bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prospective Sense of Agency is Rooted in Local and Global Properties of Intrinsic Functional Brain Networks
Authors: Di Plinio Simone , Perrucci Mauro Gianni , Ebisch Sjoerd J. H. 
Published: June 2020

Abstract
The sense of agency (SoA) refers to a constitutional aspect of the self describing the extent to which individuals feel in control over their actions and consequences thereof. Although the SoA has been associated with mental health and well-being, it is still unknown how interindividual variability in the SoA is embedded in the intrinsic brain organization. We hypothesized that the prospective component of an implicit SoA is associated with brain networks related to SoA and sensorimotor predictions on multiple spatial scales. We replicated previous findings by showing a significant prospective SoA as indicated by intentional binding effects. Then, using task-free fMRI and graph analysis, we analyzed associations between intentional binding effects and the intrinsic brain organization at regional, modular, and whole-brain scales. The results showed that intermodular connections of a frontoparietal module including the premotor cortex, supramarginal gyrus, and dorsal precuneus are associated with individual differences in prospective intentional binding. Notably, prospective intentional binding effects were also related to global brain modularity within a specific structural resolution range. These findings suggest that an implicit SoA generated through sensorimotor predictions relies on the intrinsic organization of the brain connectome on both local and global scales.
Expiratory Muscle Strength Training in patients After Total Laryngectomy; A Feasibility Pilot Study
Authors: van Sluis Klaske E. , Kornman Anne F. , Groen Wim G. , van den Brekel Michiel W. M. , van der Molen Lisette , Hoffman-Ruddy Bari , Stuiver Martijn M. 
Published: June 2020

Objectives: Expiratory muscle strength training (EMST) is a threshold based device-driven treatment for improving expiratory pressure. EMST proved to be effective in different patient groups to improve cough function. To date, EMST has not been tested in the total laryngectomy population (TL). Methods: This prospective, randomized case-series study examined feasibility, safety, and compliance of EMST in a group of TL participants and its effects on pulmonary function, physical exertion, fatigue, and vocal functioning. Ten TL participants were included in the study to perform a 4 till 8 weeks of EMST. Objective and subjective outcome measures included manometry, spirometry, cardio pulmonary exercise testing (CPET), voice recordings, and patient reported outcome measures. Group means were reported and estimates of the effect are shown with a 95% confidence interval, using single sample t-tests. Results: Nine participants completed the full study protocol. Compliance to the training program was high. All were able to perform the training, although it requires adjustments of the device and skills of the participants. Maximum expiratory pressure (MEP) and vocal functioning in loudness improved over time. After EMST no changes were seen in other objective and subjective outcomes. Conclusions: EMST appears to be feasible and safe after total laryngectomy. MEP improved over time but no improvement in the clinically relevant outcome measures were seen in this sample of relatively fit participants. Further investigation of the training in a larger group of participants who report specifically pulmonary complaints is recommended to investigate if the increase in MEP results in clinical benefits. Level of Evidence: 4
Supporting adults with mental health problems through further education
Authors: Buchanan Denise , Warwick Ian 
Published: June 2020

Aim: To identify how a college of further (tertiary) education might promote the wellbeing of adults with mental health problems. Study design: Qualitative study of the college-related experiences of people with mental health problems. Setting: A further education college in inner-city London, UK. Methods: Fifteen students, all of whom had been diagnosed with mental health problems, were selected from a range of courses, including those attending a special cookery class, those on mainstream courses, and former-students who had studied on one of a number of courses and who might or might not have completed their studies. Data were collected through two individual semi-structured interviews. Results: Findings focus on barriers to learning outside and inside college and how these were overcome, as well as participants’ perceived links between learning and their mental health and wellbeing. Conclusion: Discussion highlights the necessity of ‘bridging’ between health and education services in order to enable adults with mental health problems to benefit from lifelong learning opportunities in a potentially transformative way.
Physical activity in and out-of-school and academic performance in Spain
Authors: Gómez-Fernández Nerea , Albert Juan-Francisco 
Published: June 2020

