bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Cardiovascular Risk Management be improved by Shared Care with General Practice to Prevent Cognitive Decline Following Stroke/TIA? A feasibility randomised controlled Trial (SERVED Memory)
Authors: Davison William , Myint Phyo K , Loke Yoon K , Ravenhill Garth , Turner David A , Fox Chris , Shepstone Lee , Potter John F 
Published: April 2020

Abstract
BackgroundCognitive impairment and dementia following cerebrovascular disease are increasingly common in the UK. One potential strategy to prevent post-stroke cognitive decline is multimodal vascular risk factor management. However, its efficacy remains uncertain and its application in vulnerable patients with incident cerebrovascular disease and early cognitive impairment has not been assessed.The primary aim of this study was to assess the feasibility of recruitment and retention of patients with early cognitive impairment post-stroke or transient ischaemic attack (TIA) to a trial of enhanced vascular risk factor management combining primary and secondary care.MethodsIn this single centre, open label trial adults with a recent stroke or TIA and mild cognitive impairment (MCI) were randomised 1:1 to a three-monthly multimodal vascular risk factor intervention jointly delivered by the trial team and General Practitioner (GP), or control (defined as usual care from the GP). Chosen risk factors were blood pressure (BP), total cholesterol, blood glucose (HbA1C) in those with diabetes, and heart rate and adequacy of anticoagulation in those with atrial fibrillation (AF). Similar patients with normal cognition were enrolled in an embedded observational cohort and also received usual care from the GP. Repeat cognitive screening was undertaken in all participants after 12 months.ResultsSeventy three participants were recruited to the randomised trial and 94 to the observational cohort (21.8% of those screened). From the randomised trial 35/73 (47.9%) dropped out before final follow-up. In all groups guideline based rates of risk factor control were mostly poor at baseline and did not significantly improve during follow-up. The observational cohort demonstrated greater decline in cognitive test scores at 12 months, with no difference between the randomised groups.ConclusionsRecruitment to such a study was feasible, but retention of participants was difficult and generally poor rates of risk factor control suggested insufficient application of the intervention. Consequently, successful scaling up of the trial would require protocol changes with less reliance on primary care services. Any future trial should include participants with normal cognition post-stroke as they may be at greatest risk of cognitive decline.Trial RegistrationISRCTN, ISRCTN42688361. Registered 16 April 2015, https://www.isrctn.com/ISRCTN42688361
Does diabetes mellitus increase the occurrence of early thrombosis in deep vein following unicompartmental arthroplasty of the knee: a retrospective cohort study
Authors: Jiao Xu-Feng , Li Zheng , An Shuai , Huang Jiang , Feng Ming-Li , Zheng Jia-Xing , Cao Guanglei 
Published: April 2020

Abstract
IntroductionMany patients with knee osteoarthritis also suffer from diabetes mellitus and the possibility of deep venous thrombosis (DVT) is increased following unicompartmental knee arthroplasty (UKA). Therefore, we evaluated whether DVT occurrence increased 3 days following operation in diabetic patients undergoing UKA.Materials and methodsThe incidence of deep venous thrombosis between non-diabetic and diabetic patients who underwent UKA in our hospital from August 2018 to January 2020 was compared, and the effect of glycosylated hemoglobin levels on DVT was evaluated.ResultsOf the 84 patients, 25 (29.8%) had diabetes and 59 (70.2%) did not. Within 3 days after operation, DVT occurred in 12 cases (48.0%) in the diabetic group and 8 cases (13.6%) (p < 0.001) in the control group. In logistic regression analysis, the results demonstrated that the risk of deep venous thrombosis in diabetic group was 5.53 times higher compared with non-diabetic group. For every 1 unit increase of glycosylated hemoglobin, the incidence of DVT increased 2.88 times (95% CI: 1.097–7.559, p = 0.032). There was no significant difference in age, sex, body mass index, hypertension, mode of anesthesia, operation time, intraoperative blood loss, tourniquet pressure and time between the two groups.ConclusionThe incidence of DVT in diabetic patients within 3 days after UKA is significantly higher than that in non-diabetic patients. The higher the concentration of glycosylated hemoglobin, the greater the risk of DVT.
Efficacy and safety of thrombolysis for acute ischemic stroke with atrial fibrillation: a meta-analysis
Authors: Hu Yunzhen , Ji Chunmei 
Published: April 2020

