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Delay in Hip Fracture Repair in the Elderly: A Missed Opportunity Towards Achieving Better Outcomes.

J Surg Res 2021 May 11;266:142-147. Epub 2021 May 11.

Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan. Electronic address:

Background: Hip fractures are a major cause of morbidity and mortality in the elderly. The American Academy of Orthopedic Surgeons (AAOS) recommends surgical repair within 48 hours of admission, as this is associated with lower postoperative mortality and complications. This study demonstrates the association between patient demographics, level of care, and hospital region to delay in hip fracture repair in the elderly. Read More

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Assessment of the Cytoprotective Effects of High-Dose Valproic Acid Compared to a Clinically Used Lower Dose.

J Surg Res 2021 May 11;266:125-141. Epub 2021 May 11.

Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan; Department of Surgery, Feinberg School of Medicine/Northwestern University, Chicago, Illinois. Electronic address:

Objective: Valproic acid (VPA) treatment improves survival in animal models of injuries on doses higher than those allowed by Food and Drug Administration (FDA). We investigated the proteomic alterations induced by a single high-dose (140mg/kg) of VPA (VPA140) compared to the FDA-approved dose of 30mg/kg (VPA30) in healthy humans. We also describe the proteomic and transcriptomic changes induced by VPA140 in an injured patient. Read More

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The therapeutic role of lactobacillus and montelukast in combination with metformin in diabetes mellitus complications through modulation of gut microbiota and suppression of oxidative stress.

Int Immunopharmacol 2021 May 12;96:107757. Epub 2021 May 12.

Pharmacology department, Faculty of pharmacy, Horus University-Egypt, New Damietta 34518, Egypt.

Male reproductive dysfunction is one of the overlooked findings of diabetes mellitus (DM) that deserves greater scientific attention. This study is designed to explore the therapeutic potential of metformin and montelukast, in combination with Lactobacillus, for modulation of intestinal flora and suppression of oxidative stress in testicular and liver damage in diabetic male rats. A DM model was induced by streptozotocin (STZ)which caused functional, biochemical, and inflammatory injuries to the testicular and liver tissues. Read More

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The impact of emergency department observation units on a health system.

Am J Emerg Med 2021 Apr 30;48:231-237. Epub 2021 Apr 30.

Department of Emergency Medicine, Observation Medicine, Emory University School of Medicine, 531 Asbury Circle - Annex, Suite N340, Atlanta, Georgia. Electronic address:

Importance: Protocol driven ED observation units (EDOU) have been shown to improve outcomes for patients and payers, however their impact on an entire health system is unknown. Two thirds of US hospitals do not have such units.

Objective: To determine the impact of a protocol-driven EDOU on health system length of stay, cost, and resource utilization. Read More

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Dual-energy CT of the liver: True noncontrast vs. virtual noncontrast images derived from multiple phases for the diagnosis of fatty liver.

Eur J Radiol 2021 Apr 29;140:109741. Epub 2021 Apr 29.

Siemens Healthineers Ltd., 23 Chungjeong-ro, Seoul, 03737, Republic of Korea.

Purpose: To evaluate the difference in liver density and to compare the performance to diagnose fatty liver between true noncontrast (TNC) images and virtual noncontrast (VNC) images generated from dual-energy CT (DECT).

Materials And Methods: Patients who underwent liver dynamic DECT and MRI were included (n = 49). Two observers measured the liver and spleen densities on TNC images and three VNC images from the arterial, portal and delayed phases of DECT (VNCa, VNCp and VNCd, respectively). Read More

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Pre-registration nursing and occupational therapy students' experience of interprofessional simulation training designed to develop communication and team-work skills: A mixed methods study.

Nurse Educ Pract 2021 May 3;53:103073. Epub 2021 May 3.

Centre for Quality and Patient Safety Research, Institute of Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong, VIC 3228, Australia. Electronic address:

To bridge the gap between university and the clinical environment, the university where this study was conducted incorporated interprofessional simulation sessions into the curricula for pre-registration nursing and occupational therapy students. The purpose of the study was to evaluate the effectiveness of simulation training to support the development of students' interprofessional communication and teamwork skills. Study participants were first-year students. Read More

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The guidelines and policies that influence the conduct of Animal-Assisted Activities in Residential Aged-Care Facilities: A systematic integrative review.

Complement Ther Clin Pract 2021 May 3;44:101395. Epub 2021 May 3.

School of Health, Medical and Applied Science, Central Queensland University, Central Queensland University, 6 University Drive, Branyan Queensland, 4670, Australia. Electronic address:

Introduction: For some time, Residential Aged Care Facilities (RACF) have incorporated animals into their environment to relieve loneliness and isolation for aged-care residents. However, research examining this practice is not as developed. This paper aims to identify the policies and practices influencing the conduct of Animal-Assisted Activities (AAA) in RACF focusing on the Australian context. Read More

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The mediating effect of parenting stress and couple relationship quality on the association between material hardship trajectories and maternal mental health status.

