bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carbohydrate mouth rinse improves resistance exercise capacity in the glycogen-lowered state
Authors: Durkin Matthew , Akeroyd Harriet , Holliday Adrian 
Published: July 2020

The effect of carbohydrate mouth rinse (CHO MR) on resistance exercise performance is equivocal and may be moderated by carbohydrate availability. This study determined the effect of CHO MR on low-load resistance exercise capacity completed in a fed but glycogen-lowered state. Twelve resistance-trained men (age: 22 ± 4 years; height: 1.79 ± 0.05 m; mass: 78.7 ± 7.8 kg; bench press one-repetition maximum (1RM): 87 ± 21 kg; squat 1RM: 123 ± 19 kg) completed two fed-state resistance exercise bouts consisting of six sets of bench press and six sets of squat to failure at 40% 1RM. Each bout was preceded by glycogen-depleting cycling the evening before, with feeding controlled to create acute energy deficit and maintain low muscle glycogen. During resistance exercise, participants rinsed with either a 6% CHO MR solution or a taste-matched placebo (PLA) between sets. Total volume workload was greater with CHO MR (9354 ± 2051 vs. 8525 ± 1911 kg, p = 0.010). Total number of repetitions of squat were greater with CHO MR (107 ± 26 vs. 92 ± 16, p = 0.017); the number of repetitions of bench press were not significantly different (CHO MR: 120 ± 24 vs. PLA: 115 ± 22, p = 0.146). This was independent of differences in feeling or arousal. CHO MR may be an effective ergogenic aid for athletes completing resistance exercise when in energy deficit and with low carbohydrate availability. Novelty: CHO MR can increase low-load resistance exercise capacity undertaken in a glycogen-lowered but fed state. This effect was driven by a greater number of repetitions-to-failure in the squat — using muscles lowered in glycogen content with exhaustive cycling on the evening prior to resistance exercise — but not bench press.
Management of Little Finger Metacarpal Fractures: A Meta-Analysis of the Current Evidence
Authors: Chong Han Hong , Hau Melinda YT. , Shah Rohi , Singh Harvinder 
Published: July 2020

Background: The little finger metacarpal neck fracture, also known as boxer’s fracture, is a commonly encountered upper limb fracture in orthopaedics. There are multiple ways of managing this fracture, ranging from immediate mobilization to rigid internal fixation. However, there is still a lack of consensus on the best management option. The aim of this study is to review all comparative studies, either randomized trial or cohort studies, on little finger metacarpal neck fracture management, meta-analyze the radiological and functional outcome between conservative and operative management. Methods: A systematic search of the literature was conducted between year 1987 to 2018 on MEDLINE and EMBASE. To be included, studies needed to have shown comparison between conservative against operative management, assessing the radiological (palmar angulation) and the patient reported functional outcomes. The data were pooled using fixed-effect method. The methodology was adapted from the Cochrane Handbook for Systematic Review of Interventions and compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PROSPERO CRD42018099168). Results: 5 full papers were included in our study. Our meta-analysis showed that compared to operative management, conservative management report worse radiological palmar angulation at follow-up; but equivalent functional outcome in terms of Quick-DASH and grip strength. Conservative studies also showed fewer mean days off in comparison to operative management. Conservative management also showed equivalent Total Active Motion (TAM) and Visual Analogue Score for Pain (VAS), but some studies had insufficient data to be pooled. Conclusions: Regardless of palmar angulation, conservative treatment of little finger metacarpal neck fracture provides an equivalent functional outcome to surgical intervention with an earlier return to work and no risk of surgical complications. Larger, randomised controlled trials are required.
Prognostic Factors Affecting Clinical Outcomes of Arthroscopic Assisted Reduction and Volar Plating through Preservation of Pronator Quadratus for Intra-Articular Distal Radius Fracture
Authors: Jung Jae-Uk , Yang Seok-Won , Kim Jung-Sang , Park Jae-Wook , Kim Jong-Pil 
Published: July 2020

