bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative analgesia in patients undergoing laparoscopic hernia repair
Authors: Wu Yu , Cai Zenghua , Li Yanli , Kang Yuling , Fu Bohan , Wang Jinbao 
Published: May 2022

Abstract

Objective:
To observe the effect of Ketorolac tromethamine combined with dezocine prior administration on hemodynamics and postoperative sedation in patients undergoing laparoscopic hernia repair.

Methods:
100 male patients aged 60 to 80 years old, a line to elective laparoscopic inguinal hernia repair, were randomly divided into four groups: control group (Group A) and dezocine group (Group B), ketorolac tromethamine group (Group C), ketorolac tromethamine combined with dezocine group (Group D). Patients were administrated with 0.1 mg/kg dezocine in Group B, 0.5 mg/kg ketorolac in Group C, 0.1 mg/kg dezocine, and 0.5 mg/kg ketorolac in Group D, and with an equal dose of normal saline in group A. The heart rate (HR) and mean arterial pressure (MAP) of patients in 4 groups were recorded at each time point as follows, T0 (enter the operating room), T1 (before skin resection), 10 min after pneumoperitoneum (T2), mesh placement (T3), and laryngeal mask extraction (T4). Operation time, awakening time (time from drug withdrawal to consciousness recovery), the dosage of propofol, sufentanil, remifentanil, and intraoperative vasoactive drug dosage were recorded to compare. Visual analog scale score and sedation Ramsay score were evaluated 1, 6, 12, and 24 hours after extubation.

Results:
There was no significant difference in operation time, anesthesia recovery time, sufentanil dosage, and vasoactive drugs among all groups. The amount of propofol in Group B and D was less than that in Group A and C (P < .05), and there was no difference between Group B and D, A and C (P > .05). The amount of remifentanil in Group B, C, and D was less than that in Group A (P < .05), and Group D was less than B and C (P < .05). After extubation, HR and MAP were significantly higher than before (P < .05). Compared with T0, HR and MAP increased in each group at T4, but MAP and HR in Group D increased the least (P < .05). There were significant differences between Group B, C, D, and A, MAP and HR fluctuated little during extubation (P < .05), but there was a significant difference between Group D and B, C (P < .05). Visual analog scale scores of Group B, C, and D were lower than those of A at 1, 6, and 12 hours after surgery (P < .05), and there was a significant difference between Group D, and B, C (P < .05). Ramsay scores in Group B and D were higher than those in A and C at 1 and 6 hours after the operation (P < .05). There was no difference in the incidence of adverse reactions among groups.

Conclusion:
The prophylactic use of ketorolac tromethamine and dezocine before laparoscopic inguinal hernia repair can reduce hemodynamic disorder during anesthesia recovery, increase postoperative sedative and analgesic effects.
Miller Fisher syndrome after COVID-19 vaccination: Case report and review of literature
Authors: Siddiqi Ahsun Rizwan , Khan Tehrim , Tahir Muhammad Junaid , Asghar Muhammad Sohaib , Islam Md. Saiful , Yousaf Zohaib 
Published: May 2022

Abstract

Rationale:
Miller Fisher syndrome (MFS) is a rare variant of Guillain-Barre syndrome, classically diagnosed based on the clinical triad of ataxia, areflexia, and ophthalmoplegia. MFS is usually preceded by viral infections and febrile illness; however, only a few cases have been reported after vaccinations.

Patient concerns:
A 53-year-old hypertensive male presented with a 2-day history of progressive ascending paralysis of the lower limbs along with diplopia and ataxia, 8 days after the first dose of the Sinovac–Coronavac coronavirus disease 2019 (COVID-19) vaccination, with no prior history of any predisposing infections or triggers.

Diagnoses:
Physical examination showed moderate motor and sensory loss with areflexia in the lower limbs bilaterally. Routine blood investigations and radiological investigations were unremarkable. Cerebrospinal fluid analysis showed albuminocytologic dissociation and nerve conduction studies revealed prolonged latencies with reduced conduction velocities. The diagnosis of MFS was established based on the findings of physical examination, cerebrospinal fluid analysis, and nerve conduction studies.

Interventions:
A management plan was devised based on intravenous immunoglobulins, pregabalin, and physiotherapy. However, due to certain socioeconomic factors, the patient was managed conservatively with regular physiotherapy sessions.