Background: Academic performance in school stems from an interaction of factors associated with students, families and schools. Among these factors, physical activity could play a very relevant role. Objective: The goal of this study was to determine whether students’ physical activities in and outside school were related to their academic performance. Design, setting and method: We used the Programme for International Student Assessment (PISA) 2015 database for Spain using ordinary least squares (OLS) regression models to answer our research questions. Results: Results suggest a positive association between the number of days per week doing moderate physical activities and academic performance in science, reading and mathematics. However, a higher number of days per week doing vigorous physical activities was associated with lower scores in reading and science. We also find a negative association between exercising or practising sports before going to school and the scores achieved in the three competences evaluated. Conclusions: Our results show that physical activity can play an important role in academic performance and that the effects of physical activity on children and teenagers should be further investigated.
The effect of Balint training on the psychological skills of residents beyond family medicine residency
Authors: Hamadeh Gracia , Antoun Jumana , Romani Maya 
Published: June 2020

Background: Engaging with the psychological well-being of patients is central to patient care. The empathy and psychological skills of practitioners may be enhanced by Balint training during the residency years. However, there is scarce evidence concerning the outcomes of Balint training beyond graduation. Objective: The aim of the study was to compare the psychological skills of practising family medicine graduates who had received Balint training during their residency compared to the skills of those who did not. Design: Cross-sectional, mixed-methods study. Setting: Family medicine graduates at the American University of Beirut. Methods: A telephone-based interview or an online-based questionnaire was used to survey family medicine graduates between 2007 and 2018. Those who graduated between 2012 and 2018 had received Balint training, whereas the remainder had not. Psychological skills and abilities were measured using an 11-item Psychological Medicine Inventory (PMI) questionnaire. Results: Thirty-seven family medicine graduates participated in the study, with a response rate of 69.8%. There was no difference in the PMI item scores between those who received Balint training as compared to those who did not. In response to an open-ended question, participants emphasised the importance of Balint seminars in improving their communication abilities, dealing with ‘difficult’ patients, finding blind spots and developing the doctor–patient relationship. Exploratory factor analysis revealed three components that explained 80.6% of the total variance. None of these components was associated with Balint training. Conclusion: Although PMI scores did not differ between those who received Balint and those who did not, Balint training may improve family medicine graduates’ confidence to engage with the psychological problems of patients beyond residency based on the statements made by the practising graduates.
Surgical treatment of coronary atherosclerotic heart disease with right coronary artery aneurysm: a case report
Authors: Wang Feng , Liu Guiqing , Mao Xin 
Published: June 2020

Introduction: The etiology of coronary artery aneurysms is unknown. Coronary atherosclerosis is considered to be the main etiology. This case reports a patient with a large coronary aneurysm of the right coronary artery. Case report: A 65-year-old woman was hospitalized with intermittent chest pain and underwent coronary angiography and echocardiography which showed a large coronary aneurysm of the right coronary artery. The patient recovered well after ligation of coronary artery aneurysms with additional coronary artery bypass grafting. Discussion: The etiology of coronary aneurysms is unknown, which is relatively rare and mostly secondary. Majority of coronary artery aneurysms are located in the right coronary artery. There is currently no standard treatment. Surgical treatment of coronary artery aneurysms may be considered as a safe treatment option. Conclusion: The standard surgical treatment for coronary artery aneurysms is unclear. For symptomatic large coronary aneurysms, ligation of coronary artery aneurysms with additional coronary artery bypass grafting can achieve good results.
Survival following venoarterial extracorporeal membrane oxygenation in postcardiotomy cardiogenic shock adults
Authors: Chen Fei , Wang Liangshan , Shao Juanjuan , Wang Hong , Hou Xiaotong , Jia Ming 
Published: June 2020