Abstract
Background
The efficacy and safety of intravenous thrombolysis (IVT) in acute ischemic stroke with atrial fibrillation (AF) were controversial.
Methods
We performed a meta-analysis of all relevant studies retrieved by systematic searches of the, Embase, and Cochrane databases up to December 31, 2019. Modified Rankin Scale (mRS) scores 0–1 at 90 days, mRS 0–2 at 90 days, overall mortality, and symptomatic intracranial hemorrhage (sICH) incidence were collected as outcome measures. Fixed effects meta-analytical models were used, and between-study heterogeneity was assessed.
Results
A total of 8,509 patients were enrolled in eighteen studies. In AF IVT versus non-AF IVT studies, AF was associated with a significant decrease in the proportion of patients with mRS of 0–1 (24.1% vs. 34.5%; OR 0.57; 95% CI 0.50–0.65; P = 0.000), mRS of 0–2 (33.6% vs. 47.8%; OR 0.50; 95% CI 0.44–0.57; P = 0.000) and significant higher in mortality (19.4% vs. 11.5%; OR 2.05; 95% CI 1.79–2.36; P = 0.000) and sICH incidence (6.4% vs. 4.1%; OR 1.60; 95% CI 1.27–2.01; P = 0.000). In AF IVT versus AF non-IVT studies, thrombolysis carried a higher risk of sICH (5.7% vs. 1.6%; OR 3.44; 95% CI 2.04–5.82; P = 0.000) instead of a better prognosis. Subgroup analysis in prospective studies also suggested a poorer functional prognosis and higher mortality in AF patients treated IVT compared with non-IVT.
Conclusion
Patients with AF had worse outcomes than those without AF after thrombolytic therapy. Patients with AF had a higher incidence of sICH after thrombolysis than those without thrombolysis.
Hospital transfer of people with dementia: results of the European RightTimePlaceCare project on their frequency, factors associated and costs
Authors: Argilés F. Javier Afonso , Meyer Gabriele , Stephan Astrid , Comas Mercè , Wübker Ansgar , Leino-Kilpi Helena , Lethin Connie , Saks Kai , Soto-Martin Maria , Sutcliffe Caroline , Verbeek Hilde , Zabalegui Adelaida , Renom-Guiteras Anna 
Published: April 2020

Abstract
Background
Hospitalisation is a critical moment for people with dementia and a major challenge for health care systems. The aims of this study were 1) to describe the frequency of hospital transfer among people with dementia from eight European countries, 2) to examine the factors associated with hospital transfer and 3) to evaluate the costs related with it.
Methods
The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was carried out with data collected from people with dementia who lived either at home or had been admitted to a nursing home in the last three months, as well as from their caregivers. Data on hospital transfers at three months were gathered with the "The Resource Utilization in Dementia" instrument. Demographic data, functional, cognitive and neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status and falls were evaluated with validated tools. Multivariate regression models were used to investigate the factors associated with hospital transfers. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2018.
Results
The study sample comprised 1,700 people with dementia and their informal caregivers. Within three months, 16.7% experienced ≥ 1 hospital transfers. Multivariate logistic regression model showed a higher probability of hospital transfers among people with dementia with unintentional weight loss, polypharmacy, falls and those living in the community. The estimated costs per person with dementia/year among the participants living in a nursing home were 980.56 euros and 2,535.39 euros among those receiving home care.
Conclusion
Transfer to hospital is frequent among people with dementia, especially among those living in the community. These events are associated with the onset of geriatric syndromes such as involuntary weight loss, accidental falls and polypharmacy, and impose a remarkable economic burden. These results suggest that there is a need to develop and implement cost-effective supportive interventions that focus on the identification of people with dementia at risk of hospital transfer, the assessment and management of these geriatric syndromes and the promotion of individualised care planning for them, in order to prevent unnecessary hospital transfers.
Comorbidities associated with nontuberculous mycobacterial disease in Japanese adults: A claims-data analysis
Authors: Uno Shunsuke , Aasakura Takanori , Morimoto Kozo , Yoshimura Kimio , Uwamino Yoshifumi , Nishimura Tomoyasu , Hoshino Yoshihiko , Hasegawa Naoki 
Published: April 2020

