bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid Sequence Induction With a Standard Intubation Dose of Rocuronium After Magnesium Pretreatment Compared With Succinylcholine: A Randomized Clinical Trial
Authors: Czarnetzki C. , Albrecht E. , Masouyé P. , Baeriswyl M. , Poncet A. , Robin M. , Kern C. , Tramèr M.R. 
Published: June 2022

(Anesth Analg. 2021;133:1540–1549)
Succinylcholine is the muscle relaxant commonly chosen for rapid sequence induction, despite many adverse effects. Rocuronium bromide, 1.0 to 1.2 mg/kg, can also be used for rapid sequence induction with an onset time comparable to that of succinylcholine, but prolonged recovery time. The onset time of rocuronium may be shortened using magnesium sulfate. This superiority study compared the use of intravenous pretreatment of magnesium sulfate followed by a dose of rocuronium with the use of succinylcholine in terms of intubation conditions.
Analgesia After Cesarean Delivery in the United States 2008-2018: A Retrospective Cohort Study
Authors: Reed S.E. , Tan H.S. , Fuller M.E. , Krishnamoorthy V. , Ohnuma T. , Raghunathan K. , Habib A.F. 
Published: June 2022

(Anesth Analg. 2021;133:1550–1558)
Multimodal, opioid-sparing analgesia is currently recommended for postcesarean pain management in the United States. These regimens combine neuraxial morphine, scheduled nonsteroidal anti-inflammatory drugs (NSAIDs) and scheduled acetaminophen. Recent studies have supported the use of scheduled acetaminophen plus opioids on an as-needed basis rather than acetaminophen-opioid combination drugs. This study aimed to investigate analgesia following cesarean delivery under neuraxial anesthesia in the United States and examine variations in analgesic regimens over time and between institutions.
Critical Tracheal Stenosis From Adenoid Cystic Carcinoma During Pregnancy: Case Report
Authors: Pino R.M. , Riley L.E. 
Published: June 2022

(J Clin Anesth. 2021;77:110620)
The complication of full-term pregnancy by malignancy occurs in an estimated 0.1% of cases. Adenoid cystic carcinoma (ACC) is itself a rare cancer of the head and neck, amounting to just 0.2% of tracheal tumors. As an aggressive carcinoma, ACC produces critical symptoms including airway obstruction often preceded initially by coughing, stridor, dyspnea, and hemoptysis. This case report advances the literature with documentation of the most extensive ACC during pregnancy with advancing tracheal stenosis reported to date, and critical methods by which a difficult airway was managed during cesarean delivery (CD).
CE: An Evidence-Based Yoga Practice for Hospitalized Adults on Medical–Psychiatric Units
Authors: Dossett Angela , Smith Anne , Gingerich Marcia K. , Cullen Laura 
Published: June 2022

ABSTRACT

Background:
Yoga-based treatments, which are recognized by the National Institutes of Health's National Center for Complementary and Integrative Health as a form of complementary and alternative medicine, have proven to be beneficial for people with various psychiatric disorders, including depression, anxiety, posttraumatic stress disorder, and attention deficit–hyperactivity disorder, as well as schizophrenia and other psychotic disorders.

Purpose:
The purpose of this evidence-based practice (EBP) project was to offer structured yoga sessions as a means of providing stress relief, promoting relaxation, reducing anxiety, and improving quality of care among male and female adult patients (ages 18 years and older) hospitalized in a locked medical–psychiatric unit within an academic medical center for treatment of both acute medical and acute psychiatric conditions.

Practice change and implementation:
The Iowa Model and Implementation Strategies for EBP provided the guiding framework for this pilot project. Patients were offered once weekly, 30-to-60-minute yoga sessions for 12 weeks and were screened for their ability to participate by the nurse–yoga instructor and the interprofessional team. Using a Precision Implementation Approach, a data-driven selection of strategies from the implementation framework promoted the adoption and sustainability of the practice change, which were further advanced through interprofessional reinforcement of yoga practice and internal reporting.

Results:
Patient feedback was sought before and after yoga sessions. Thirty-nine patients responded to the pre-yoga questionnaire and 38 patients responded to the post-yoga questionnaire. Patients reported improved mood after yoga, with 23% (nine of 39) reporting feelings of calm and relaxation pre-yoga compared with 76% (29 of 38) post-yoga, and 41% (16 of 39) reporting feelings of anxiety pre-yoga compared with just 5% (two of 38) post-yoga.