Background: Studies reporting long-term outcomes of venoarterial extracorporeal membrane oxygenation–treated coronary artery bypass grafting patients are scarce. The objective of this study was to examine the survival outcomes and identify mortality risk factors for coronary artery bypass grafting patients who received venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock. Methods: Data from 121 consecutive venoarterial extracorporeal membrane oxygenation–treated coronary artery bypass grafting patients at the Beijing Anzhen Hospital between January 2012 and December 2016 were analyzed. Multivariable Cox regression modeling was used to identify factors independently associated with 36-month mortality. Results: Seventy-seven patients (64%) could be weaned from venoarterial extracorporeal membrane oxygenation, 56 patients (46%) survived to hospital discharge, and 41 patients (34%) survived to 36 months. Older age (hazard ratio, 1.06; 95% confidence interval [CI], 1.03-1.10; p < 0.001), left main coronary artery disease (hazard ratio, 1.64; 95% CI, 1.04-2.59; p < 0.001), and vasoactive inotropic score (hazard ratio, 1.09; 95% CI, 1.02-1.16; p = 0.011) were independent risk factors associated with 36-month mortality. The area under the receiver operating characteristic curve for the logistic regression model, which was constructed with three pre–extracorporeal membrane oxygenation parameters—age ⩾ 60 years, left main coronary artery disease, and vasoactive inotropic score > 60—was 0.87 (95% CI, 0.81-0.94). Age and left main coronary artery disease significantly increased the discriminatory performance of Sepsis-related Organ Failure Assessment score (0.79 vs. 0.91, p = 0.025). Conclusions: Older age, left main coronary artery disease, and vasoactive inotropic score were associated with 36-month mortality in coronary artery bypass grafting patients who received venoarterial extracorporeal membrane oxygenation.
Predicting first-trimester outcome of embryos with cardiac activity in women with recurrent spontaneous abortion
Authors: Li Huixian , Qin Shuang , Xiao Fanfan , Li Yuhong , Gao Yunhe , Zhang Jiexin , Xiao Qing 
Published: June 2020

Objective This study was performed to evaluate the capability of routine clinical indicators to predict the early outcome of embryos with cardiac activity in women with recurrent spontaneous abortion (RSA). Methods A retrospective cohort study of pregnant women with a history of RSA in a Chinese tertiary hospital was performed using unadjusted and multivariable logistic regression. Results Of 789 pregnant women with RSA, 625 (79.21%) had ongoing pregnancy, whereas 164 (20.79%) developed abortion before 20 full weeks of gestational age even after embryonic heart motion was detected. The final model had an area under the curve of 0.81 (95% confidence interval, 0.78–0.84) with a sensitivity of 74.39%, a specificity of 76.00%, and a false-positive rate of 52.32% at a fixed detection rate of 90%. Conclusions The combination of multiple routine clinical indicators was valuable in predicting the early outcome of embryos with cardiac activity in viable pregnancies with RSA. However, this model might result in a high false-positive rate with a fixed detection rate of 90%; other markers must be investigated to identify first-trimester RSA once positive embryonic heart motion is established.
Homology analysis of 51 penicillin-intermediate Streptococcus pneumoniae isolates from Wenzhou City, China
Authors: Zhang Jin , Hu Da-Kang , Gao Chun-Yan , Shen Wei-Wei , Luo Xin-Hua , Yu Jian , Li Xiang-Yang , Jiang Xin-Yu , Zhu Wu-Shuang , Chen Wei-Qing 
Published: June 2020

Objective To investigate drug resistance features and homology among penicillin-intermediate Streptococcus pneumoniae isolates from Wenzhou City, China. Methods Fifty-one penicillin-intermediate S. pneumoniae isolates were obtained from respiratory samples of infants and children hospitalized with lung infections. An antimicrobial susceptibility test was used to assess drug resistance. Polymerase chain reaction and agarose gel electrophoresis were used to identify S. pneumoniae isolates and pulsed-field gel electrophoresis (PFGE) was used to analyze molecular subtypes. Hierarchical cluster analysis of PFGE fingerprints was used to compare genetic diversity and relatedness of S. pneumoniae isolates. The Quellung test was used for serotyping. Results Fifty-one penicillin-intermediate S. pneumoniae isolates showed evidence of multi-drug resistance and polyclonal origins. The isolates were classified into 25 subtypes through hierarchical cluster analysis of PFGE fingerprints. Three of these subtypes formed a supertype (15/51, 16/51 and 8/51 isolates), while the remaining subtypes occurred sporadically (12/51 isolates). Conclusions Transmission of penicillin-intermediate S. pneumoniae is mostly vertical and to a lesser extent horizontal. Effective prevention strategies, including respiratory tract management and contact isolation, are essential to control nosocomial S. pneumoniae infection. Once susceptibility is confirmed, vancomycin, high-dose penicillin or third-generation cephalosporins (cefotaxime and ceftriaxone) may be used to treat penicillin-intermediate S. pneumoniae.
Leptin improves intestinal flora dysfunction in mice with high-fat diet-induced obesity
Authors: Li Xiaolin , Shi Weihong , Xiong Qinghua , Hu Yungang , Qin Xu , Wan Guanqun , Zeng Qi 
Published: June 2020