Background: This study aimed to evaluate the clinical and radiological outcomes following an arthroscopic-assisted reduction and volar plating (AR-VP) surgery through pronator quadratus (PQ) preservation for treating intra-articular distal radius fractures (IA-DRFs) and to assess prognostic factors that affect functional outcomes. Methods: Between March 2014 and February 2017, 54 patients who had intra-articular DRF and underwent AR-VP through the PQ preservation technique and completed 1-year follow-up were enrolled. Patients were divided into the satisfactory group (excellent and good results) and an unsatisfactory group (fair and poor results) based on the modified Mayo Wrist Scoring System (MMWS) scored at 1-year follow-up to determinate prognostic factors that affected clinical outcomes. Patients’ demographics, clinical outcome measures (VAS, DASH, PRWE, etc.), and pre-and post-operative radiographic parameters were analyzed. Results: The outcomes according to MMWS were 10 excellent, 22 good, 14 fair, and 8 poor. A univariate analysis showed a significant difference between the groups (p < .05) for all radiographic parameters, sex, and the presence of an intra-articular comminution. In the multivariate analysis, female gender, presence of an intra-articular comminution, and difference of palmar articular tilt compared to uninjured wrist (> 20.1°) at trauma were considered as significant poor prognostic factors of functional outcome. Conclusions: AR-VP surgery through PQ preservation for intra-articular DRFs has reliable clinical and radiological outcomes. However, female gender, presence of an intra-articular comminution, and difference of palmar articular tilt compared to the uninjured wrist (> 20.1°) at initial injury were considered poor prognostic factors for AR-VP through PQ preservation for intra-articular DRF.
A Radiomics Model for Predicting the Response to Bevacizumab in Brain Necrosis after Radiotherapy
Authors: Cai Jinhua , Zheng Junjiong , Shen Jun , Yuan Zhiyong , Xie Mingwei , Gao Miaomiao , Tan Hongqi , Liang Zhongguo , Rong Xiaoming , Li Yi , Li Honghong , Jiang Jingru , Zhao Huiying , Argyriou Andreas A. , Chua Melvin L.K. , Tang Yamei 
Published: July 2020

Abstract

Purpose:
Bevacizumab is considered a promising therapy for brain necrosis after radiotherapy, while some patients fail to derive benefit or even worsen. Hence, we developed and validated a radiomics model for predicting the response to bevacizumab in patients with brain necrosis after radiotherapy.

Experimental Design:
A total of 149 patients (with 194 brain lesions; 101, 51, and 42 in the training, internal, and external validation sets, respectively) receiving bevacizumab were enrolled. In total, 1,301 radiomic features were extracted from the pretreatment MRI images of each lesion. In the training set, a radiomics signature was constructed using the least absolute shrinkage and selection operator algorithm. Multivariable logistic regression analysis was then used to develop a radiomics model incorporated in the radiomics signature and independent clinical predictors. The performance of the model was assessed by its discrimination, calibration, and clinical usefulness with internal and external validation.

Results:
The radiomics signature consisted of 18 selected features and showed good discrimination performance. The model, which integrates the radiomics signature, the interval between radiotherapy and diagnosis of brain necrosis, and the interval between diagnosis of brain necrosis and treatment with bevacizumab, showed favorable calibration and discrimination in the training set (AUC 0.916). These findings were confirmed in the validation sets (AUC 0.912 and 0.827, respectively). Decision curve analysis confirmed the clinical utility of the model.

Conclusions:
The presented radiomics model, available as an online calculator, can serve as a user-friendly tool for individualized prediction of the response to bevacizumab in patients with brain necrosis after radiotherapy.
Periodontal Disease, Tooth Loss, and Risk of Serrated Polyps and Conventional Adenomas
Authors: Lo Chun-Han , Nguyen Long H. , Wu Kana , Ogino Shuji , Chan Andrew T. , Giovannucci Edward L. , Song Mingyang 
Published: July 2020

