bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do toe blood pressures predict healing after minor lower limb amputation in people with diabetes? A systematic review and meta-analysis
Authors: Linton Clare , Searle Angela , Hawke Fiona , Tehan Peta Ellen , Sebastian Mathew , Chuter Vivienne 
Published: June 2020

Purpose of study:To investigate toe systolic blood pressure and/or toe-brachial pressure index in predicting healing post minor diabetic foot amputations.Key methods:A systematic search of EMBASE and PubMed (including Medline and The Cochrane Library) was conducted from database inception to 9 March 2020. Two authors independently reviewed and selected relevant studies. Quality was assessed with a modified Critical Appraisal Skill Programme checklist.Main results:Ten studies met the inclusion criteria. Nine studies investigating toe systolic blood pressure reported healing occurred at mean toe systolic blood pressure values ⩾30 mmHg, ranging between 30 and 83.6 mmHg. The meta-analysis (four studies) found toe systolic blood pressure <30 mmHg had 2.09 times the relative risk of non-healing post amputation, compared to toe systolic blood pressure ⩾30 mmHg (relative risk = 2.09, 95% confidence interval: 1.37–3.20, p = 0.001). Two studies investigating toe-brachial pressure index report successful healing where toe-brachial pressure index >0.2, with one study reporting a higher value of 0.8.Main conclusions:Successful post-amputation healing outcomes were reported at mean toe systolic blood pressure ⩾30 mmHg, and the results varied considerably between the studies. Further research should identify whether variables, including amputation level, method of wound closure and length of post-operative follow-up periods, affect the values of toe systolic blood pressure and toe-brachial pressure index observed in this review.
The characteristics of isolated para-aortic lymph node metastases in endometrial cancer and their prognostic significance
Authors: Guo Jianbin , Qian Haili , Ma Fei , Zhang Ying , Cui Xiujuan , Duan Hua 
Published: June 2020

Background: The aim of this study was to clarify the features and prognostic significance of isolated para-aortic lymphatic metastasis of endometrial cancer. Methods: A retrospective study of patients with stage IIIC endometrial cancer was performed based on the Surveillance, Epidemiology, and End Results (SEER) database. A total of 2767 patients were divided into three groups according to the lymphatic metastasis patterns: isolated pelvic lymphatic metastasis, isolated para-aortic lymphatic metastasis and dual lymphatic metastasis. The clinic-pathological characteristics and prognosis of patients were compared among the three groups. Result: The proportion of patients with isolated para-aortic lymphatic metastasis was 13.70%. Patients with isolated pelvic lymphatic metastasis or isolated para-aortic lymphatic metastasis shared similar histological characteristics, except that patients with isolated para-aortic lymphatic metastasis had a lower proportion of tumors over 5 cm in diameter than patients with isolated pelvic lymphatic metastasis (35.1% versus 45.7%, p = 0.001). Compared with patients with dual lymphatic metastasis, isolated para-aortic lymphatic metastasis was more common in patients with endometrioid tumors (78.6% versus 67.3%, p < 0.001), grade 1–2 cancers (53.3% versus 36.3%, p < 0.001) and negative peritoneal cytology (76.2% versus 61.1%, p < 0.001). Dual lymphatic metastasis was an independent predictive factor for the poor outcomes of patients at stage IIIC. However, in stage IIIC endometrioid tumors, patients with isolated pelvic lymphatic metastasis and those with isolated para-aortic lymphatic metastasis shared similar prognosis. Patients at stage IIIC with nonendometrioid tumors and patients at stage IV could not be further divided into subgroups according to lymphatic metastasis patterns in terms of prognosis. Conclusion: Endometrioid patients with isolated pelvic lymphatic metastasis and isolated para-aortic lymphatic metastasis share similar clinical pathological characteristics and prognoses.
Serial Perioperative Assessment of Free Flap Perfusion With Laser Angiography
Authors: Massaro Anthony , Gomez Juliana , Weyh Ashleigh Michelle , Bunnell Anthony , Warrick Matthew , Pirgousis Philip , Fernandes Rui 
Published: June 2020

