bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Reactivity Index as an Effective Predictor of Mortality in Children With Refractory Septic Shock
Authors: Lee En-Pei , Zhao Lu-Lu , Hsia Shao-Hsuan , Chan Oi-Wa , Lin Chia-Ying , Su Ya-Ting , Lin Jainn-Jim , Wu Han-Ping 
Published: March 2020

Background: Vasoplegia is vascular hyporesponsiveness to vasopressors and is an important phenomenon in children with refractory septic shock. This study aimed to develop an objective formula correlated with vasoplegia and evaluate the predictive power for mortality in children with refractory septic shock. Materials and Methods: We retrospectively analyzed children with refractory septic shock admitted to a pediatric intensive care unit (PICU) and monitored their hemodynamics via a pulse index continuous cardiac output (PiCCO) system. Serial hemodynamic data including cardiac index (CI), systemic vascular resistant index (SVRI) and vasoactive-inotropic score (VIS) were recorded during the first 72 hours after PICU admission. We defined vascular reactivity index (VRI) as SVRI/VIS and analyzed the effect of VRI in predicting mortality in children with refractory septic shock. Results: Thirty-three children with refractory septic shock were enrolled. The SVRI was lower in the mortality group compared to the survival group ( P < .05). The average area under the receiver operating characteristic curve of VRI within the first 72 hours was 0.8 and the serial values of VRI were significantly lower in the mortality group during the period from 0 to 48 hours ( P < .05). However, there were no significant differences in serial CI values between the survival and mortality groups. Conclusions: Vasoactive-inotropic score may potentially be used to quantify the severity of vasoplegia based on the clinical response of vessels after resuscitation with vasopressors. Lower VRI levels may indicate a higher risk of mortality in children with septic shock.
Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis
Authors: Gür Fatih , Can Gür Ganime 
Published: March 2020

Objectives: This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. Data Sources: PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. Study Inclusion and Exclusion Criteria: Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. Data Extraction: This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. Data Synthesis: Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). Results: The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. Conclusions: Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
Predictors of Cognitive Improvement Following Treatment for Late-Life Depression
Authors: Siddarth Prabha , Funes Cynthia M. , Laird Kelsey T. , Ercoli Linda , Lavretsky Helen 
Published: March 2020

Objective: Cognitive impairment is frequently comorbid with late-life depression (LLD) and often persists despite remission of mood symptoms with antidepressant treatment. Increasing understanding of factors that predict improvement of cognitive symptoms in LLD is useful to inform treatment recommendations. Methods: We used data from 2 randomized clinical trials of geriatric depression to examine the relationships between sociodemographic factors (resilience, quality of life) and clinical factors (age of depression onset, severity of depression, apathy) with subsequent cognitive outcomes. One hundred sixty-five older adults with major depression who had completed one of 2 clinical trials were included: (1) methylphenidate plus placebo, citalopram plus placebo, and citalopram plus methylphenidate or (2) citalopram combined with Tai Chi or health education. A comprehensive neuropsychiatric battery was administered; 2 measures of cognitive improvement were examined, one defined as an increase in general cognitive performance score of at least 1 standard deviation and the other 0.5 standard deviation pre–post treatment. Results: At posttreatment, 59% of participants had remitted, but less than a third of those who remitted showed cognitive improvement (29%). Cognitive improvement was observed in 18% of nonremitters. Lower baseline depression severity, greater social functioning, and depression onset prior to 60 years of age were significantly associated with cognitive improvement. None of the other measures, including baseline apathy, resilience, and depression remission status, were significantly associated with cognitive improvement. Conclusions: Lower severity of depression, earlier onset, and greater social functioning may predict improvement in cognitive functioning with treatment for depression in LLD.
Audiological disturbances in patients with primary antiphospholipid syndrome
Authors: Erez Daniel , Abarbuch Eran , Natour Amed , Meyer Avraham , Natour Aiman , Dovrish Zamir , Levy Yair 
Published: March 2020

Background Antiphospholipid syndrome (APS) is an autoimmune disease of hypercoagulability state in the presence of antibodies against phospholipids. Many neurological deficits related to APS have been described. Sensory neural hearing loss has been described only anecdotally, mostly in case reports. This study investigated a possible association between hearing disorders and APS. Methods Seventeen patients (aged 20–80 years) diagnosed with primary APS were evaluated for evidence of hearing disorders. All had otoscopy, full audiometry test, brainstem evoked response audiometry and otoacoustic emissions testing, and completed a questionnaire. Hearing levels were compared to the standard hearing levels of the general population by age group. Results Of the 17 APS patients, 10 (age groups 20–29 and 50–59) had significantly reduced hearing levels in all or part of the tested frequencies compared to standard levels. Three patients (age group 60–69) had better hearing levels at low frequencies compared to standard hearing levels. Conclusion These findings support the existence of hearing disorders in primary APS.
Diagnostic value of urinary monocyte chemoattractant protein-1 in evaluating the activity of lupus nephritis: a meta-analysis
Authors: Xia Yuan-Rui , Li Qing-Ru , Wang Jun-Ping , Guo Heng-Sheng , Bao Yu-Qing , Mao Yan-Mei , Wu Jun , Pan Hai-Feng , Ye Dong-Qing 
Published: March 2020