Conclusion:
Yoga sessions provided by a nurse certified in yoga instruction improved patients' mood and sense of well-being. Instructional materials and videos were created to promote sustained use. The EBP of providing yoga sessions grew from a pilot program to a sustained change with more widespread use. In addition to patients hospitalized on medical–psychiatric units, the health system expanded the sessions to include inpatients on behavioral health units.
Does Nasal Screening for Methicillin-Resistant Staphylococcus aureus (MRSA) Prevent Deep Surgical Site Infections for Elective Cervical Spinal Fusion?
Authors: Xiong Grace X. , Greene Nattaly E. , Hershman Stuart H. , Fogel Harold A. , Schwab Joseph H. , Bono Christopher M. , Tobert Daniel G. 
Published: June 2022

Study Design:
Retrospective cohort study.

Objective:
The objective of this study was to determine the relationship between nasal methicillin-resistant Staphylococcus aureus (MRSA) testing and surgical site infection (SSI) rates in the setting of primary posterior cervical instrumented spine surgery.

Summary of Background Data:
Preoperative MRSA screening and decolonization has demonstrated success for some orthopedic subspecialties in prevention of SSIs. Spine surgery, however, has seen varied results, potentially secondary to the anatomic and surgical heterogeneity of the patients included in prior studies. Given that prior research has demonstrated greater propensity for gram positive SSIs in the cervical spine, we sought to investigate if MRSA screening would be more impactful in the cervical spine.

Materials and Methods:
Adult patients undergoing primary instrumented posterior cervical procedures from January 2015 to December 2019 were reviewed for MRSA testing <90 days before surgery, preoperative mupirocin, perioperative antibiotics, and SSI defined as operative incision and drainage (I&D) <90 days after surgery. Logistic regression modeling used SSI as the primary outcome, MRSA screening as primary predictor, and clinical and demographic factors as covariates.

Results:
This study included 668 patients, of whom MRSA testing was performed in 212 patients (31.7%) and 6 (2.8%) were colonized with MRSA. Twelve patients (1.8%) underwent an I&D. On adjusted analysis, preoperative MRSA testing was not associated with postoperative I&D risk. Perioperative vancomycin similarly had no association with postoperative I&D risk. Notably, 6 patients (50%) grew methicillin sensitive Staphylococcus aureus from intraoperative cultures, with no cases of MRSA.

Conclusions:
There was no association between preoperative nasal MRSA screening and SSIs in primary posterior cervical instrumented procedures, nor was there any association between vancomycin or infection rate. Furthermore, there was a preponderance of gram positive infections but none caused by MRSA. Given these findings, the considerable cost and effort associated with MRSA testing in the setting of primary posterior cervical instrumentation may not be justified. Further research should investigate if higher-risk scenarios demonstrate greater utility of preoperative testing.
Impact of Pharmacists to Improve Patient Care in the Critically Ill: A Large Multicenter Analysis Using Meaningful Metrics With the Medication Regimen Complexity-ICU (MRC-ICU) Score*
Authors: Sikora Andrea , Ayyala Deepak , Rech Megan A. , Blackwell Sarah B. , Campbell Joshua , Caylor Meghan M. , Condeni Melanie Smith , DePriest Ashley , Dzierba Amy L. , Flannery Alexander H. , Hamilton Leslie A. , Heavner Mojdeh S. , Horng Michelle , Lam Joseph , Liang Edith , Montero Jennifer , Murphy David , Plewa-Rusiecki Angela M. , Sacco Alicia J. , Sacha Gretchen L. , Shah Poorvi , Smith Michael P. , Smith Zachary , Radosevich John J. , Vilella Antonia L. ,   for the MRC-ICU Investigator Team
Published: June 2022

OBJECTIVES:
Despite the established role of the critical care pharmacist on the ICU multiprofessional team, critical care pharmacist workloads are likely not optimized in the ICU. Medication regimen complexity (as measured by the Medication Regimen Complexity-ICU [MRC-ICU] scoring tool) has been proposed as a potential metric to optimize critical care pharmacist workload but has lacked robust external validation. The purpose of this study was to test the hypothesis that MRC-ICU is related to both patient outcomes and pharmacist interventions in a diverse ICU population.

DESIGN:
This was a multicenter, observational cohort study.

SETTING:
Twenty-eight ICUs in the United States.

PATIENTS:
Adult ICU patients.

INTERVENTIONS:
Critical care pharmacist interventions (quantity and type) on the medication regimens of critically ill patients over a 4-week period were prospectively captured. MRC-ICU and patient outcomes (i.e., mortality and length of stay [LOS]) were recorded retrospectively.

