bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between carotid flow time and fluid responsiveness in children under general anesthesia
Authors: Lin Elaina E. , Glau Christie , Conlon Thomas W. , Chen Aaron E. , Kaplan Summer L. , Posada Adriana , Nishisaki Akira 
Published: June 2022

AbstractBackgroundFluid administration in children undergoing surgery requires precision, however, determining fluid responsiveness can be challenging. Ultrasound has been used widely in the emergency department and intensive care units as a noninvasive, bedside manner of determining volume status, but the intraoperative period presents unique challenges as often the chest and abdomen are inaccessible for ultrasound. We investigate whether carotid artery ultrasound, specifically carotid flow time, can be used to determine fluid responsiveness in children under general anesthesia.MethodsProspective observational study of 87 children ages 1–12 years who were scheduled for elective noncardiac surgery. Ultrasound of the carotid artery and heart was performed at three time points: (1) after inhalational induction of anesthesia with the subject spontaneously breathing, (2) during positive pressure ventilation through endotracheal tube or supraglottic airway with tidal volume set at 8 ml/kg with PEEP of 10 cmH2O, and (3) after a 10 ml/kg fluid bolus. Carotid flow time and cardiac output were measured from saved images.ResultsCorrected carotid flow time (FTc) increased with initiation of positive pressure ventilation in both fluid responders and nonresponders (352.7 vs. 365.3 msec, p = .005 in fluid responders; 348.3 vs. 365.2 msec, p = .001 in nonresponders). FTc increased after fluid bolus in both responders and nonresponders (365.3 vs. 397.6 msec, p < .001 in fluid responders; 365.2 vs. 397.2 msec, p < .001 in nonresponders). However, baseline FTc during spontaneous ventilation or positive pressure ventilation prior to fluid bolus was not associated with fluid responsiveness.DiscussionFlow time increases with initiation of positive pressure ventilation and after administration of a fluid bolus. FTc may serve as an indicator of fluid status but does not predict fluid responsiveness in children under general anesthesia.
Fluid bolus administration in children, who responds and how? A systematic review and meta‐analysis
Authors: Loomba Rohit S. , Villarreal Enrique G. , Farias Juan S. , Flores Saul , Bronicki Ronald A. 
Published: June 2022

AbstractBackgroundFluid boluses are frequently utilized in children. Despite their frequency of use, there is little objective data regarding the utility of fluid boluses, who they benefit the most, and what the effects are.AimsThis study aimed to conduct pooled analyses to identify those who may be more likely to respond to fluid boluses as well as characterize clinical changes associated with fluid boluses.MethodsA systematic review of the literature and meta‐analysis was conducted to identify pediatric studies investigating the response to fluid boluses and clinical changes associated with fluid boluses.ResultsA total of 15 studies with 637 patients were included in the final analyses with a mean age of 650 days ± 821.01 (95% CI 586 to 714) and a mean weight of 10.5 kg ± 7.19 (95% CI 9.94 to 11.1). The mean bolus volume was 12.14 ml/kg ± 4.09 (95% CI 11.8 to 12.5) given over a mean of 19.55 min ± 10.16 (95% CI 18.8 to 20.3). The following baseline characteristics were associated with increased likelihood of response [represented in mean difference (95% CI)]: greater age [207.2 days (140.8 to 273.2)], lower cardiac index [−0.5 ml/min/m2 (−0.9 to −0.3)], and lower stroke volume [−5.1 ml/m2 (−7.9 to −2.3)]. The following clinical parameters significantly changed after a fluid bolus: decreased HR [−5.6 bpm (−9.8 to −1.3)], increased systolic blood pressure [7.7 mmHg (1.0 to 14.4)], increased mean arterial blood pressure [5.5 mmHg (3.1 to 7.8)], increased cardiac index [0.3 ml/min/m2 (0.1 to 0.6)], increased stroke volume [4.3 ml/m2 (3.5 to 5.2)], increased central venous pressure [2.2 mmHg (1.1 to 3.3)], and increased systemic vascular resistance [2.1 woods units/m2 (0.1 to 4.2)].ConclusionFluid blouses increase arterial blood pressure or cardiac output by 10% in approximately 56% of pediatric patients. Fluid blouses lead to significant decrease in HR and significant increases in cardiac output, stroke volume, and systemic vascular resistance. Limited published data are available on the effects of fluid blouses on systemic oxygen delivery.
Clearance of atypical cutaneous manifestations of hyper‐IgE syndrome with dupilumab
Authors: Nihal Aman , Comstock Jeanette R. , Holland Kristen E. , Singh Anne Marie , Seroogy Christine M. , Arkin Lisa M. 
Published: June 2022