Outcomes:
Follow-up after 6 weeks showed remarkable improvement, with complete resolution of symptoms 10 weeks after the discharge.

Lessons:
This case suggests that MFS is a rare adverse effect after COVID-19 vaccination and additional research is required to substantiate a temporal association. Further studies are needed to understand the pathophysiology behind such complications to enhance the safety of COVID-19 vaccinations in the future.
Newly Licensed Nurse Perceived Incivility: A Valid and Reliable Assessment Tool
Authors: Agee Emily , Boots Brenda K. , Cantu Chelcia , Hunley Amber N. , Mains Brandi C. , McElroy Susan , Oertle Dena L. , Olney Adrienne , Pontius Camie , Schotte Amy L. 
Published: May 2022

OBJECTIVE
To test the instrument, Nursing Student Perception of Civil and Uncivil Behaviors (NSPCUB) in newly licensed nurses' (NLNs') to create a credible measure of NLNs' perceptions of civil/uncivil behaviors by RNs.

BACKGROUND
Uncivil behaviors in the workplace result in poor morale, absenteeism, and turnover. When targeted toward NLNs, the outcome of these behaviors can affect not only a job but a future career.

METHODS
A convenience sample of NLNs from 3 cohorts completed the modified NSPCUB-NLN 12-item survey. Exploratory factor analysis and reliability statistics were conducted. Concurrent validity was evaluated.

RESULTS
Exploratory factor analysis identified passive and active incivility subscales with high reliability (overall Cronbach's α = 0.917). Participants expressing positive experiences scored higher than those with negative experiences (P < 0.0001), supporting instrument validity.

CONCLUSIONS
This study demonstrated that the NSPCUB-NLN is a valid and reliable instrument for use with NLNs. This will assist nurse leaders in evaluating unit cultures for incivility, guiding interventions for a healthy work environment.
Opioid agonist treatment improves progression through the HIV cascade of care among people living with HIV who use unregulated opioids
Authors: Juwono Stephen , Milloy M.-J. , Choi JinCheol , Fairbairn Nadia , Nolan Seonaid , Socías M. Eugenia 
Published: May 2022

Objectives:
Opioid agonist treatment (OAT) has been shown to improve certain HIV-related treatment measures among people with HIV (PHIV) with opioid use disorder (OUD). However, there is limited data on the impacts of OAT along the whole HIV cascade of care.

Design and Methods:
Using data from an ongoing cohort of PHIV who use drugs in Vancouver, Canada, we used cumulative link mixed-effects models to estimate the independent effect of OAT on achieving progressive steps in the HIV cascade among participants using unregulated opioids daily, after adjusting for confounders.

Results:
Between 2005 and 2017, we recruited 639 PHIV regularly using opioids (median age 42 years, 59% male, 56% White), of whom 70% were on OAT at their baseline visit. Engagement in OAT showed a nonsignificant trend with higher linkage to HIV care (adjusted partial proportional odds ratio [APPO] = 1.75, 95% confidence interval [CI]: 0.83–3.69), and significantly higher cumulative odds of successfully achieving subsequent HIV cascade steps: on ART (APPO = 3.85, 95% CI: 2.33–6.37); adherent to ART (APPO = 3.15, 95% CI: 2.15–4.62); and HIV viral suppression (APPO = 2.18, 95% CI: 1.51–3.14).

Conclusions:
This study found a high level of OAT engagement among PHIV using unregulated opioids and that OAT engagement resulted in significantly increased progression through some of the higher steps of the HIV cascade. While these findings are encouraging, they highlight the need to reach populations off OAT to maximize the clinical and community-level benefits of ART.
Adverse perinatal outcomes associated with HAART and monotherapy: systematic review and meta-analysis
Authors: Portwood Clara , Sexton Harriet , Kumarendran Mary , Brandon Zoe , Kirtley Shona , Hemelaar Joris 
Published: May 2022

Objectives:
Assess adverse perinatal outcomes in women living with HIV (WLHIV) receiving HAART or zidovudine (ZDV) monotherapy, compared with antiretroviral therapy (ART)-naive WLHIV and HIV-negative women.

Design:
Systematic review and meta-analysis.