Study Design: Prospective cohort study. Objective: Reconstruction with microvascular free flaps is quite predictable but excessive fluids intraoperatively and excessive use of vasopressors have been implicated in postoperative complications. However, vasopressors assist in limiting fluid administration and counteract vasodilatory effects of general anesthetics, while maintaining proper intravascular volume. This is of paramount importance during surgery to ensure adequate tissue and organ perfusion. The purpose of this study is to quantify perfusion changes in free flaps at specific time points during peri- and postoperative periods, incorporating SPY technology. Methods: A prospective study of patients who underwent free flap reconstruction was conducted (n = 9), using SPY laser angiography with indocyanine green to assess effects of general anesthetics and vasopressors on flap perfusion. Free flaps were evaluated prior to pedicle division, after inset and anastomosis, and in the immediate postoperative setting. Mean perfusion, mean arterial pressure, total operative time, fluid shifts, and vasopressor use were recorded. Data were analyzed with univariate and multivariable analyses. Results: Those with major complications in this cohort, on average received less vasopressors, had shorter operation times and less blood loss, however, they received more fluids intraoperatively. Conclusion: Changes in mean perfusion to the free flap during the intraoperative and immediate postoperative period are nominal.
Continuous changes in biological levels of complete blood count in a high altitude area of China
Authors: Luo Xuan , Feng Lei , Bai XueJing , Zhu JiangXian , Zhao GuanCheng , Wu MengNa , Yan ZeFeng 
Published: June 2020

Objectives: We aimed to establish a new reference interval of blood cell parameters by classifying and counting blood Cells of 16- to 85-year-old healthy volunteers and observing continuous changes with age. Methods: We analyzed the blood cell parameters of 42,678 cases (men, 24,406; women, 18,272), and compared the blood cell parameters of men and women in different age groups using an independent samples t-test. Using limits of 2.5%–97.5%, a 90% confidence interval was used to develop new reference intervals. Results: Counts of blood cell parameters, including white blood Cells, neutrophils, lymphocytes, monocytes, eosinophils, basophils, red blood Cells, hemoglobin, hematocrit, distribution width of red blood Cells and platelets, were found to differ between men and women in different age groups. These parameters were used to establish a new reference interval of blood Cells. Conclusion: The blood cell parameters of both men and women changed with increasing age. The reference interval that we established will provide more accurate basic evidence for clinical diagnosis and treatment of diseases.
Lasmiditan mechanism of action – review of a selective 5-HT1F agonist
Authors: Clemow David B. , Johnson Kirk W. , Hochstetler Helen M. , Ossipov Michael H. , Hake Ann M. , Blumenfeld Andrew M. 
Published: June 2020

AbstractMigraine is a leading cause of disability worldwide, but it is still underdiagnosed and undertreated. Research on the pathophysiology of this neurological disease led to the discovery that calcitonin gene-related peptide (CGRP) is a key neuropeptide involved in pain signaling during a migraine attack. CGRP-mediated neuronal sensitization and glutamate-based second- and third-order neuronal signaling may be an important component involved in migraine pain. The activation of several serotonergic receptor subtypes can block the release of CGRP, other neuropeptides, and neurotransmitters, and can relieve the symptoms of migraine. Triptans were the first therapeutics developed for the treatment of migraine, working through serotonin 5-HT1B/1D receptors. The discovery that the serotonin 1F (5-HT1F) receptor was expressed in the human trigeminal ganglion suggested that this receptor subtype may have a role in the treatment of migraine. The 5-HT1F receptor is found on terminals and cell bodies of trigeminal ganglion neurons and can modulate the release of CGRP from these nerves. Unlike 5-HT1B receptors, the activation of 5-HT1F receptors does not cause vasoconstriction.The potency of different serotonergic agonists towards 5-HT1F was correlated in an animal model of migraine (dural plasma protein extravasation model) leading to the development of lasmiditan. Lasmiditan is a newly approved acute treatment for migraine in the United States and is a lipophilic, highly selective 5-HT1F agonist that can cross the blood-brain barrier and act at peripheral nervous system (PNS) and central nervous system (CNS) sites.Lasmiditan activation of CNS-located 5-HT1F receptors (e.g., in the trigeminal nucleus caudalis) could potentially block the release of CGRP and the neurotransmitter glutamate, thus preventing and possibly reversing the development of central sensitization. Activation of 5-HT1F receptors in the thalamus can block secondary central sensitization of this region, which is associated with progression of migraine and extracephalic cutaneous allodynia. The 5-HT1F receptors are also elements of descending pain modulation, presenting another site where lasmiditan may alleviate migraine. There is emerging evidence that mitochondrial dysfunction might be implicated in the pathophysiology of migraine, and that 5-HT1F receptors can promote mitochondrial biogenesis. While the exact mechanism is unknown, evidence suggests that lasmiditan can alleviate migraine through 5-HT1F agonist activity that leads to inhibition of neuropeptide and neurotransmitter release and inhibition of PNS trigeminovascular and CNS pain signaling pathways.
Fabrication and Photocatalytic Activity of Ag3PO4/T-ZnOw Heterostructures
Authors: Tang Jianke , Meng Rongqian , Wang Qi , Zhang Shengjian , Li Qiaoling 
Published: June 2020