J Affect Disord 2021 May 1;290:31-39. Epub 2021 May 1.

Department of Research, Cizik School of Nursing, University of Texas Health Science Center, 6901 Bertner Avenue, 591, Houston, TX 77030, United States.

Background: Household material hardships could have a negative impact on maternal mental health. Understanding mechanisms by which material hardship trajectories affect maternal depression and anxiety could aid health care professionals and researchers to design better interventions to improve mental health outcomes among mothers.

Methods: The study identified family-level mechanisms by which material hardship trajectories affect maternal depression and anxiety using Fragile Families and Child Wellbeing Study data (n = 1,645). Read More

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Multidisciplinary treatment strategy for locally advanced gastric cancer: A systematic review.

Surg Oncol 2021 May 11;38:101599. Epub 2021 May 11.

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Multidisciplinary management of patients with locally advanced gastric cancer (LAGC) remains unstandardized worldwide. We performed a systemic review to summarize the advancements, regional differences, and current recommended multidisciplinary treatment strategies for LAGC.

Methods: Eligible studies were identified through a comprehensive search of PubMed, Web of Science, Cochrane Library databases and Embase. Read More

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Prevalence and associated risk factors of coronary artery disease in patients with a zero coronary calcium score.

Clin Imaging 2021 May 10;77:207-212. Epub 2021 May 10.

Department of Radiology, Faculty of Medicine, Gazi University, Emniyet, Mevlana Blv. No:29, 06560 Yenimahalle, Ankara, Türkiye.

Purpose: A zero coronary calcium score (CCS) is not able to provide a definite exclusion for coronary artery disease (CAD). The goal of this study was to determine the prevalence and associated cardiovascular risk factors of CAD in patients with zero CCS.

Methods: Six hundred thirteen patients with zero CCS referred to coronary calcium score analysis (CCSA) and coronary computed tomography angiography (CCTA) with suspicion of CAD were included. Read More

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Nitrogen cascade in the agriculture-food-environment system of the Yangtze Delta, 1998-2018.

Sci Total Environ 2021 May 7;787:147442. Epub 2021 May 7.

Center for Material Cycles and Waste Management Research, National Institute for Environmental Studies, Tsukuba 305-8506, Japan.

The nitrogen (N) cascade in rural areas of Changshu County should be measured and evaluated due to the large increase in anthropogenic disturbances in China's Yangtze Delta. Here, we developed a village-scale N flow model using Changshu County and its towns as a case study. The model included four subsystems and was used to describe the driving forces behind the N cascade from agricultural food production and household consumption to the environment (agriculture-food-environment) system. Read More

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Dynamic stormwater management to mitigate phosphorous export.

Sci Total Environ 2021 May 7;787:147506. Epub 2021 May 7.

City of Cambridge, Department of Public Works, 147 Hampshire St, Cambridge, MA 02139, United States of America.

Altered stormwater flow characteristics and associated changes in nutrient and sediment fluxes due to urbanization threaten the water quality of many water bodies. For example, particle-bound phosphorus in stormwater runoff adds to the nutrient pool that can produce harmful algal blooms, and the associated particulate material can endanger fish and other living organisms in surface waters by increasing turbidity. While many studies have investigated how Total Solids (TS) particle size distributions vary in urban stormwater and the associated design criteria for Best Management Practices (BMPs) to remove TS, few studies have included different forms of phosphorus and their association with particle sizes to characterize design criteria to specifically maximize Total Phosphorus (TP) removal. Read More

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An evaluation of undergraduate student nurses' gameful experience while playing an escape room game as part of a community health nursing course.

Nurse Educ Today 2021 May 4;103:104948. Epub 2021 May 4.

Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; Research group Water and Environmental Health (B43_20R), University Institute of Research in Environmental Science of Aragón, University of Zaragoza, Zaragoza, Spain. Electronic address:

Background: The integration of innovative strategies to teaching and learning in higher education, such as escape room games, can enhance the acquisition of key professional competencies including communication, teamwork and critical thinking.

Objectives: This study aimed to evaluate undergraduate student nurses' gameful experience while playing an escape room game as part of a nursing course.

Design: Cross-sectional descriptive study. Read More

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Continuous positive airway pressure improves work of breathing in pediatric chronic heart failure.

Sleep Med 2021 Apr 19;83:99-105. Epub 2021 Apr 19.

Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades F-75015, Paris, France; Université de Paris, VIFASOM F-75004, Paris, France.