Methods:
We conducted a systematic literature review by searching PubMed, CINAHL, Global Health, and EMBASE for studies published during 1 January 1980 to 20 April 2020. We included studies reporting on the association of pregnant WLHIV receiving HAART or ZDV monotherapy with 11 perinatal outcomes: preterm birth (PTB), very PTB, spontaneous PTB (sPTB), low birth weight (LBW), very LBW, term LBW, preterm LBW, small for gestational age (SGA), very SGA (VSGA), stillbirth, and neonatal death. Random-effects meta-analyses were conducted.

Results:
Sixty-one cohort studies assessing 409 781 women were included. WLHIV receiving ZDV monotherapy were associated with a decreased risk of PTB [relative risk 0.70, 95% confidence interval (CI) 0.62–0.79] and LBW (0.77, 0.67–0.88), and comparable risk of SGA, compared with ART-naive WLHIV. WLHIV receiving ZDV monotherapy had a comparable risk of PTB and LBW, and an increased risk of SGA (1.16, 1.04–1.30) compared with HIV-negative women. In contrast, WLHIV receiving HAART were associated with a comparable risk of PTB and LBW, and increased risk of SGA (1.38, 1.09–1.75), compared with ART-naive WLHIV. WLHIV receiving HAART were associated with an increased risk of PTB (1.55, 1.38–1.74), sPTB (2.09, 1.48–2.96), LBW (1.79, 1.51–2.13), term LBW (1.88, 1.23–2.85), SGA (1.80,1.34–2.40), and VSGA (1.22, 1.10–1.34) compared with HIV-negative women.

Conclusion:
Pregnant WLHIV receiving HAART have an increased risk of a wide range of perinatal outcomes compared with HIV-negative women.
Incident depression among Medicare beneficiaries with disabilities and HIV
Authors: Yu Xiaoying , Baillargeon Jacques , Berenson Abbey B. , Westra Jordan R. , Giordano Thomas P. , Kuo Yong-Fang 
Published: May 2022

Objective:
Despite disproportionally high prevalence of HIV and depression in persons with disabilities, no data have been published on the incidence and correlates of depression in Medicare beneficiaries with disabilities. We assessed the effect of HIV infection on developing depression in this population.

Design:
We conducted a retrospective matched cohort study using a 5% sample of Medicare beneficiaries who qualified for disability coverage (1996–2015).

Methods:
Beneficiaries with incident (n = 2438) and prevalent (n = 5758) HIV were individually matched with beneficiaries without HIV (HIV−, n = 20 778). Fine-Gray models with death as a competing risk were used to assess the effect of HIV status, age, and cohort period on developing depression by sex strata.

Results:
Beneficiaries with HIV had a higher risk of developing depression within 5 years (P < 0.0001). Sex differences were observed (P < 0.0001), with higher subdistribution hazard ratios (sHR) in males with HIV compared with controls. The risk decreased with age (P < 0.0001) and increased in recent years (P < 0.0001). There were significant age-HIV (P = 0.004) and period-HIV (P = 0.006) interactions among male individuals, but not female individuals. The sHR was also higher within the first year of follow-up among male individuals, especially those with incident HIV.

Conclusion:
Medicare enrollees with disabilities and HIV had an increased risk of developing depression compared to those without HIV, especially among males and within the first year of HIV diagnosis. The HIV-depression association varied by sex, age, and cohort period. Our findings may help guide screening and comprehensive management of depression among subgroups in this vulnerable population.
Proof of concept study for a closed ex vivo limb perfusion system for 24-hour subnormothermic preservation using acellular perfusate
Authors: Veraza Rafael J. , Lopez Riley , Parry Olivia , Sleeter Justin , Cano Isabella , Bohara Udipta , Merlo Jaclyn , Jessop Israel , Weitzel Erik , Bunegin Leonid 
Published: May 2022

BACKGROUND
The two approaches to vascularized tissue machine perfusion use either the open (nonpressurized) or closed (pressurized) perfusion system. Most studies describing isolated limb perfusion preservation rely on open perfusion systems and report tissue edema exceeding 40% after 12 to 14 hours of preservation. A variant of machine perfusion places the limb and perfusate into a reservoir closed to atmosphere. It is hypothesized that the reservoir pressure, acting as a transmural pressure, has the advantage of reducing edema formation by counteracting the hydrostatic pressure gradient from the perfusion pressure. This proof-of-concept study aim was to demonstrate feasibility of the Universal Limb Stasis System for Extended Storage (ULiSSES) device (closed, vertical perfusion system) to preserve forelimbs of Sus scrofa swine for 24 hours of subnormothermic perfusion compared with an open, horizontal perfusion system. The ULiSSES is a compact, practical device that applies pulsatile, pressurized perfusion through the novel use of a diaphragm pump powered by compressed oxygen.

