bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture alleviates chronic pain and comorbid conditions in a mouse model of neuropathic pain: the involvement of DNA methylation in the prefrontal cortex
Authors: Jang Jae-Hwan , Song Eun-Mo , Do Young-Ho , Ahn Sora , Oh Ju-Young , Hwang Tae-Yeon , Ryu Yeonhee , Jeon Songhee , Song Mi-Yeon , Park Hi-Joon 
Published: August 2020

Abstract
Chronic pain reduces life quality and is an important clinical problem associated with emotional and cognitive dysfunction. Epigenetic regulation of DNA methylation is involved in the induction of abnormal behaviors and pathological gene expression. We examined whether acupuncture can restore epigenetic changes caused by chronic pain, and identified the underlying mechanisms in neuropathic pain mice. Acupuncture treatment for 6 months (3 days/week) improved mechanical/cold allodynia and the emotional/cognitive dysfunction caused by left partial sciatic nerve ligation (PSNL)-induced neuropathic pain. The effects of acupuncture were associated with global DNA methylation recovery in the prefrontal cortex (PFC). Analysis of DNA methylation patterns in PFC indicated that 1364 overlapping genes among 4442 and 4416 methylated genes in the PSNL vs sham and PSNL vs acupuncture points groups, respectively, were highly associated with the DNA methylation process. Acupuncture restored the reduced expression of 5-methylcytosine, methyl-cytosine-phospho-guanine binding protein 2, and DNA methyltransferase family enzymes induced by PSNL in PFC. Methylation levels of Nr4a1 and Chkb associated with mitochondrial dysfunction were decreased in PFC of the PSNL mice, and increased by acupuncture. By contrast, high expression of Nr4a1 and Chkb mRNA in PSNL mice decreased after acupuncture. We also found that acupuncture inhibited the expression of Ras pathway-related genes such as Rasgrp1 and Rassf1. Finally, the expression of Nr4a1, Rasgrp1, Rassf1, and Chkb mRNA increased in the neuronal cells treated with Mecp2 small interfering RNA. These results suggest that acupuncture can relieve chronic pain-induced comorbid conditions by altering DNA methylation of Nr4a1, Rasgrp1, Rassf1, and Chkb in the PFC.
Psychometric Properties of the Turkish Version of the Dietary Sodium Restriction Questionnaire
Authors: Korkmaz Ebru Konal , Ardahan Melek 
Published: August 2020

Background
Sodium restriction is the primary nonpharmacological treatment in heart failure (HF) to prevent rehospitalization and reduce HF symptom burden. Despite the importance of restricting sodium in the diet, the prevalence of nonadherence to a low-sodium diet has been known to be high. To reduce the high prevalence of nonadherence, we have to know the facilitating and challenging factors. The planned behavior theory shows those factors, including attitudes, social norms, and perceived behavioral control. The Dietary Sodium Restriction Questionnaire (DSRQ) was developed based on the planned behavior theory. However, in Turkey, the psychometric properties of this instrument have not been studied yet. Therefore, the aim of this study was to conduct a psychometric testing of the Turkish version of the DSRQ among patients with HF.

Methods
Data were collected from 300 patients who were recommended a sodium-restricted diet because of a diagnosis of HF. Validity was tested using content validity index, Kendall W, and exploratory and confirmatory factor analyses. Reliability was tested using item-total and interitem correlations, Cronbach's α coefficient of reliability, independent-sample t test, and test-retest analysis.

Results
The exploratory factor analysis revealed that 3 factors accounted for 78.2% of the explained variance. The factor loads ranged between 0.67 and 0.96. The results of the confirmatory factor analysis showed goodness-of-fit indices greater than 0.90, with a root-mean-square error of approximation less than 0.10 and a root-mean-square residual of 0.05. The Cronbach's α coefficient for DSRQ was 0.92 and for each subscale was as follows: attitude and subjective norm, 0.97; perceived external behavior control, 0.89; and perceived internal behavior control, 0.83.