Objective This study aimed to assess systematically the overall diagnostic value of urinary monocyte chemoattractant protein-1 (uMCP-1) in systemic lupus erythematosus (SLE) patients with active lupus nephritis (LN). Methods Articles from PubMed, Web of Science, EMBASE and Cochrane Library were retrieved up to 5 November 2019. Study quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, and statistical analyses were performed. Results A total of seven original studies with 521 participants were included in this meta-analysis. The summary estimates were: sensitivity 0.89 (95% confidence interval (CI) 0.86–0.93), specificity 0.63 (95% CI 0.55–0.69), positive likelihood ratio 2.16 (95% CI 1.66–2.80), negative likelihood ratio 0.15 (95% CI 0.08–0.30), diagnostic odds ratio 19.40 (95% CI 7.24–51.96) and area under the curve 0.9042. Conclusion As a non-invasive biomarker, uMCP-1 has high diagnostic accuracy for active LN.
Thyroid Hormone in the Pathogenesis of Congenital Intestinal Dysganglionosis
Authors: Wang Fang , Jing Ping , Zhan Peiyan , Zhang Hongyi 
Published: March 2020

Introduction The objective of this study is to investigate the role of thyroid hormone (TH) in the pathogenesis of intestinal dysganglionosis (ID). Methods A zebrafish model of congenital hypothyroidism (CH) was created by exposing the larvae to the 6-propyl-2-thiouracil (PTU). The enteric neurons were labeled with anti-HuC/D antibodies. The number of enteric neurons was counted. The larval intestine was dissociated and stained with anti-p75 and anti-α4 integrin antibodies. Mitosis and apoptosis of the p75+ α4 integrin+ enteric neural crest cells (ENCCs) were studied using flow cytometry. Intestinal motility was studied by analyzing the transit of fluorescent tracers. Results PTU (25 mg/L) significantly reduced TH production at 6- and 9-days post fertilization without changing the body length, body weight, and intestinal length of the larvae. Furthermore, PTU inhibited mitosis of ENCCs and reduced the number of enteric neurons throughout the larval zebrafish intestine. Importantly, PTU inhibited intestinal transit of fluorescent tracers. Finally, thyroxine supplementation restored ENCC mitosis, increased the number of enteric neurons, and recovered intestinal motility in the PTU-treated larvae. Conclusions PTU inhibited TH production, reduced the number of enteric neurons, impaired intestinal motility, and impeded ENCC mitosis in zebrafish, suggesting a possible role of CH in the pathogenesis of ID.
Family relations of older people: Personal and practical support
Authors: Sigurdardottir Sigurveig H , Juliusdottir Sigrun , Karlsson Thorlakur 
Published: March 2020

Summary In this study, we examined older people’s views and experiences of family relations in Iceland. The goal was to explore the frequency and kinds of contact, and the support older people received from their adult biological children and stepchildren. We performed cluster sampling covering community centers in municipalities nationwide in Iceland. The questionnaire was answered by 273 older people, including 193 women (75%) and 64 men (25%). The average age was 79 years. About 200 (74%) lived in the capital area of Reykjavik, while 70 (26%) lived in the countryside. Findings Older people received more support from biological children than stepchildren. Specifically, differences were found in both frequency and quality of contact. The results revealed gender differences; daughters offering more help and support than sons. Older women have more frequent contact and closer relationships with their biological children than with other children. Relationships with stepchildren were weaker in all respects. These results are discussed in connection to structural and cultural factors, with a focus on the implications of changes in family structure, new communication styles, and effects of media. Applications Although the increased frequencies of divorce and stepparenting can affect connections within families, communities commonly disregard the different needs of stepfamilies, sometimes called “stepblindness”. Policy makers and professionals such as social workers need to concede different needs of older people in stepfamilies. Conclusions are drawn from the perspective of welfare policy issues, such as the need of more precise law provisions and implementations on social services for families.
Rotational care practices in minority ethnic families managing dementia: A qualitative study
Authors: Nielsen T Rune , Waldemar Gunhild , Nielsen Dorthe S 
Published: March 2020

