bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Long-Term Oral Beta-Blocker Therapy in Patients Who Underwent Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction With Preserved Left Ventricular Ejection Fraction: A Systematic Review and Meta-analysis
Authors: Maqsood Muhammad H. , Alam Mahboob , Atar Dan , Birnbaum Yochai 
Published: November 2020

Abstract:
After the results of the first multicenter, prospective randomized clinical trial (RCT) evaluating long-term efficacy of oral beta-blockers in patients with preserved left ventricular ejection fraction (LVEF) after ST elevation myocardial infarction (STEMI), we decided to conduct an updated systematic review and meta-analysis to evaluate the long-term efficacy of oral beta-blocker use in patients with preserved LVEF who underwent percutaneous coronary intervention (PCI) for STEMI. A time-limited search from January 1, 1999, to April 16, 2020, on PubMed and EMBASE was conducted on April 16, 2020, for observational studies and clinical trials evaluating the efficacy of long-term oral beta-blockers in patients with preserved LVEF after STEMI treated with PCI. The comparative outcomes between beta-blockers and non–beta-blockers were assessed by pooling weighted odds ratio (OR) with 95% confidence interval (CI) using random-effects model. The outcomes of interest were all-cause mortality and major adverse cardiac event (MACE). Twelve studies (11 observational and 1 RCT) comprising 32,108 patients (19,740 on beta-blocker therapy and 12,368 without beta-blocker therapy) were included. Of which, 75% percent were male (mean age of 64 years: 63.87 ± 3.01 years on beta-blocker therapy and 64.76 ± 3.02 years on non–beta-blocker therapy; P = 0.129) with a follow-up of up to 4.7 years. Unadjusted all-cause mortality [OR = 0.58 (95% CI: 0.42–0.79)] and adjusted all-cause mortality [OR = 0.64 (95% CI: 0.48–0.87)] were significantly lower in patients on the long-term beta-blocker therapy group. However, unadjusted MACE [OR = 0.87 (95% CI: 0.70–1.08)] was not reduced with beta-blocker therapy in these patients. Patients with preserved LVEF after STEMI treated with PCI on long-term oral beta-blocker therapy have a significant reduction in risk of all-cause mortality, without an effect on MACE rates. The only RCT included showed neutral effect, so results of ongoing RCTs are anticipated. Considering that the only high-quality data (RCT) suggest a neutral effect, one should be cautious in interpreting the conclusion.
Agrin Yes-associated Protein Promotes the Proliferation of Epicardial Cells
Authors: Jing Xiaodong , Liu Bin , Deng Songbai , Du Jianlin , She Qiang 
Published: November 2020

Abstract:
Embryonic epicardial cells make an important contribution to cardiac development. However, their proliferation mechanism is still unclear. Epicardial cells from E12.5 fetal hearts were used in our study. Agrin was used to treat these cells. The expression of Aurora B, Ki67, and pH3 was measured by quantitative reverse transcription-polymerase chain reaction and immunofluorescence. The proportion of cells in G1/S/G2 phase was determined by flow cytometry. The results showed that agrin significantly increased the expression of ki67, pH3, and Aurora B in epicardial cells. Flow cytometry results showed that agrin significantly increased the proportion of epicardial cells in S phase. However, blocking yes-associated protein significantly downregulated the levels of ki67, pH3, and Aurora B and the proportion of epicardial cells in S phase. Thus, our results suggest that agrin may promote the proliferation of epicardial cells by regulating the yes-associated protein activity. This may be useful in exploring heart development mechanisms and preventing congenital heart disease.
Atorvastatin Enhances Foam Cell Lipophagy and Promotes Cholesterol Efflux Through the AMP-Activated Protein Kinase/Mammalian Target of Rapamycin Pathway
Authors: Zheng Shuzhan , Du Yanfei , Ye Qiang , Zha Kelan , Feng Jian 
Published: November 2020