Background: Sleep disordered breathing (SDB) is common in adults with chronic heart failure (CHF), but its prevalence in children remains unclear. Continuous positive airway pressure (CPAP) is the treatment of SDB but deleterious hemodynamic effects have been reported.

Methods: We prospectively analyzed SDB in children with CHF and the effect of CPAP on work of breathing (WOB) and cardiac index (CI). Read More

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Associations between sleep and academic performance in US adolescents: a systematic review and meta-analysis.

Sleep Med 2021 Apr 17;83:71-82. Epub 2021 Apr 17.

Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. Electronic address:

This systematic review and meta-analysis aim to investigate the relationship between sleep and academic performance in students enrolled in secondary education programs in the United States. The study team conducted a literature search of 4 databases-PubMed, Embase, CINAHL, and ERIC-on September 19 and repeated December 17, 2020. Studies were included if they were observational, published in a peer-reviewed, non-predatory journal, available in full-text, written in English, included adolescents enrolled in an organized academic program, took place in the US, and evaluated the effect of sleep duration and/or sleep quality on academic performance. Read More

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Chronic sleep restriction triggers inadequate napping habits in adolescents: a population-based study.

Sleep Med 2021 Apr 19;83:115-122. Epub 2021 Apr 19.

Human Chronobiology Laboratory, Department of Physiology, Biological Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil. Electronic address:

Background: The prevalence of chronic sleep restriction during adolescence is a major public health issue. Napping has been adopted to alleviate sleep pressure complaints. However, it also has the potential to amplify sleep restriction due to a vicious cycle triggered by delayed sleep times. Read More

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Sleep disturbances in autism spectrum disorder without intellectual impairment: relationship with executive function and psychiatric symptoms.

Sleep Med 2021 Apr 22;83:106-114. Epub 2021 Apr 22.

Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.

The autism spectrum disorder (ASD) is a neurodevelopmental condition, frequently accompanied by medical and psychiatric pathology. One of the most commonly found problems associated with ASD is sleep disturbances, which are estimated to affect approximately 80% of the people with ASD, not only during childhood but also in the adolescence and adult stages. Nevertheless, the relationship of these sleep difficulties with autism severity, as well as other associated impairments such as executive functioning and psychiatric disorders (eg, depression), has not yet been widely studied. Read More

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Interprofessional clinical pathway program effects on patient outcomes in the setting of neutropenic fever: An integrative review.

Eur J Oncol Nurs 2021 May 2;52:101974. Epub 2021 May 2.

Brown University School of Public Health, 121 S. Main St, Ste. 6, Providence, RI, 02903, USA; Providence VA Medical Center, 830 Chalkstone Ave, Bld. 32, Providence, RI, 02903, USA.

Purpose: Neutropenic fever (NF) is an oncologic emergency linked to substantial healthcare costs, treatment delays, and increased patient mortality. Clinical pathways have emerged as a coordinated, interprofessional approach to NF management. The aim of this review was to examine the research question: What is the effect of an interprofessional clinical pathway program on outcomes (time-to-antibiotic, mortality, cost, readmissions and length of stay) in patients presenting with NF?

Methods: Using the integrative review method of Whittemore and Knafl, the databases PubMed, CINAHL and Scopus were searched for articles published in English between 1997 to present that met the following criteria: (1) reported clinical pathway implementation, and (2) reported outcome data on patients 18 years or older who were diagnosed with NF. Read More

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Correlation of MRSA polymerase chain reaction (PCR) wound swab testing and wound cultures in skin and soft tissue infections.

Diagn Microbiol Infect Dis 2021 Apr 15;100(4):115389. Epub 2021 Apr 15.

Department of Pharmaceutical Science and Research, School of Pharmacy, Marshall University, Huntington, WV.

Methicillin-resistant Staphylococcus aureus is a considerable pathogen in the setting of skin and soft tissue infections (SSTIs). MRSA PCR swab testing is widely used in the setting of respiratory tract infections, however little data exists relating to the use of MRSA PCR swab testing in SSTIs. Three thousand, nine hundred and ninety-five patients were included in this retrospective study that aimed to validate the clinical correlation of MRSA PCR wound swab testing in SSTIs through sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) analysis. Read More

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Exposures and associations with clinical phenotypes in hypersensitivity pneumonitis: A scoping review.

Respir Med 2021 May 6;184:106444. Epub 2021 May 6.

Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: https://twitter.com/KerriBerriKerri.

Antigen identification is important for establishing a confident diagnosis of hypersensitivity pneumonitis (HP). There are no systematically curated lists of HP-associated exposures that inform clinical relevance or disease phenotype. We sought to systematically identify all reported causes of HP in the literature and evaluate their clinical relevance. Read More

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Functional performance tests in interstitial lung disease: Impairment and measurement properties.

