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Perceptions of the moral obligations of pediatric nurses during an active shooter event in a children's hospital.

J Pediatr Nurs 2021 Jul 29;60:252-259. Epub 2021 Jul 29.

Arkansas Children's Hospital, 1 Children's Way, Slot 807, Little Rock, AR 72202, United States. Electronic address:

Purpose: To explore and compare the perceptions of nurses and parent/family advisors regarding pediatric nurses' moral obligations to children and families during an active shooter event in a children's hospital.

Design And Methods: This was a descriptive, exploratory study using survey methodology. A convenience sample of all licensed nurses and parent/family advisors from four children's hospitals across the United States were recruited. Read More

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Treatment Switch in Poor Responders with Locally Advanced Gastric Cancer After Neoadjuvant Chemotherapy.

Ann Surg Oncol 2021 Jul 29. Epub 2021 Jul 29.

Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing, China.

Background: Among locally advanced gastric cancer (LAGC) patients, poor response to initial neoadjuvant chemotherapy (NAC) is associated with unfavorable outcomes; however, changing the postoperative therapy regimen in this group of patients is unclear. We compared the poor responders who continued the original protocols with that of patients who switched treatment after NAC plus D2 gastrectomy.

Methods: Our study included LAGC patients who achieved tumor regression grade 3 according to the American Joint Committee on Cancer/College of American Pathologists system, after NAC, between December 2006 and December 2017 at our institution. Read More

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Reuse of COVID-19 face mask for the amelioration of mechanical properties of fat clay: A novel solution to an emerging waste problem.

Sci Total Environ 2021 Jun 29;794:148746. Epub 2021 Jun 29.

Civil Engineering Department, Khwaja Fareed University of Engineering and Information Technology (KFUEIT), Rahim Yar Khan 64200, Pakistan. Electronic address:

Not only has the COVID-19 pandemic caused a global health crisis, but it has also changed the dynamics of waste generation around the world. This situation demands a productive solution for face mask (FM) waste management to solve several associated environmental issues. In the current study, a novel soil treatment method is proposed for the improvement of mechanical characteristics of fat clay by using FM as fiber reinforcement and silica fume (SF) as the cementitious agent in the form of a composite binary admixture (CBA). Read More

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Use of an app as a complementary strategy to speech-language therapy in a case of cognitive-communication disorder.

Codas 2021 23;33(5):e20200011. Epub 2021 Jul 23.

Departamento de Formação Específica em Fonoaudiologia, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense - UFF - Nova Friburgo (RJ), Brasil.

With the aging of the population, there is an increase in the incidence of common diseases to this age group, such as dementias. Efforts to improve the quality of health care for these patients, including speech-language therapy, have grown. This study aims to evaluate the effectiveness and applicability of the Talk Around It as a complementary strategy in the language therapy of a patient with cognitive communication disorder. Read More

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Neuromuscular Blockade and Reversal Agent Practice Variability in the US Inpatient Surgical Settings.

Adv Ther 2021 Jul 28. Epub 2021 Jul 28.

Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, 02115, USA.

Introduction: The management of neuromuscular blockade (NMB) has evolved over time and remains a critical component of general anesthesia. However, NMB use varies by patient and procedural characteristics, clinical practices, protocols, and drug access. National utilization patterns are unknown. Read More

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Technical note: On the impact of the kV imaging configuration on doses from planar images during motion-synchronized treatments on Radixact®.

J Appl Clin Med Phys 2021 Jul 26. Epub 2021 Jul 26.

Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Kilovoltage radiographs are acquired during motion-synchronized treatments on Radixact to localize the tumor during the treatment. Several previous publications have provided estimates of patient dose from these planar radiographs. However, a recent hardware update changed several aspects of the kV imaging system, including a new X-ray tube, an extended source-to-axis distance (SAD), and a larger field size. Read More

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Assessing the impact of COVID-19 on healthcare staff at a combined elderly care and specialist palliative care facility: A cross-sectional study.

Palliat Med 2021 Jul 23:2692163211028065. Epub 2021 Jul 23.

Marymount University Hospital and Hospice, Curraheen, Cork, Ireland.

Background: In the pre-COVID-19 era, healthcare professionals experienced stress and burnout. The international literature confirms that COVID-19 placed significant additional burdens on healthcare workers.

Aim: To describe and characterise the magnitude and variety of ways in which the COVID-19 pandemic affected the personal, social and professional lives of healthcare workers representing several multidisciplinary specialties in a fully-integrated palliative and elderly care service. Read More

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Incidence, associated risk factors, and the ideal mode of delivery following preterm labour between 24 to 28 weeks of gestation in a low resource setting.

PLoS One 2021 22;16(7):e0254801. Epub 2021 Jul 22.

University of Manchester, Manchester, United Kingdom.