Abstract:
Foam cells are the main pathological components of atherosclerosis. Therapies reducing foam cell formation can effectively prevent atherosclerotic diseases and cardiovascular events. Beyond lowering plasma cholesterol levels, the pleiotropic functions of statins in atherosclerosis have not been fully elucidated. In the present study, atorvastatin reduced cholesterol content and increased cholesterol efflux from foam cells in a concentration-dependent manner. Atorvastatin (10 μM) inhibited foam cell formation within 48 hours. Furthermore, we found that atorvastatin inhibited foam cell formation by promoting lipophagy, which was manifested by increased autophagy-related gene 5 (Atg5) expression, elevated ratio of microtubule-associated protein1 light chain 3 (LC3) II to LC3I, reduced p62 expression, and increased LC3 and lipid droplets colocalization in foam cells treated with atorvastatin. The autophagy inducer, rapamycin (Rap), did not increase the lipophagy enhancement effect of atorvastatin, but the autophagy inhibitor, 3-methyladenine, suppressed the effect of atorvastatin on Atg5 expression and the LC3II/LC3I ratio, as well as the increased p62 expression, suppressed lipophagy, attenuated cholesterol efflux and increased cholesterol content in foam cells. Further analysis revealed that atorvastatin promoted lipophagy by upregulating adenosine 5′-monophosphate-activated protein kinase (AMPK) phosphorylation, and downregulating mammalian target of rapamycin phosphorylation, whereas the AMPK inhibiter, compound C, attenuated these effects. In conclusion, atorvastatin reduced lipid accumulation and promoted cholesterol efflux by enhancing lipophagy in foam cells and thereby inhibited foam cell formation. The enhanced lipophagy of foam cells was exerted through the AMPK/mammalian target of rapamycin signaling pathway.
Resection of hepatocellular carcinoma in patients with portal hypertension: long-term results based on direct intraoperative measurement of portal venous pressure
Authors: Wang Sheng-Yu , Chau Ivy Yenwen , Hsia Cheng-Yuan , Lei Hao-Jan , Chou Shu-Cheng , Kao Yi-Chu , Chau Gar-Yang 
Published: November 2020

Introduction:
The existence of differences in long-term prognosis of hepatocellular carcinoma (HCC) patients with or without portal hypertension (PH) undergoing hepatic resection remains controversial. Our aim was to clarify the long-term prognosis of HCC patients with PH undergoing hepatectomy. PH diagnosis was based on intraoperative portal venous pressure (PVP) measurement.

Materials and Methods:
Between May 2001 and April 2005, 68 patients with HCC underwent liver resection. PVP was directly measured at the beginning of surgery. Patients were divided into a high (>11 mm Hg) (n=33) or a low (≤11 mm Hg) (n=35) PVP group. Clinicopathologic factors and postoperative outcomes were compared between the 2 groups, with tumor staging stratification according to Milan criteria (selection criteria for patients receiving transplantation). Median follow-up time was 101 months.

Results:
Postoperative mortality was 0. Median PVP was 10.7 mm Hg (range; 2.9–23.5 mm Hg). Compared with patients with low PVP, patients with high PVP had lower platelet counts, lower serum albumin levels, higher ALT concentration, higher international normalized ratio, higher Model for End-Stage Liver Disease (MELD score), and increased blood loss and blood transfusion. Multivariate logistic regression analysis revealed factors related to high PVP: serum albumin level <3.6 g/dL (odd ratio: 5.532, 95% confidence interval: 1.286-23.79, P=0.022), and MELD score >6 (odd ratio: 5.585; 95% confidence interval: 1.638-19.040, P=0.006). Postoperative morbidity was comparable between the 2 groups. Overall survival and disease-free survival rates in the high PVP group were significantly lower than in the low PVP group (P<0.05). Subgroup analysis showed that, for patients within Milan criteria, those in the high PVP group had lower overall survival (P=0.032) and disease-free survival (P=0.016) than in those in the low PVP group. For patients outside the Milan criteria, no differences in survival were observed.

Conclusions:
In patients with early stage HCC undergoing resection, high PVP is associated with impaired long-term prognosis. For these patients, close follow-up and early salvage liver transplants for recurrent disease may be necessary to improve long-term prognosis after surgery.
Update on pediatric pulmonary arterial hypertension
Authors: Ivy Dunbar , Frank Benjamin S. 
Published: November 2020

Purpose of review
Pulmonary arterial hypertension (PAH) causes high morbidity and mortality in children. In this review, we discuss advances in diagnosis and treatment of this disorder.

Recent findings
Proceedings published from the 2018 World Symposium updated the definition of pulmonary hypertension to include all adults and children with mean pulmonary artery pressure more than 20 mmHg. Targeted PAH therapy is increasingly used off-label, but in 2017, bosentan became the first Food and Drug Administration-targeted PAH therapy approved for use in children.