Conclusions
The DSRQ is a valid and reliable instrument in assessing the attitudes, beliefs, and perceived behavioral control related to following a low-sodium diet of patients with HF in the Turkish population.
Anti-inflammatory Combination Therapy for the Treatment of Schizophrenia
Authors: Buchanan Robert W. , Weiner Elaine , Kelly Deanna L. , Gold James M. , Chen Shuo , Zaranski Jennifer , Blatt Frank , Wehring Heidi , Carpenter William T. 
Published: August 2020

Abstract

Background
Despite adequate antipsychotic treatment, most people with schizophrenia continue to exhibit persistent positive and negative symptoms and cognitive impairments. The current study was designed to examine the efficacy and safety of adjunctive anti-inflammatory combination therapy for these illness manifestations.

Methods
Thirty-nine people with either Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, schizophrenia or schizoaffective disorder were entered into a 12-week double-blind, 2-arm, triple-dummy, placebo-controlled, randomized clinical trial: 19 were randomized to anti-inflammatory combination therapy and 20 were randomized to placebo. The Brief Psychiatric Rating Scale positive symptom item total score was used to assess positive symptom change, the Scale for the Assessment of Negative Symptoms total score was used to assess negative symptom change, the Calgary Depression Scale total score was used to assess depressive symptom change, and the MATRICS Consensus Cognitive Battery was used to assess neuropsychological test performance.

Results
There was a significant time effect for Brief Psychiatric Rating Scale positive symptom item score (t
226 = −2.66, P = 0.008), but the treatment (t
54=1.52, P = 0.13) and treatment × time (t
223 = 0.47, P = 0.64) effects were not significant. There were no significant time (t
144 = 0.53, P = 0.72), treatment (t
58=0.48, P = 0.63), or treatment × time (t
143 = −0.20, P = 0.84) effects for the Scale for the Assessment of Negative Symptoms total score; or for any of the other symptom measures. There were no significant group differences in the change in the MATRICS Consensus Cognitive Battery composite score over the course of the study (F
1,26=2.20, P = 0.15).

Conclusions
The study results suggest that there is no significant benefit of combined anti-inflammatory treatment for persistent positive symptoms or negative symptoms or cognitive impairments (clinicaltrials.gov trial number: NCT01514682).
Cycle Threshold to Test Positivity in COVID-19 for Return to Work Clearance in Health Care Workers
Authors: Domeracki Sandra , Clapp Robert N. , Taylor Kristopher , Lu Chuanyi M. , Lampiris Harry , Blanc Paul D. 
Published: August 2020

Objective:
To ascertain whether reverse transcriptase polymerase chain reaction (RT-PCR) cycle amplifications until detection, the cycle threshold (Ct), could help inform return to work (RTW) strategies for health care workers (HCWs) recovering from COVID-19 infection.

Methods:
Sequential Ct data from COVID-19 nasal pharyngeal (NP) RT-PCR testing in all COVID-19 positive HCWs at a single institution. Analysis of Ct in relation to time until negative testing for RTW clearance.

Results:
Data for 12 employees showed that time elapsed until RT-PCR test-based RTW clearance ranged from 7 to 57 days (median, 34.5 days). Lower initial Ct correlated with the total time elapsed until clearance (r = –0.80; P = 0.002).

Conclusion:
Considering the RT-PCR Ct, which correlates with the estimated viral load, may help inform RTW planning and decision making beyond solely relying on dichotomized positive/negative results.
Vitamin D Supplementation in COVID-19 Patients: A Clinical Case Series
Authors: Ohaegbulam Kim C. , Swalih Mohamed , Patel Pranavkumar , Smith Miriam A. , Perrin Richard 
Published: August 2020

Background:
Coronavirus disease 2019 (COVID-19) has infected more than 4.4 million people and caused more than 300,000 deaths partly through acute respiratory distress syndrome with propensity to affect African American and Hispanic communities disproportionately. Patients with worse outcomes have exhibited higher blood plasma levels of proinflammatory cytokines. Activation of the vitamin D receptor expressed on immune cells has been shown to directly reduce the secretion of inflammatory cytokines, such as interleukin-6, and indirectly affect C-reactive protein.

Areas of Uncertainty:
The significance of the vitamin D pathway in patients diagnosed with COVID-19.

Therapeutic Innovation:
Vitamin D supplementation in patients after diagnosis of COVID-19.

