bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pituitary Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study
Authors: Robba Chiara , Aspide Raffaele , Pegoli Marianna , Kondratyeva Ekaterina , Gritti Paolo , Fustini Marco F. , Battaglini Denise , Pelosi Paolo , Hutchinson Peter J. , Helmy Adel , Bortolotti Carlo , Zenesini Corrado , Bilotta Federico 
Published: June 2020

Background:
The prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage (aSAH) remains incompletely elucidated. Furthermore, it is not clear whether these abnormalities impact patient outcomes. The aim of this study was to evaluate the prevalence of pituitary dysfunction after aSAH and its effect on outcomes.

Methods:
We carried out a prospective, cohort study including adult patients (18 y of age or older) with a diagnosis of aSAH who were admitted to the intensive care unit in 3 centers between January 2017 and January 2019. Exclusion criteria were previous hypopituitarism, hormonal replacement therapies for pituitary dysfunction or any corticosteroid treatment. Endocrine function was tested within the first 48 hours after aSAH onset (acute phase), after 1 to 3 weeks (subacute phase), and after 6 to 12 months (chronic phase). Clinical outcomes were assessed at 6 to 12 months using the modified Rankin Scale.

Results:
Fifty-six patients were included in the study; all were studied in the acute phase, 34 were studied in the subacute phase, and 49 in the chronic phase. Pituitary dysfunction was identified in 92.3% (95% confidence interval; [CI]: 86.6%-98.0%) of cases in the acute phase, in 83.3% (95% CI: 70.8%-95.8%) in the subacute phase, and in 83.3% (95% CI: 72.7%-93.9%) of cases in the chronic phase. The most commonly identified abnormality was dysfunction of the pituitary-gonadal axis. There was no correlation between pituitary dysfunction and clinical outcome.

Conclusion:
Pituitary dysfunction is common after aSAH, but does not affect 6 to 12-month clinical outcomes.
Selection Criteria for Cochlear Implantation in the United Kingdom and Flanders: Toward a Less Restrictive Standard
Authors: van der Straaten Tirza F. K. , Briaire Jeroen J. , Vickers Deborah , Boermans Peter Paul B. M. , Frijns Johan H. M. 
Published: June 2020

Objectives:
The impact of the newly introduced cochlear implantation criteria of the United Kingdom and Flanders (Dutch speaking part of Belgium) was examined in the patient population of a tertiary referral center in the Netherlands. We compared the patients who would be included/excluded under the new versus old criteria in relation to the actual improvement in speech understanding after implantation in our center. We also performed a sensitivity analysis to examine the effectiveness of the different preoperative assessment approaches used in the United Kingdom and Flanders.

Design:
The selection criteria were based on preoperative pure-tone audiometry at 0.5, 1, 2, and 4 kHz and a speech perception test (SPT) with and without best-aided hearing aids. Postoperatively, the same SPT was conducted to assess the benefit in speech understanding.

Results:
The newly introduced criteria in Flanders and the United Kingdom were less restrictive, resulting in greater percentages of patients implanted with CI (increase of 30%), and sensitivity increase of 31%. The preoperative best-aided SPT, used by both countries, had the highest diagnostic ability to indicate a postoperative improvement of speech understanding. We observed that patient selection was previously dominated by the pure-tone audiometry criteria in both countries, whereas speech understanding became more important in their new criteria. Among patients excluded by the new criteria, seven of eight (the United Kingdom and Flanders) did exhibit improved postoperative speech understanding.

Conclusions:
The new selection criteria of the United Kingdom and Flanders led to increased numbers of postlingually deafened adults benefitting from CI. The new British and Flemish criteria depended on the best-aided SPT with the highest diagnostic ability. Notably, the new criteria still led to the rejection of candidates who would be expected to gain considerably in speech understanding after implantation.
Vestibular Function in Children With a Congenital Cytomegalovirus Infection: 3 Years of Follow-Up
Authors: Dhondt Cleo , Maes Leen , Rombaut Lotte , Martens Sarie , Vanaudenaerde Saartje , Van Hoecke Helen , De Leenheer Els , Dhooge Ingeborg 
Published: June 2020

Objectives:
Congenital cytomegalovirus (cCMV) infection is the most common nongenetic cause of sensorineural hearing loss in children. Due to the close anatomical relationship between the auditory and the vestibular sensory organs, cCMV can also be an important cause of vestibular loss. However, the prevalence and nature of cCMV-induced vestibular impairment is still underexplored. The aim of this study was to investigate the occurrence and characteristics of vestibular loss in a large group of cCMV-infected children, representative of the overall cCMV-population.