MEASUREMENTS AND MAIN RESULTS:
A total of 3,908 patients at 28 centers were included. Following analysis of variance, MRC-ICU was significantly associated with mortality (odds ratio, 1.09; 95% CI, 1.08–1.11; p < 0.01), ICU LOS (β coefficient, 0.41; 95% CI, 00.37–0.45; p < 0.01), total pharmacist interventions (β coefficient, 0.07; 95% CI, 0.04–0.09; p < 0.01), and a composite intensity score of pharmacist interventions (β coefficient, 0.19; 95% CI, 0.11–0.28; p < 0.01). In multivariable regression analysis, increased patient: pharmacist ratio (indicating more patients per clinician) was significantly associated with increased ICU LOS (β coefficient, 0.02; 0.00–0.04; p = 0.02) and reduced quantity (β coefficient, –0.03; 95% CI, –0.04 to –0.02; p < 0.01) and intensity of interventions (β coefficient, –0.05; 95% CI, –0.09 to –0.01).

CONCLUSIONS:
Increased medication regimen complexity, defined by the MRC-ICU, is associated with increased mortality, LOS, intervention quantity, and intervention intensity. Further, these results suggest that increased pharmacist workload is associated with decreased care provided and worsened patient outcomes, which warrants further exploration into staffing models and patient outcomes.
Safety and Acceptance of Acupuncture and Acupressure in Children, Adolescents, and Young Adults Undergoing Hematopoietic Stem Cell Transplant
Authors: Bettini Elizabeth , Idiokitas Risi , Mahmood Laila , Jacobs Shana , Steinhorn David 
Published: June 2022

Background
Hematopoietic stem cell transplant (HSCT) is associated with significant morbidity and high symptom burden including mucositis pain, nausea, and vomiting. There is little documentation in the literature regarding acupuncture or acupressure for children undergoing HSCT.

Objective
The purpose of this study was to determine the safety and acceptance of acupuncture and acupressure in children undergoing HSCT in a large tertiary care children’s hospital.

Methods
This is a descriptive retrospective study that evaluated 80 admissions to the HSCT unit over a 24-month period. Every child admitted for HSCT was offered acupuncture or acupressure as part of their care.

Results
Of 80 patients, 46 were male patients (ages range, 0-32 years; mean, 8 years). Diagnoses include leukemia/lymphoma, sickle cell disease, aplastic anemia, neuroblastoma, and other metabolic, other solid tumor, or other hematologic disorders. Both allogenic and autologous were represented. Sixty-six patients (82.5%) agreed to treatment with acupuncture, acupressure, or both. There were no adverse effects or safety concerns noted. Symptoms addressed by acupuncture or acupressure included pain from mucositis, nausea, constipation, diarrhea, anxiety, insomnia, and general wellness or healing.

Conclusion
This study demonstrates that acupuncture and acupressure are well accepted by children and their families admitted for HSCT and are safe even when performed in the first 4 weeks following transplant when the patient is likely to have thrombocytopenia.

Implications for Practice
These findings suggest that there may be more therapies for patients undergoing HSCT to help with symptom control.
Effective amelioration of lucio phenomenon with adjuvant tofacitinib therapy in a patient with dual infection of M. leprae and M. lepromatosis : A case report from India.
Authors: Patel Nayankumar Harshadkumar , Padhiyar Jignaben Krunal , Patel Kathak Ashok , Patel Jahnvi Rakeshkumar , Lakum Megha Pratapabhai , Singh Itu 
Published: June 2022

Introduction: Lucio phenomenon (LP) is characteristic reaction pattern seen in patient of diffuse lepromatous leprosy(DLL). Dual infection of M. leprae and M. lepromatosis in case of DLL is confirmed from other endemic country but same is yet to be documented from India. Conventionally LP is treated with high dose of systemic glucocorticoid (GC) and anti-leprosy treatment (ALT). Here we are reporting an interesting case of leprosy lymphadenitis as initial presentation in case of LP and DLL due to dual infection with M. leprae and M. lepromatosis who responded favorably to tofacitinib as adjuvant to ALT and systemic GC therapy. Case report: A 24-year-old man presented with complaint of swelling over bilateral inguinal region, pus filled skin lesions with multiple ulcers, fever and joint pain. Post hospitalization investigations showed presence of anemia, leukocytosis and elevated acute and chronic inflammatory markers. Skin and lymph node biopsies were suggestive of LP and Leprosy lymphadenitis. Presence of M.leprae and M. lepromatosis was confirmed by PCR study of tissue. Despite of anti-leprosy treatment, oral GC and thalidomide therapy patient continue developing new lesions. Post one-month commencement of adjuvant tofacitinib, patient experienced excellent clinical improvement as healing of all existing lesions and cessation of new lesion of LP. Conclusion: Our case confirms the presence of dual infection with M. leprae and lepromatosis in India. Lymph node involvement as initial presentation of DLL should be considered in endemic area. Tofacitinib can emerge as promising new adjuvant therapy for recalcitrant lepra reaction.
Catellatospora tritici sp. nov., a novel cellulase-producing actinobacterium isolated from rhizosphere soil of wheat (Triticum aestivum L.) and emended description of the genus Catellatospora
Authors: Yang Yanming , Qian Lulu , Lin Jiaying , Qi Cuiping , Zhao Tianxin , Wang Xiangjing , Zhao Junwei , Xiang Wensheng 
Published: June 2022