AbstractHyper‐IgE syndromes (HIES) are a heterogeneous group of rare primary immunodeficiency diseases classically characterized by the triad of atopic dermatitis, and recurrent cutaneous and pulmonary infections. Autosomal dominant, loss‐of‐function STAT3 pathogenic variants are the most common genetic cause, which lead to deficiency of Th17 lymphocytes, impaired interferon gamma production, and IL‐10 signal transduction, and an unbalanced IL‐4 state. Dupilumab, a monoclonal antibody to the IL‐4a receptor, inhibits both IL‐4 and IL‐13, and has been shown to improve atopic dermatitis and other manifestations of HIES including asthma and allergic bronchopulmonary aspergillosis. We present a pediatric patient with HIES who presented predominantly with eosinophilic folliculitis, recurrent cutaneous infections, and other non‐eczematous findings and achieved sustained clearance with dupilumab.
Evaluation of 1H‐NMR Spectroscopy‐Based Quantification Methods of the Supramolecular Aggregation of a Molecular Photosensitizer†
Authors: Pehlken Christian , Pfeffer Michael G. , Reich Katharina , Rau Sven 
Published: June 2022

AbstractThe supramolecular dimerization of a ruthenium polypyridyl precursor of a well‐developed family of hydrogen‐evolving photocatalysts via π–π interactions of the polyheteroaromatic bridging ligand was quantified with concentration‐dependent 1H‐NMR spectroscopy. The data sets were analyzed with different calculation and fit methods. A comparison between the results of direct calculation and linear and nonlinear approaches showed that the application of a global nonlinear fit procedure yields the best results. The presented methods are also applicable for dimerization processes in the solution of other molecular moieties.
Arbuscular mycorrhizal fungi: Effects on secondary metabolite accumulation of traditional Chinese medicines
Authors: Ran Z. , Ding W. , Cao S. , Fang L. , Zhou J. , Zhang Y. 
Published: June 2022

AbstractTraditional Chinese medicine (TCM) has played a pivotal role in maintaining the health of people, and the intrinsic quality of TCM is directly related to the clinical efficacy. The medicinal ingredients of TCM are derived from the secondary metabolites of plant metabolism and are also the result of the coordination of various physiological activities in plants. Arbuscular mycorrhizal fungi (AMF) are among the most ubiquitous plant mutualists that enhance the growth and yield of plants by facilitating the uptake of nutrients and water. Symbiosis of AMF with higher plants promotes growth and helps in the accumulation of secondary metabolites. However, there is still no systematic analysis and summation of their roles in the application of TCM, biosynthesis and accumulation of active substances of herbs, as well as the mechanisms. AMF directly or indirectly affect the accumulation of secondary metabolites of TCM, which is the focus of this review. First, in this review, the effects of AMF symbiosis on the content of different secondary metabolites in TCM, such as phenolic acids, flavonoids, alkaloids and terpenoids, are summarized. Moreover, the mechanism of AMF regulating the synthesis of secondary metabolites was also considered, in combination with the establishment of mycorrhizal symbionts, response mechanisms of plant hormones, nutritional elements and expression of key enzyme their activities. Finally, combined with the current application prospects for AMF in TCM, future in‐depth research is planned, thus providing a reference for improving the quality of TCM. In this manuscript, we review the research status of AMF in promoting the accumulation of secondary metabolites in TCM to provide new ideas and methods for improving the quality of TCM.
Social network subtypes among socially disconnected older adults at risk for suicide: A latent class analysis
Authors: Parkhurst Kimberly A. , Daks Jennifer S. , Conwell Yeates , Podgorski Carol A. , Van Orden Kimberly A. 
Published: June 2022