Abstract
Growing data indicate an association between periodontal disease and the development of cancer. However, the evidence for colorectal cancer has been inconsistent and longitudinal study examining its precursor lesions is lacking. We prospectively collected information on periodontal disease and number of tooth loss in the Nurses' Health Study (1992–2002) and the Health Professionals Follow-up Study (1992–2010). Polyp diagnosis was acquired via self-reported questionnaires and confirmed through review of medical records. We used logistic regression to calculate the multivariate-adjusted ORs and 95% confidence intervals (CI) with adjustment for smoking and other known risk factors for periodontal disease and colorectal cancer. In this study, we included 17,904 women and 24,582 men. We documented 2,336 cases of serrated polyps and 4,102 cases of conventional adenomas among 84,714 person-endoscopies throughout follow-up. The ORs of serrated polyps and conventional adenomas comparing individuals with and without periodontal disease were 1.17 (95% CI, 1.06–1.29) and 1.11 (95% CI, 1.02–1.19), respectively. Compared with participants without tooth loss, those who lost ≥4 teeth had 20% (OR, 1.20; 95% CI, 1.03–1.39) greater risk of serrated polyps (Ptrend 0.01). Among never smokers, similar associations with periodontal disease were observed for both serrated polyps (OR, 1.20; 95% CI, 1.02–1.41) and conventional adenomas (OR, 1.12; 95% CI, 1.00–1.26). History of periodontal disease and possibly higher number of tooth loss may modestly increase the risk of developing colorectal precursor lesions. Our findings advance our understanding of the interplay between oral health, microbiome, and early colorectal carcinogenesis.
Stakeholder Perspectives on Overcoming Barriers to Cascade Testing in Lynch Syndrome: A Qualitative Study
Authors: Srinivasan Swetha , Hampel Heather , Leeman Jennifer , Patel Amit , Kulchak Rahm Alanna , Reuland Daniel S. , Roberts Megan C. 
Published: July 2020

Abstract
Cascade testing (i.e., genetic testing of family members of individuals with disease) among families affected by hereditary cancer disorders, such as Lynch syndrome, is suboptimal and thus represents a missed opportunity in cancer prevention. We aimed to fill a gap in the literature by exploring multilevel barriers and facilitators to the implementation of cascade testing for Lynch syndrome. We conducted semistructured, in-depth interviews guided by the Consolidated Framework for Implementation Research and the Integrated Behavioral Model among key stakeholders (n = 60): Patients with Lynch syndrome and relatives (n = 20), providers (n = 20), and administrators (n = 20). Transcripts were double-coded (20% sample) using template analysis in ATLAS.ti. Barriers identified included (i) low awareness about Lynch syndrome, (ii) psychosocial barriers, (iii) lack of provider follow-up, (iv) accessibility to genetic counseling, and (v) fear of discrimination. Facilitators included (i) motivation to engage in cascade testing and (ii) free genetic testing offered to relatives. Stakeholders also recommended strategies to overcome implementation barriers in the short-term (increasing education, preparing patients for communicating with relatives), medium-term (optimizing clinical workflow and staffing resources), and long-term (nationwide standardization). These findings indicate that modifiable, multilevel barriers to the implementation of cascade testing in Lynch syndrome are experienced across stakeholders. Understanding and targeting implementation barriers is imperative to achieving public health impact of precision health interventions such as cascade testing.
A Comprehensive Review and Perspective on Anticancer Mechanisms of Withaferin A in Breast Cancer
Authors: Hahm Eun-Ryeong , Kim Su-Hyeong , Singh Krishna B. , Singh Kamayani , Singh Shivendra V. 
Published: July 2020

AbstractWithaferin A (hereafter abbreviated as WA) is a promising anticancer steroidal lactone abundant in a medicinal plant (Withania somnifera) native to Asia. The root/leaf extract of Withania somnifera, which belongs to the Solanaceae family, continues to be included in the Ayurvedic medicine formulations of alternative medicine practice. Numerous chemicals are detectable in the root/leaf extract of Withania somnifera [e.g., withanolides (WA, withanone, withanolide A, etc.), alkaloids, sitoindosides, etc.], but the anticancer effect of this medicinal plant is largely attributed to WA. Anticancer effect of WA was initially reported in the early 70s in the Ehrlich ascites tumor cell model in vitro. Since then, numerous preclinical studies have been performed using cellular and animal models of different cancers including breast cancer to determine cancer therapeutic and chemopreventive effects of WA. Chemoprevention, a word first introduced by Dr. Michael B. Sporn, was intended to impede, arrest, or reverse carcinogenesis at its earliest stages with pharmacologic agents. This review succinctly summarizes the published findings on anticancer pharmacology of WA in breast cancer focusing on pharmacokinetic behavior, in vivo efficacy data in preclinical models in a therapeutic and chemoprevention settings, and its known effects on cancer-relevant cellular processes (e.g., growth arrest, apoptosis induction, autophagy, metabolic adaptation, immune function, etc.) and molecular targets (e.g., suppression of oncogenes such as estrogen receptor-α, STAT3, etc.). Potential gaps in knowledge as well as future research directions essential for clinical development of WA for chemoprevention and/or treatment of breast cancer are also discussed.
Cardiac Emerinopathy
Authors: Ishikawa Taisuke , Mishima Hiroyuki , Barc Julien , Takahashi Masanori P. , Hirono Keiichi , Terada Shigenori , Kowase Shinya , Sato Teruki , Mukai Yasushi , Yui Yoshiaki , Ohkubo Kimie , Kimoto Hiroki , Watanabe Hiroyuki , Hata Yukiko , Aiba Takeshi , Ohno Seiko , Chishaki Akiko , Shimizu Wataru , Horie Minoru , Ichida Fukiko , Nogami Akihiko , Yoshiura Koh-Ichiro , Schott Jean-Jacques , Makita Naomasa 
Published: July 2020