AbstractThe Ag3PO4/tetrapod-like ZnO whisker (T-ZnOw) heterostructures were prepared via a simple precipitation method. The obtained heterostructures were characterized by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, high-resolution transmission electron microscopy, X-ray photoelectron spectroscopy, and UV-Vis diffuse reflectance spectroscopy. The photodegradation activity of Ag3PO4/T-ZnOw was evaluated by the degradation of Rhodamine B (RhB) under visible light irradiation. When the molar ratio of Ag3PO4 to T-ZnOw was 10% (Ag3PO4/T-ZnOw-2), the highest degradation efficiency (92.9%) could be achieved among the heterostructures. The photodegradation rate constant of Ag3PO4/T-ZnOw-2 (0.05179 min−1) was 3.59 times that of T-ZnOw (0.01444 min−1). Besides, the Ag3PO4/T-ZnOw-2 photocatalyst still possessed a degradation efficiency of 77.8% after four successive cycles. The Ag3PO4/T-ZnOw-2 catalyst had much higher photocatalytic activity than pure T-ZnOw and better stability and reusability than pure Ag3PO4. The effect of different scavengers on degradation efficiency was investigated, and the possible photocatalytic mechanism of the Ag3PO4/T-ZnOw photocatalyst was also put forward.
Neuroprotective effect of paricalcitol in a rat model of transient global cerebral ischemia
Authors: Kim Sung Wook , Oh Joo Suk , Park Jungtaek , Jeong Hyun Ho , Oh Young Min , Choi Semin , Choi Kyoung Ho 
Published: June 2020

Abstract
Background
Paricalcitol is known to attenuate ischemic-reperfusion injury of various organs. However, it is not known whether paricalcitol prevents neuronal injury after global cerebral ischemia. The purpose of this study is to investigate the neuroprotective effect of paricalcitol in a rat model of transient global cerebral ischemia.

Methods
This is a prospective, randomized experimental study. Male Sprague-Dawley rats that survived 10 min of four-vessel occlusion were randomly assigned to two treatment groups: one group was treated with paricalcitol 1 μg/kg IP, and the other was given an equivalent volume of normal saline IP. Drugs were administered at 5 min, 1 day, 2 days, and 3 days after ischemia. Neurologic function was assessed at 2 h, 1 day, 2 days, 3 days, and 4 days after ischemia. We tested motor function 3 days after ischemia using the rotarod test. Also, we tested memory function 4 days after ischemia using the passive avoidance test. We assessed neuronal degeneration in the hippocampus of surviving rats 4 days after ischemia.

Results
Eight rats were allocated to each group. No significant differences were found between the groups in terms of survival rate, motor coordination, or memory function. The neurological function score 2-h post-ischemia was significantly higher in the paricalcitol group (p = 0.04). Neuronal degeneration was significantly less in the paricalcitol group compared with the control group (p = 0.01).