AbstractObjectivesWe sought to characterize the social networks of older adults who report feeling lonely or like a burden on others, psychological states that are associated with risk for suicide according to the Interpersonal Theory of Suicide.MethodsWe used a latent class analysis to identify distinct groups of older adults based on social network characteristics and perceptions of their networks within a sample of older adults endorsing loneliness and/or feeling like a burden. We examined associations between class membership and mental health outcomes.ResultsFour network types were identified: small, cohabitating networks with daily contact; moderate‐sized family‐oriented networks with multiple contacts weekly; moderate‐sized friend‐oriented networks with weekly contact; and average‐sized mixed networks with weekly contact. The friend‐oriented class reported the greatest loneliness, perceived burden, and lifetime prevalence of suicidal ideation and attempts.ConclusionsSocial network composition may be more explanatory of loneliness and perceived burden than number of members alone. Profile differences in outcomes suggest utilizing tailored social connectedness interventions. Individuals with small‐to‐moderate networks may benefit most from interventions designed to build friendships. Individuals with many close confidants may benefit most from psychotherapy. Individuals reporting moderately frequent contact with moderately‐sized networks may benefit from both intervention types.
Can a measurement error perspective improve estimation in neighborhood effects research? A hierarchical Bayesian methodology
Authors: Mayer Duncan J. , Fischer Robert L. 
Published: June 2022

AbstractObjectiveNeighborhood effects research often employs aggregate data at small geographic areas to understand neighborhood processes. This article investigates whether empirical applications of neighborhood effects research benefit from a measurement error perspective.MethodsThe article situates neighborhood effects research in a measurement error framework and then details a Bayesian methodology capable of addressing measurement concerns. We compare the proposed model to conventional linear models on crime data from Detroit, Michigan, as well as two simulated examples that closely mirror the sampling process.ResultsThe Detroit data example shows that the proposed model makes substantial differences to parameters of interest and reduces the mean squared error. The simulations confirm the benefit of the proposed model, regularly recovering parameters and conveying uncertainty where conventional linear models fail.ConclusionA measurement error perspective can improve estimation for data aggregated at small geographic areas.
Identifying critical DO2 with compensatory reserve during simulated hemorrhage in humans
Authors: Koons Natalie J. , Moses Catherine D. , Thompson Patrick , Strandenes Geir , Convertino Victor A. 
Published: June 2022

AbstractBackgroundBased on previous experiments in nonhuman primates, we hypothesized that DO2crit in humans is 5–6 ml O2·kg−1 min−1.Study Design and MethodsWe measured the compensatory reserve (CRM) and calculated oxygen delivery (DO2) in 166 healthy, normotensive, nonsmoking subjects (97 males, 69 females) during progressive central hypovolemia induced by lower body negative pressure as a model of ongoing hemorrhage. Subjects were classified as having either high tolerance (HT; N = 111) or low tolerance (LT; N = 55) to central hypovolemia.ResultsHT and LT groups were matched for age, weight, BMI, and vital signs, DO2 and CRM at baseline. The CRM‐DO2 relationship was best fitted to a logarithmic model in HT subjects (amalgamated R2 = 0.971) and a second‐order polynomial model in the LT group (amalgamated R2 = 0.991). Average DO2crit for the entire subject cohort was estimated at 5.3 ml O2·kg−1 min−1, but was ~14% lower in HT compared with LT subjects. The reduction in DO2 from 40% CRM to 20% CRM was 2‐fold greater in the LT compared with the HT group.ConclusionsAverage DO2crit in humans is 5.3 ml O2·kg−1 min−1, but is ~14% lower in HT compared with LT subjects. The CRM‐DO2 relationship is curvilinear in humans, and different when comparing HT and LT individuals. The threshold for an emergent monitoring signal should be recalibrated from 30% to 40% CRM given that the decline in DO2 from 40% CRM to 20% CRM for LT subjects is located on the steepest part of the CRM‐DO2 relationship.
Severity of nasopharyngeal collapse before and after corrective upper airway surgery in brachycephalic dogs
Authors: Clarke Dana L. , Reetz Jennifer A. , Drobatz Kenneth J. , Holt David E. 
Published: June 2022