METHODS
Forelimbs from swine were preserved in ULiSSES device (closed perfusion system) (n = 9) and in an open perfusion system (n = 4) using subnormothermic modified Krebs-Henseleit solution. Physiological parameters were measured at the start and every 3 hours for 24 hours. Limbs were weighed before and after perfusion to compare weight gain. Edema and cellular integrity were evaluated using histopathology pre and post perfusion.

RESULTS
Closed perfusion system showed superiority compared with the open perfusion system in terms of oxygen consumption, reduction in vascular resistance, and overall tissue integrity. The closed perfusion system demonstrated a 21% reduction in weight gain compared with the open perfusion system and significantly reduced intracellular edema.

CONCLUSION
The ULiSSES closed, pressurized perfusion technology has translatable military applications with the potential to preserve porcine limbs for 24 hours with improved results compared with an open perfusion system.
County-level Differences in Liver-related Mortality, Waitlisting, and Liver Transplantation in the United States
Authors: Cannon Robert M. , Nassel Ariann , Walker Jeffery T. , Sheikh Saulat S. , Orandi Babak J. , Shah Malay B. , Lynch Raymond J. , Goldberg David S. , Locke Jayme E. 
Published: May 2022

Background.
Much of our understanding regarding geographic issues in transplantation is based on statistical techniques that do not formally account for geography and is based on obsolete boundaries such as donation service area.

Methods.
We applied spatial epidemiological techniques to analyze liver-related mortality and access to liver transplant services at the county level using data from the Centers for Disease Control and Prevention and Scientific Registry of Transplant Recipients from 2010 to 2018.

Results.
There was a significant negative spatial correlation between transplant rates and liver-related mortality at the county level (Moran’s I, –0.319; P = 0.001). Significant clusters were identified with high transplant rates and low liver-related mortality. Counties in geographic clusters with high ratios of liver transplants to liver-related deaths had more liver transplant centers within 150 nautical miles (6.7 versus 3.6 centers; P < 0.001) compared with all other counties, as did counties in geographic clusters with high ratios of waitlist additions to liver-related deaths (8.5 versus 2.5 centers; P < 0.001). The spatial correlation between waitlist mortality and overall liver-related mortality was positive (Moran’s I, 0.060; P = 0.001) but weaker. Several areas with high waitlist mortality had some of the lowest overall liver-related mortality in the country.

Conclusions.
These data suggest that high waitlist mortality and allocation model for end-stage liver disease do not necessarily correlate with decreased access to transplant, whereas local transplant center density is associated with better access to waitlisting and transplant.
Altered dynamical integration/segregation balance during anesthesia-induced loss of consciousness
Authors: Lord Louis-David , Carletti Timoteo , Fernandes Henrique , Turkheimer Federico E. , Expert Paul 
Published: May 2022

AbstractIn recent years, brain imaging studies have begun to shed light on the neural correlates of physiologically-reversible altered states of consciousness such as deep sleep, anesthesia, psychedelic experiences. The emerging consensus is that normal waking consciousness requires the exploration of a dynamical repertoire enabling both global integration i.e. long-distance interactions between brain regions, and segregation, i.e. local processing in functionally specialized clusters. Altered states of consciousness have notably been characterized by a tipping of the integration/segregation balance away from this equilibrium. Historically, functional MRI (fMRI) has been the modality of choice for such investigations. However, fMRI does not enable characterization of the integration/segregation balance at sub-second temporal resolution. Here, we investigated global brain spatiotemporal patterns in electrocorticography (ECoG) data of a monkey (Macaca fuscata) under either ketamine or propofol general anaesthesia. We first studied the effects of these anesthetics from the perspective of band-specific synchronization across the entire ECoG array, treating individual channels as oscillators. We further aimed to determine whether synchrony within spatially localized clusters of oscillators was differently affected by the drugs in comparison to synchronization over spatially distributed subsets of ECoG channels, thereby quantifying changes in integration/segregation balance on physiologically-relevant time scales. The findings reflect global brain dynamics characterized by a loss of long-range integration in multiple frequency bands under both ketamine and propofol anaesthesia, most pronounced in the beta (13-30Hz) and low-gamma bands (30-80Hz), and with strongly preserved local synchrony in all bands.
TRAUMA AND CUE-ASSOCIATED WORKING MEMORY DEFICITS IN A RAT MODEL OF POSTTRAUMATIC STRESS DISORDER
Authors: McGonigle C. E. , Lapish C. C. , Logrip M. L. 
Published: May 2022

