bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient satisfaction and quality of life in hypothyroidism: An online survey by the british thyroid foundation
Authors: Mitchell Anna L. , Hegedüs Laszlo , Žarković Miloš , Hickey Janis L. , Perros Petros 
Published: September 2020

AbstractObjectiveDissatisfaction with treatment and impaired quality of life (QOL) are reported among people with treated hypothyroidism. We aimed to gain insight into this.Design and patientsWe conducted an online survey of individuals with self‐reported hypothyroidism.ResultsNine hundred sixty‐nine responses were analysed. Dissatisfaction with treatment was common (77.6%), and overall QOL scores were low. Patient satisfaction did not correlate with type of thyroid hormone treatment, but treatment with combination levothyroxine (L‐T4) and liothyronine (L‐T3) or with desiccated thyroid extract (DTE) was associated with significantly better reported QOL than L‐T4 or L‐T3 monotherapies (P < .001); however, multivariate analysis inclusive of other clinical parameters failed to confirm an association between type of thyroid hormone treatment and QOL or satisfaction. Multivariate analysis showed positive correlations between satisfaction and age (P = .026), male gender (P = .011), being under the care of a thyroid specialist (P < .001), family doctor (GP) prescribing DTE or L‐T4 + L‐T3 or L‐T3 (P < .001) and being well informed about hypothyroidism (P < .001); negative correlations were observed between satisfaction and negative experiences with L‐T4 (P < .001) and expectations for more support from the GP (P < .001), for L‐T4 to resolve all symptoms (P = .004), and to be referred to a thyroid specialist (P < .001). For QOL, positive correlations were with male gender (P = .011) and duration of hypothyroidism (P = .002); negative correlations were with age (P = .027), visiting the GP more than 3 times before diagnosis (P < .001), sourcing DTE or L‐T3 independently (P = .014), negative experiences with L‐T4 (P = .013), having expectations for L‐T4 to resolve all symptoms (P < .001) and of more support from the GP (P = .006).ConclusionsMultiple parameters including prior healthcare experiences and expectations influence satisfaction with hypothyroidism treatment and QOL. Focusing on enhancing the patient experience and clarifying expectations at diagnosis may improve satisfaction and QOL.
Sociodemographic, lifestyle and medical influences on serum testosterone and sex hormone–binding globulin in men from UK Biobank
Authors: Yeap Bu B. , Marriott Ross J. , Antonio Leen , Bhasin Shalender , Dobs Adrian S. , Dwivedi Girish , Flicker Leon , Matsumoto Alvin M. , Ohlsson Claes , Orwoll Eric S. , Raj Suchitra , Reid Christopher M. , Vanderschueren Dirk , Wittert Gary A. , Wu Frederick C. W. , Murray Kevin 
Published: September 2020

AbstractObjectiveSerum testosterone concentrations are affected by factors unrelated to hypothalamo‐pituitary‐testicular axis pathology. We evaluated the impact of sociodemographic, lifestyle and medical factors, on serum testosterone and sex hormone–binding globulin (SHBG) in men aged 40‐69 years.DesignCross‐sectional analysis of 208,677 community‐dwelling men from the UK Biobank.MeasurementsWe analysed associations of different factors with serum testosterone and SHBG (immunoassays) and calculated free testosterone (cFT), using smoothed centile plots, linear mixed models and effect size estimates.ResultsMedian (interquartile range) for serum testosterone was 11.6 (9.4‐14.1) nmol/L, SHBG 36.9 (27.9‐48.1) nmol/L and cFT 213 (178‐255) pmol/L. Age and BMI were inversely associated with testosterone and cFT, while SHBG was associated with age and inversely with BMI (all P < .001). Living with a partner, (South) Asian ethnicity, never or previous smoker and some medical conditions were associated with lower testosterone. Poultry or fish eater, and higher physical activity were associated with higher testosterone (all P < .001). Testosterone was lowered by ~0.5 nmol/L across ages, ~1.5 nmol/L for BMI 30 vs 25 kg/m2, ~2 nmol/L for (South) Asian ethnicity, living with partner, college/university qualifications, low red meat eater, insufficient physical activity and 0.3‐1.0 nmol/L with cardiovascular disease or diabetes. Different combinations of these factors varied serum testosterone by ~4 nmol/L, SHBG by ~30 nmol/L and cFT by ~60 pmol/L.ConclusionsThe identified modifiable risk factors support lifestyle‐based interventions in men with low testosterone concentrations. Considering sociodemographic, lifestyle and medical factors facilitates more personalized interpretation of testosterone testing results with respect to existing reference ranges.
Iatrogenic hypoglycaemia following glucose‐insulin infusions for the treatment of hyperkalaemia
Authors: Tee Su Ann , Devine Kerri , Potts Adam , Javaid Usman , Razvi Salman , Quinton Richard , Roberts Graham , Leech Nicola J. 
Published: September 2020

