bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract WP88: Volumetric Measures of Hemorrhagic Transformation After Acute Ischemic Stroke Predicts Neurological Deterioration Better Than Radiologic Classification
Authors: Hamzehloo Ali , Kumar Atul , Heitsch Laura , Strbian Daniel , Slowik Agnieszka , Tatlisumak Turgut , Lee Jin-Moo , Dhar Rajat
Published: June 2021

Introduction:
Hemorrhagic transformation (HT) after acute ischemic stroke (AIS) may contribute to neurologic deterioration. The current radiologic classification of HT is qualitative and distinguishes petechial hemorrhagic infarction from parenchymal hematoma (PH-1 and PH-2). However, this grading scheme is subjective and may not accurately reflect the impact of HT on neurological status and outcome. We sought to evaluate whether the volume of hemorrhage was a better marker of deterioration.

Methods:
We evaluated AIS patients with follow-up CT imaging from a prospective stroke genetics study. HT seen within 36 hours of AI was classified using ECASS criteria. In addition, we outlined all confluent areas of hemorrhage to derive hemorrhage volume (HV). We calculated ΔNIHSS as the difference between baseline and 24-hour NIHSS. Early neurological deterioration (END) was defined as ΔNIHSS of -4 points or more. Association of radiologic HT grade and HV with ΔNIHSS and END were analyzed using linear regression and receiver-operating-curve testing.

Results:
We analyzed 948 stroke patients with median NIHSS 7 (IQR 4-14), 64% receiving tPA and ΔNIHSS +2 (IQR 0-5). 294 (31%) had HT (146 HI1, 63 HI2, 42 PH1 and 43 PH2). HT was associated with higher baseline NIHSS but not with tPA treatment or ΔNIHSS. END occurred in 113 (12%) including 46 with HT (16%) vs. 67 (10%) without HT (p=0.02). Amongst those with HT, the radiologic grade was not associated with ΔNIHSS or END (20% of PH2, 20% of PH1 vs. 15% of HI1/HI2, p=0.40). However, greater HV was associated with ΔNIHSS (adjusting for baseline NIHSS and tPA, estimate -1.5 point per 10-ml, p=0.0001) and with END (those with END had median HV 7 vs. 3-ml, p=0.001). A cut-off of 12-ml had 45% sensitivity and 90% specificity for END (AUC of 0.72).

Conclusion:
We demonstrated that while HT was associated with a higher risk of END, the ECASS classification alone did not distinguish those who worsened. It appears that hemorrhage volume may better predict worsening NIHSS and END with moderate sensitivity.
Abstract WP93: Cross-Institution Adaptive CT Perfusion Protocol for Stroke Workup Can Save Time, Radiation Dose and Improve Diagnostic Quality
Authors: Chung Charlotte Y , Lee Ting-Yim , Krupinski Elizabeth A , Nieboer Koenraad H , Prater Adam B
Published: June 2021

Introduction:
CT perfusion (CTP) is an integral part of the diagnosis and treatment pathway for acute ischemic stroke patients, however CTP protocols vary in scan duration and radiation dose across institutions. An ideal protocol would customize scan acquisition for each individual patient in real-time to avoid truncation-related postprocessing errors and minimize time and radiation dose. We explore the potential time and radiation dosage savings if such an ideal adaptive CTP protocol were implemented across institutions.

Methods:
We retrospectively assessed 148 CTP scans across two institutions, postprocessed by an expert reader with the CT perfusion 4D Neuro software package (GE Healthcare). Bolus arrival, peak and exit time for the arterial input (AIF) and venous output (VOF) functions were determined via inflection point analysis of time-attenuation curves. An empirically determined customized adaptive scan protocol (Figure) was generated based on each patient’s AIF/VOF curves. Resultant reduction in radiation dose, scan acquisition time and total protocol time were calculated.

Results:
With the adaptive protocol, all scans would have optimal diagnostic image quality, which addresses the 3% and 18% exams of sub diagnostic quality at the two institutions respectively. Average total protocol time decreased by 153 s and 12 s (59% and 9%) and average radiation dose decreased by 61% and 12% respectively, in comparison to current protocols at the two institutions. Scan acquisition time increased for 7% (11 of 148) of exams.

Conclusions:
An adaptive CTP protocol would realize significant time and radiation savings across institutions. Methods for real-time identification of VOF end times are currently under development.
Abstract WP95: Feasibility of 24/7 Neurohospitalist Presence and Impact on Alteplase DTN Times and Mortality
Authors: Schneider Alexander T , Taylor Reid , Jones Robin , Nanz Roy , Jauch Edward
Published: June 2021

Introduction:
After hours stroke coverage in community hospitals is typically provided on-call from home or through telehealth. Lack of immediate on-site stroke expertise may delay door-to-needle (DTN) times for IV alteplase. A 750-bed community hospital that had evening emergency stroke coverage by a neurologist on-call from home transitioned to 24/7 neurohospitalist coverage in October 2015.

Methods:
Data were obtained from patients treated with alteplase in the ED for ischemic stroke. We evaluated the DTN times at baseline and after intervention of the new care model dichotomized by daytime (7a-5p) and evening (5p-7a). Mortality (death in hospital and discharge (DC) to hospice) was assessed. Data were compared for statistical correlation using a Mood’s Median Test and 2-sample t-test.