Summary
In recent years, advanced imaging and clinical monitoring have allowed improved risk stratification of pulmonary hypertension patients. New therapies, approved in adults and used off-label in pediatric patients, have led to improved outcomes for affected children.
Efficiency and Safety of Scleral Lenses in Rehabilitation of Refractive Errors and High Order Aberrations After Penetrating Keratoplasty
Authors: Penbe Aysegul , Kanar Hatice Selen , Simsek Saban 
Published: November 2020

Objectives:
Visual rehabilitation after penetrating keratoplasty (PK) has difficulties linked to the high spherical and/or cylindric refractive errors with high order aberrations (HOAs) based on the ocular surface irregularities. We aimed to present the scleral contact lens (SCL)-induced complications and improvements in refractive errors and HOA with SCL fitting in post-PK patients.

Methods:
In this prospective study, 38 eyes of 35 patients who underwent PK and using SCLs were included. Uncorrected visual acuity, best-corrected visual acuity (BCVA), spherical equivalence, manifest astigmatism (Cyl), keratometry, and wavefront analyses of HOAs with corneal topography of all patients were measured before SCL and after 8 hrs of SCL wearing-on. The endothelial cellular density (ECD) changes at 6 months were also recorded. Any complications related to SCL were noted.

Results:
All patients showed an improvement in visual acuity with SCL. Uncorrected visual acuity before SCL fitting was 1.15±0.26 log of minimal angle of resolution (logMAR) and BCVA was 0.84±0.24 logMAR. The contact lens-corrected visual acuity decreased to 0.13±0.09 logMAR. Spherical equivalence, Cyl, and keratometry parameters decreased significantly with SCL. The anterior corneal HOAs, coma, and astigmatism coefficients decreased significantly. Conjunctival prolapse (in one eye) and graft rejection episode (in two eyes) were observed during follow-up time (14.25±1.3 months) and they restarted to use SCLs after treatment. The ECD decrease was similar with those who not using SCLs after PK in the literature.

Conclusion:
Our results indicate that scleral lenses may be a safe and effective option for the treatment of corneal astigmatism and HOAs associated with PK.
Nocturnal Variability of Intraocular Pressure Monitored With Contact Lens Sensor Is Associated With Visual Field Loss in Glaucoma
Authors: Yang Zhiyong , Mansouri Kaweh , Moghimi Sasan , Weinreb Robert N. 
Published: November 2020

Purpose:
The aim was to determine whether 24-hour recording of intraocular pressure (IOP)-related ocular dimensional changes with a contact lens sensor (CLS, Triggerfish) is associated with the rate of visual field (VF) progression in primary open-angle glaucoma (POAG) patients.

Design:
This was a retrospective, observational cohort study.

Participants:
Patients with POAG were included from the Glaucoma Clinic and Diagnostic Innovations in Glaucoma Study at the Hamilton Glaucoma Center at University of California, San Diego.

Methods:
A session of 24-hour CLS recording was acquired for 1 eye from each patient. The mean follow-up time was 9.9±4.0 years. The association between CLS variables and rate of change of mean deviation was determined by univariate and multivariate mixed linear regression models.

Results:
Thirty-two patients, aged 69.8±13.6 years were included, 50% were female. An average of 11.6±5.6 standard automated perimetry examinations was available with a mean rate of mean deviation progression of −0.2±0.4 dB/year. Mean IOP was 17.8±4.2 mm Hg. The mean number of IOP-lowering medications were 1.2±1.0. Each 10-unit larger nocturnal variability of IOP-related ocular dimensional changes measured by CLS recording was significantly associated with −0.25±0.11 dB faster VF loss in POAG patients (P=0.035).

Conclusions:
Twenty-four-hour CLS recording of IOP-related ocular dimensional change was associated with faster VF progression. Such CLS recordings are useful to assess the risk of in progression in POAG patients.
The interobserver agreement of the HEART-score, a multicentre prospective study
Authors: van Meerten Kirsten F. , Haan Rowan M.A. , Dekker Ineke M.C. , van Zweden Henriëtte J.J. , van Zwet Erik W. , Backus Barbra E. 
Published: November 2020

Background and importance
Chest pain is one of the most common presentations to the emergency department (ED). The HEART-score is used to assess the 30-day risk of developing a major adverse cardiac event (MACE). The HEART-score enables clinicians to classify patients in low, intermediate, or high-risk groups though little is known as to whether this can be done reliably and reproducibly in a prehospital setting.