Background:

Mutations in the nuclear envelope genes encoding
LMNA
and
EMD
are responsible for Emery-Dreifuss muscular dystrophy. However,
LMNA
mutations often manifest dilated cardiomyopathy with conduction disturbance without obvious skeletal myopathic complications. On the contrary, the phenotypic spectrums of
EMD
mutations are less clear. Our aims were to determine the prevalence of nonsyndromic forms of emerinopathy, which may underlie genetically undefined isolated cardiac conduction disturbance, and the etiology of thromboembolic complications associated with
EMD
mutations.

Methods:
Targeted exon sequencing was performed in 87 probands with familial sick sinus syndrome (n=36) and a progressive cardiac conduction defect (n=51).

Results:

We identified 3 X-linked recessive
EMD
mutations (start-loss, splicing, missense) in families with cardiac conduction disease. All 3 probands shared a common clinical phenotype of progressive atrial arrhythmias that ultimately resulted in atrial standstill associated with left ventricular noncompaction (LVNC), but they lacked early contractures and progressive muscle wasting and weakness characteristic of Emery-Dreifuss muscular dystrophy. Because the association of LVNC with
EMD
has never been reported, we further genetically screened 102 LVNC patients and found a frameshift
EMD
mutation in a boy with progressive atrial standstill and LVNC without complications of muscular dystrophy. All 6 male
EMD
mutation carriers of 4 families underwent pacemaker or defibrillator implantation, whereas 2 female carriers were asymptomatic. Notably, a strong family history of stroke observed in these families was probably due to the increased risk of thromboembolism attributable to both atrial standstill and LVNC.

Conclusions:
Cardiac emerinopathy is a novel nonsyndromic X-linked progressive atrial standstill associated with LVNC and increased risk of thromboembolism.
Proteomic Signatures During Treatment in Different Stages of Heart Failure
Authors: Michelhaugh Sam A. , Camacho Alexander , Ibrahim Nasrien E. , Gaggin Hanna , D’Alessandro David , Coglianese Erin , Lewis Gregory D. , Januzzi James L. 
Published: July 2020

Background:
Proteomics have already provided novel insights into the pathophysiology of heart failure (HF) with reduced ejection fraction. Previous studies have evaluated cross-sectional protein signatures of HF, but few have characterized proteomic changes following HF with reduced ejection fraction treatment with ARNI (angiotensin receptor/neprilysin inhibitor) therapy or left ventricular assist devices.

Methods:
In this retrospective omics study, we performed targeted proteomics (N=625) of whole blood sera from patients with American College of Cardiology/American Heart Association stage D (N=29) and stage C (N=12) HF using proximity extension assays. Samples were obtained before and after (median=82 days) left ventricular assist device implantation (stage D; primary analysis) and ARNI therapy initiation (stage C; matched reference). Oblique principal component analysis and point biserial correlations were used for feature extraction and selection; standardized mean differences were used to assess within and between-group differences; and enrichment analysis was used to generate and cluster Gene Ontology terms.

Results:

Core sets of proteins were identified for stage C (N=9 proteins) and stage D (N=18) HF; additionally, a core set of 5 shared HF proteins (NT-proBNP [N-terminal pro-B type natriuretic peptide], ESM [endothelial cell-specific molecule]-1, cathepsin L1, osteopontin, and MCSF-1) was also identified. For patients with stage D HF, moderate (δ, 0.40–0.60) and moderate-to-large (δ, 0.60–0.80) sized differences were observed in 8 of their 18 core proteins after left ventricular assist devices implantation. Additionally, specific protein groups reached concentration levels equivalent (
g
<0.10) to stage C HF after initiation on ARNI therapy.