Results:
There were 579 cases from January 2015 through July 2019 treated with alteplase in the ED for ischemic stroke. Patients available for study pre- and post-intervention were 84 and 495, respectively (Table 1). Daytime arrival was more common. Significant improvements in door-to-neurohospitalist at bedside and DTN time were observed regardless of time of day, but the greatest difference seen was in evening hours. Using an ANOVA model, EMS arrival was the most significant factor predicting DTN times. Despite fewer patients arriving via EMS in the post-intervention group (90% vs 94% baseline), the DTN times improved post intervention. Mortality was significantly improved after the intervention. Despite a 44% increase in code stroke arrivals to the ED, the feasibility of the care model over ~4 years was maintained by no loss of any neurohospitalists and the addition of 1 more.

Conclusion:
In-hospital 24/7 model of neurohospitalist coverage is a feasible model for large community hospitals and is associated with significantly faster DTN times and reduced mortality. We will explore other aspects of the care model and other changes occurring during the study period.
Abstract WP96: The Efficacy and Safety of HT047 in Patients With Acute Ischemic Stroke: A Multi-Center, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Phase II Trial
Authors: Heo Sung Hyuk , Kim Bum Joon , Chang Dae-Il , Choi Hye-Yeon , Kim Young Seo , Koh Seong-Ho , Park Jong-Ho , Lee Yeong-Bae , Jang Min Uk , Ahn Sung Hwan , Song Jungbin , Kim Hocheol
Published: June 2021

Introduction:
HT047 is an herbal mixture extract of the
Scutellaria baicalensis
and
Pueraria lobata
plants, which have been widely used to treat ischemic stroke in traditional Korean medicine. The aims of this trial are to investigate whether HT047 can improve neurological status, particularly motor function, in acute ischemic stroke patients, and to determine the safety and tolerance of HT047.

Methods:
In this randomized, double-blind, placebo-controlled, parallel-group, phase II trial, we enrolled patients with acute ischemic stroke within the past 14 days from 8 centers in Korea. The participating patients must have a Fugl-Meyer Assessment (FMA) motor score ≤55 with arm or leg weakness, and Korean version of the National Institutes of Health Stroke Scale (K-NIHSS) score of ≥4 and ≤15. Seventy-eight participants will be randomized in a 1:1:1 ratio and given high-dose HT047 (750 mg three times a day), low-dose HT047 (500 mg three times a day), or a placebo for 12 weeks. The primary endpoint is the change in FMA motor score between baseline and week 12. The trial is registered with ClinicalTrials.gov, NCT02828540.

Results:
Between Aug, 2016, and Aug, 2018, we randomly assigned 78 patients to one of the three study groups, of whom 66 patients were assessed for the primary endpoint in full analysis set. The median (min, max) changes in FMA motor score of high-dose HT047 and low-dose HT047 were 24 (0, 63) and 43 (-2, 70) (placebo group=28 [0, 63], p=0.929 and p=0.705, respectively). The prevalence of favorable outcome defined as modified Rankin scale score of 0-2 were 47.6% (p=0.919) in high-dose HT047 group and 57.1% (p=0.106) in low-dose HT047 group (31.6% in placebo group). Adverse events were similar across the three study groups.

Conclusions:
This study is a first-in-human trial of HT047, and there were no between-group differences on the primary and secondary endpoints.
Abstract WP97: The Aptamer BT200 Blocks Von Willebrand Factor and Platelet Function in Blood of Stroke Patients
Authors: Kovacevic Katarina , Greisenegger Stefan , Buchtele Nina , Gelbenegger Georg , Langer Agnes , Gilbert James C , Zhu Shuhao , Jilma Bernd
Published: June 2021

Background:
The effect of conventional anti-platelet agents is limited in secondary stroke prevention, and their effects are further blunted under conditions of high shear stress in the presence of increased levels of circulating VWF. VWF mediates platelet adhesion to collagen under high shear stress and is thereby critically involved in thrombus formation at sites of stenotic extracranial intracranial arteries (reviewed by Buchtele et al. 2018). We have created a novel anti-VWF aptamer (BT200) which could be useful for secondary stroke prevention, because the anti-VWF aptamer ARC1779 effectively reduced cerebral embolization after carotid endarterectomy (Markus et al. 2011).

Aims:
To characterize the effects of BT200 in blood of patients with large artery atherosclerosis stroke.

Methods:
Blood samples were obtained from 30 patients with acute stroke Inhibition of VWF activity by BT200 was quantified by REAADS ELISA and VWF ristocetin cofactor activity (VWF:RCo), platelet function under high shear rates with the PFA-100, and ristocetin-induced platelet aggregation in whole blood.

Results:
The majority of stroke patients had elevated VWF:RCo levels (mean: 198%; range 55-330%). Of 15 patients receiving clopidogrel with or without aspirin, only two had a prolonged collagen adenosine diphosphate closure time (CADP-CT) >123s, and only one patient had a ristocetin induced aggregation of <20U. BT200 concentration dependently inhibited VWF activity to <3% and VWF dependent platelet function (p<0.001): BT200 invariably prolonged CADP-CT to target levels of >300s, and decreased aggregation to <20U in blood samples from all patients.