Background: Preterm labour, between 24 to 28 weeks of gestation, remains prevalent in low resource settings. There is evidence of improved survival after 24 weeks though the ideal mode of delivery remains unclear. There are no clear management protocols to guide patient management. Read More

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Mourning During Corona: A Phenomenological Study of Grief Experience Among Close Relatives During COVID-19 Pandemics.

Omega (Westport) 2021 Jul 20:302228211032736. Epub 2021 Jul 20.

Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.

Considering the need for observing health protocols, the experience of the loss and the grieving process has changed in nature during this disease. Therefore, this study aims to gain a deep understanding of the experience of mourning during COVID-19 pandemic by exploring the experiences of survivors of the death of their loved. During COVID-19 pandemic, the inability to hold the usual ceremonies for mourning and receive the social support needed in this period, the relatives of the deceased encounter various conditions that disrupt the grieving process and may lead to the spread of unresolved grief in future. Read More

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Trajectories of antenatal depression and adverse pregnancy outcomes.

Am J Obstet Gynecol 2021 Jul 16. Epub 2021 Jul 16.

Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Chicago IL.

Background: Antenatal depression affects approximately one in seven pregnancies, with an increasing prevalence across gestation. Data regarding the associations between antenatal depression and adverse pregnancy outcomes yield conflicting results. However, previous studies evaluated the cross-sectional prevalence of depression at various time points, and not the trajectory of depressive symptoms across gestation. Read More

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Prenatal serum screening for Down syndrome and neural tube defects in the United States: Changes in utilization patterns from 2012 to 2020.

J Med Screen 2021 Jul 19:9691413211031610. Epub 2021 Jul 19.

Department of Pathology and Laboratory Medicine, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA.

Objective: To compile current usage of serum-based prenatal screening for Down syndrome in the United States and compare it with results from a similar 2011/2012 survey.

Setting: The College of American Pathologists maternal screening proficiency testing survey includes a supplemental question on the first of three yearly distributions.

Methods: Information regarding tests offered and the monthly number of pregnancies tested for US-based laboratories were reviewed. Read More

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Reproducible induction of depressive-like behavior in C57BL/6J mice exposed to chronic social defeat stress with a modified sensory contact protocol.

Life Sci 2021 Jul 13;282:119821. Epub 2021 Jul 13.

Department of Environmental Biochemistry, Division of Biological Sciences, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, Japan. Electronic address:

Aims: C57BL/6J mice are well-known to exhibit resilience to chronic social defeat stress (CSDS) for induction of depressive-like behavior. Establishment of protocols for reproducible induction of depressive-like behavior in C57BL/6J mice would be useful to elucidate the underlying molecular mechanisms using target gene-knock-in and -out mice whose background is generally C57BL/6J. Here, we developed a modified CSDS protocol for reproducible induction of depressive-like behavior in C57BL/6J mice, and compared the profile of their gut microbiota with that with the standard CSDS protocol. Read More

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Understanding adaptations in the Veteran Health Administration's Transitions Nurse Program: refining methodology and pragmatic implications for scale-up.

Implement Sci 2021 Jul 13;16(1):71. Epub 2021 Jul 13.

Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care (COIN), VA Eastern Colorado Health Care System, 1700 N. Wheeling Street, P1-151 Research, Denver, CO, 80045, USA.

Background: When complex health services interventions are implemented in real-world settings, adaptations are inevitable. Adaptations are changes made to an intervention, implementation strategy, or context prior to, during, and after implementation to improve uptake and fit. There is a growing interest in systematically documenting and understanding adaptations including what is changed, why, when, by whom, and with what impact. Read More

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Standardization of Procedures to Contain Cost and Reduce Variability of Care After the Pandemic.

Front Surg 2021 24;8:695341. Epub 2021 Jun 24.

Thoracic Surgery, San Gerardo Hospital, Azienda Socio Sanitaria Territoriale (ASST)-Monza, Monza, Italy.

The coronavirus disease 2019 (COVID-19) pandemic has changed many aspects of our private and professional routine. In particular, the lockdowns have severely affected the entire healthcare system and hospital activities, forcing it to rethink the protocols in force. We suggest that this scenario, in spite of the new challenges involving so far complex healthcare providers, may lead to the unique opportunity to rethink pathways and management of patients. Read More

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Effect of Aging on the Microstructure and Optical Properties of Translucent ZrO 2 Ceramics.

Acta Stomatol Croat 2021 Jun;55(2):114-128

Professor; Dental Clinic, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia.

Objectives: The development and placement of translucent zirconia ceramics on the dental materials market is in full swing. This research aimed to investigate how aging protocols affect the microstructure, color parameters and translucency of a new-generation monolithic zirconia ceramic.