ABSTRACTPosttraumatic stress disorder (PTSD) is associated with a variety of neural and behavioral alterations in response to trauma exposure, including working memory impairments. Rodent models of PTSD have not fully investigated chronic or reactive working memory deficits, despite clinical relevance. The present study utilizes footshock trauma to induce a posttraumatic stress state in rats and evaluates the effect of trauma and trauma-paired odor cues on working memory performance in the odor span task. Results demonstrate the emergence of chronic deficits in working memory among traumatized animals by three weeks post-trauma. The presentation of a trauma-paired odor cue was associated with further decrement in working memory performance. Further, anxiety-like behaviors indicative of PTSD can predict the degree of working memory impairment in response to the trauma-paired odor cue. This study enhances validation of an existing rodent model of PTSD through replication of the clinical observations of working memory deficits associated with PTSD. This will facilitate future work to probe underlying mechanistic dysregulation of working memory following trauma exposure and for future development of novel treatment strategies.
Further antibody escape by Omicron BA.4 and BA.5 from vaccine and BA.1 serum
Authors: Tuekprakhon Aekkachai , Huo Jiandong , Nutalai Rungtiwa , Dijokaite-Guraliuc Aiste , Zhou Daming , Ginn Helen M. , Selvaraj Muneeswaran , Liu Chang , Mentzer Alexander J. , Supasa Piyada , Duyvesteyn Helen M.E. , Das Raksha , Skelly Donal , Ritter Thomas G. , Amini Ali , Bibi Sagida , Adele Sandra , Johnson Sile Ann , Constantinides Bede , Webster Hermione , Temperton Nigel , Klenerman Paul , Barnes Eleanor , Dunachie Susanna J. , Crook Derrick , Pollard Andrew J , Lambe Teresa , Goulder Philip ,   OPTIC consortium,   ISARIC4C consortium, Fry Elizabeth E. , Mongkolsapaya Juthathip , Ren Jingshan , Stuart David I. , Screaton Gavin R 
Published: May 2022

SummaryThe Omicron lineage of SARS-CoV-2, first described in November 2021, spread rapidly to become globally dominant and has split into a number of sub-lineages. BA.1 dominated the initial wave but has been replaced by BA.2 in many countries. Recent sequencing from South Africa’s Gauteng region uncovered two new sub-lineages, BA.4 and BA.5 which are taking over locally, driving a new wave. BA.4 and BA.5 contain identical spike sequences and, although closely related to BA.2, contain further mutations in the receptor binding domain of spike. Here, we study the neutralization of BA.4/5 using a range of vaccine and naturally immune serum and panels of monoclonal antibodies. BA.4/5 shows reduced neutralization by serum from triple AstraZeneca or Pfizer vaccinated individuals compared to BA.1 and BA.2. Furthermore, using serum from BA.1 vaccine breakthrough infections there are likewise, significant reductions in the neutralization of BA.4/5, raising the possibility of repeat Omicron infections.
Modeling suggests that multiple immunizations or infections will reveal the benefits of updating SARS-CoV-2 vaccines
Authors: Desikan Rajat , Linderman Susanne L. , Davis Carl , Zarnitsyna Veronika , Ahmed Hasan , Antia Rustom 
Published: May 2022

AbstractWhen should vaccines to evolving pathogens such as SARS-CoV-2 be updated? Our computational models address this focusing on updating SARS-CoV-2 vaccines to the currently circulating Omicron variant. Current studies typically compare the antibody titers to the new variant following a single dose of the original-vaccine versus the updated-vaccine in previously immunized individuals. These studies find that the updated-vaccine does not induce higher titers to the vaccine-variant compared with the original-vaccine, suggesting that updating may not be needed. Our models recapitulate this observation but suggest that vaccination with the updated-vaccine generates qualitatively different humoral immunity, a small fraction of which is specific for unique epitopes to the new variant. Our simulations suggest that these new variant-specific responses could dominate following subsequent vaccination or infection with either the currently circulating or future variants. We suggest a two-dose strategy for determining if the vaccine needs updating and for vaccinating high-risk individuals.