Objective
The aim of this study was to compare the interobserver agreement of the HEART-score between ambulance nurses and ED physicians.

Design, settings, and participants
Patients ≥18 years, with chest pain of suspected cardiac origin presented by ambulance to the EDs of four regional hospitals, were prospectively enrolled between October 2018 and April 2019.

Outcomes measure and analysis
The primary endpoint was interobserver agreement of the HEART-scores calculated by ambulance nurses compared to those calculated by ED physicians. Agreement was measured using Cohen’s Kappa (K) both for overall HEART-score and dichotomized HEART categories. A secondary endpoint was the occurrence of a MACE at 30 days after inclusion.

Main results
A total of 307 patients were enrolled of which 166 patients were male (54%). The mean age was 64.8 years. In 23% (95% confidence interval, 18–27), patients were scored in the low-risk category by both ambulance nurses and ED physicians. The K for the overall HEART-score compared between ambulance nurses and ED physicians was 0.514. The K for the low-risk category versus intermediate and high-risk category was 0.591. Both are defined as ‘moderate’. MACE within 30 days occurred in 64 patients (21%). In the low-risk group as defined by the ambulance nurses, there was a 7% risk of MACE compared to an average 5% MACE risk in the ED physician group.

Conclusions
The moderate interobserver agreement of the HEART-score does not currently support the use of the HEART-score by ambulance nurses in a prehospital setting. Training for prehospital nurses is vital to ensure that they are able to calculate the HEART-score accurately.
Hydroxychloroquine and COVID-19: Lack of Efficacy and the Social Construction of Plausibility
Authors: Rughiniş Cosima , Dima Lorena , Vasile Sorina 
Published: November 2020

Background:
Severe acute respiratory syndrome coronavirus 2 SARS- Cov2 has taken the world by surprise. Among the first promising repurposing agents proposed for treatment and prophylaxis, 2 antimalarial agents came into limelight: chloroquine and its less toxic derivative, hydroxychloroquine (HCQ). Intense research and public debates have followed.

Areas of Uncertainty:
As HCQ is still used and studied, future research may bring novel evidence, modifying the state-of-the-art. Despite the lack of a single randomized control trial (RCT) with positive results, there are currently (as for the search on 30th of August 2020) more than 250 RCT registered on ClinicalTrials.gov with HCQ in COVID patients, and more than 150 of them are “still recruiting” or “not yet recruiting” patients.

Data Sources:
Our study combines a therapeutic evaluation of RCT data with a sociological analysis of related controversies, examining scientific and public arena discourses.

Results:
Although any hope of a positive effect was brought exclusively by some and not all of the observational studies, none of the 7 RCT published until now have found any benefit. From a sociological perspective, the HCQ controversy is a useful case study for understanding the construction of plausibility in a cultural context polarized into competing versions of reality, with different epistemologies and ideologies.

Conclusions:
The results of the first RCTs have been published, and they are disappointing; beneficial effects of HCQ could not be proven either for negative conversion on polymerase chain reactions of COVID patients or for postexposure prophylaxis. The question to be asked is: how many studies do we need until HCQ is abandoned? Argumentative time work, appealing to temporal properties of HCQ including its historical use, accumulation of evidence, alternative therapeutic scenarios, and sensationalist tempo for rhetorical purpose, plays a significant role in its continuing legitimation.
Adapting Index/Partner Services for the Treatment of Chlamydia Among Young African American Men in a Community Screening Program
Authors: Jones Austin T. , Craig-Kuhn Megan Clare , Schmidt Norine , Gomes Gérard , Scott Glenis , Watson Shannon , Hines Phazal , Davis Javone , Lederer Alyssa M. , Martin David H. , Kissinger Patricia J. 
Published: November 2020

Background
Screening for asymptomatic Chlamydia trachomatis (Ct) among men has not been recommended because feasibility and efficacy are unknown. Check It is a seek-test-treat community-based Ct screening program for African American men who have sex with women and who are 15 to 24 years of age. This is an evaluation of adaptations made to the program aimed at improving index/partner notification and treatment rates.