AbstractObjectivesTo study the incidence of, and risk factors for, iatrogenic hypoglycaemia following GwI infusion in our institution.ContextHyperkalaemia is a life‐threatening biochemical abnormality. Glucose‐with‐insulin (GwI) infusions form standard management, but risk iatrogenic hypoglycaemia (glucose ≤ 3.9 mmol/L). Recently updated UK guidelines include an additional glucose infusion in patients with pretreatment capillary blood glucose (CBG) < 7.0 mmol/L.DesignRetrospective analysis of outcomes for GwI infusions prescribed for hyperkalaemia from 1 January to 28 February 2019, extracted from the Newcastle upon Tyne Hospitals NHS Foundation Trust electronic platform (eRecord).Participants132 patients received 228 GwI infusions for hyperkalaemia.Main outcome measuresIncidence, severity and time to onset of hypoglycaemia.ResultsHypoglycaemia incidence was 11.8%. At least 1 hypoglycaemic episode occurred in 18.2% of patients with 6.8% having at least 1 episode of severe hypoglycaemia (< 3.0 mmol/L). Most episodes (77.8%) occurred within 3 h of treatment. Lower pretreatment CBG (5.9 mmol/L [4.1 mmol/L‐11.2 mmol/L], versus 7.6 mmol/L [3.7 mmol/L‐31.3 mmol/L], P = .000) was associated with hypoglycaemia risk. A diagnosis of type 2 diabetes and treatment for hyperkalaemia within the previous 24 h were negatively associated.ConclusionsWithin our inpatient population, around 1 in 8 GwI infusions delivered as treatment for hyperkalaemia resulted in iatrogenic hypoglycaemia. Higher pretreatment CBG and a diagnosis of type 2 diabetes were protective, irrespective of renal function. Our findings support the immediate change to current management, either with additional glucose infusions or by using glucose‐only infusions in patients without diabetes. These approaches should be compared via a prospective randomized study.
Nourishing Environments, Caring Cities: Gardening and the Social Reproduction of the Urban Environment in Deindustrial Michigan
Authors: Maurer Megan 
Published: September 2020

AbstractThrough vegetable gardening, residents of a small city in Michigan, USA, are striving to make their urban environments more socially equitable and ecologically sustainable. While gardeners across differences of class and race are motivated by a desire to change their environments and educate others, they do so in distinct ways due to different priorities. These range from neighborhood upkeep to ecological sustainability, and variation aligns with existing, intersecting forms of class distinction and racial differentiation. To engage the shared desires for equitable and sustainable urban life motivating gardeners, together with the class‐ and race‐based inequalities that shape and are shaped by their practices, this paper analyzes gardening as a form of social reproduction of the urban environment. Drawing on interviews and participant observation, this research examines the differences between gardens created for neighborhood upkeep as compared to those created for ecological sustainability, finding identifiable differences in gardening methods, spatial forms, and aesthetics directly related to gardeners’ motivations as they are shaped by experiences of race and class inequality. As both climate change and public disinvestment in social reproduction continue, the experiences of these gardeners indicate the insufficiency of shared motivations in realizing needs for just sustainability, and the importance of recognizing and responding to manifestations of social and environmental inequality in gardening motivation and practice.
Peri‐implant bone alterations under the influence of abutment screw preload stress. A preclinical vivo study
Authors: Al‐Omari Farah A. , Nagasawa Masako , Suliman Mubarak , Khraisat Ameen , Uoshima Katsumi 
Published: September 2020

