunction in clinical diseases, animal models, and pathophysiological changes, discuss their known ligands and downstream signaling pathways, and identify unresolved questions and future perspectives of this new receptor.
Testing the Impact of Protocolized Care of Patients With Severe Traumatic Brain Injury Without Intracranial Pressure Monitoring: The Imaging and Clinical Examination Protocol
Authors: Chesnut Randall M. , Temkin Nancy , Videtta Walter , Lujan Silvia , Petroni Gustavo , Pridgeon Jim , Dikmen Sureyya , Chaddock Kelley , Hendrix Terence , Barber Jason , Machamer Joan , Guadagnoli Nahuel , Hendrickson Peter , Alanis Victor , La Fuente Gustavo , Lavadenz Arturo , Merida Roberto , Lora Freddy Sandi , Romero Ricardo , Pinillos Oscar , Urbina Zulma , Figueroa Jairo , Ochoa Marcelo , Davila Rafael , Mora Jacobo , Bustamante Luis , Perez Carlos , Leiva Jorge , Carricondo Carlos , Mazzola Ana Maria , Guerra Juan 
Published: February 2023

BACKGROUND:
Most patients with severe traumatic brain injury (sTBI) in low- or-middle-income countries and surprisingly many in high-income countries are managed without intracranial pressure (ICP) monitoring. The impact of the first published protocol (Imaging and Clinical Examination [ICE] protocol) is untested against nonprotocol management.

OBJECTIVE:
To determine whether patients treated in intensive care units (ICUs) using the ICE protocol have lower mortality and better neurobehavioral functioning than those treated in ICUs using no protocol.

METHODS:
This study involved nineteen mostly public South American hospitals. This is a prospective cohort study, enrolling patients older than 13 years with sTBI presenting within 24 h of injury (January 2014-July 2015) with 6-mo postinjury follow-up. Five hospitals treated all sTBI cases using the ICE protocol; 14 used no protocol. Primary outcome was prespecified composite of mortality, orientation, functional outcome, and neuropsychological measures.

RESULTS:
A total of 414 patients (89% male, mean age 34.8 years) enrolled; 81% had 6 months of follow-up. All participants included in composite outcome analysis: average percentile (SD) = 46.8 (24.0) nonprotocol, 56.9 (24.5) protocol. Generalized estimating equation (GEE) used to account for center effects (confounder-adjusted difference [95% CI] = 12.2 [4.6, 19.8], P = .002). Kaplan–Meier 6-month mortality (95% CI) = 36% (30%, 43%) nonprotocol, 25% (19%, 31%) protocol (GEE and confounder-adjusted hazard ratio [95% CI] = .69 [.43, 1.10], P = .118). Six-month Extended Glasgow Outcome Scale for 332 participants: average Extended Glasgow Outcome Scale score (SD) = 3.6 (2.6) nonprotocol, 4.7 (2.8) protocol (GEE and confounder-adjusted and lost to follow-up–adjusted difference [95% CI] = 1.36 [.55, 2.17], P = .001).

CONCLUSION:
ICUs managing patients with sTBI using the ICE protocol had better functional outcome than those not using a protocol. ICUs treating patients with sTBI without ICP monitoring should consider protocolization. The ICE protocol, tested here and previously, is 1 option.
The midbody component Prc1-like is required for microtubule reorganization during cytokinesis and dorsal determinant segregation in the early zebrafish embryo
Authors: Nair Sreelaja , Welch Elaine L. , Moravec Cara E. , Trevena Ryan L. , Hansen Christina L. , Pelegri Francisco 
Published: February 2023

ABSTRACTWe show that the zebrafish maternal-effect mutation too much information (tmi) corresponds to zebrafish prc1-like (prc1l), which encodes a member of the MAP65/Ase1/PRC1 family of microtubule-associated proteins. Embryos from tmi homozygous mutant mothers display cytokinesis defects in meiotic and mitotic divisions in the early embryo, indicating that Prc1l has a role in midbody formation during cell division at the egg-to-embryo transition. Unexpectedly, maternal Prc1l function is also essential for the reorganization of vegetal pole microtubules required for the segregation of dorsal determinants. Whereas Prc1 is widely regarded to crosslink microtubules in an antiparallel conformation, our studies provide evidence for an additional function of Prc1l in the bundling of parallel microtubules in the vegetal cortex of the early embryo during cortical rotation and prior to mitotic cycling. These findings highlight common yet distinct aspects of microtubule reorganization that occur during the egg-to-embryo transition, driven by maternal product for the midbody component Prc1l and required for embryonic cell division and pattern formation.
Locally Recurrent Rectal Cancer: Toward a Second Chance at Cure? A Population-Based, Retrospective Cohort Study
Authors: Swartjes Hidde , van Rees Jan M. , van Erning Felice N. , Verheij Marcel , Verhoef Cornelis , de Wilt Johannes H. W. , Vissers Pauline A. J. , Koëter Tijmen 
Published: February 2023