Conclusions
Paricalcitol significantly attenuated neuronal injury in the hippocampus. Although motor coordination, memory function, and survival rate were not significantly improved by paricalcitol treatment in this study, paricalcitol remains a potential neuroprotective drug after global cerebral ischemia.
The local hypothalamic–pituitary–adrenal axis in cultured human dermal papilla cells
Authors: Lee Eun Young , Nam You Jin , Kang Sangjin , Choi Eun Ju , Han Inbo , Kim Jinwan , Kim Dong Hyun , An Ji Hae , Lee Sunghou , Lee Min Ho , Chung Ji Hyung 
Published: June 2020

AbstractBackgroundStress is an important cause of skin disease, including hair loss. The hormonal response to stress is due to the HPA axis, which comprises hormones such as corticotropin releasing factor (CRF), adrenocorticotropic hormone (ACTH), and cortisol. Many reports have shown that CRF, a crucial stress hormone, inhibits hair growth and induces hair loss. However, the underlying mechanisms are still unclear. The aim of this study was to examine the effect of CRF on human dermal papilla cells (DPCs) as well as hair follicles and to investigate whether the HPA axis was established in cultured human DPCs.ResultsCRF inhibited hair shaft elongation and induced early catagen transition in human hair follicles. Hair follicle cells, both human DPCs and human ORSCs, expressed CRF and its receptors and responded to CRF. CRF inhibited the proliferation of human DPCs through cell cycle arrest at G2/M phase and induced the accumulation of reactive oxygen species (ROS). Anagen-related cytokine levels were downregulated in CRF-treated human DPCs. Interestingly, increases in proopiomelanocortin (POMC), ACTH, and cortisol were induced by CRF in human DPCs, and antagonists for the CRF receptor blocked the effects of this hormone.ConclusionThe results of this study showed that stress can cause hair loss by acting through stress hormones. Additionally, these results suggested that a fully functional HPA axis exists in human DPCs and that CRF directly affects human DPCs as well as human hair follicles under stress conditions.
Response to “understanding the behavioural determinants of opioid prescribing among family physicians: a qualitative study”
Authors: Busse Jason W. , Juurlink David , Buckley D. Norman , Guyatt Gordon H. 
Published: June 2020

AbstractThe 2017 Canadian opioid Guideline made both strong recommendations, indicating that all or almost all fully informed patients would choose the recommended course of action, and weak recommendations, in which different choices are appropriate for individual patients based on their values and preferences. The Guideline’s recommendation to taper legacy patients prescribed high-dose opioid therapy is weak, and mandatory tapering is expressly discouraged.
Genetic variants of VDR and CYP2R1 affect BMI independently of serum vitamin D concentrations
Authors: Bakos Bence , Szili Balázs , Szabó Boglárka , Horváth Péter , Kirschner Gyöngyi , Kósa János P. , Toldy Erzsébet , Lakatos Péter , Tabák Ádám G. , Takács István 
Published: June 2020

Abstract
Background
Vitamin D metabolism and obesity have been linked by several studies, however the reason for this association is unclear. Our objective was to investigate potential correlations between genetic variants in key enzymes of vitamin D metabolism and the body mass index on a representative and random sample of Hungarian adults.

Methods
Altogether 462 severely vitamin D deficient individuals were studied at the end of winter in order to decrease environmental and maximize any relevant genetic effect. Furthermore, participants with lifestyle factors known to affect vitamin D homeostasis were also excluded. We selected 23 target SNPs in five genes that encode key proteins of vitamin D metabolism (NADSYN1, GC, CYP24A1, CYP2R1, VDR).

Results
Variants in 2 genetic polymorphisms; rs2853564 (VDR) and rs11023374 (CYP2R1) showed a significant association with participants‘ BMI. These associations survived further adjustment for total-, free-, or bioactive-25(OH) vitamin D levels, although the variance explained by these 2 SNPS in BMI heterogeneity was only 3.2%.