Objective This study investigated the effects of leptin on intestinal flora and inflammation in mice with high-fat diet (HFD)-induced obesity. Methods Mice were fed an HFD for 8 weeks; some were concurrently administered oral leptin for 4 weeks. Pathological changes in adipose tissue were detected using hematoxylin–eosin staining; endotoxin content in adipose tissue was measured by enzyme-linked immunosorbent assay. Intestinal flora were characterized by 16S bacterial rDNA sequencing. Levels of Toll-like receptor 4 (TLR4), nuclear factor-κB inhibitor α (IκB-α), and phosphorylated c-Jun N-terminal kinase (p-JNK) were detected by western blotting. Results Mice in the HFD group exhibited weight gain, elevated endotoxin content, and adipocyte hypertrophy, compared with the non-obese control group. Moreover, abundance of bacteria in the Bacteroides genus and community diversity were both reduced in the HFD group; reductions also were observed at corresponding phylum, class, and order levels. Levels of TLR4, IκB-α, and p-JNK were also elevated in the HFD group. Compared with the model group, leptin administration reduced the weight gain and endotoxin content, while increasing Bacteroides abundance and community diversity; it also reduced the levels of TLR4, IκB-α, and p-JNK. Conclusion Leptin administration improved intestinal flora dysfunction and inflammation in mice with HFD-induced obesity.
Promising results of stent graft placement for cephalic arch stenosis after repeated failure of angioplasty in patients on hemodialysis
Authors: Feng Pin-Chao , Lee Chun-Hui , Hsieh Hung-Chang , Ko Po-Jen , Yu Sheng-Yueh , Lin Yu-Sheng 
Published: June 2020

Objective Cephalic arch stenosis (CAS) causes repeated dysfunction and failure of arteriovenous access. Percutaneous transluminal angioplasty is the standard initial treatment for CAS, but its outcome is unsatisfactory. This study aimed to evaluate the outcome of stent graft placement for CAS in patients on hemodialysis. Methods A retrospective chart review from a tertiary medical center was performed in patients receiving stent graft placement for CAS between January 2012 and 2016. Patency was analyzed using the Kaplan–Meier method. Results Twenty-one patients received stent graft placement for CAS. Technical and clinical success rates were 100%. Primary target lesion patency was 95% (95% confidence interval [CI], 86%–100%), 76% (95% CI, 58%–94%), and 43% (95% CI, 22%–64%) at 3, 6, and 12 months, respectively. No significant difference in patency was observed between the arteriovenous fistula and arteriovenous graft groups. Assisted primary patency was 95% (95% CI, 86%–100%), 71% (95% CI, 52%–91%), and 57% (95% CI, 36%–78%) at 3, 6, and 12 months, respectively. Secondary patency was 100% at 3, 6, and 12 months. Conclusions After repeated failed angioplasty for cephalic arch stenosis, patients on hemodialysis who receive stent graft placement have effective and durable outcomes.
Effect of positive end-expiratory pressure on functional residual capacity in two experimental models of acute respiratory distress syndrome
Authors: Wang Yu-Mei , Sun Xiu-Mei , Zhou Yi-Min , Chen Jing-Ran , Cheng Kun-Ming , Li Hong-Liang , Yang Yan-Lin , Zhou Jian-Xin 
Published: June 2020