A Gram-positive, cellulose-degrading actinobacterium, designed strain NEAU-YM18T, was isolated from rhizosphere soil of wheat (Triticum aestivum L.) sampled in Langfang, Hebei Province, PR China. The novel strain was characterized using a polyphasic approach. Morphological and chemotaxonomic characteristics confirmed that strain NEAU-YM18T belonged to the genus

Catellatospora

. Cells of strain NEAU-YM18T were observed to contain meso- and 3-hydroxy-diaminopimelic acids as diagnostic cell-wall amino acids. The acyl type of the cell-wall muramic acid was glycolyl. The whole-cell hydrolysates were xylose, glucose and ribose. The phospholipids consisted of diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylinositol. The major fatty acids were iso-C15 : 0, iso-C16 : 0, C18 : 1
ω9c and summed feature 5 (anteiso-C18 : 0/C18 : 2
ω6,9c). The menaquinones were MK-9(H4), MK-9(H6) and MK-9(H2). The DNA G+C content was 71.1 %. The results of 16S rRNA gene sequence and phylogenetic analyses indicated that strain NEAU-YM18T was closely related to

Catellatospora chokoriensis

2-25(1)T (98.4 % 16S rRNA gene sequence similarity),

Catellatospora vulcania

NEAU-JM1T (98.3%) and

Catellatospora sichuanensis

H14505T (98.3 %) and formed a branch with

C. sichuanensis

H14505T. Furthermore, the whole genome phylogeny of strain NEAU-YM18T showed that the strain formed an independent clade. The digital DNA–DNA hybridization results between NEAU-YM18T and

C. chokoriensis

2-25(1)T,

C. vulcania

NEAU-JM1T and

C. sichuanensis

H14505T were 25.0, 24.7 and 24.7 %, respectively, and the whole-genome average nucleotide identity values between them were 81.5, 81.4 and 81.4 %, respectively. These genetic results and some phenotypic characteristics could distinguish strain NEAU-YM18T from its reference strains. In addition, genomic analysis confirmed that strain NEAU-YM18T had the potential to decompose cellulose and produce bioactive compounds. Therefore, strain NEAU-YM18T represents a novel species of the genus

Catellatospora

, for which the name Catellatospora tritici sp. nov. is proposed. The type strain is NEAU-YM18T (=CCTCC AA 2020040T=JCM 33977T).
Social effects of rabies infection in male vampire bats (Desmodus rotundus)
Authors: Cárdenas Canales Elsa M. , Stockmaier Sebastian , Cronin Eleanor , Rocke Tonie , Osorio Jorge E. , Carter Gerald G. 
Published: June 2022

Abstract (resumen en español, S1)Rabies virus (RABV) transmitted by the common vampire bat (Desmodus rotundus) poses a threat to agricultural development and public health throughout the Neotropics. The ecology and evolution of rabies host-pathogen dynamics are influenced by two infection-induced behavioral changes. RABV-infected hosts often exhibit increased aggression which facilitates transmission, and rabies also leads to reduced activity and paralysis prior to death. Although several studies document rabies-induced behavioral changes in rodents and other dead-end hosts, surprisingly few studies have measured these changes in vampire bats, the key natural reservoir throughout Latin America. Here, we take advantage of an experiment designed to test the safety and efficacy of an oral rabies vaccine in captive male vampire bats to quantify for the first time how rabies affects allogrooming and aggressive behaviors in the vampire bat. Compared to non-rabid vampire bats, rabid individuals reduced their allogrooming prior to death, but we did not detect increases in aggression among bats. To put our results in context, we review what is known and what remains unclear about behavioral changes of rabid vampire bats.
Evaluation of sampling and concentration methods for Salmonella enterica serovar Typhi detection from wastewater
Authors: Zhou Nicolette A. , Ong Angelo Q.W. , Fagnant-Sperati Christine S. , Harrison Joanna Ciol , Kossik Alexandra L. , Beck Nicola K. , Shirai Jeffry H. , Burnor Elisabeth , Swanstrom Rachael , Demeke Bethel , Patel Suhani ,   Typhoid Environmental Surveillance Working Group, Meschke John Scott 
Published: June 2022