AbstractObjectivesThe study purpose was to examine peri‐implant bone alternations around osseointegrated implants caused solely by abutment screw preload stress using different tightening torque values.Materials and methodsTwenty 20‐ to 22‐week‐old Japanese white rabbits received two implants each in right and left femurs. Implants were randomly assigned to one of three tightening torque groups or the control (Cont) group. After 8 weeks, 35 Ncm torque was delivered to abutment screws in the recommended torque (RT) group (n = 16). Other screws received 70 Ncm torque as the high torque (HT) group (n = 16). Temporary tightening (TT) groups (n = 8) received only 70 Ncm torque without preload stress as screws were untightened immediately. Cont group (n = 40) remained in situ. Animals were euthanized at 4, 6, 8, and 10 weeks after torque application. Micro‐CT images were then taken, and undecalcified ground sections were stained with toluidine blue.ResultsCross‐sections of cortical bone showed remodeling activities adjacent to the implant in all groups. While bone marrow spaces appearance was relatively small in Cont and TT groups, RT and HT groups showed large bone marrow spaces and extensive remodeling activity. Bone‐to‐implant contact was significantly less in RT and HT groups compared with Cont and TT groups at different time points (p ˂ .05). Furthermore, RT and HT groups showed significantly less bone volume and area (p ˂ .05).ConclusionResults suggested that preload stress without any occlusal loading might negatively affect peri‐implant bone stability and initiate bone remodeling. This could alter bone mechanical properties, subsequently influencing long‐term implant success.
Sublingual immunotherapy vs placebo in the management of grass pollen‐induced allergic rhinitis in adults: A systematic review and meta‐analysis
Authors: Boldovjáková Dominika , Cordoni Sara , Fraser Craig John , Love Aimee Beth , Patrick Lorna , Ramsay Gary James , Ferguson Aaron Stephen James , Gomati Anas , Ram Bhaskar 
Published: September 2020

AbstractIntroductionAllergic rhinitis (AR) is a common inflammatory condition of the nasal mucosa affecting approximately 20% of the population worldwide. Current therapies include intranasal antihistamines, corticosteroids, subcutaneous and sublingual immunotherapy (SLIT). This review and meta‐analysis assess the efficacy of SLIT in the management of grass pollen‐induced AR in adults.MethodsOvid EMBASE, Ovid EBM Reviews, Cochrane Central Register of Controlled Trials, Ovid MedLine and PubMed were searched using the following terms: ‘sublingual immunotherapy’, ‘SLIT’, ‘rhinitis’, ‘allergic rhinitis’, ‘rhinosinusitis’ and ‘rhino‐conjunctivitis’. All included studies were double‐blind, placebo‐controlled and randomised trials. Primary outcome was symptom score and secondary outcome included quality of life and safety profile. Meta‐analysis of symptom improvement was carried out.ResultsSix studies were identified with 979 subjects randomly allocated to SLIT and 992 to a placebo control. All studies reported an improvement in symptoms with SLIT, with five reaching statistical significance (P < .05). Four studies reported statistically significant improvement in quality of life (P < .05). Oral pruritus was the most common adverse event reported. The overall risk of bias was high in 50% of the studies.ConclusionsSublingual immunotherapy was a safe and effective treatment for grass pollen‐induced AR in adults, and therefore, consideration should be given to its use for moderate‐to‐severe disease in the UK‐wide population.
Comparative study of microvascular function: Forearm blood flow versus dynamic retinal vessel analysis
Authors: Schirutschke Holger , Kochan Johannes , Haink Kristin , Rettig Ronny , Parmentier Simon Paul , Ziemssen Tjalf , Passauer Jens 
Published: September 2020

AbstractObjectiveRecently, dynamic retinal vessel analysis (DVA) has gained interest for investigation of microvascular function but comparative measurements with standard methods like the forearm blood flow technique (FBF) are uncommon till now.MethodsWe recruited 23 high‐risk cardiovascular patients (Risk) and 17 healthy persons (Ctrl). During the FBF experiment, postocclusive reactive hyperaemia (RH) as well as endothelium‐dependent and independent vasodilation was measured by infusion of acetylcholine (ACh) and sodium nitroprusside (SNP) into the brachial artery. The dynamic vessel analyzer was applied for measurement of the retinal arterial and venous response to flickering light during DVA and for determination of the central retinal arterial (CRAE) and venous equivalent (CRVE).ResultsForearm blood flow technique was significantly attenuated in the patient group during postocclusive RH (p < .005). The increase of FBF in response to SNP did not differ significantly between the two groups (p = .09). In contrast, the FBF response to ACh was significantly blunted in the patient group (p < .05), indicating endothelial dysfunction. DVA did not detect any difference of retinal arterial (p = .68) or retinal venous (p = .93) vasodilation between both groups. The CRAE (p = .55) and CRVE (p = .83) did not differ significantly in either group.ConclusionsForearm blood flow and DVA cannot be regarded as equivalent methods for testing of microvascular function. Possible explanations include differences in the vascular beds and vessel diameters examined as well as differences in the trigger mechanisms applied. Further studies are needed to define the role of DVA in this context.
Chromatin‐modifying drugs and metabolites in cell fate control
Authors: Yao Ziyue , Chen Yu , Cao Wenhua , Shyh‐Chang Ng 
Published: September 2020