Conclusions:
BT200 effectively inhibits VWF activity and VWF-dependent platelet function in blood from patients with acute stroke. Results from this study proved useful for planning of the ongoing phase I and planned phase II trial.
Friendship, Uncertainty, and “Commonplacing” in Renaissance Florence
Authors: Tóth Gábor Mihály
Published: June 2021

In fifteenth-century Florence, friendship—or the client–patron relationship, as contemporaries termed it—was often associated with uncertainties and risks. An investigation of diaries, notebooks, and letter correspondences of the time, from the perspective of game theory and decision theory, reveals how Florentines reasoned about the uncertainties of friendship, deploying an array of knowledge-constructing practices, under the rubric of “commonplacing,” to understand it. The preventive techniques that Florentines applied to cope with the conflicting testimonies of the contemporary information culture (the increase in the variety and the availability of vernacular texts, the expansion of literacy, etc.) only served to intensify their predicament. The fact that clients and patrons largely viewed their relationship in the same way challenges the traditional notion of that relationship as asymmetrical.
Two new species of Astrothelium (Trypetheliaceae) with amyloid ascospores inhabiting the canopy of Quercus humboldtii trees in Colombia
Authors: SIMIJACA DIEGO , LÜCKING ROBERT , MONCADA BIBIANA
Published: June 2021

Subandine and high Andean forests are often dominated by oak trees and these are recognized as suitable phorophytes for diverse epiphyte communities. Among the latter, lichens in the upper strata appear to be understudied. Here, we report the discovery of two new species of Astrothelium (Trypetheliaceae), a diverse genus of tropical crustose lichens, both with the unusual feature of muriform, amyloid ascospores. Astrothelium mordonialensis is characterized by an olive-green thallus with solitary ascomata producing muriform and amyloid ascospores with tightened center and A. rogitamae by a light brownish to greenish grey thallus with yellow pigmented solitary ascomata, producing muriform and amyloid ascospores.
Description of Idaea josephinae sp. n. from the Iberian Peninsula (Lepidoptera: Geometridae)
Authors: GUERRERO JUAN-JOSE , HAUSMANN AXEL , ORTIZ ANTONIO S.
Published: June 2021

Idaea josephinae sp. n. is described from the Iberian Peninsula. Differential characters from its North African sister species Idaea lobaria (Chrétien, 1909) in external appearance and genitalia, and in the 5’ barcode fragment of the mitochondrial COI gene (the DNA barcode) are presented.
miR-27b-3p Down-Regulation Prevents Hypoxia-Induced Cardiomyocyte Apoptosis Through Regulating Yes-Associated Protein 1 (YAP1) Expression
Authors: Wang Lilin , Feng Bo , Zhu Shu
Published: June 2021

Background: Congenital heart disease (CHD) is one of the most common birth defects. MicroR-NAs (miRNAs) are a group of endogenous, non-coding small RNAs and mediate the target genes expression. An increasing evidence showed that in recent years, miRNAs have given rise to more
and more attention in heart protection and development. In our research, the main purpose was to determine the effect of miR-27b-3p in CHD and analyze related mechanisms. Methods: We performed qRT-PCR analysis to examine miR-27b-3p expression in myocardial tissue from 30 patients with
CHD and hypoxia-induced H9C2 cells. Then, we performed biological software TargetScan to predict the relationship of miR-27b-3p and YAP1, and dual luciferase reporter gene assay was used to verify the results. H9C2 cells were transfected with inhibitor control, miR-27b-3p inhibitor, miR-27b-3p
inhibitor + control-siRNA or miR-27b-3p inhibitor + YAP1-siRNA for 6 hours and then induced by hypoxia for 72 hours. Subsequently, we performed MTT and FCM analysis to detect cell viability and apoptosis. Finally, we used western blot assay to measure the expression of apoptosis-related proteins.
Results: Our study indicated that miR-27b-3p expression in myocardial samples of cyanotic CHD patients was significantly higher than that of the acyanotic CHD patients. miR-27b-3p expression was gradually up-regulated with the increase of hypoxia induction time in H9C2 cells. Besides,
we confirmed that YAP1 was a target gene of miR-27b-3p. Moreover, our results showed that miR-27b-3p inhibitor improved cell viability, decreased apoptosis, and affected apoptosis-related proteins expression in hypoxia induced H9C2 cells. These changes were reversed by YAP1-siRNA. All data
demonstrated that miR-27b-3p/YAP1 might be new potential bio-marker and therapeutic target for CHD treatment.
Carbohydrate and Protein Supplements, an Effective Means for Maintaining Exercise-Induced Glucose Metabolism Homeostasis
Authors: Ruan Dingguo , Deng Hong , Xu Xiaoyang
Published: June 2021

This study aimed to verify the effects of an independently developed carbohydrate and protein (CHO+P) beverage (7.2% oligosaccharide and 1.6% soy-polypeptide) supplement on exerciseinduced glucose metabolism and associated gene expression. Mice received 1 mL/100 g body weight of normal
saline (group C; n = 36) or CHO+P (group E; n = 36) at 30 min before an immediately after exercise. Mice without exercise and supplementation served as normal controls (group NC; n = 9). The expression levels related to glucose metabolism were measured at 0, 4, 12, and
24 h after exercise (n = 9 per group). The blood glucose, insulin, and liver glycogen contents in groups C and E were dramatically lower than group NC immediately after exercise. Those in group E were significantly higher than group C, with few differences between the two. Muscle glycogen
was restored more quickly when the CHO+P beverage was consumed compared to normal saline. Furthermore, exercise-induced increase in glucose transporter-4 (GLUT-4) mRNA could be depressed by CHO+P supplementation but enhanced in GLUT-4 protein. Interleukin-6 (IL-6) showed a double peak curve
in the recovery period, but IL-6 increased again in group E earlier than group C. These findings confirmed that the beverage has significantly improved time in maintaining blood glucose stability, reducing glycogen consumption, accelerating glycogen resynthesis, and repairing injury in rats.
This study suggests the future application of this beverage in humans with experimental support and provides a scientific direction for promoting glycogen synthesis and recovery through nutrition.
Circular RNA Circ_0008035 Participates in the Progression of Multiple Myeloma by Regulating miRNA-1256
Authors: Zhao Caifang , Zhang Jingcheng , Jia Yongqing , Peng Jing , He Wei , Luo Chao , Hu Huixian
Published: June 2021