Design:
Ninety-three children (41 boys, 52 girls) with a confirmed diagnosis of cCMV were enrolled in this prospective longitudinal study. They were born at the Ghent University Hospital or referred from another hospital for multidisciplinary follow-up in the context of cCMV. The test protocol consisted of regular vestibular follow-up around the ages of 6 months, 1 year, 2 years, and 3 years with the video Head Impulse Test, the rotatory test, and the cervical Vestibular Evoked Myogenic Potential test.

Results:
On average, the 93 patients (52 asymptomatic, 41 symptomatic) were followed for 10.2 months (SD: 10.1 mo) and had 2.2 examinations (SD: 1.1). Seventeen (18%) patients had sensorineural hearing loss (7 unilateral, 10 bilateral). Vestibular loss was detected in 13 (14%) patients (7 unilateral, 6 bilateral). There was a significant association between the occurrence of hearing loss and the presence of vestibular loss (p < 0.001), with 59% (10/17) vestibular losses in the group of hearing-impaired children compared to 4% (3/76) in the group of normal-hearing subjects. In the majority of the cases with a vestibular dysfunction (85%, 11/13), both the semicircular canal system and the otolith system were affected. The remaining subjects (15%, 2/13) had an isolated semicircular canal dysfunction. Sixty-one patients already had at least one follow-up examination. Deterioration of the vestibular function was detected in 6 of them (10%, 6/61).

Conclusions:
cCMV can impair not only the auditory but also the vestibular function. Similar to the hearing loss, vestibular loss in cCMV can be highly variable. It can be unilateral or bilateral, limited or extensive, stable or progressive, and early or delayed in onset. As the vestibular function can deteriorate over time and even normal-hearing subjects can be affected, vestibular evaluation should be part of the standard otolaryngology follow-up in all children with cCMV.
Climate change, air pollution, and allergic respiratory diseases: a call to action for health professionals
Authors: Deng Shi-Zhou , Jalaludin Bin B. , Antó Josep M. , Hess Jeremy J. , Huang Cun-Rui 
Published: June 2020

Abstract
Rising emissions of greenhouse gases in the atmosphere have warmed the planet substantially and are also accompanied by poor air quality. The increased prevalence of allergic airway disease worldwide can be partially attributed to those global environmental changes. Climate change and air pollution pose adverse impacts on respiratory allergies, and that the mechanisms are complex and interactive. Adverse weather conditions, such as extreme temperatures, can act directly on the respiratory tract to induce allergic respiratory illnesses. Thunderstorms and floods can alter the production and distribution of aeroallergens while wildfires and dust storms increase air pollution, and therefore indirectly enhance health risks. Concentrations of particulate matter and ozone in the air have been projected to increase with climate warming and air stagnation, and the rising temperatures and CO2 increase pollen, molds, and spores, which escalate the risk of allergic respiratory diseases. The synergistic effects of extreme heat and aeroallergens intensify the toxic effect of air pollutants, which in turn augment the allergenicity of aeroallergens. With the Earth's climate change, migration of humans and plants shift the living environments and allergens of susceptible people. Urban residents are exposed to multiple factors while children are sensitive to environmental exposure. Since climate change may pose many unexpected and persistent effects on allergic respiratory diseases, health professionals should advocate for effective mitigation and adaptation strategies to minimize its respiratory health effects.
Health effects of air pollution: a Southern European perspective
Authors: Viegi Giovanni , Baldacci Sandra , Maio Sara , Fasola Salvatore , Annesi-Maesano Isabella , Pistelli Francesco , Carrozzi Laura , La Grutta Stefania , Forastiere Francesco 
Published: June 2020

Abstract

Objective
To summarize the main updated evidence about the health effects of air pollution, with a special focus on Southern Europe.

Data sources
Literature was obtained through PubMed Central and the official websites of European Agencies and Scientific Societies.