Abstract
Background
Nontuberculous mycobacterial (NTM) lung disease is one of a growing number of chronic health problems that is difficult to cure in aging societies. While it is important to be vigilant about associated comorbidities in order to provide better patient care, data on the prevalence of comorbidities stratified by country or region are scarce. We aimed to elucidate the comorbidities associated with NTM disease based on Japanese health insurance claims data.
Methods
Cross-sectional analyses were performed using the claims data for 2014 provided by the Japan Medical Data Center Co., Ltd. Patients aged 20–75 years with ≥ 3 claims associated with NTM disease were identified and matched to 10 sex-and-age-matched controls that had never made a claim for NTM disease. Thirty-one comorbidities previously suspected to be associated with NTM disease were selected, and the prevalence of these comorbidities compared between cases and controls.
Result
Overall, 419 NTM patients (134 males and 285 females) and 4190 non-NTM controls were selected from the JMDC database. Aspergillosis, asthma, bronchiectasis, chronic heart failure, diffuse panbronchiolitis, gastroesophageal reflux, interstitial pneumonia, lung cancer, cancer other than breast, lung, ovary, or prostate cancer, and rheumatic arthritis were associated with NTM disease in both males and females. Chronic obstructive pulmonary disease was associated with NTM in males while chronic kidney disease, osteoporosis, and Sjögren syndrome were associated with NTM in females.
Conclusion
NTM disease was associated with multiple comorbidities that should be considered when providing medical care to individuals with NTM disease.
What we know and don’t know about the Immunization Program of Ethiopia: A Scoping Review of the Literature
Authors: Tilahun Binyam , Mekonnen Zeleke , Sharkey Alyssa , Shahabuddin Asm , Feletto Marta , Zelalem Meseret , Shiekh Kabir 
Published: April 2020

Abstract
Background: There has been significant recent prioritization and investment in the immunization program in Ethiopia. However, coverage rates have stagnated and remained low for many years, suggesting the presence of systemic barriers to implementation. Hence, there is a need to consolidate the existing knowledge, in order to address them and consequently improve program effectiveness. Methods: A thorough literature review and Delphi method were used. In the literature review, we searched Pubmed/Medline, WHO library, Science direct, Cochrane library, Google scholar and Google using different combinations of search strategies. Studies that applied any study design, data collection and analysis methods related to immunization program were included. In the Delphi method, a panel of 28 national and international experts were participated to identify current evidence gaps and set research priorities under the immunization program. Results: In this review, a total of 55 studies and national documents were included. The review showed that the vaccination coverage ranged from 20.6% in Afar to 91.7% in Amhara region with large inequities related to socio-economic, health service access and knowledge about vaccination across different settings. Only one study reported evidence on timeliness of immunization as 60%. The review revealed that 80% of health facilities provide immunization service nationally while service availability was only 2% in private health facilities. This review indicated that poor vaccine storage, vaccine shortage, service interruptions, poor defaulter tracing, low community engagement and poor documentation were the main barriers for the EPI program with variations across different regions. Through expert panel of discussion using Delphi method, 10 priority research areas were identified across different domains of the immunization program at national level.Conclusion: We found out that there is substantial knowledge on vaccination coverage, however, there is little evidence on timeliness of vaccination. The existing barriers that affect full immunization coverage also varied from context to context which indicates there is a need to design and implement evidence based locally tailored interventions. This review also indicated evidence gaps with more focus on health system related implementation barriers at lower level and identified further research priorities in the immunization program of Ethiopia.
Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial
Authors: Kasepalu Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Vähi Mare , Kals Jaak 
Published: April 2020