Anomalous expression of micro RNAs (miRNAs) and circular RNAs (circRNAs) were strongly correlated to the progression of multiple cancers, including multiple myeloma (MM). This study aimed to investigate whether circ_0008035 exerts its roles on MM cells by targetingmiRNA-1256. To analyze
the levels of circ_0008035 and miRNA-1256 in MM samples and healthy bone marrow samples, a real time quantitative PCR (RT-qPCR) assay was executed. Cell proliferation and apoptosis were detected with a cell counting kit (CCK-8) and flow cytometry assay, respectively. The cell invasive and
migration ability were assessed using a transwell assay. Dual-luciferase reporter assay and RTqPCR were applied to analyze and compare the targeting effect of circ_0008035 and miRNA-1256. Circ_0008035 was overexpressed, while miRNA-1256 expression declined in MM bone marrow tissues. RPMI8226
cells transfected with si-circ_0008035 or miRNA-1256 mimic exhibited lower proliferation and migration capabilities, while cell apoptosis was remarkably elevated. Circ_0008035 acts as a miRNA-1256sponge and negatively controls miRNA-1256 expression. Transfection of anti-miRNA-1256 reversed
proliferation and migration inhibition and promoted cell apoptosis, which was motivated by si-circ_0008035 transfection. Circ_0008035 negatively regulated miRNA-1256, and the circ_0008035/miRNA-1256 axis regulates the progression of MM, thus providing a potential target for MM therapy.
Effects of Parathyroid Hormone on Osteoporotic Fracture Healing in Mice via Non-Phospholipases C-Dependent Protein Kinase C Signaling Pathway
Authors: Wang Lei , Liu Linjuan , Sun Sixin , Xiao Li , Jiang Qinyi , Ding Hua
Published: June 2021

Objectives: This study was aimed to explore the effects of parathyroid hormone (PTH) on osteoporotic fracture healing in mice and the underlying mechanisms. Methods: Microarray analysis was conducted to analyze the gene expression level in MC3T3-E1 cells. Carboxyfluorescein
succinimidyl ester (CFSE) staining and flow cytometry was adopted to analyze the proliferation and apopto-sis of MC3T3-E1 cells. qRT-PCR was used to analyze the mRNA expression level. Fluorescence resonance energy transfer (FRET) assay was conducted to detect PKC activity. The bone mineral
density (BMD) and bone volume (BV)/total volume (TV) were determined via enzyme-linked immunosorbent assay (ELISA) and microscopic computed tomography (micro-CT). Results: ERK1/2 was abnormally expressed in MC3T3-E1 cells after GlylArg19hPTH (1-34) + KT5720 treatment. GlylArg19hPTH
(1-34)+ KT5720 treatment promoted cell proliferation, inhibited cell apoptosis, and upregulatedthe expression of osteogenesis-related genes (ALP, OPN, Runx2 and OPG) in MC3T3-E1 cells, which were due to the activation of the non-PLC-dependent PKC signaling pathway and can be blocked by PKC
inhibitor Go6983 or ERK1/2 inhibitor BVD-523. Moreover, the activity of PKC in MC3T3-E1 cells treated with GlylArg19hPTH (1-34) + KT5720 + Go6983 was alleviated by ERK1/2 inhibitor BVD-523. In vivo, specific activation of the non-PLC-dependent PKC signaling pathway increased the serum
levels of APL and OPG in mice with osteoporotic fracture, which were reversed by PKC inhibitor Go6983 and ERK1/2 inhibitor BVD-523. Moreover, PKC inhibitor Go6983 and ERK1/2 inhibitor BVD-523 suppressed the elevation of BV/TV and BMD induced by specific activation of the non-PKC-dependent
signaling pathway. Conclusions: Taken together, PTH stimulates osteoporotic fracture healing in mice through the non-PLC-dependent PKC signaling pathway in which ERK1/2 exerts a vital role.
Profiles of Poor Decoders, Poor Comprehenders, and Typically Developing Readers in Adolescents Learning English as a Second Language
Authors: Li Miao , Kirby John R. , Geva Esther , Koh Poh Wee , Zhang Huan
Published: June 2021

This study examined (a) the identification of various reading groups across languages in Chinese (L1) adolescents learning English as a second language (ESL), in terms of their word-reading and reading comprehension skills, (b) overlap in reading group membership across languages, and (c) the performance of the various reading groups on reading-related language comprehension measures in English. The participants were 246 eighth-grade students from an English-immersion program in a middle school in China. Latent profile analysis identified three reading groups in each language: (a) a typically developing reader group with average or above-average word-reading and reading comprehension, (b) a group with poor decoding/word-reading skills and weak reading comprehension, and (c) a group with poor reading comprehension in the absence of poor decoding/word reading. The overlap in profile characteristics across languages for typically developing readers and poor decoders was high (about 68% for typically developing readers and 54% for poor decoders), whereas the overlap for being poor comprehenders in each language was moderate (about 37%). Furthermore, poor decoders in either language performed more poorly than the typically developing and poor comprehender groups on word reading in the other language, while poor comprehenders in either language performed more poorly than the typically developing and poor decoder groups on reading comprehension in the other language. The comparison of the reading groups’ performance on English reading-related language comprehension measures showed that poor comprehenders and poor decoders performed worse than typically developing readers. Implications for identification and instruction of ESL children with reading difficulties are discussed.
Using virtual reality to treat aggressive behavior problems in children: A feasibility study
Authors: Alsem Sophie C , van Dijk Anouk , Verhulp Esmée E , De Castro Bram O
Published: June 2021