Study selection
Recent shreds of evidence about the health effects of air pollution coming from international reports and original research were collected and described in this review.

Results
Air pollution is an avoidable risk factor that causes a huge burden for society, in terms of death, health disorders, and huge socio-economic costs. The southern European countries face a more threatening problem because they experience the effects of both anthropogenic pollutants and natural dusts (particulate matter [PM]). The European Environment Agency reported the number of premature deaths in the 28 countries of the European Union attributable to air pollutant exposure in the year 2016: 374,000 for PM2.5, 68,000 for nitrogen dioxide, and 14,000 for ozone. In Italy, time series and analytical epidemiological studies showed increased cardio-respiratory hospital admissions and mortality, as well as increased risk of respiratory diseases in people living in urban areas.

Conclusions
Based on abundant evidence, the World Health Organization, which hosts the Global Alliance against Chronic Respiratory Diseases (GARD), the scientific respiratory societies, and the patients’ associations, as well as others in the health sector, must increase their engagement in advocacy for clean air policies.
LncRNA Gm4419 Regulates Myocardial Ischemia/Reperfusion Injury Through Targeting the miR-682/TRAF3 Axis
Authors: Zhao Guixiang , Hailati Juledezi , Ma Xiaoyun , Bao Zhen , Bakeyi Maerjiaen , Liu Zhiqiang 
Published: June 2020

Abstract:
Myocardial cell death during acute myocardial infarction occurs because of acute ischemia, persistent ischemia, reperfusion-associated injury, and the inflammatory infiltrate as a response to cell necrosis. In the present study, quantitative real-time PCR showed that lncRNA Gm4419 was highly upregulated in ischemia/reperfusion myocardial tissues and hypoxia/reoxygenation H9C2 cells, whereas miR-682 was downregulated. Knocking down Gm4419 with sh-Gm4419 resulted in the rescue of myocardial infarction and apoptosis induced by ischemia/reperfusion or hypoxia/reoxygenation. Our study further demonstrated that Gm4419 may bind with miR-682 directly. Moreover, in vitro experiments further demonstrated that miR-682 could bind to tumor necrosis factor receptor-associated factor 3 (TRAF3) directly. Most importantly, TRAF3 overexpression could counteract the effect of sh-Gm4419. Taken together, our study indicated that Gm4419 may target miR-682 via sponging to increase TRAF3 expression, thereby contributing to myocardial I/R injury. Therefore, the Gm4419/miR-682/TRAF3 axis may be an important regulatory mechanism in myocardial ischemia/reperfusion injury.
A Potential Role for CXCR2 in Early-onset Preeclampsia: Placental CXCR2 Expression is Related to Increased Blood Pressure and Serum LDH Levels
Authors: Zhang Yan-Ping , Liu Xi-Jing , Jia Jin , Wang Tao , Li Li , Zhou Rong 
Published: June 2020

Abstract

Objective:
This study was aimed to determine the changes in CXCR2 expression in preeclampsia placenta and its correlation with clinical parameters.

Methods:
Sixty-four gravidas ranging in age from 25 to 42 years referred to the obstetrics unit of the West China Second University Hospital from April 2012 to October 2012 were recruited in this case-control study; women were diagnosed and divided into early-onset preeclampsia group (n = 22), late-onset preeclampsia group (n = 22), and healthy pregnancy group (n = 20). After immunolocalized in human placenta, the levels of CXCR2 protein and messenger ribonucleic acid (mRNA) were detected by enzyme-linked immunosorbent assay and real-time quantitative polymerase chain reaction. Correlations between placental CXCR2 protein expression with systolic blood pressure and lactate dehydrogenase (LDH) in early-onset preeclampsia were examined using Pearson or Spearman's correlation coefficients.

Results:
Placental CXCR2 protein and mRNA expression in early-onset preeclampsia was significantly lower than it was in placentas from healthy pregnancy pregnancies and late-onset preeclampsia (P < 0.05). The placental CXCR2 protein expression correlated negatively with systolic blood pressure and LDH in early-onset preeclampsia (r = −0.51, P < 0.05; r = −0.43, P < 0.05).