AbstractObjectiveTo determine the severity of nasopharyngeal collapse in brachycephalic dogs before and after corrective airway surgery.AnimalsTwenty‐three brachycephalic dogs (21 with clinical signs referrable to the upper airway) and nine clinically normal nonbrachycephalic dogs (controls).MethodsDogs were evaluated with fluoroscopy awake and standing with the head in a neutral position. The magnitude of nasopharyngeal collapse was measured as the maximum reduction in the dorsoventral dimension of the nasopharynx during respiration and expressed as a percentage. Brachycephalic dogs were anesthetized, the airway evaluated, and corrective upper airway surgery (alaplasty, staphylectomy, sacculectomy, tonsillectomy) was performed. A cohort (n = 11) of the surgically treated brachycephalic dogs had fluoroscopy repeated a minimum of 6 weeks after surgery.ResultsMedian preoperative reduction in the dorsoventral dimensions of the nasopharynx was greater in brachycephalic dogs (65%; range: 8–100%) than in controls (10%; range: 1–24%,p = .0001). Surgery did not improve the reduction in dorsoventral diameter of the nasopharynx during respiration in brachycephalic dogs (n = 11) postoperatively (p = .0505).Conclusion and clinical significanceNasopharyngeal collapse was a common and sometimes severe component of brachycephalic airway obstruction syndrome in the cohort of dogs evaluated. The lack of significant postoperative improvement may represent a type II error, a failure to adequately address anatomical abnormalities that increase resistance to airflow, or inadequate upper airway dilator muscle function in some brachycephalic dogs.
One Health Consensus Report Annotation Checklist (OH‐CRAC): A cross‐sector checklist to support harmonized annotation of surveillance data in reports
Authors: Lopez de Abechuco Estibaliz , Dórea Fernanda , Buschhardt Tasja , Scaccia Nazareno , Günther Taras , Foddai Alessandro , Dups‐Bergmann Johanna , Filter Matthias 
Published: June 2022

AbstractTo facilitate cross‐sector integration of surveillance data it is necessary to improve and harmonize the meta‐information provided in surveillance data reports. Cross‐sector integration of surveillance results in sector‐specific reports is frequently difficult as reports with a focus on a single sector often lack aspects of the relevant meta‐information necessary to clarify the surveillance context. Such reporting deficiencies reduce the value of surveillance reports to the One Health community. The One Health Consensus Report Annotation Checklist (OH‐CRAC), described in this paper along with potential application scenarios, was developed to improve the current practice of annotating data presented in surveillance data reports. It aims to provide guidance to researchers and reporting officers on what meta‐information should be collected and provided to improve the completeness and transparency of surveillance data reports. The OH‐CRAC can be adopted by all One Health‐related sectors and due to its cross‐sector design, it supports the mutual mapping of surveillance meta‐information from sector‐specific surveillance reports on federal, national and international levels. To facilitate the checklist completion, OH‐CRAC is also available as an online resource that allows the collection of surveillance meta‐information in an easy and user‐friendly manner. Completed OH‐CRAC checklists can be attached as annexes to the corresponding surveillance data reports or even to individual data files regardless of the data source. In this way, reports and data become better interpretable, usable and comparable to information from other sectors, improving their value for all surveillance actors and providing a better foundation for advice to risk managers.
COVID‐19 coagulopathy – what should we treat?
Authors: Chowdary Pratima 
Published: June 2022

New Findings
What is the topic of this review?
Overview of the coagulation abnormalities, including elevated D‐dimers widely reported with COVID‐19, often labelled as COVID coagulopathy.

What advances does it highlight?
The review highlights the changes in bronchoalveolar haemostasis due to apoptosis of alveolar cells, which contributes to acute lung injury and acute respiratory distress syndrome; the pathophysiological mechanisms, including endothelial dysfunction and damage responsible for thrombosis of pulmonary microcirculation and potential contribution to the hypoxaemia of COVID‐19 acute lung injury; and changes in coagulation proteins responsible for the hypercoagulability and increased risk of thrombosis in other venous and arterial beds. The rationale for anticoagulation and fibrinolytic therapies is detailed, and potential confounders that might have led to less than expected improvement in the various randomised controlled trials are considered.