Background Although minority ethnic families have a lower uptake of dementia care services, little research has explored how minority ethnic carers cope with and manage dementia care in their everyday lives. The aim of this study was to investigate organization of family dementia care in Turkish, Pakistani, and Arabic speaking minority ethnic families from the perspective of family carers, primary care dementia coordinators, and multicultural link workers in Denmark. Methods Semi-structured qualitative individual and group interviews with minority ethnic family carers, primary care dementia coordinators, and multicultural link workers. Hermeneutic phenomenology was used as theoretical framework and results were analyzed using thematic analysis. Results A total of 21 individual and four group interviews were conducted, including a total of 30 participants. A key finding was that the care responsibility was usually shared between several family members, who took turns to provide 24-hour care for the person with dementia. Rotational 24-hour care, either by having the person with dementia live with different family members or by having different family members take turns to move in with the person with dementia, emerged as a common alternative to formal care. Another important finding was that despite decreasing the burden of care of individual family carers, rotational care could be confusing and stressful to the person with dementia and could have a negative impact on the quality of life of all involved. Conclusion The way minority ethnic families organize dementia care have implications for understanding and communicating about support needs. Higher reliance on shared family care should not be taken to indicate that minority ethnic communities are not in need of support from formal services.
Immunosuppressant Use and Gout in the Prevalent Solid Organ Transplantation Population
Authors: Brigham Mark D. , Milgroom Andrew , Lenco Mara Onita , Wang Zheng , Kent Jeffrey D. , LaMoreaux Brian , Johnson Richard J. , Mandell Brian F. , Hadker Nandini , Sanchez Herman , Francis Kevin , Radeck Lauren P. , Miyasato Gavin , Li Justin W. 
Published: March 2020

Introduction: Gout is a common comorbidity among solid organ transplantation patients and is usually attributed to the use of cyclosporine. This study aims to evaluate the prevalence of gout among solid organ transplantation patients to determine the prevalence in the tacrolimus era. Research Questions: To what degree is cyclosporine still used among prevalent solid organ transplantation patients? How prevalent is gout in the solid organ transplantation population not being treated by cyclosporine? Methods: Immunosuppressant regimens and gout prevalence among prevalent solid organ transplantation patients were assessed using retrospective claims data for a representative sample of commercially insured patients. For comparison to the prevalent solid organ transplantation population, immunosuppressant use at time of transplantation was compiled from published reports. Results: Between 2012 and 2016, the use of cyclosporine declined while use of tacrolimus increased, with greater cyclosporine use among prevalent versus incident solid organ transplantation patients. The prevalence of gout was 18.3%, 9.3%, and 9.1% for solid organ transplantation patients on cyclosporine, tacrolimus, and neither, respectively. Among all solid organ transplantation patients with gout, 66.6% and 21.5% were on tacrolimus versus cyclosporine. The prevalence of gout among noncyclosporine solid organ transplantation patients was significantly higher than in the general population without solid organ transplantation. Discussion: Despite declining cyclosporine use, gout prevalence remains high, with the majority of patients with gout receiving tacrolimus rather than cyclosporine. In summary, gout remains a frequent comorbidity of solid organ transplantation.
A generative adversarial network for artifact removal in photoacoustic computed tomography with a linear-array transducer
Authors: Vu Tri , Li Mucong , Humayun Hannah , Zhou Yuan , Yao Junjie 
Published: March 2020

With balanced spatial resolution, penetration depth, and imaging speed, photoacoustic computed tomography (PACT) is promising for clinical translation such as in breast cancer screening, functional brain imaging, and surgical guidance. Typically using a linear ultrasound (US) transducer array, PACT has great flexibility for hand-held applications. However, the linear US transducer array has a limited detection angle range and frequency bandwidth, resulting in limited-view and limited-bandwidth artifacts in the reconstructed PACT images. These artifacts significantly reduce the imaging quality. To address these issues, existing solutions often have to pay the price of system complexity, cost, and/or imaging speed. Here, we propose a deep-learning-based method that explores the Wasserstein generative adversarial network with gradient penalty (WGAN-GP) to reduce the limited-view and limited-bandwidth artifacts in PACT. Compared with existing reconstruction and convolutional neural network approach, our model has shown improvement in imaging quality and resolution. Our results on simulation, phantom, and in vivo data have collectively demonstrated the feasibility of applying WGAN-GP to improve PACT’s image quality without any modification to the current imaging set-up. Impact statement This study has the following main impacts. It offers a promising solution for removing limited-view and limited-bandwidth artifact in PACT using a linear-array transducer and conventional image reconstruction, which have long hindered its clinical translation. Our solution shows unprecedented artifact removal ability for in vivo image, which may enable important applications such as imaging tumor angiogenesis and hypoxia. The study reports, for the first time, the use of an advanced deep-learning model based on stabilized generative adversarial network. Our results have demonstrated its superiority over other state-of-the-art deep-learning methods.
Retrospective evaluation of the endovascular repair of the anastomotic pseudoaneurysm of the transplanted renal artery using the snorkel technique
Authors: Haijie Che , Fubo Song , Xiaoying Li , Ying Yu , Zenghui Pu 
Published: March 2020