Conclusion:
Significant abnormal placental CXCR2 expression in early-onset preeclampsia, and its correlations with some clinical parameters (systolic blood pressure and LDH) were discovered, suggesting that CXCR2 may play a role in the pathogenesis of early-onset preeclampsia.
Preterm Birth, From the Biological Knowledges to the Prevention: An Overview
Authors: Tosto Valentina , Giardina Irene , Tsibizova Valentina , Renzo Gian Carlo Di 
Published: June 2020

Abstract
The time of birth is a critical determinant of perinatal and long-term outcomes, and even trans-generational effects. Preterm birth is still the leading cause of infant mortality and morbidity. Unfortunately, rates of preterm birth remain high worldwide. Preterm parturition is a complex syndrome, which can be induced by several factors such as infection, cervical pathology, uterine overdistension, progesterone deficiency, vascular alterations (utero-placental ischemia, decidual hemorrhage), maternal and fetal stress, allograft reaction, allergic phenomena, and probably other several unknown factors. The mechanisms responsible for early labor activation have been partially identified and involve receptors, chemokines, and inflammatory cytokines. It is very useful to understand the cellular and biochemical pathways responsible for preterm labor activation to identify, treat, and prevent negative outcome in a timely manner. Researchers and clinicians play a key role in improving biochemical knowledge on preterm delivery, identifying risk factors, and applying multilevel preventive strategies.
New Concept and Management for Sepsis in Pregnancy and the Puerperium
Authors: Fan Shang-Rong , Liu Ping , Yan Shao-Mei , Huang Lei , Liu Xiao-Ping 
Published: June 2020

Abstract
Sepsis, which is life-threatening organ dysfunction resulting from a dysregulated host response to infection, remains a major cause for the admission of pregnant women to the intensive care unit and is one of the leading causes of maternal morbidity and mortality. The obstetric causes include uterine infection, septic abortion, and wound infection. The non-obstetric causes include pyelonephritis and pneumonia. Maternal sepsis may also be from obstetrical critical illness, such as obstetric severe hemorrhage, obstetric (amniotic fluid/pulmonary) embolism, acute fatty liver of pregnancy, and congestive heart failure, cardiopulmonary arrest, and major trauma. The most commonly reported pathogens in maternal sepsis include Escherichia coli, Streptococcus, Staphylococcus, and other gram-negative bacteria. Maternal sepsis may cause intrauterine infection, which results in (1) preterm premature rupture of membranes or preterm labor or birth, (2) cerebral white matter damage or cerebral palsy or neurodevelopmental delay, (3) stillbirth, (4) early- or late-onset sepsis, and (5) perinatal death. The “Hour-1 bundle” should be initiated within the first hour of the recognition of sepsis. The use of early, appropriate antibiotics is crucial in the management of maternal sepsis. Fetal status should be monitored. Appropriate and early source control should be provided. The decision for delivery is often quite complex and should be individualized to each patient's clinical scenario while taking into consideration the suspected source of infection, maternal status, fetal well-being, and gestational age. Extracorporeal membrane oxygenation has been increasingly used in refractory sepsis during pregnancy and the puerperium.
Health Literacy of Patients Attending Cardiac Rehabilitation
Authors: Beauchamp Alison , Sheppard Robyn , Wise Frances , Jackson Alun 
Published: June 2020

Purpose:
Cardiac rehabilitation (CR) is effective at reducing further cardiac events. However, dropout rates are high, and maintenance of behavioral change post-CR is challenging. Health literacy (HL) may influence self-management of cardiac risk, yet few studies have explored this association. This study aimed to describe HL among CR attendees; first to describe the HL profiles of people commencing CR and second to examine HL changes between program entry and completion.

Methods:
CR attendees in Melbourne, Australia, completed the Health Literacy Questionnaire (HLQ) at program admission and completion. The HLQ measures HL across 9 scales. Cluster analysis grouped participants according to their HL profile. Effect sizes were used to determine changes in HLQ scores. Post-program interviews explored the role of HL in participant recovery.

Results:
Participants completed baseline (n = 60) and post-program (n = 38) data collection. Mean age was 60.3 ± 11.7 yr, and 38.3% had myocardial infarction and/or percutaneous coronary intervention. Approximately 18% of participants did not complete the program. Five HL clusters were revealed. The clusters most likely to drop out were confident users of the health system. The cluster least likely to drop out reported lower confidence in their ability to find health information and navigate services. Information-seeking ability improved over time, but no other HL improvements were seen.