Patients and Pharmacological Interventions:
We report 4 vitamin D deficient patients diagnosed with COVID-19 in April 2020 who were provided with either cholecalciferol of 1000 IU daily (standard dose) or ergocalciferol 50,000 IU daily for 5 days (high dose) as part of supplementation.

Clinical Outcomes:
Patients that received a high dose of vitamin D supplementation achieved normalization of vitamin D levels and improved clinical recovery evidenced by shorter lengths of stay, lower oxygen requirements, and a reduction in inflammatory marker status.

Conclusions:
Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distress syndrome in patients in underserved communities where resources to expensive and sought-after medications may be scarce. Randomized clinical trials will serve as an appropriate vessel to validate the efficacy of the therapeutic regimen and dissection of the pathway.
Prevention of adverse drug effects: a pharmacogenomic approach
Authors: Scott Erika N. , Hasbullah Jafar S. , Carleton Bruce C. , Ross Colin J.D. 
Published: August 2020

Purpose of reviewAdverse drug reactions (ADRs) are a serious burden and can negatively impact patient quality of life. One of these ADRs, anthracycline-induced cardiotoxicity (ACT), occurs in up to 65% of treated patients and can lead to congestive heart failure. Pharmacogenetic studies have helped to reveal the mechanisms of ACT and, consequently, inform current strategies to prevent ACT in the clinic.Recent findingsMany pharmacogenetic studies have been conducted for ACT, but few have led to the development of clinical practice guidelines and clinical genetic testing for ACT. This is, in part, because of lack of replication in independent patient cohorts and/or validation of an affected biological pathway. Recent advances in pharmacogenetic studies have been made through the use of novel methods that directly implicate dysregulated genes and perturbed biological pathways in response to anthracycline treatment.SummaryFurthering the understanding of the genetics and altered biological pathways of ACT through these novel methods can inform clinical treatment strategies and enable refinement of current clinical practice guidelines. This can therefore lead to improvement in clinical pharmacogenetic testing for further reduction of the incidence of ACT in pediatric cancer patients taking anthracyclines.
FETOS
Authors: Hanot Quentin , Wieczorek Valerie , Wypych Marion , Machuron François , Thevenon André 
Published: August 2020

Objective
Thoracic outlet syndrome is caused by the compression of blood vessels and nerves leading to the upper limbs; the level of functional discomfort in activities of daily living can be significant. This discomfort has been evaluated using a variety of nonspecific scales, prompting the development a specific self-questionnaire (“Functional Evaluation in Thoracic Outlet Syndrome). Here, the scale’s test-retest reliability, sensitivity to change, and criterion validity were assessed.

Design
Between May 2015 and July 2017, a total of 37 patients were assessed during an intensive rehabilitation program. The Functional Evaluation in Thoracic Outlet Syndrome self-questionnaire comprises 16 items rated on a 4-point scale: impossible, major discomfort, moderate discomfort, or no difficulty. A total score is then calculated and the usual level of discomfort is rated on a numerical scale. The questionnaire was completed on day (D)1, D2, and the day of discharge.

Results
The questionnaire showed very good test-retest reliability, with an overall correlation coefficient above 0.91. The overall score was highly sensitive to change, with a significant median improvement (−5.89) between D1 and discharge (P < 0.001). Of the 16 items, 9 showed significant scalability in their individual sensitivity to change. The criterion validity was moderate: the coefficient for the correlation with the numerical scale was 0.68 on D1 (P < 0.001), 0.55 on D2 (P < 0.001), and 0.69 at discharge (P < 0.001).

Conclusions
The Functional Evaluation in Thoracic Outlet Syndrome self-questionnaire is a quick, simple way of assessing the impact of thoracic outlet syndrome on activities of daily living. The overall score and most of the items displayed good reproducibility and sensitivity to change.
Electronic trauma resuscitation documentation and decision support using T6 Health Systems Mobile Application: A combat trauma center pilot program
Authors: Angotti Lisa M. , How Remealle A. , Barnack Katie R. , Aden James K. , Vitale Dominick A. , Folwell Jared S. , Neel Jason M. , Srivilasa Charlie N. , Sams Valerie G. 
Published: August 2020

BACKGROUND
The care of trauma patients in combat operations is handwritten on a five-page flow sheet. The process requires the manual scanning and uploading of paper documents to bridge the gap between electronic and paper record management. There is an urgent operational need for an information technology solution that will enable medics to better capture patient treatment information, which will improve long-term health care without impacting short-term care responsibilities.