Objective To evaluate the endovascular repair of the transplanted renal artery anastomotic pseudoaneurysm using the snorkel technique. Methods From April 2012 to December 2017, we performed endovascular repair in six patients, who were diagnosed with transplanted renal artery anastomotic pseudoaneurysm, using the snorkel technique. The “snorkel” stent and the “parallel” stent were placed in the transplanted kidney and the external iliac artery, respectively. Another covered stent was implanted at the proximal end of the external iliac artery to match the diameter of the iliac artery. Result and conclusion: Of the six patients, three patients recovered. Two patients experienced pseudoaneurysm rupture due to infection, and one patient developed stent thrombosis; all three patients underwent graft nephrectomy. The endovascular treatment of transplanted renal artery anastomotic pseudoaneurysm with the snorkel technique is a feasible method but needs to comply with certain indications.
Prognostic impact of acellular mucin pools towards the patients with locally advanced rectal cancer achieving pathological complete response after preoperative chemoradiotherapy
Authors: Zhang Lin , Guan Huajie , Luo Qiuyun , Yuan Lifang , Mao Yulan , Wu Xiaojun , Pan Zhizhong , Lin Junzhong , Peng Jianhong 
Published: March 2020

Background: To date, the prognostic significance of acellular mucin pools in tumors from patients with locally advanced rectal cancer (LARC) undergoing preoperative chemoradiotherapy (CRT) and subsequently obtaining pathological complete response (pCR) has not been well determined. Our current study aimed to explore the prognostic impact on these patients of acellular mucin pools. Methods: We collected clinical data from 117 consecutive LARC patients who achieved pCR after preoperative CRT and then underwent radical resection. Two groups of patients were generated, according to the presence or absence of acellular mucin pools. The 5-year disease-free survival (DFS) and overall survival (OS) rates were compared between the two groups of patients. Results: A total of 27 (23.1%) patients presented with acellular mucin pools. At a median follow-up period of 64 months, patients with acellular mucin pool showed a 5-year DFS rate (96.3% versus 83.7%, p = 0.110) and 5-year OS rate (100% versus 87.5%, p = 0.054) statistically similar to those of patients without acellular mucin pools. In univariable and multivariable Cox regression analyses, the presence of acellular mucin pools was not determined as an independent risk factor for DFS [hazard ratio (HR): 0.222; 95% confidence interval (CI): 0.029–1.864; p = 0.145] or OS (HR: 0.033; 95% CI: 0.000–9.620; p = 0.238). Conclusions: Acellular mucin pools had no significant prognostic impact on LARC patients showing pCR after preoperative CRT.
The effect of load and plane of elevation on acromial stress after reverse shoulder arthroplasty
Authors: Lockhart Jason S , Wong Murray T , Langohr G Daniel G , Athwal George S , Johnson James A 
Published: March 2020

Background Acromial fractures are a substantial complication following reverse shoulder arthroplasty, reported to affect up to 7% of patients. Previous studies have shown that implant placement affects acromial stress during elevation of the arm in the scaption plane. The purpose of this study was to investigate the results of arm loading and variation in plane of elevation on acromial stresses. Methods Nine elevation angles (0°–120°), in three planes of elevation (abduction (0°), scaption (30°), and forward elevation (60°)), and three hand loads (0, 2.5, 5 kg) were investigated. Finite element models were generated using computed tomography data from 10 cadaveric shoulders (age 68 ± 19 yrs) to determine acromial stress distributions. Models were created for a lateralized glenosphere (0, 5, 10 mm), inferiorized glenosphere (0, 2.5, 5 mm), and humeral offset (−5, 0, 5 mm). Results For all planes of elevation (0°, 30°, 60°) and hand loads (0, 2.5, 5 kg) investigated, glenoid lateralization consistently increased acromial stress, glenoid inferiorization consistently decreased acromial stress, and humeral offset proved to be insignificant in altering acromial stress. Abduction resulted in significantly higher peak acromial stresses (p = 0.002) as compared to scaption and forward elevation. Conclusions In addition to implant position and design, patient activity, such as plane of elevation and hand loads, has substantial effects on acromial stresses. Level of evidence Basic science study