Methods
The original Check It intervention included free testing and treatment, contact tracing performed by a third party, expedited index therapy, and expedited partner therapy via pharmacy pickup. The intervention was adapted after a series of in-depth interviews eliciting information to refine the program. Changes included continuity of testing, notification, and treatment by the same staff; expanded hours; and patient-delivered partner therapy with a medication mail-delivery option. Rates of index male and partner treatment were compared using log-binomial models and generalized estimating equations.

Results
Men in the adapted intervention (n = 85) were more likely than men in the original intervention (n = 99) to be contacted (relative risk [RR], 1.14; 95% confidence interval [CI], 1.02–1.27), make a treatment plan (RR, 1.14; 95% CI, 1.01–1.27), and complete treatment (RR, 1.45; 95% CI, 1.20–1.75). Female sexual partners were significantly more likely to complete treatment in postadaptation (n = 153) compared with preadaptation (n = 161; RR, 3.02; 95% CI, 1.81–5.05).

Conclusions
Compared with third-party notification and expedited index therapy/expedited partner therapy available by pharmacy pickup only, patient-delivered partner therapy with mail-delivery option, staff available at nontraditional hours, and staff continuity across testing, notification, and treatment significantly improved index and partner treatment completion.
Vision Screening among Children with Autism Spectrum Disorder
Authors: Swanson Mark W. , Lee Sarah Dille , Frazier Marcela G. , Bade Annette , Coulter Rachel Anastacia 
Published: November 2020

SIGNIFICANCE
Vision problems occur at higher rates in children with autism spectrum disorder (ASD) than in the general population. Some professional organizations recommend that children with neurodevelopmental disorders need comprehensive assessment by eye care professionals rather than vision screening.

METHODS
Data from the 2011 to 2012 National Survey of Children's Health (NSCH) were accessed. Logistic regression was used to evaluate differences between vision screening rates in eye care professionals' offices and other screening locations among children with and without ASD.

RESULTS
Overall, 82.21% (95% confidence interval [CI], 78.35 to 86.06%) of children with ASD were reported to have had a vision screening as defined by the NSCH criteria. Among children younger than 5 years with ASD, 8.87% (95% CI, 1.27 to 16.5%) had a vision screening at a pediatrician's office, 41.1% (95% CI, 20.54 to 61.70%) were screened at school, and 37.62% (95% CI, 9.80 to 55.45%) were examined by an eye care professionals. Among children with ASD older than 5 years, 24.84% (95% CI, 18.42 to 31.26%) were screened at school, 22.24% (95% CI, 17.26 to 27.21%) were screened at the pediatricians' office, and 50.15% (95% CI, 44.22 to 56.08%) were examined by eye care professionals. Based on estimates from NSCH, no children in the U.S. population younger than 5 years with ASD screened in a pediatrician's office were also seen by an eye care provider.

CONCLUSIONS
If the public health goal is to have all children with ASD assessed in an eye care professional's office, data from the NSCH indicate that we as a nation are falling far short of that target.
Sinonasal Chondrosarcoma Presenting With Isolated Severe Vision Loss
Authors: Nguyen Michael T. B. , Farahvash Armin , Dickson Brendan C. , Lee John M. , Cusimano Michael D. , Tsang Derek S. , Micieli Jonathan A. 
Published: November 2020

Abstract:
A 24-year-old man presented with a 2-month history of progressive, painless vision loss in the right eye, with no history of headache, nasal congestion, rhinorrhea, or epistaxis. His visual acuity was counting fingers at 1 ft in the right eye and 20 of 20 in the left eye with a right relative afferent pupillary defect and mild temporal optic disc pallor. MRI of the brain and orbits showed a mass involving bilateral ethmoid and sphenoid sinuses and right nasal cavity. He underwent urgent extended endoscopic endonasal transsphenoidal approach for resection of the sinonasal skull base tumor and photon radiation therapy. Pathology revealed a well-differentiated cartilaginous neoplasm with focal areas of entrapped native bone, consistent with a chondrosarcoma WHO grade I/III. At 6-month follow-up after surgery, he had a visual acuity of 20/40 in the right eye and 20/20 in the left eye. Malignant tumors from the sinonasal area should be kept in the differential diagnosis for compressive optic neuropathies and may present with vision loss even in the absence of nasal or sinus symptoms.