METHODS
We conducted a process improvement project to evaluate the ability of T6 Health Systems Mobile Application to improve combat casualty care data collection at a deployed trauma hospital. We performed a head-to-head comparison of the completeness and accuracy of data capture of electronic versus handwritten records to determine noninferiority.

RESULTS
During the 90-day pilot, there were 131 trauma evaluations of which 53 casualty resuscitations (40.5%) were also documented in the electronic application. We compared completeness and accuracy of admit, prehospital, primary survey, secondary survey, interventions, and trends data. We found an overall 13% increase in data capture at 96% accuracy compared with the written record, suggesting that the electronic record was superior. Completion of electronic documentation compared with paper by section was statistically significantly higher for admitting data, 119.7% (p < 0.0001); prehospital, 116.2% (p = 0.0039); primary, 109.6% (p < 0.001); and secondary, 125.5% (p < 0.001). We also had the medical evacuation teams document prehospital and en route care and then synchronize the record in the trauma bay, allowing the trauma teams there to continue documenting on the same casualty record, likely contributing to superiority because teams did not have to redocument based on an oral report.

CONCLUSION
Our pilot program in the deployed environment demonstrated a mobile technology that actually enhanced the completeness and accuracy of paper trauma documentation that has the capability of providing patient-specific decision support and real-time data analysis.

LEVEL OF EVIDENCE
Care Management, level IV.
Machine Learning Applied to Clinical Laboratory Data Predicts Patient-Specific, Near-Term Relapse in Patients in Medication for Opioid Use Disorder Treatment
Authors: Pyzowski Paul , Herbert Barbara , Malik Wasim Q 
Published: August 2020

AbstractWe have developed a data-driven, algorithmic method for identifying patients in an out-patient buprenorphine program at high risk for relapse in the following seven days. This method uses data already available in clinical laboratory data, can be made available in a timely matter, and is easily understandable and actionable by clinicians. Use of this method could significantly reduce the rate of relapse in addiction treatment programs by targeting interventions at those patients most at risk for near term relapse.
Etiological Profile and Resistance of Bacterial Isolates from Samples of Cerebrospinal Fluid in Kosovo, during the years 2014-2019
Authors: Qarkaxhija Rita 
Published: August 2020

AbstractCerebrospinal fluid is a dynamic, metabolically active substance that has numerous important functions. It is considered a valuable diagnostic aid in assessing infectious inflammatory conditions, involving the brain, spinal cord, and meninges.The discovery and use of antimicrobial agents has fundamentally changed medicine from a therapeutic point of view, enabling the treatment of many diseases once considered threatening and deadly. However, after prolonged exposure of various microorganisms to these agents, the development of antimicrobial resistance has been enabled through the adaptive selection mechanism. The emergence of this resistance in the main pathogenic microorganisms is a very problematic and threatening issue in public health, making it a global problem. Resistance of various microorganisms in Kosovo, according to annual reports of CAESAR, compared to other European countries, is quite worrying. It reaches the tops of the lists for high resistance, along with other Balkan countries, such as Serbia, Montenegro, and North Macedonia.The purpose of this research was to define the etiology and level of resistance of microorganisms to antimicrobial agents, which are encountered in invasive samples of cerebrospinal fluid. This research is a retrospective, descriptive type analysis, which includes the data gathered from January 1, 2014 to May 7, 2019. We have a total of 185 bacteria isolated from 1499 isolates, conducted at the National Institute of Public Health in Kosovo. The determination of antimicrobial resistance was performed according to automated systems and the method of disk diffusion.
Face Coverings and Respiratory Tract Droplet Dispersion
Authors: Bandiera Lucia , Pavar Geethanjali , Pisetta Gabriele , Otomo Shuji , Mangano Enzo , Seckl Jonathan R. , Digard Paul , Molinari Emanuela , Menolascina Filippo , Viola Ignazio Maria 
Published: August 2020