Conclusions:
HF with reduced ejection fraction severity associates with distinct proteomic signatures that reflect underlying disease attributes; these core signatures may be useful for monitoring changes in cardiac function following initiation on ARNI or left ventricular assist device implantation.
Active Case Finding for Rheumatic Fever in an Endemic Country
Authors: Okello Emmy , Ndagire Emma , Atala Jenifer , Bowen Asha C. , DiFazio Marc P. , Harik Nada S. , Longenecker Chris T. , Lwabi Peter , Murali Meghna , Norton Scott A. , Omara Isaac Otim , Oyella Linda Mary , Parks Tom , Pulle Jafesi , Rwebembera Joselyn , Sarnacki Rachel J. , Spurney Christopher F. , Stein Elizabeth , Tochen Laura , Watkins David , Zimmerman Meghan , Carapetis Jonathan R. , Sable Craig , Beaton Andrea 
Published: July 2020

Background
Despite the high burden of rheumatic heart disease in sub‐Saharan Africa, diagnosis with acute rheumatic fever (ARF) is exceedingly rare. Here, we report the results of the first prospective epidemiologic survey to diagnose and characterize ARF at the community level in Africa.

Methods and Results
A cross‐sectional study was conducted in Lira, Uganda, to inform the design of a broader epidemiologic survey. Key messages were distributed in the community, and children aged 3 to 17 years were included if they had either (1) fever and joint pain, (2) suspicion of carditis, or (3) suspicion of chorea, with ARF diagnoses made by the 2015 Jones Criteria. Over 6 months, 201 children met criteria for participation, with a median age of 11 years (interquartile range, 6.5) and 103 (51%) female. At final diagnosis, 51 children (25%) had definite ARF, 11 (6%) had possible ARF, 2 (1%) had rheumatic heart disease without evidence of ARF, 78 (39%) had a known alternative diagnosis (10 influenza, 62 malaria, 2 sickle cell crises, 2 typhoid fever, 2 congenital heart disease), and 59 (30%) had an unknown alternative diagnosis.

Conclusions
ARF persists within rheumatic heart disease–endemic communities in Africa, despite the low rates reported in the literature. Early data collection has enabled refinement of our study design to best capture the incidence of ARF and to answer important questions on community sensitization, healthcare worker and teacher education, and simplified diagnostics for low‐resource areas. This study also generated data to support further exploration of the relationship between malaria and ARF diagnosis in rheumatic heart disease/malaria‐endemic countries.
Temporal Trends in Pregnancy‐Associated Stroke and Its Outcomes Among Women With Hypertensive Disorders of Pregnancy
Authors: Wu Pensée , Jordan Kelvin P. , Chew‐Graham Carolyn A. , Coutinho Thais , Lundberg Gina P. , Park Ki E. , Chappell Lucy C. , Myint Phyo K. , Maas Angela H. E. M. , Mamas Mamas A. 
Published: July 2020

Background
Stroke is a serious complication of hypertensive disorders of pregnancy (HDP), with potentially severe and long‐term sequelae. However, the temporal trends, predictors, and outcomes of stroke in women with HDP at delivery remain unknown.

Methods and Results
All HDP delivery hospitalizations with or without stroke event (ischemic, hemorrhagic, or unspecified) between 2004 and 2014 in the United States National Inpatient Sample were analyzed to examine incidence, predictors, and prognostic impact of stroke. Of 4 240 284 HDP delivery hospitalizations, 3391 (0.08%) women had stroke. While the prevalence of HDP increased over time, incident stroke rates decreased from 10 to 6 per 10 000 HDP delivery hospitalizations between 2004 and 2014. Women with stroke were increasingly multimorbid, with some risk factors being more strongly associated with ischemic strokes, including congenital heart disease, peripheral vascular disease, dyslipidemia, and sickle cell disease. Delivery complications were also associated with stroke, including cesarean section (odds ratio [OR], 1.58; 95% CI, 1.33–1.86), postpartum hemorrhage (OR, 1.91; 95% CI, 1.33–1.86), and maternal mortality (OR, 99.78; 95% CI, 59.15–168.31), independently of potential confounders. Women with stroke had longer hospital stays (median, 6 versus 3 days), higher hospital charges (median, $14 655 versus $4762), and a higher proportion of nonroutine discharge locations (38% versus 4%).

Conclusions
The incidence of stroke in women with HDP has declined over time. While a relatively rare event, identification of women at highest risk of ischemic or hemorrhagic stroke on admission for delivery is important to reduce long‐term sequelae.