Conclusion:
There is a wide range of HL profiles in people attending CR. Findings suggest that CR programs should consider a variety of approaches to meet the diverse HL requirements of attendees.
The Effects of Maintenance Cardiac Rehabilitation
Authors: Sánchez-Delgado Juan Carlos , Camargo Sepulveda Diana Carolina , Cardona Zapata Adalgiza , Franco Pico Mayra Yulieth , Santos Blanco Lina Marcela , Jácome Hortúa Adriana Marcela , Dutra de Souza Hugo Celso , Angarita-Fonseca Adriana 
Published: June 2020

Purpose:
Maintenance cardiac rehabilitation (M-CR) programs aim to preserve the health benefits achieved during phase II cardiac rehabilitation (CR). The aim of this study was to establish the effects of M-CR on functional capacity, quality of life, risk factors, costs, mortality, and morbidity, among other outcomes.

Methods:
Scopus, ISI Web of Science, PubMed, Embase & Embase classic OVID, and Lilacs were searched. Randomized controlled trials, published between 2000 and 2016, on the effects of M-CR in patients with cardiovascular disease, who had graduated from CR, having a control or comparison arm were included. Citations were processed by two authors, independently. Methodological quality was assessed using PEDro, and level of evidence graded with the Scottish scale. Outcomes were qualitatively synthesized.

Results:
The searches retrieved 1901 studies with 26 articles meeting inclusion criteria (3752 participants). Some trials tested M-CR in nonclinical settings, and others used resistance or high-intensity interval training. The methodological quality of 11 articles was good, with a level of evidence (1+) and a grade B recommendation. Results showed M-CR resulted in increased or maintained functional capacity, quality of life, and physical activity levels, when compared with the control. No adverse events were reported. Few studies assessed rehospitalizations and mortality.

Conclusion:
Quality of included trials was low because it is not possible to double-blind in M-CR trials and also due to the heterogeneity of M-CR interventions. Understanding, availability, and use of M-CR programs should be increased.
Visual performance after bilateral toric extended depth-of-focus IOL exchange targeted for micromonovision
Authors: Georgiev Stefan , Palkovits Stefan , Hirnschall Nino , Döller Birgit , Draschl Petra , Findl Oliver 
Published: June 2020

Purpose:
To evaluate overall patient satisfaction, spectacle independence, binocular visual acuity, rotational stability, prevalence of optical phenomena, and decentration and tilt after bilateral toric extended depth-of-focus intraocular lens (EDOF IOL) implantation targeted for micromonovision.

Setting:
Department of Ophthalmology, Hanusch Hospital, Vienna, Austria.

Design:
Prospective case series.

Methods:
The study included 52 eyes of 26 patients with regular corneal astigmatism from 0.75 to 2.60 diopters (D) that were implanted bilaterally with a toric EDOF IOL targeted for micromonovision. Postoperative visual acuity, astigmatism reduction, rotation, tilt, decentration, spectacle independence, patient satisfaction, and photic phenomena were assessed.

Results:
For the 52 eyes studied, binocular means expressed in logarithm of the minimum angle resolution for postoperative corrected distance, uncorrected distance, uncorrected intermediate, and uncorrected near visual acuities were −0.10 (±0.12), −0.01 (±0.13), 0.01 (±0.14), and 0.13 (±0.14), respectively. Mean refractive astigmatism reduction was 1.31 ± 0.67 D resulting in a mean refractive cylinder of 0.47 ± 0.46 D at the 3-month visit. Mean postoperative rotation was 3.5 ± 3.5 degrees, at the 3-month time point. Most prevalent dysphotopsia were halos, starburst, and glare affecting 6 (23%), 6 (23%), and 5 (19%) of 26 patients, respectively; 20 (77%) of 26 patients reported spectacle independence, with 19 (95%), 19 (95%), and 14 (70%) of 20 patients questioned being satisfied with distance, intermediate, and near vision, respectively.

Conclusions:
Toric EDOF IOL implantation targeted for micromonovision resulted in reliable reduction of preoperative astigmatism with a high degree of postoperative rotational predictability and centration, enabling functional distance, intermediate, and near vision, which manifested itself in high patient satisfaction.