Abstract
Background Vascular surgery affects tissues` blood supply and microcirculation and might lead to mitochondrial dysfunction, which may result in the accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients.Methods. This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 hours postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria).Results Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p=0.023) - there was a significant decrease (-0.007 µmol/L, ± 0.020 µmol/L, p=0.0233) in the RIPC group and insignificant increase (0.002 µmol/L, ±0.015 µmol/L, p=0.481) in the sham group. Additionally, a statistically significant decrease (p<0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was a statistically significant increase (p<0.05) in the levels of C0 (carnitine) and a statistically significant decrease in the level of C18:1-OH. In the RIPC group, a statistically significant decrease (p<0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2.Conclusions It can be concluded that RIPC has an effect on the levels of ACs and can therefore have protective effects on mitochondria in the vascular surgery patients. Further studies conducted on metabolically more homogenous populations are needed to make more definite conclusions about the effect of RIPC on the levels of ACs.Trial registration: ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414.
Effects Which M6A RNA Methylation Regulation Exerts on the Prognosis of Hepatocellular Carcinoma
Authors: Jia Baoxue , Pei Xiaojian , Sun Yue , Xing Yaming , Hu Jinna , Wang Qiong , Wang Yukun 
Published: April 2020

Abstract
Background: Hepatocellular carcinoma (HCC) ,which has been known as the most common subtype in the range of primary liver cancer . Besides, it hails as one of China ’s common cancers , giving rise to the major cancer death cause in men. N6 methyladenosine (m6A) RNA methylation is under the regulation of m6A RNA methylation regulators in dynamic way (the proteins of "writer" "eraser"; "reader"). More and more evidences show that the m6A modification level is connected with self-renewal of tumor stem cells, the growth, proliferation, anti chemotherapy and radiosensitivity of tumor cells. The relationship between m6A RNA and human cancer types has been confirmed in a variety of cancers. This research aims to investigate the relationship betwixt m6A RNA methylation regulators and liver cancer. Methods: firstly, the comparison of the expression levels harbored by 13 major m6A RNA methylation regulators in liver cancer with normal tissues was conducted by means of the data of TCGA database. Secondly, we cluster the presentation data of m6A RNA methylated regulator uniformly and dissect HCC tissue into two subgroups (group 1 and 2) by comparing these subgroups according to the overall survival rate (OS), WHO phase and pathological level . Thirdly, based on the combination of least absolute contraction with selection operator (lasso) regression, the risk characteristics of m6A RNA methylation regulators was constructed , which affected OS in TCGA analysis. Results: there were significant differences in the presentation degrades held by 12 major m6A RNA methylation regulators in liver cancers and normal tissues. The primary liver cancer was divided into 1 and 2 groups. It was found that the OS of 1 subgroup was poor, the WHO stage was high and the pathological grade was high. In TCGA analysis, five m6A methylation regulators (YTHDF1, ZC3H13, YTHDF2, METTL3 and KIAA1429) were selected to affect OS, and a risk marker significantly related to who staging was constructed, which was also an independent prognostic marker of OS. Conclusion: m6A RNA methylation regulator is a key player in the progression of HCC and has potential value in the prediction and treatment of HCC.
Identification of risk factors for involuntary psychiatric hospitalization: Using environmental socioeconomic data and methods of machine learning to improve prediction
Authors: Karasch Olaf , Schmitz-Buhl Mario , Mennicken R Roman , Zielasek Jürgen , Gouzoulis-Mayfrank Euphrosyne 
Published: April 2020