Conclusion
Our results show two novel examples of the relationship between genetics of vitamin D and BMI, highlighting the potential role of vitamin D hormone in the physiology of obesity.
Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study
Authors: Botero-Tovar Natalia , Arocha Zuluaga Gina Paola , Ramírez Varela Andrea 
Published: June 2020

Abstract
Background
Intersectoral actions (ISA) are a recognized relationship between the health sector and other sectors to improve health outcomes. Although a frequent topic in public health studies, evidence for systematic evaluation of implementation of ISA is scarce. An intersectoral health intervention for infants under one-year-old with, and at risk of, stunting (low height-for-age) was developed by a public-private partnership in Bogotá, Colombia, during 2018 and 2019. Here we report a case study conducted in parallel to the intervention designed to assess factors that influenced implementation of the ISA.

Methods
The case study was developed using a concurrent mixed-methods design, with the qualitative component giving context to the quantitative results. The qualitative component was obtained from four workshops, three focus groups, and 17 semi-structured interviews with actors involved in the intersectoral intervention. The quantitative component was obtained with two questionnaires that evaluated perceptions on improvement and partnership functioning of the ISA.

Results
This study collected information from 122 participants. The intervention demanded intersectoral collaboration. Political will, motivated human resources, and recognition that health improvement results from collaboration, were factors that facilitated intersectoral actions. Intersectoral actions were limited by difficulties in engaging the health sector, communication challenges related to local health service decentralization, and administrative barriers.

Conclusions
Intersectoral actions have recently been discussed in the literature due to challenges in implementation and doubts regarding economic outcomes. The implementation of intersectoral public health interventions can be jeopardized by a lack of coordination and management skills.
Open fenestration discectomy versus microscopic fenestration discectomy for lumbar disc herniation: a randomized controlled trial
Authors: Hamawandi Sherwan A. , Sulaiman Injam Ibrahim , Al-Humairi Ameer Kadhim 
Published: June 2020

Abstract
Background
Fenestration discectomy, for symptomatic lumbar disc herniation, is the most common surgical procedure in spine surgery. It can be done by open or microscopic procedures. This study compared the results of fenestration microdiscectomy with open fenestration discectomy in the treatment of symptomatic lumbar disc herniation as a relation to the functional outcome, leg pain, back pain, hospital stay, returns to daily activity, cost, recurrence, reoperation and type of surgery for recurrent disc herniation.

Methods
60 patients age (29 - 50 years), with L4-L5 disc herniation, are divided randomly into group A- 30 patients underwent an open fenestration discectomy- and group B- 30 patients underwent fenestration microdiscectomy. All patients are assessed at 1 week, 3 months, 6 months, 12 months after surgery for Oswestry disability index and Visual analogue scale for back pain and leg pain and followed up for 4 years.

Results
In both groups, all patients have minimal disability by Oswestry Disability Index after surgery.
There were significant differences between means of post-operative Visual Analogue Scale for back pain between these two groups after 1 week (3.7 in group A versus 2.2 in group B) (t = 13.28, P = < 0.001*) and after 3 months (1.73 in group A versus 0.43 in group B) (t = 10.54, P = < 0.001*).
There were no significant differences between two groups regarding post-operative VAS for leg pain, recurrence (5 patients in group A versus 4 patients in group B) and reoperation rate (2 patients in each group).
There were significant differences between means of length of hospital stay (2.10 in group A versus 1.06 in group B) (P < 0.001), time of returning to daily activities (7.33 in group A versus 4.03 in group B) (P < 0.001) and cost of surgery (1996.66 in group A versus 3003.3 in group B) (P < 0.001).

Conclusion
Use of microscope in fenestration discectomy for treatment of symptomatic lumbar disc herniation can achieve the same goals of open fenestration regarding nerve root decompression and relief of leg pain with advantage of less back pain, less hospital staying and early return to daily activities with disadvantage of more cost with the use of microscope. With 4 years follow up, there was no significant deference in rate of recurrence and reoperation with the use of microscope but we found that type of surgery for recurrent cases may be less invasive if microscope was used in primary surgery.

Trial registration
NCT, NCT04112485. Registered 30 September 2019 - Retrospectively registered, https://clinicaltrials.gov/NCT04112485