Evidence-based cognitive behavioral therapies (CBTs) for children with aggressive behavior problems have only modest effects. Research is needed into new methods to enhance CBT effectiveness. The aims of the present study were to (1) examine whether interactive virtual reality is a feasible treatment method for children with aggressive behavior problems; (2) investigate children’s appreciation of the method; and (3) explore whether children’s aggression decreased during the ten-session treatment. Six boys (8–12 years) participated at two clinical centers in the Netherlands. Newly developed weekly reports were collected on treatment feasibility (therapist-report), treatment appreciation (child report), and children’s aggression (child/parent report). Results supported treatment feasibility: therapists delivered on average 98% of the session content, provided more than the recommended practice time in virtual reality, experienced few technical issues, and were satisfied with their treatment delivery. Children highly appreciated the treatment. Parents reported decreases in children’s aggression over the treatment period (i.e., between week 1 and week 10), but children did not. The promising findings of this feasibility study warrant randomized controlled trials to determine whether interactive virtual reality enhances CBT effectiveness for children with aggressive behavior problems.
Roles of Angioplasty With Drug-Coated Balloon for Chronic Ischemia in Wound Healing
Authors: Hata Yosuke , Iida Osamu , Ito Nobuhiro , Soga Yoshimitsu , Fukunaga Masashi , Kawasaki Daizo , Fujihara Masahiko , Kozuki Amane , Takahara Mitsuyoshi , Mano Toshiaki
Published: June 2021

Purpose:

Clinical trials have demonstrated sustained benefits of drug-coated balloon (DCB) angioplasty compared with noncoated balloon angioplasty in symptomatic peripheral artery disease (PAD) presenting with femoropopliteal (FP) artery disease. However, there is still controversy whether particulate embolization caused by crystalline paclitaxel, the so-called “downstream effect,” is adversely associated with clinical outcomes after use of FP DCB among chronic limb-threatening ischemia (CLTI) patients. The current RADISH (Roles of Angioplasty with Drug-coated balloon for chronic ISchemia in wound Healing) study investigated wound healing following DCB therapy vs non-DCB therapy for real-world CLTI patients presenting with FP lesions.

Materials and Methods:

This multicenter, retrospective study analyzed 927 patients with CLTI (mean age, 76±10 years; male, 57.8%; diabetes mellitus, 64.5%; dialysis, 50.7%) presenting with FP lesions and treated endovascularly via DCB (138 patients) vs non-DCB therapy (789 patients) between April 2014 and March 2019. The primary outcome measure was 1-year wound healing, while the secondary outcome measure was 1-year primary patency. Clinically-driven target lesion revascularization (CD-TLR), limb salvage and overall survival were also analyzed by using propensity score matching analysis.

Results:

The propensity score matching extracted 111 pairs (as many patients in the DCB group and 629 patients in the non-DCB group). The 1-year cumulative incidence of wound healing (95% CI) was 74.4% (62.6% to 82.5%) in the DCB group and 71.9% (60.4% to 80.1%) in the non-DCB group, with no significant intergroup difference (p=0.93). The DCB group had a higher rate of primary patency (p=0.002) and freedom from CD-TLR (p=0.010) than the non-DCB group, whereas there was no significant intergroup difference in limb salvage (p=0.21) or overall survival (p=0.93).

Conclusion:

The current analysis of data from the RADISH study demonstrated that DCB therapy did not lead to delayed wound healing and reduced restenosis rate in CLTI patients presenting FP lesions. From this results, DCB therapy would be a reasonable treatment option for CLTI patients.
A Chinese perspective on the actual and preferred sources of coaching knowledge
Authors: Ji Xiangbo , Xu Jianhua , Cheng Liping , Sun Jianfei , Zhang Xiaocheng
Published: June 2021

Efforts to improve coaching effectiveness require an understanding of the common sources of coaches’ knowledge acquisition. Sports coaches utilise multiple learning sources, yet limited direct evidence elucidates the manner in which Chinese coaches learn to coach and the evolution of their learning sources throughout their careers’ development. This research examines the actual and preferred sources of coaching knowledge for Chinese coaches and analyses changes in learning sources from Junior to Senior level coaches. One hundred coaches from China, including 60 Junior coaches, 23 Intermediate coaches and 17 Senior coaches, completed an online questionnaire. The survey results indicated that coaches acquire knowledge from formal, informal and non-formal learning situations. However, formal coach education (coach education programmes) is the most important source of knowledge acquisition for all coaches. Furthermore, as coaches develop, the sources to acquire knowledge will gradually change from athletic experience to interaction with other coaches. Based on these findings, we suggest that national sport governing bodies build more comprehensive coach education systems by establishing a scientific mentoring system and organising regular coach-themed clinics, seminars, meetings and so on. Future research is needed to examine how coaches in China’s dominant programmes learn to coach and how this learning is practically applied.
Blame the Pandemic: Buffering the Association Between Stress and Relationship Quality During the COVID-19 Pandemic
Authors: Neff Lisa A. , Gleason Marci E. J. , Crockett Erin E. , Ciftci Oyku
Published: June 2021