Abstract
Background: The purpose of this study was to identify factors associated with a high risk of involuntary psychiatric in-patient hospitalization both on the individual level and on the level of mental health services and the socioeconomic environment that patients live in. Methods: The present study expands on a previous analysis of the health records of 5764 cases admitted as in-patients in the four psy­chiat­ric hospitals of the Metropolitan City of Cologne, Germany, in the year 2011 (1773 cases treated under the Mental Health Act and 3991 cases trea­ted voluntarily). Our previous analysis had included medical, socio­demographic and socioeconomic data of every case and used a machine learning-based prediction model employing chi-squared automatic interaction detection (CHAID). Our current analysis attempts to improve the previous one through (1) optimizing the machine learning procedures (use of a different type of decision-tree prediction model (CART) and application of hyperparameter tuning), and (2) the addition of socioeconomic data on the patients’ environment to the data set. Results: Compared to our previous analysis, model fit was improved. Main diagnoses of an organic mental or a psychotic disorder (ICD-10 groups F0 and F2), suicidal behavior upon admission, admission outside of regular service hours and absence of outpatient treatment prior to admission were confirmed as powerful predictors of detention. Particularly high risks were shown for (1) patients with an organic mental disorder, specifically if they were retired, admitted outside of regular service hours and lived in assisted housing, (2) patients with suicidal tendencies upon admission who did not suffer from an affective disorder, specifically if it was unclear whether there had been previous suicide attempts, or if the affected person lived in areas with high unemployment rates, and (3) patients with psychosis, specifically those who lived in densely built areas with a large proportion of small or one-person households. Conclusions: Certain psychiatric diagnoses and suicidal tendencies are major risk factors for involuntary psychiatric hospitalization. In addition, service-related and environmental socioeconomic factors contribute to the risk for detention. Identifying modifiable risk factors and particularly vulnerable risk groups should help to develop suitable preventive measures.
TMIGD1 is Expressed at Low Levels in Abdominal Adhesion Tissue and Reduces Oxidative Stress in Peritoneal Mesothelial Cells
Authors: Wu Yunhua , Li Xuqi , Shen Cong , Wang Zijun , Liu Dong , Gao Qiuying , Wei Guangbing 
Published: April 2020

Abstract
BackgroundPostoperative abdominal adhesion is one of the most commonly observed complications after abdominal surgery. However, there is no effective treatment for adhesion other than enterolysis. Mesothelial cell repair plays an extremely important role in the process of adhesion formation. Here, we hypothesize that transmembrane and immunoglobulin domain-containing 1 (TMIGD1) is expressed at low levels in abdominal adhesion tissue and can reduce oxidative stress and promote cell adhesion in peritoneal mesothelial cells.Materials and MethodsFirst, we performed gene microarray analysis and used qPCR, western blotting, immunohistochemistry and immunofluorescence to detect the expression of TMIGD1 in rat adhesion tissue and normal peritoneal tissue. Then, we established a TMIGD1-overexpressing HMrSV5 cell line and detected ROS, apoptosis, and the mitochondrial membrane potential by the MTT assay, western blotting, flow cytometry with 2’,7’-dichlorofluorescein diacetate (DCFH-DA) as a probe. Furthermore, we examined p38 phosphorylation in different TMIGD1-expressing cell lines and used a p38 inhibitor to determine whether the antioxidant effect of TMIGD1 is dependent on p38. Finally, we evaluated the adhesion ability of different TMIGD1 cell lines using scratch wound and adhesion assays.ResultsTMIGD1 was expressed at low levels in adhesion tissue and at lower levels in mesothelial cells. TMIGD1 overexpression alleviated H2O2-induced oxidative stress injury in human HMrSV5 cell lines. The phosphorylation level of p38 was higher in the TMIGD1-overexpressing cell line, and we found that the effect of TMIGD1 was inhibited by a p38 inhibitor. In addition, TMIGD1 overexpression inhibited mesothelial cell migration and promoted mesothelial cell adhesion.ConclusionTMIGD1 is expressed at low levels in abdominal adhesion tissue and can reduce H2O2-induced oxidative stress by promoting p38 phosphorylation. In addition, TMIGD1 can promote cell adhesion.# These authors contributed equally to this work.