AbstractRespiratory droplets are the primary transmission route for SARS-CoV-2. Evidence suggests that virus transmission can be reduced by face coverings, but robust evidence for how mask usage might affect safe distancing parameters is lacking. Accordingly, we investigate the effectiveness of surgical masks and single-layer cotton masks on mitigating dispersion of large respiratory droplets (i.e. non aerosol). We tested a manikin ejecting fluorescent droplets and human volunteers in speaking and coughing conditions. We quantified the number of droplets in flight using laser sheet illumination and UV-light for those that had landed at table height at up to 2m. For human volunteers, expiratory droplets were caught on a microscope slide 5cm from the mouth. Whether manikin or human, wearing a face covering decreased the number of projected droplets by >1000-fold. We estimated that a person standing 2m from someone coughing without a mask is exposed to over 1000 times more respiratory droplets than from someone standing 5 cm away wearing a basic single layer mask. Our results indicate that face coverings show consistent efficacy at blocking respiratory droplets. If aerosol transmission is later determined to be a significant driver of infection, then our findings may overestimate the effectiveness of face coverings.
ACE2 expression in adipose tissue is associated with COVID-19 cardio-metabolic risk factors and cell type composition
Authors: El-Sayed Moustafa Julia S. , Jackson Anne U. , Brotman Sarah M. , Guan Li , Villicaña Sergio , Roberts Amy L. , Zito Antonino , Bonnycastle Lori , Erdos Michael R. , Narisu Narisu , Stringham Heather M. , Welch Ryan , Yan Tingfen , Lakka Timo , Parker Stephen , Tuomilehto Jaakko , Collins Francis S. , Pajukanta Päivi , Boehnke Michael , Koistinen Heikki A. , Laakso Markku , Falchi Mario , Bell Jordana T. , Scott Laura J. , Mohlke Karen L. , Small Kerrin S. 
Published: August 2020

AbstractCOVID-19 severity has varied widely, with demographic and cardio-metabolic factors increasing risk of severe reactions to SARS-CoV-2 infection, but the underlying mechanisms for this remain uncertain. We investigated phenotypic and genetic factors associated with subcutaneous adipose tissue expression of Angiotensin I Converting Enzyme 2 (ACE2), which has been shown to act as a receptor for SARS-CoV-2 cellular entry. In a meta-analysis of three independent studies including up to 1,471 participants, lower adipose tissue ACE2 expression was associated with adverse cardio-metabolic health indices including type 2 diabetes (T2D) and obesity status, higher serum fasting insulin and BMI, and lower serum HDL levels (P<5.32×10-4). ACE2 expression levels were also associated with estimated proportions of cell types in adipose tissue; lower ACE2 expression was associated with a lower proportion of microvascular endothelial cells (P=4.25×10-4) and higher macrophage proportion (P=2.74×10-5), suggesting a link to inflammation. Despite an estimated heritability of 32%, we did not identify any proximal or distal genetic variants (eQTLs) associated with adipose tissue ACE2 expression. Our results demonstrate that at-risk individuals have lower background ACE2 levels in this highly relevant tissue. Further studies will be required to establish how this may contribute to increased COVID-19 severity.
Lower respiratory tract myeloid cells harbor SARS-CoV-2 and display an inflammatory phenotype
Authors: Bain William , Peñaloza Hernán F. , Ladinsky Mark S. , van der Geest Rick , Sullivan Mara , Ross Mark , Kitsios Georgios D. , Methe Barbara , McVerry Bryan J. , Morris Alison , Watson Alan M. , Watkins Simon C. , St Croix Claudette M. , Stolz Donna B. , Bjorkman Pamela J. , Lee Janet S. 
Published: August 2020

AbstractSARS-CoV-2 pneumonia may induce an aberrant immune response with brisk recruitment of myeloid cells into the lower respiratory tract, which may contribute to morbidity and mortality. We describe endotracheal aspirate samples from seven patients with SARS-CoV-2 pneumonia requiring mechanical ventilation. We note SARS-CoV-2 virions within lower respiratory tract myeloid cells shown by electron tomography, immunofluorescence confocal imaging, and immuno-electron microscopy. Endotracheal aspirates are primarily composed of mononuclear and polymorphonuclear leukocytes. These myeloid cells that harbor virus are frequently positive for CD14 and/or CD16 and most display an inflammatory phenotype marked by expression of IL-6 and tissue factor mRNA transcript and protein expression.