AbstractCoronavirus disease 19 (COVID‐19) causes acute lung injury with diffuse alveolar damage, alveolar–capillary barrier disruption, thrombin generation and alveolar fibrin deposition. Clinically, hypoxaemia is associated with preserved lung compliance early in the disease, suggesting the lack of excessive fluid accumulation typical of other lung injuries. Notably, autopsy studies demonstrate infection of the endothelium with extensive capillary thrombosis distinct from the embolic thrombi in pulmonary arteries. The inflammatory thrombosis in pulmonary vasculature secondary to endothelial infection and dysfunction appears to contribute to hypoxaemia. This is associated with elevated D‐dimers and acquired hypercoagulability with an increased risk of deep vein thrombosis. Hypercoagulability is secondary to elevated plasma tissue factor levels, von Willebrand factor, fibrinogen, reduced ADAMTS‐13 with platelet activation and inhibition of fibrinolysis. Multi‐platform randomised controlled studies of systemic therapeutic anticoagulation with unfractionated and low molecular mass heparins demonstrated a survival benefit over standard care with full‐dose anticoagulation in patients with non‐severe disease who require supplemental oxygen, but not in severe disease requiring ventilatory support. Late intervention and the heterogeneous nature of enrolled patients can potentially explain the apparent lack of benefit in severe disease. Improvement in oxygenation has been demonstrated with intravenous fibrinolytics in small studies. Inhaled anticoagulants, thrombolytic agents and non‐specific proteolytic drugs in clinical trials for decreasing alveolar fibrin deposition might benefit early disease. Essentially, COVID‐19 is a multi‐system disorder with pulmonary vascular inflammatory thrombosis that requires an interdisciplinary approach to combination therapies addressing both inflammation and intravascular thrombosis or alveolar fibrin deposits to improve outcomes.
Las palabras pintadas de Comalapa: ts’íib en la obra de Negma Coy y Edgar Calel
Authors: Worley Paul M. , Palacios Rita 
Published: June 2022

Este ensayo examina la obra de los autores-artistas Negma Coy y Edgar Calel, originarios de Chi Xot (San Juan Comalapa, Chimaltenango, Guatemala), a través del ts’íib. Irma Otzoy, Gaspar Pedro González y Pedro Uc Be, intelectuales mayas, explican el ts’íib como una producción artística que rebasa los límites de la palabra escrita. El ts’íib revela la palabra escrita, la grafía latina específicamente, como un instrumento más dentro de otras textualidades que participan en la creación de se mismo espacio de deleite y aprendizaje.
Exploring the psychological impact of working during COVID-19 on medical and nursing students: a qualitative study
Authors: Griffin Louise , Riley Ruth 
Published: June 2022

ObjectivesTo identify the psychological impact of working during the COVID-19 pandemic on medical and nursing students’ psychological well-being. To inform recommendations for the provision of future student well-being support.DesignAn interpretative qualitative, semistructured interview study employing maximum variation sampling, snowball sampling and a thematic analysis.SettingA large West Midlands (UK) university with medical and nursing undergraduate and postgraduate programmes. Study undertaken between January and May 2020.ParticipantsA purposive sample of eight medical (six women and two men) and seven nursing (all women) students who worked >2 weeks in a healthcare setting during the COVID-19 pandemic (from 1 March 2020 onwards).ResultsFour core themes with corresponding subthemes were identified: (1) COVID-19 sources of distress—working conditions, exposure to suffering, death and dying, relationships and teams, individual inexperience and student identity, (2) negative impact on mental health and well-being—psychological and emotional distress, delayed distress, exhaustion, mental ill health, (3) protective factors from distress—access to support, environment, preparation and induction, recognition and reward, time for breaks and rest and (4) positive experiences and meaningful outcomes.ConclusionsStudent pandemic deployment has had a significant negative impact on students’ psychological well-being, as a result of demanding working conditions, unprecedented exposure to death and suffering and lack of preparation for new job roles. Universities and healthcare organisations must formally acknowledge this impact and provide well-being support for distressed students working in such challenging contexts. They must also establish more supportive and inclusive healthcare environments for medical and nursing students in future pandemic and postpandemic circumstances, through the implementation of support systems and adequate preparation.