Abstract
Background
In current practice, rates of locally recurrent rectal cancer (LRRC) are low due to the use of the total mesorectal excision (TME) in combination with various neoadjuvant treatment strategies. However, the literature on LRRC mainly consists of single- and multicenter retrospective cohort studies, which are prone to selection bias. The aim of this study is to provide a nationwide, population-based overview of LRRC after TME in the Netherlands.

Patients and Methods
In total, 1431 patients with nonmetastasized primary rectal cancer diagnosed in the first six months of 2015 and treated with TME were included from the nationwide, population-based Netherlands Cancer Registry. Data on disease recurrence were collected for patients diagnosed in these 6 months only. Competing risk cumulative incidence, competing risk regression, and Kaplan–Meier analyses were performed to assess incidence, risk factors, treatment, and overall survival (OS) of LRRC.

Results
Three-year cumulative incidence of LRRC was 6.4%; synchronous distant metastases (LRRC-M1) were present in 44.9% of patients with LRRC. Distal localization, R1–2 margin, (y)pT3-4, and (y)pN1-2 were associated with an increased LRRC rate. No differences in LRRC treatment and OS were found between patients who had been treated with or without prior n(C)RT. Curative-intent treatment was given to 42.9% of patients with LRRC, and 3-year OS thereafter was 70%.

Conclusions
Nationwide LRRC incidence was low. A high proportion of patients with LRRC underwent curative-intent treatment, and OS of this group was high in comparison with previous studies. Additionally, n(C)RT for primary rectal cancer was not associated with differences in treatment and OS of LRRC.
Maladaptive Neuroplasticity in Corticospinal Tract after Ankle Sprain: Causal Links Established by Mendelian Randomization
Authors: XUE XIAO’AO , LI YI , WANG YIRAN , LI QIANRU , XU XIAOYUN , LU RONG , HUA YINGHUI 
Published: February 2023

ABSTRACT

Purpose
It has been hypothesized that the corticospinal tract (CST) is involved in the neural origins underlying muscular deficits after an ankle sprain. Microstructural differences in the CST have been reported in patients with and without a history of ankle sprain, but the causal links between the CST and the injuries have not been verified. This study aimed to explore whether genetically predisposed ankle sprains would impair the integrity and organization of CST neurites, manifesting as reduced fractional anisotropy (FA) and increased orientation dispersion index (ODI).

Methods
Single-nucleotide polymorphisms (SNP) associated with ankle sprains were identified from genome-wide association studies (GWAS) in FinnGen based on hospital discharge records (7223 cases and 245,598 controls). Outcome statistics for CST microstructures were collected from the GWAS from diffusion-weighted-imaging outcomes in the UK Biobank (33,224 participants). Random-effect, inverse-variance weighted Mendelian randomization was used as the primary method.

Results
Eighteen SNP were selected as forming possible causal links between ankle sprains and CST structure; F value ranged from 755 to 1026. Ankle sprains were associated with a reduction in the FA of the right CST (β = −0.033, P = 0.0439), whereas no significant effects were observed on the left side (β = −0.029, 0.004; P = 0.0748). Ankle sprains significantly increased the ODI of the left CST (β = 0.053, P = 0.0036) and the right CST (β = 0.038, P = 0.0259). No significant pleiotropy or heterogeneity was observed in the analyses.