The COVID-19 pandemic created a unique climate for examining the links between stressful conditions and couples’ relationship well-being. According to theories of stress spillover, stressors originating outside the relationship, such as work stress and financial uncertainty, often undermine relationship quality. However, if individuals can easily attribute their problems to the stressful circumstances, their relationship may be more resilient. Given the salience of the pandemic, the current study used two waves of 14-day daily diary data collected from 191 participants to examine whether blaming the pandemic for problems may reduce stress spillover. We also expected the buffering effect of pandemic blaming attributions to wane as stressful conditions persisted and continued to tax partners’ coping resources. Multilevel modeling confirmed that women, but not men, who were more blaming of the pandemic exhibited reduced stress spillover during the COVID-19 outbreak; notably, this buffering effect did not weaken over time.
A scoping review of Q-methodology in healthcare research
Authors: Churruca Kate , Ludlow Kristiana , Wu Wendy , Gibbons Kate , Nguyen Hoa Mi , Ellis Louise A. , Braithwaite Jeffrey
Published: June 2021

Background

Q-methodology is an approach to studying complex issues of human ‘subjectivity’. Although this approach was developed in the early twentieth century, the value of Q-methodology in healthcare was not recognised until relatively recently. The aim of this review was to scope the empirical healthcare literature to examine the extent to which Q-methodology has been utilised in healthcare over time, including how it has been used and for what purposes.

Methods

A search of three electronic databases (Scopus, EBSCO-CINAHL Complete, Medline) was conducted. No date restriction was applied. A title and abstract review, followed by a full-text review, was conducted by a team of five reviewers. Included articles were English-language, peer-reviewed journal articles that used Q-methodology (both Q-sorting and inverted factor analysis) in healthcare settings. The following data items were extracted into a purpose-designed Excel spreadsheet: study details (e.g., setting, country, year), reasons for using Q-methodology, healthcare topic area, participants (type and number), materials (e.g., ranking anchors and Q-set), methods (e.g., development of the Q-set, analysis), study results, and study implications. Data synthesis was descriptive in nature and involved frequency counting, open coding and the organisation by data items.

Results

Of the 2,302 articles identified by the search, 289 studies were included in this review. We found evidence of increased use of Q-methodology in healthcare, particularly over the last 5 years. However, this research remains diffuse, spread across a large number of journals and topic areas. In a number of studies, we identified limitations in the reporting of methods, such as insufficient information on how authors derived their Q-set, what types of analyses they performed, and the amount of variance explained.

Conclusions

Although Q-methodology is increasingly being adopted in healthcare research, it still appears to be relatively novel. This review highlight commonalities in how the method has been used, areas of application, and the potential value of the approach. To facilitate reporting of Q-methodological studies, we present a checklist of details that should be included for publication.
Implementation of a patient centred medical home (PCMH) initiative in general practices in New South Wales, Australia
Authors: Metusela Christine , Dijkmans-Hadley Bridget , Mullan Judy , Gow Andrew , Bonney Andrew
Published: June 2021

Background

With an ageing population and an increase in chronic disease burden in Australia, Patient Centred Medical Home (PCMH) models of care have been identified as potential options for primary care reform and improving health care outcomes. Adoption of PCMH models are not well described outside of North America. We examined the experiences of seven general practices in an Australian setting that implemented projects aligned with PCMH values and goals supported by their local Primary Health Network (PHN).

Method

Qualitative and quantitative data were collected over a twelve month period, including semi-structured interviews, participant observation, and practice data to present a detailed examination of a subject of study; the implementation of PCMH projects in seven general practices. We conducted 49 interviews (24 pre and 25 post) with general practitioners, practice managers, practice nurses and PHN staff. Framework analysis deploying the domains of a logic model was used to synthesis and analyse the data.

Results

Facilitators in implementing successful, sustainable change included the capacity and willingness of practices to undertake change; whole of practice engagement with a shared vision towards PCMH change; engaged leadership; training and support; and structures and processes required to provide team-based, data driven care. Barriers to implementation included change fatigue, challenges of continued engaged leadership and insufficient time to implement PCMH change.

Conclusions

Our study examined the experiences of implementing PCMH initiatives in an Australian general practice setting, describing facilitators and barriers to PCMH change. Our findings provide guidance for PHNs and practices within Australia, as well as general practice settings internationally, that are interested in undertaking similar quality improvement projects.
Sleep duration, vegetable consumption and all-cause mortality among older adults in China: a 6-year prospective study
Authors: Bai Chen , Guo Muqi , Yao Yao , Ji John S. , Gu Danan , Zeng Yi
Published: June 2021

Background

Sleep duration and vegetable consumption are associated with mortality at old age (termed as sleep-mortality linkage and vegetable-mortality linkage, respectively). Yet, little is known about the interplay of sleep duration and vegetable consumption on mortality.

Methods

A dataset of nationwide longitudinal survey with 13,441 participants aged 65 years or older recruited in 2008 and followed up till 2014 was used. Sleep duration was classified into five groups (≤5, 6, 7–8, 9, and ≥ 10 h/day). Vegetable consumption was classified as either high frequency (eating vegetables almost daily) or low frequency. We used parametric Weibull hazard regression models to estimate associations of sleep duration and frequency of vegetable consumption with mortality, adjusting for demographics, socioeconomic factors, family/social support, health practice, and health conditions.