AbstractFor multicellular organisms, it is essential to produce a variety of specialized cells to perform a dazzling panoply of functions. Chromatin plays a vital role in determining cellular identities, and it dynamically regulates gene expression in response to changing nutrient metabolism and environmental conditions. Intermediates produced by cellular metabolic pathways are used as cofactors or substrates for chromatin modification. Drug analogues of metabolites that regulate chromatin‐modifying enzyme reactions can also regulate cell fate by adjusting chromatin organization. In recent years, there have been many studies about how chromatin‐modifying drug molecules or metabolites can interact with chromatin to regulate cell fate. In this review, we systematically discuss how DNA and histone‐modifying molecules alter cell fate by regulating chromatin conformation and propose a mechanistic model that explains the process of cell fate transitions in a concise and qualitative manner.
Gender differences in heart transplantation: Twenty‐five year trends in the nationwide Spanish heart transplant registry
Authors: García‐Cosío María D. , González‐Vilchez Francisco , López‐Vilella Raquel , Barge‐Caballero Eduardo , Gómez‐Bueno Manuel , Martínez‐Selles Manuel , Arizón Jose M. , Rangel Sousa Diego , González‐Costello José , Mirabet Sonia , Pérez‐Villa Félix , Díaz‐Molina Beatriz , Rábago Gregorio , Portolés Ocampo Ana , de la Fuente‐Galán Luis , Garrido Iris , Delgado‐Jiménez Juan F. 
Published: September 2020

AbstractThe study of gender differences may lead into improvement in patient care. We have aimed to identify the gender differences in heart transplantation (HT) of adult HT recipients in Spain and their evolution in a study covering the years 1993–2017 in which 6740 HT (20.6% in women) were performed. HT indication rate per million inhabitants was lower in women, remaining basically unchanged during the 25‐year study period. HT rate was higher in men, although this decreased over the 25‐year study period. Type of heart disease differed in men versus women (p < .001): ischemic heart disease 47.6% versus 22.5%, dilated cardiomyopathy 41.3% versus 34.6%, or other 36% versus 17.8%, respectively. Men were more frequently diabetics (18% vs. 13.1% p < .001), hypertensives (33.1% vs. 24% p < .001), and smokers (21.7% vs. 12.9% p < .001), respectively. Women had more pre‐HT malignancies (7.1% vs. 2.8% p < .001), and their clinical status was worse at HT due to renal function and mechanical ventilation. Adjusted survival (p = .198) and most of the mortality‐related variables were similar in men and women. Death occurred more frequently in women due to rejection (7.9% vs. 5.1% p < .001) and primary failure (18.2% vs. 12.5% p < .001) and in men due to malignancies (15.1% vs. 6.6% p < .001).
Outpatient COVID‐19 surveillance testing in orthotopic heart transplant recipients
Authors: Carey Sandra A. , Afzal Aasim , Jamil Aayla , Williams Sarah , Gottlieb Robert L. 
Published: September 2020

AbstractCOVID‐19 case fatality rate in the United States is currently reported at 4.8% based on the confirmed cases of COVID‐19. However, there are conflicting reports of estimated deaths in the post‐cardiac transplantation patient population associated with COVID‐19.MethodsObservational, retrospective analysis of a large cohort of post Orthotopic Heart Transplantation (OHT) patients in a high volume heart transplantation program in Dallas, Texas underwent outpatient COVID‐19 screening and testing for both SARS‐CoV‐2 nasopharyngeal RT‐PCR and anti‐SARS‐CoV2 IgG serology as a result of a clinic protocol to facilitate re‐opening of face‐to‐face outpatient clinical visits.ResultsThe full outpatient cohort tested at time of their clinic visit tested negative for COVID‐19 by nasopharyngeal RT‐PCR. Only 2 patients tested seropositive for anti‐SARS‐COV2 IgG. Five positive inpatient cases were also identified and all, but one recovered.ConclusionA COVID‐19 surveillance protocol can be easily instituted in this high‐risk population and facilitate safe transplant clinic operation. As the cases and prevalence increase across the United States, further strategies will need to be developed to determine the best course of action to help manage this select population while minimizing their exposure to the ongoing pandemic.
Efficacy and safety of a sodium‐glucose co‐transporter‐2 inhibitor versus placebo as an add‐on therapy for people with type 2 diabetes inadequately treated with metformin and a dipeptidyl peptidase‐4 inhibitor: a systematic review and meta‐analysis of randomised controlled trials
Authors: De Buitléir C. , O’ Connor E. , Satti M. M. , Shaw J. , Liew A. 
Published: September 2020