Material And Methods: Translucent zirconia ceramics KATANA-Zirconia STML with different surface treatments (as sintered - control, glazed, polished) was tested using two aging protocols (hydrothermal degradation in autoclave at 134 °C and 2 bars for three hours, chemical degradation in four-percent acetic acid at 80 °C for 16 hours) in order to examine phase composition using X-ray diffraction analysis and ΔE, ΔL and ΔC color parameters through spectrophotometry. Read More

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The feasibility and efficacy of short-term visual-motor training in pediatric posterior fossa tumor survivors.

Eur J Phys Rehabil Med 2021 Jul 12. Epub 2021 Jul 12.

Department of Neurocognitive, Psychophysiological Research and Physical Rehabilitation in Rehabilitation Center Russian Field, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.

Background: Pediatric posterior fossa tumor (PFT) survivors experience a range of cognitive and motor impairments that require timely rehabilitation of these functions. In Russia, rehabilitation services are only just beginning to be formed; therefore, it is necessary to test rehabilitation protocols for children surviving cancer.

Aim: To evaluate the efficacy of short-term cognitive and motor training (CMT) aimed on visualmotor integration in PFT survivors using training devices. Read More

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Efficacy of DPP-4 inhibitors and SGLT2 inhibitors compared to sulphonylureas in adult patients with diabetes with low c-peptide levels with or without anti-GAD65 antibody positivity.

Diabetes Metab Syndr 2021 Jul 5;15(4):102197. Epub 2021 Jul 5.

Department of Medicine, All India Institute of Medical Sciences, Rishikesh, India.

Background And Aims: Latent Autoimmune Diabetes of Adulthood (LADA) is different from type 2 diabetes. Present treatment protocols do not reflect that. DPP-4 and SGLT2 inhibitors have changed therapy. Read More

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Pain medication requirements in patients with opioid use disorder at the time of surgical abortion: An exploratory study.

Contraception 2021 Jul 6. Epub 2021 Jul 6.

Boston Medical Center/Boston University, Boston, MA, United States.

Objective: To assess sedation medication dosage differences between patients with and without opioid use disorder at the time of surgical abortion.

Study Design: We performed a retrospective cohort study, identifying patients obtaining a surgical abortion in our ambulatory procedure unit between 2012 and 2017. We identified 64 patients with documented opioid use disorder at the time of their procedure and assigned 64 patients without opioid use disorder to a control cohort. Read More

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PI-RADS v2.1: What has changed and how to report.

SA J Radiol 2021 1;25(1):2062. Epub 2021 Jun 1.

Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy.

Multiparametric magnetic resonance imaging (MRI) of the prostate has become a vital imaging tool in daily radiological practice for the stratification of the risk of prostate cancer. There has been a recent update to the Prostate Imaging-Reporting and Data System (PI-RADS). The updated changes in PI-RADS, which is version 2. Read More

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Florigen governs shoot regeneration.

Sci Rep 2021 Jul 1;11(1):13710. Epub 2021 Jul 1.

Plant Science Institute, ARO, Volcani Center, PO Box 6, 50250, Bet Dagan, Israel.

It is widely known that during the reproductive stage (flowering), plants do not root well. Most protocols of shoot regeneration in plants utilize juvenile tissue. Adding these two realities together encouraged us to study the role of florigen in shoot regeneration. Read More

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COVID-19 Changed the Incidence and the Pattern of Pediatric Traumas: A Single-Centre Study in a Pediatric Emergency Department.

Int J Environ Res Public Health 2021 06 18;18(12). Epub 2021 Jun 18.

Department of Orthopedics, Children's Hospital Bambino Gesù, Palidoro, 00165 Rome, Italy.

The first wave of COVID-19 spread worldwide from March to May 2020. Italy was one of the countries in the world where the lockdown period was most prolonged and restrictive. To date, the impact of prolonged lockdown on pediatric traumas has not fully investigated. Read More

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Challenges and lessons learned for institutional review board procedures during the COVID-19 pandemic.

J Clin Transl Sci 2021 Mar 16;5(1):e107. Epub 2021 Mar 16.

Department of Medicine, David Geffen School of Medicine at UCLA, Clinical and Translational Sciences Institute, Los Angeles, CA, USA.

The COVID-19 pandemic changed the clinical research landscape in America. The most urgent challenge has been to rapidly review protocols submitted by investigators that were designed to learn more about or intervene in COVID-19. International Review Board (IRB) offices developed plans to rapidly review protocols related to the COVID-19 pandemic. Read More

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Current demographic and auditory profiles of adult cochlear implant candidates and factors affecting uptake.

Int J Audiol 2021 Jun 30:1-7. Epub 2021 Jun 30.

Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Israel.

Objectives: Despite growth of CI and widening of implantation criteria, penetration rates remain low and the clinical profile of adult CI candidates has not substantially changed. This study evaluated the demographic and auditory profiles of current adult CI candidates and identified factors affecting CI uptake.