Results

Over the six-year study period, when only demographics were present, participants sleeping ≤5, 6, 9, and ≥ 10 h/day had relative hazard (RH) of mortality 1.18 (p < 0.001), 1.14(p < 0.01), 1.06 (p > 0.1), and 1.30 (p < 0.001), respectively, compared to those sleeping 7–8 h/day. The HRs were attenuated to 1.08 (p < 0.05), 1.08 (p < 0.05), 1.09 (p < 0.1), 1.18(p < 0.001), respectively, when all other covariates were additionally adjusted for. High frequency of eating vegetables was associated with 22% lower risk of mortality (RH= 0.78, p < 0.001) compared to low frequency in the demographic model, and with 9% lower risk (RH = 0.91, p < 0.05) in the full model. Subpopulation and interaction analyses show that the sleeping-mortality linkage was stronger in female, urban, oldest-old (aged ≥80), and illiterate participants compared to their respective male, rural, young-old, and literate counterparts. High frequency of vegetable intakes could offset the higher mortality risk in participants with short-sleeping duration, but low frequency of eating vegetables could exacerbate mortality risk for participants with either short or long sleep duration; and except for few cases, these findings held in subpopulations.

Conclusions

Too short and too long sleep durations were associated with higher mortality risk, and infrequent vegetable consumption could exacerbate the risk, although frequent vegetable intake could offset the risk for short sleep duration. The relationship between these two lifestyles and mortality was complex and varied among subpopulations.
The concordance in lesion detection and characteristics between the Anatomical Intelligence and conventional breast ultrasound Scan method
Authors: Li Juan , Wang Hao , Wang Lu , Wei Ting , Wu Minggang , Li Tingting , Liao Jifen , Tan Bo , Lu Man
Published: June 2021

Background

The aim of this study was to investigate the concordance in lesion detection, between conventional Handhold Ultrasound (HHUS) and The Anatomical Intelligence for Breast ultrasound scan method.

Result

The AI-breast showed the absolute agreement between the resident and an experienced breast radiologist. The ICC for the scan time, number, clockface location, distance to the nipple, largest diameter and mean diameter of the lesion obtained by a resident and an experienced breast radiologist were 0.7642, 0.7692, 0.8651, 0.8436, 0.7502, 0.8885, respectively. The ICC of the both practitioners of AI-breast were 0.7971, 0.7843, 0.9283, 0.8748, 0.7248, 0.8163, respectively. The k value of Anatomical Intelligence breast between experienced breast radiologist and resident in these image characteristics of boundary, morphology, aspect ratio, internal echo, and BI-RADS assessment were 0.7424, 0.7217, 0.6741, 0.6419, 0.6241, respectively. The k value of the two readers of AI-breast were 0.6531, 0.6762, 0.6439, 0.6137, 0.5981, respectively.

Conclusion

The anatomical intelligent breast US scanning method has excellent reproducibility in recording the lesion location and the distance from the nipple, which may be utilized in the lesions surveillance in the future.
Rhinovirus prevalence as indicator for efficacy of measures against SARS-CoV-2
Authors: Kitanovski Simo , Horemheb-Rubio Gibran , Adams Ortwin , Gärtner Barbara , Lengauer Thomas , Hoffmann Daniel , Kaiser Rolf ,   Respiratory Virus Network
Published: June 2021

Background

Non-pharmaceutical measures to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be carefully tuned as they can impose a heavy social and economic burden. To quantify and possibly tune the efficacy of these anti-SARS-CoV-2 measures, we have devised indicators based on the abundant historic and current prevalence data from other respiratory viruses.

Methods

We obtained incidence data of 17 respiratory viruses from hospitalized patients and outpatients collected by 37 clinics and laboratories between 2010-2020 in Germany. With a probabilistic model for Bayes inference we quantified prevalence changes of the different viruses between months in the pre-pandemic period 2010-2019 and the corresponding months in 2020, the year of the pandemic with noninvasive measures of various degrees of stringency.

Results

We discovered remarkable reductions δ in rhinovirus (RV) prevalence by about 25% (95% highest density interval (HDI) [−0.35,−0.15]) in the months after the measures against SARS-CoV-2 were introduced in Germany. In the months after the measures began to ease, RV prevalence increased to low pre-pandemic levels, e.g. in August 2020 δ=−0.14 (95% HDI [−0.28,0.12]).

Conclusions

RV prevalence is negatively correlated with the stringency of anti-SARS-CoV-2 measures with only a short time delay. This result suggests that RV prevalence could possibly be an indicator for the efficiency for these measures. As RV is ubiquitous at higher prevalence than SARS-CoV-2 or other emerging respiratory viruses, it could reflect the efficacy of noninvasive measures better than such emerging viruses themselves with their unevenly spreading clusters.
A high degree of knee flexion after TKA promotes the ability to perform high-flexion activities and patient satisfaction in Asian population
Authors: Han Hyuk-Soo , Kim Jong Seop , Lee Bora , Won Sungho , Lee Myung Chul
Published: June 2021

Background

This study investigated whether achieving a higher degree of knee flexion after TKA promoted the ability to perform high-flexion activities, as well as patient satisfaction and quality of life.

Methods

Clinical data on 912 consecutive primary TKA cases involving a single high-flexion posterior stabilized fixed-bearing prosthesis were retrospectively analyzed. Demographic and clinical data were collected, including knee flexion angle, the ability to perform high-flexion activities, and patient satisfaction and quality of life.