AbstractAimsTo conduct a systematic review and meta‐analysis to assess the efficacy, safety and tolerability of sodium‐glucose co‐transporter‐2 inhibitors vs placebo as add‐on therapy after metformin and dipeptidyl peptidase‐4 inhibitor dual therapy in type 2 diabetes.MethodsThis systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PROSPERO registration number: CRD42018099398). A search was conducted via PubMed, www.clinicaltrials.gov and Cochrane Central Register of Controlled Trials of relevant randomised controlled trials up until 14 August 2020 that compared sodium‐glucose co‐transporter‐2 inhibitors vs placebo as add‐on therapy after metformin and dipeptidyl peptidase‐4 inhibitor therapy. A random‐effects model was used.ResultsSix randomised controlled trials (1661 participants) met the inclusion criteria. Compared with placebo, sodium‐glucose co‐transporter‐2 inhibitor treatment, as add‐on to metformin and dipeptidyl peptidase‐4 inhibitor therapy, was associated with a significant reduction in HbA1c level [mean difference –8 mmol/mol, 95% CI –10, –6 (–0.7%, 95% CI –0.9, –0.6); P < 0.00001], in fasting plasma glucose level [mean difference –1.70 mmol/l, 95% CI –1.91, –1.49; P < 0.00001], in weight (mean difference –1.76 kg, 95% CI –2.04, –1.48; P < 0.00001) and in blood pressure (systolic blood pressure: mean difference –3.6 mmHg, 95% CI –4.8, –2.4; P < 0.00001; diastolic blood pressure: mean difference –1.5 mmHg; 95% CI –2.4, –0.6; P = 0.002). Genital mycotic infections (odds ratio 7.37, 95% CI 3.06, 17.76; P < 0.00001) were more common with sodium‐glucose co‐transporter‐2 inhibitors, but there was no significant statistical difference in urinary tract infections (odds ratio 1.16, 95% CI 0.63, 2.13; P = 0.64), in hypoglycaemia (odds ratio 1.36, 95% CI 0.61, 3.04; P = 0.45), or in discontinuation rates due to adverse events (odds ratio 1.52, 95% CI 0.78, 2.97; P = 0.22) between the two groups.ConclusionsIn comparison with placebo, add‐on therapy with a sodium‐glucose co‐transporter‐2 inhibitor is significantly more efficacious in lowering HbA1c, fasting plasma glucose and weight in people with type 2 diabetes following inadequate glycaemic control with metformin and a dipeptidyl peptidase‐4 inhibitor. The rate of discontinuation due to adverse events was similar despite higher risk of genital mycotic infections.
Neuromodulation in Psychiatric disorders: Experimental and Clinical evidence for reward and motivation network Deep Brain Stimulation: Focus on the medial forebrain bundle
Authors: Döbrössy Máté D. , Ramanathan Chockalingam , Ashouri Vajari Danesh , Tong Yixin , Schlaepfer Thomas , Coenen Volker A. 
Published: September 2020

AbstractDeep brain stimulation (DBS) in psychiatric illnesses has been clinically tested over the past 20 years. The clinical application of DBS to the superolateral branch of the medial forebrain bundle in treatment‐resistant depressed patients—one of several targets under investigation—has shown to be promising in a number of uncontrolled open label trials. However, there are remain numerous questions that need to be investigated to understand and optimize the clinical use of DBS in depression, including, for example, the relationship between the symptoms, the biological substrates/projections and the stimulation itself. In the context of precision and customized medicine, the current paper focuses on clinical and experimental research of medial forebrain bundle DBS in depression or in animal models of depression, demonstrating how clinical and scientific progress can work in tandem to test the therapeutic value and investigate the mechanisms of this experimental treatment. As one of the hypotheses is that depression engenders changes in the reward and motivational networks, the review looks at how stimulation of the medial forebrain bundle impacts the dopaminergic system.