Respir Med 2021 Apr 28;184:106413. Epub 2021 Apr 28.

Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina, Londrina, Brazil; Department of Rehabilitation Sciences, University Pitágoras UNOPAR, Londrina, Brazil. Electronic address:

Background: There is limited information regarding impairment in functional performance tests and their measurement properties in ILD. The present study aimed to verify the impairment and measurement properties of functional performance tests in ILD.

Methods: ILD and healthy individuals underwent assessments of pulmonary function, peripheral muscle strength (handgrip force and maximum isometric contraction of quadriceps femoris - MIVCq) and exercise capacity (6-min walk test - 6MWT). Read More

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Improving river hydromorphological assessment through better integration of riparian vegetation: Scientific evidence and guidelines.

J Environ Manage 2021 May 12;292:112730. Epub 2021 May 12.

Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal.

River hydromorphology has long been subjected to huge anthropogenic pressures with severe negative impacts on related ecosystems' functioning and water quality. Therefore, improving river hydromorphological conditions represents a priority task in sustainable river management and requires proper assessment tools. It is well known that riparian vegetation plays a crucial role in sustaining river hydromorphological conditions. Read More

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Intolerance of uncertainty and obsessive-compulsive disorder dimensions.

J Anxiety Disord 2021 May 8;81:102417. Epub 2021 May 8.

Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, 235 E. Cameron Ave, Chapel Hill, NC, 27514, USA.

Intolerance of uncertainty (IU), which can include prospective (i.e., desire for predictability) and inhibitory (i. Read More

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Priapism in Sickle Cell Disease: An Evaluation of the Knowledge of an at Risk Population in Jamaica.

Sex Med 2021 May 11;9(3):100339. Epub 2021 May 11.

Sickle Cell Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica.

Introduction: Ischemic priapism is characterized by painful erections that may lead to erectile dysfunction. Men with sickle cell disease (SCD) are particularly prone to this condition, however, the knowledge among this population with respect to possible complications is not well known.

Aim: The objective of this study was to evaluate the knowledge of males with SCD about priapism and its possible consequences. Read More

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Comparison of the cardio-respiratory response of a training session on cycloergometer or treadmill versus an Adapted Physical Activity session on Nintendo Wii, in patients with chronic respiratory disease.

Respir Med Res 2021 Apr 28;79:100827. Epub 2021 Apr 28.

Dept of Internal Medicine and Chest Diseases, EA3878 (GETBO), CIC INSERM 1412, University Hospital of Brest, European University of Occidental Brittany, Brest, France.

Objectives: During a pulmonary rehabilitation program (PRP), patients frequently report that the classically proposed activities (as cycloergometer or treadmill) are not playful. The goal of adapted physical activities is to maintain physical activity that is more playful for patients. The Nintendo Wii Gaming Console allows a playful physical activity. Read More

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How has Indigenous Health Research changed in Atlantic Canada over two decades? A scoping review from 2001 to 2020.

Soc Sci Med 2021 May 3;279:113947. Epub 2021 May 3.

Dalhousie University, Canada. Electronic address:

Introduction: Indigenous communities across Canada report that transformations in Indigenous health research are needed, where the benefits of research shift intentionally, collaboratively, and with transparency from the researchers directly to Indigenous communities and partners. Despite its challenges and potential for harm, research, if done ethically and with respect and partnership, can be a force for change and will strengthen the efficacy of data on Indigenous Peoples' health and wellbeing.

Purpose: To characterize the nature, range, and extent of Indigenous health research in Atlantic Canada, and to identify gaps. Read More

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Patient expectations about a clinical diagnostic test may influence the clinician's test interpretation.

Musculoskelet Sci Pract 2021 May 6;54:102387. Epub 2021 May 6.

Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia.

Background: With medical information widely available, patients often have preconceived ideas regarding diagnostic procedures and management strategies.

Objectives: To investigate whether expectations, such as beliefs about the source of symptoms and knowledge about diagnostic tests, influence pain perception during a clinical diagnostic test.

Design: Cross-sectional study. Read More

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Influence of age on treatment and prognosis of invasive cervical cancer.

Eur J Obstet Gynecol Reprod Biol 2021 May 1;262:68-72. Epub 2021 May 1.

Department of Pathology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

Objective: Invasive cervical cancer is considered a young women's disease, however up to 20 % of cases develop cervical cancer at advanced ages. The aim was to characterize invasive cervical cancer in women aged 65 and older assessing age-specific survival differences.

Study Design: A retrospective study including cervical cancer patients was conducted at Hospital del Mar Barcelona from July-2007 to December-2016. Read More

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