Design: Preoperative data from patients who underwent CI candidacy evaluation between 2016-2018 were retrospectively reviewed. Read More

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The impact of the Covid-19 pandemic on North American milk banks.

Matern Child Nutr 2021 Jun 30:e13234. Epub 2021 Jun 30.

School of Nursing, Psychotherapy and Community Health, Dublin City University, Glasnevin, Dublin 9, Ireland.

This study aims to understand the impact of the Covid-19 pandemic on human milk banking services in North America, with a focus on the United States. We triangulated questionnaire data with interviews and text-based website data. Of the 30 human milk bank services from which data were obtained, the majority faced substantial internal organization change in terms of staffing and protocols and experienced financial hardship in particular because of decreases in donor human milk orders. Read More

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Evaluation of a revised resuscitation protocol for out-of-hospital cardiac arrest patients due to COVID-19 safety protocols: a single-center retrospective study in Japan.

Sci Rep 2021 06 21;11(1):12985. Epub 2021 Jun 21.

Department of Emergency and Critical Care Medicine, Japanese Red Cross Society, Kyoto Daini Hospital, 355-5 Haruobicho Kamigyoku, Kyoto, 602-8026, Japan.

This study aimed to determine the association between cardiopulmonary resuscitation (CPR) under the coronavirus 2019 (COVID-19) safety protocols in our hospital and the prognosis of out-of-hospital cardiac arrest (OHCA) patients, in an urban area, where the prevalence of COVID-19 infection is relatively low. This was a single-center, retrospective, observational, cohort study conducted at a tertiary critical care center in Kyoto City, Japan. Adult OHCA patients arriving at our hospital under CPR between January 1, 2019, and December 31, 2020 were included. Read More

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An observational case series of targeted virtual geriatric medicine and palliative care consults for hospitalized older adults with COVID-19.

Ann Palliat Med 2021 Jun 18;10(6):6297-6306. Epub 2021 Jun 18.

Yale School of Medicine, Section of Geriatrics, Department of Internal Medicine, New Haven, CT, USA.

Background: COVID-19 presents unique challenges to the care of hospitalized older adults, including fractured lines of communication and uncertainty surrounding long term trajectories in cognition and function. Geriatric medicine and palliative care clinicians bring specialized training in facilitating communication in the face of uncertainty. Insurance expansion of virtual visits enabled inpatient virtual consultation, which can preserve personal protective equipment and minimize exposure to clinicians. Read More

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Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points.

Front Pediatr 2021 4;9:667806. Epub 2021 Jun 4.

1st Department of Neonatology and Neonatal Intensive Care, School of Medicine, Aristotle University of Thessaloniki, Ippokrateion General Hospital, Thessaloniki, Greece.

Intense research for more than three decades expelled the view that neonates do not experience pain. The aim of this survey was to investigate whether the Greek physicians involved in neonatal intensive care have changed their perceptions regarding neonatal pain, adapting their management practices to the knowledge that have emerged in the past 20-years. This study is a survey conducted at two time-points, 20 years apart. Read More

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Use of molecular docking computational tools in drug discovery.

Prog Med Chem 2021 27;60:273-343. Epub 2021 May 27.

Cambridge Crystallographic Data Centre, Cambridge, United Kingdom.

Molecular docking has become an important component of the drug discovery process. Since first being developed in the 1980s, advancements in the power of computer hardware and the increasing number of and ease of access to small molecule and protein structures have contributed to the development of improved methods, making docking more popular in both industrial and academic settings. Over the years, the modalities by which docking is used to assist the different tasks of drug discovery have changed. Read More

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Atezolizumab-induced anaphylactic shock in a patient with hepatocellular carcinoma undergoing immunotherapy: A case report.

World J Clin Cases 2021 Jun;9(16):4110-4115

Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.

Background: Atezolizumab is a programmed death ligand 1 (PD-L1) inhibitor, and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma (HCC). Treatment with immune checkpoint inhibitors (ICIs) can lead to hypersensitivity reactions; however, anaphylactic shock is rare. We present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature review. Read More

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COVID-19 Testing in the Era of Modern Neurosurgery: Mitigating Risk in Our Vulnerable Patient Populations.

World Neurosurg 2021 Jun 13;152:80-83. Epub 2021 Jun 13.

Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Background: The respiratory illness identified as coronavirus disease 2019 (COVID-19) has resulted in a pandemic illness that has changed the face of healthcare. As the COVID-19 pandemic continues, patients have continued to require neurosurgical interventions, and the endoscopic endonasal approach for surgery has continued to be a mainstay treatment of pituitary tumors and anterior skull base lesions.

Methods: We sought to highlight the current lack of recommendations regarding testing protocols for neurosurgical patients. Read More

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