Results

Of the cases, 619 (68%) achieved > 130° of knee flexion after TKA (high flexion group). Knee flexion angle and clinical scores showed significant annual changes, with the maximum improvement seen at 5 years and slight deterioration observed at 10 years postoperatively. In the high flexion group, more than 50% of the patients could not kneel or squat, and 35% could not stand up from on the floor. Multivariate analysis revealed that > 130° of knee flexion, the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient satisfaction after TKA, while the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient quality of life after TKA.

Conclusions

High knee flexion angle (> 130°) after TKA increased the ease of high-flexion activities and patient satisfaction. The ease of high-flexion activities also increased quality of life after TKA in our Asian patients, who frequently engage in these activities in daily life.
Molecular and serological characterization of pathogenic Leptospira spp. isolated from symptomatic dogs in a highly endemic area, Brazil
Authors: Santos Cassia Moreira , Dias Gabrielle Cristini Del Rigo Santos , Saldanha Alexya Victória Pinheiro , Esteves Stephanie Bergmann , Cortez Adriana , Guedes Israel Barbosa , Heinemann Marcos Bryan , Gonçales Amane Paldês , Miotto Bruno Alonso
Published: June 2021

Background

Leptospirosis is an endemic zoonosis in Brazil, with a great impact on human and animal health. Although dogs are frequently infected by pathogenicLeptospira, the current epidemiological understanding of canine leptospirosis is mainly based on serological tests that predict the infecting serogroup/serovar. Thus, the present study aimed at identifying the causative agent for severe cases of canine leptospirosis in a highly endemic area through the isolation and characterization of the isolated strains.

Results

Urine, serum and blood samples were collected from 31 dogs with suspected acute leptospirosis treated at the Veterinary Hospital Service of Santo Amaro University between 2018 and 2019. Acute infection was confirmed in 17 dogs (54.8%) by the associated use of Polymerase Chain Reaction (PCR), Microscopic Agglutination (MAT) and bacteriological culture. Eleven dogs (35.5%) had titers ≥800, with the most frequent serogroups being Autumnalis and Icterohaemorrhagiae (n = 4 each) and Canicola (n = 2). Leptospires were recovered from four dogs, and Multilocus Sequence Analysis (MLSA) revealed infection caused byL. interrogans, which were further characterized as serogroups Canicola (n = 1) and Icterohaemorrhagiae (n = 3).

Conclusion

The identity of the isolates and serological pattern of MAT suggest that dogs are highly exposed to the serogroup Icterohaemorrhagiae and Canicola, also indicating possible circulation of serogroups not yet isolated in Brazil, notably serogroup Autumnalis. Our findings also reinforce the usefulness of using multiple diagnostic approaches to confirm acute canine leptospirosis.
Recombinant human luteinizing hormone co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age: a systematic review and meta-analysis of randomized controlled trials
Authors: Conforti Alessandro , Esteves Sandro C. , Humaidan Peter , Longobardi Salvatore , D’Hooghe Thomas , Orvieto Raoul , Vaiarelli Alberto , Cimadomo Danilo , Rienzi Laura , Ubaldi Filippo Maria , Zullo Fulvio , Alviggi Carlo
Published: June 2021

Introduction

Several studies suggest that luteinizing hormone (LH) could improve IVF outcome in women of advanced reproductive age by optimizing androgen production. In this review, we assessed the role of recombinant-human LH (r-hLH) and recombinant human follicle stimulating hormone (r-hFSH) co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age candidates for assisted reproduction.

Material and methods

Using a preregistered protocol we systematically searched Medline/PubMed, Scopus and the ISI Web of Science databases to identify randomized controlled trials in which r-hFSH monotherapy protocols were compared with r-hFSH/r-hLH co-treatment in women ≥35 years undergoing fresh IVF cycles. We calculated the pooled odds ratio (OR) for dichotomous data and the weight mean difference (WMD) for continuous data with an associated 95% confidence interval (CI). The meta-analyses were conducted using the random-effect model. P values < 0.05 were considered statistically significant. Subgroup analyses of all primary and secondary outcomes were performed only in women aged 35–40 years.

Results

Twelve studies were identified. In women aged between 35 and 40 years, r-hFSH/r-hLH co-treatment was associated with higher clinical pregnancy rates (OR 1.45, CI 95% 1.05–2.00, I2 = 0%, P = 0.03) and implantation rates (OR 1.49, CI 95% 1.10–2.01, I2 = 13%, P = 0.01) versus r-hFSH monotherapy. Fewer oocytes were retrieved in r-hFSH/r-hLH-treated patients than in r-hFSH-treated patients both in women aged ≥35 years (WMD -0.82 CI 95% -1.40 to − 0.24, I2 = 88%, P = 0.005) and in those aged between 35 and 40 years (WMD -1.03, CI − 1.89 to − 0.17, I2 = 0%, P = 0.02). The number of metaphase II oocytes, miscarriage rates and live birth rates did not differ between the two groups of women overall or in subgroup analysis.

Conclusion

Although more oocytes were retrieved in patients who underwent r-hFSH monotherapy, this meta-analysis suggests that r-hFSH/r-hLH co-treatment improves clinical pregnancy and implantation rates in women between 35 and 40 years of age undergoing ovarian stimulation for assisted reproduction technology. However, more RCTs using narrower age ranges in advanced age women are warranted to corroborate these findings.