Conclusions
A genetic predisposition to ankle sprains can lead to maladaptive neuroplasticity of the CST, manifesting as abnormally organized neurites.
Seeing Beyond the Here and Now: How Corporate Purpose Combats Corporate Myopia
Authors: Lee Ju Young , Bansal Pratima , Mascena Barbosa Alice 
Published: February 2023

Corporations are currently confronting major, interlocking crises, including climate change, biodiversity loss, inequalities, and social isolation. When under threat, executives tend to focus inward and on the short term. This is particularly unfortunate because it is in such crises that executives need to see beyond the here and now in order to ride the storms. In this paper, we argue that corporate purpose helps organizations fight such myopia and offer four mechanisms through which this works: exposing new insights, seeing issues holistically, helping to sustain focus, and bringing unity and direction.History: This paper has been accepted for the Strategy Science Special Issue on Corporate Purpose.Funding: The authors acknowledge the generous funding from the Social Sciences and Humanities Council of Canada [Grant 895-2015-0026] that contributed to the broader project in which these ideas were generated.
Management of root perforation and sodium hypochlorite extrusion injury
Authors: Hennebry Thomas , Chana Harpal 
Published: February 2023

A patient was brought to A&E by their GDP who had injected sodium hypochlorite (NaOCl) through a perforation in the patient's LR4, resulting in pain, swelling and immediate formation of a large, necrotic ulcer. Within 2 days, the patient developed paraesthesia in the distribution of the right mental nerve. Antibiotics and steroids were prescribed to alleviate the acute symptoms. The perforation was repaired with mineral trioxide aggregate (MTA) and root canal treatment was completed with the aid of a microscope. Review appointments were arranged to monitor healing of the injury.CPD/Clinical Relevance: Management of iatrogenic root perforation and associated NaOCl injury is useful knowledge.
An anaphylactic replantation: milk allergy, tooth avulsion and appropriate storage media
Authors: Potter Rosemary , Granger Clare 
Published: February 2023

Cow's milk is considered one of the gold standard storage media for avulsed teeth, and it is readily available. However, with the high prevalence of allergy to this milk, there is a potential danger of anaphylaxis when used as a storage medium. Its use and that of alternative storage media is discussed. CPD/Clinical Relevance: There is a potential for anaphylaxis when cow's milk is used as a storage medium for an avulsed tooth.
Preparación del lecho de la herida: limpieza segura y eficaz con ácido hipocloroso pH 5.5
Authors: Castro Claudia Ramírez , Duran Bárbara Ampuero , González Carolina Latorre 
Published: February 2023

Sinopsis: El objetivo de la limpieza del lecho de la herida es favorecer la remoción de materia extraña, rehidratar el lecho y acelerar el proceso de cicatrización, considerando siempre una evaluación holística del paciente. La limpieza es un paso fundamental en la preparación del lecho de la herida. En los últimos años, se ha intensificado la búsqueda y elaboración de soluciones limpiadoras con el potencial de promover la curación mediante la eliminación de barreras locales para la curación, sin comprometer el tejido sano y/o en formación. Entre ellas, el ácido hipocloroso (HOCl) puro pH 5.5 cumple con los objetivos de la preparación del lecho de la herida y de limpieza terapéutica de forma biocompatible, segura, eficaz y natural. Este artículo tiene por objetivo realizar una revisión de la evidencia existente en relación con las soluciones limpiadoras y los beneficios del HOCl puro pH 5.5. Conflicto de interés: CRC declara no tener conflicto de interés. BAD y CLG son empleadas de Laboratorio UrgoMedical Chile.
Uroterapia y mindfulness en el tratamiento de niños con disfunción vesical e intestinal: protocolo para un ensayo clínico
Authors: Assis Gisela M. , Lima de Souza Bruna M. , Martins Gisele 
Published: February 2023

Objetivo: Presentar un protocolo para ensayo clínico controlado y aleatorizado que estudie los resultados de la asociación entre técnicas de uroterapia estándar y mindfulness en la adhesión al programa y reducción de síntomas de disfunción vesical e intestinal en escolares. Método: Presentación descriptiva del protocolo. Resultados: El grupo de control deberá recibir orientaciones de medidas comportamentales gradualmente en visitas semanales, durante cuatro semanas. Tales medidas deberán contemplar: control de la ingesta de agua, intervalo de evacuación, ingestión de potenciales irritantes de la vejiga, y entrenamiento muscular del fondo pélvico. El grupo experimental deberá ser sometido al mismo protocolo, además de las técnicas de atención plena (mindfulness), previamente al inicio de cada consulta de uroterapia. Conclusión: Se espera estimular la aplicación de este protocolo en diferentes escenarios y así evaluar la contribución de la práctica de atención plena en la adhesión al tratamiento y en la reducción de síntomas.