ABSTRACTSalmonella enterica serovar (Salmonella Typhi) is the causative bacterial agent of Typhoid fever. Environmental surveillance of wastewater and wastewater-impacted surface waters has proven effective in monitoring various pathogens, and has recently been applied to Salmonella Typhi. This study evaluated eight sample collection and concentration methods with twelve variations currently being developed and used for Salmonella Typhi surveillance globally to better understand the performance of each method based on their ability to detect Salmonella Typhi and feasibility. Salmonella Typhi strains, Ty21a and Ty2, were seeded to influent wastewater at known concentrations to evaluate the following methods: grab sampling using electropositive filters, centrifugation, direct enrichment, or membrane filtration and trap sampling using Moore swabs. Concentrated samples underwent nucleic acid extraction and were detected and/or quantified via qPCR. Results suggest that all methods tested can be successful at concentrating Salmonella Typhi for subsequent detection by qPCR, although each method has its own strengths and weaknesses including the Salmonella Typhi concentrations they are best suited for with a range of positive detections observed as low as 0.1-0.001 CFU Ty21a/mL and 0.01 CFU Ty2/mL. These factors should be considered when identifying a method for environmental surveillance and will greatly depend on the use case planned.
Application of neighborhood-scale wastewater-based epidemiology in low COVID-19 incidence situations
Authors: Oh Chamteut , Zhou Aijia , O’Brien Kate , Jamal Yusuf , Wennerdahl Hayden , Schmidt Arthur R , Shisler Joanna L. , Jutla Antarpreet , Schmidt Arthur R , Keefer Laura , Brown William M. , Nguyen Thanh H. 
Published: June 2022

AbstractWastewater-based epidemiology (WBE), an emerging approach for community-wide COVID-19 surveillance, was primarily characterized at large sewersheds such as wastewater treatment plants serving a large population. Although informed public health measures can be better implemented for a small population, WBE for neighborhood-scale sewersheds is less studied and not fully understood. This study applied WBE to seven neighborhood-scale sewersheds (average population of 1,471) from January to November, 2021. Community testing data showed an average of 0.004% incidence rate in these sewersheds (97% of monitoring periods reported two or fewer daily infections). In 92% of sewage samples, SARS-CoV-2 N gene fragments were below the limit of quantification. We statistically determined 10-2.6 as the threshold of the SARS-CoV-2 N gene concentration normalized to pepper mild mottle virus (N/PMMOV) to alert high COVID-19 incidence rate in the studied sewershed. This threshold of N/PMMOV identified neighborhood-scale outbreaks (COVID-19 incidence rate higher than 0.2%) with 82% sensitivity and 51% specificity. Importantly, neighborhood-scale WBE can discern local outbreaks that would not otherwise be identified by city-scale WBE. Our findings suggest that neighborhood-scale WBE is an effective community-wide disease surveillance tool when COVID-19 incidence is maintained at a low level.Graphical abstract
Structural mechanism of leaflet-specific phospholipid modulation of a pentameric ligand-gated ion channel
Authors: Petroff John T. , Deitzen Noah M. , Santiago-McRae Ezry , Deng Brett , Washington Maya S. , Chen Lawrence J. , Moreland K. Trent , Deng Zengqin , Rau Michael , Fitzpatrick James A. J. , Yuan Peng , Joseph Thomas T. , Hénin Jérôme , Brannigan Grace , Cheng Wayland W. L. 
Published: June 2022

ABSTRACTPentameric ligand-gated ion channels (pLGICs) mediate synaptic transmission and are sensitive to their lipid environment. The mechanism of phospholipid modulation of any pLGIC is not well understood. We demonstrate that the model pLGIC, ELIC (Erwinia ligand-gated ion channel), is positively modulated by the anionic phospholipid, phosphatidylglycerol, from the outer leaflet of the membrane. To elucidate the mechanism of phosphatidylglycerol modulation, we determine a structure of ELIC in an open conformation. The structure shows a bound phospholipid in an outer leaflet site, and conformational changes in the phospholipid binding site unique to the open state. In combination with streamlined alchemical free energy perturbation calculations and functional measurements in asymmetric liposomes, the data support a mechanism by which an anionic phospholipid stabilizes the open state of a pLGIC by specific, state-dependent binding to this site.