Objective Measurement of positive end-expiratory pressure (PEEP)-induced recruitment lung volume using passive spirometry is based on the assumption that the functional residual capacity (FRC) is not modified by the PEEP changes. We aimed to investigate the influence of PEEP on FRC in different models of acute respiratory distress syndrome (ARDS). Methods A randomized crossover study was performed in 12 pigs. Pulmonary (n = 6) and extra-pulmonary (n = 6) ARDS models were established using an alveolar instillation of hydrochloric acid and a right atrium injection of oleic acid, respectively. Low (5 cmH2O) and high (15 cmH2O) PEEP were randomly applied in each animal. FRC and recruitment volume were determined using the nitrogen wash-in/wash-out technique and release maneuver. Results FRC was not significantly different between the two PEEP levels in either pulmonary ARDS (299 ± 92 mL and 309 ± 130 mL at 5 and 15 cmH2O, respectively) or extra-pulmonary ARDS (305 ± 143 mL and 328 ± 197 mL at 5 and 15 cmH2O, respectively). The recruitment volume was not significantly different between the two models (pulmonary, 341 ± 100 mL; extra-pulmonary, 351 ± 170 mL). Conclusions PEEP did not influence FRC in either the pulmonary or extra-pulmonary ARDS pig model.
Increased symmetric dimethylarginine, but not asymmetric dimethylarginine, concentrations are associated with transient myocardial ischemia and predict outcome
Authors: Szabo Zsuzsanna , Bartha Eva , Nagy Lajos , Molnar Tihamer 
Published: June 2020

Objective Asymmetric and symmetric dimethylarginines (ADMA and SDMA) are endothelial dysfunction markers. ADMA inhibits synthesis of nitric oxide. We aimed to analyze both markers in patients with coronary artery disease (CAD) who were referred for stress/rest myocardial perfusion scintigraphy (MPS). Methods All patients underwent a 2-day dipyridamole (DP) stress/rest protocol. Thereafter, patients with transient myocardial perfusion abnormality were followed up and their coronary blood flow was quantitatively assessed. Venous blood was taken before and after DP stress to measure markers. Results Baseline ADMA and SDMA concentrations were significantly higher in patients with CAD compared with healthy subjects. Pre- and post-stress SDMA concentrations were significantly higher in patients with transient myocardial perfusion abnormality compared with those with negative MPS results. However, ADMA and L-arginine concentrations were not significantly different between the two groups. None of the markers were significantly different between patients with angiographically proven low coronary flow and those with normal coronary flow. Pre-stress SDMA concentrations were an independent predictor of cardiovascular mortality during a 8-year follow-up. Conclusions Elevated serum SDMA concentrations may be helpful for selecting high-risk patients with CAD if there is any doubt in interpreting MPS. SDMA concentrations may also predict cardiovascular outcome.
Tanshinone IIA alters the transforming growth factor-β1/Smads pathway in angiotensin II-treated rat hepatic stellate cells
Authors: Wei Guo-wei , Li Ke-yue , Tang Ke-li , Shi Cheng-Xian 
Published: June 2020

Objective To investigate the effects of tanshinone IIA on the transforming growth factor-β1 (TGF-β1)/Smads signaling pathway in angiotensin II-treated hepatic stellate cells (HSCs). Methods HSCs were cultured and treated with angiotensin II (10 μM) or angiotensin II (10 μM) plus tanshinone IIA (3, 10, or 30 μM). Cells were incubated for 48 hours and proliferation was determined with the Cell Counting Kit-8. The relative mRNA expression of TGF-β1, Smad4, and Smad7 was measured by quantitative real-time PCR, and the relative protein expression levels were investigated by western blotting. Results After angiotensin II treatment, cell proliferation was significantly accelerated. Furthermore, both the mRNA and protein expression of TGF-β1 and Smad4 was significantly up-regulated, while the mRNA and protein expression of Smad7 was significantly down-regulated compared with the control cells. Tanshinone IIA inhibited the observed effects of angiotensin II in a concentration-dependent manner, with significant inhibition exerted by tanshinone IIA at 10 and 30 μM. Conclusions Angiotensin II promotes the proliferation of HSCs, possibly by regulating the expression of components along the TGF-β1/Smads signaling pathway. Tanshinone IIA inhibits the angiotensin II-induced activation of this pathway, and may, therefore, have preventive and therapeutic effects in liver fibrosis.