bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Age and Sex on α-Syn (α-Synuclein) Knockdown-Mediated Poststroke Recovery
Authors: Chelluboina Bharath , Kim Taehee , Mehta Suresh L. , Kim Joo-Yong , Bathula Saivenkateshkomal , Vemuganti Raghu 
Published: August 2020

Background and Purpose:
Increased expression of α-Syn (α-Synuclein) is known to mediate secondary brain damage after stroke. We presently studied if α-Syn knockdown can protect ischemic brain irrespective of sex and age.

Methods:
Adult and aged male and female mice were subjected to transient middle cerebral artery occlusion. α-Syn small interfering RNA (siRNA) was administered intravenous at 30 minutes or 3 hour reperfusion. Poststroke motor deficits were evaluated between day 1 and 7 and infarct volume was measured at day 7 of reperfusion.

Results:
α-Syn knockdown significantly decreased poststroke brain damage and improved poststroke motor function recovery in adult and aged mice of both sexes. However, the window of therapeutic opportunity for α-Syn siRNA is very limited.

Conclusions:
α-Syn plays a critical role in ischemic brain damage and preventing α-Syn protein expression early after stroke minimizes poststroke brain damage leading to better functional outcomes irrespective of age and sex.
The Global Macroeconomic Impacts of COVID-19: Seven Scenarios
Authors: McKibbin Warwick , Fernando Roshen 
Published: August 2020

Abstract
COVID-19 has disrupted the Chinese economy and is spreading globally. The evolution of the disease and its economic impacts are highly uncertain, making formulation of appropriate macroeconomic policy responses challenging. This paper explores seven plausible scenarios of COVID-19 and the macroeconomic outcomes using a global hybrid DSGE/CGE general equilibrium model. The results demonstrate that even a contained outbreak could significantly impact the global economy in the short run. Economic costs could be significantly avoided with greater investment in public health systems in all economies, particularly in economies where health care systems are less developed and population density is high.
Textile-based compression therapy in managing chronic oedema: Complex interactions
Authors: Kankariya Nimesh , Laing Raechel M , Wilson Cheryl A 
Published: August 2020

Background Compression is a common therapy for management of chronic disease, including oedema of the lower limb. Modern compression interventions exert pressure on the lower limb through use of one or more materials which exert pressure against the limb over time. Where these materials are textiles, they range from elastic to inelastic, and are produced using knitting, weaving, or other textile technologies which can be manipulated to control performance properties. Thus, understanding of both the materials/textiles and the human body is needed if the most appropriate compression device and treatment strategy is to be used. Neither is independent of the other. This review aims to enhance understanding of critical textile performance properties and how selection of textiles may affect treatment efficacy when managing chronic oedema of the lower limb. Method Relevant papers for review were identified via PubMed Central® library, and Google Scholar using keywords associated with textile-based treatments of the oedematous lower limb and wider interdisciplinary factors. Results Assessment of the disorder, the severity of oedema, and location of fluid accumulation are required to inform treatment of chronic oedema. While the need to understand the patient is well established (e.g. age, sex, body mass index, skin thickness and colour, patient compliance with treatment), information about preferred compression systems and material structures, and inherent properties of these, is generally lacking. Conclusion Greater detail about materials used (e.g. fabric structure, number and order of layers, fibre content) and patient diagnosis (e.g. underlying cause, severity, location of oedema; patient age and sex; evidence of compliance with treatment; pressure exerted; lower leg shape, size, and properties of the tissue) is needed to facilitate advances in efficacy of compression treatment. Reduced limb swelling with a textile-based treatment occurs simultaneously with changes to the textile itself. Textiles cannot be considered inert.
Impact of multicenter unified enhanced environmental cleaning and disinfection measures on nosocomial infections among patients in intensive care units
Authors: Huang Jing , Cui Can , Zhou Shuli , Chen Ming , Wu Hao , Jin Ronghua , Chen Xinyue 
Published: August 2020

Objectives Most Chinese hospitals have customized environmental cleaning policies and systems, with limited data availability based on evidence-based medicine. This study investigated the relationship between multidrug-resistant organism (MDRO) colonization in intensive care unit (ICU) patients and ICU surface bacterial contamination status. Methods This cross-sectional study comprised MDRO screening in ICU patients using bacterial cultivation by chromogenic medium; samples were collected before (control group) and after implementation of enhanced cleaning (cleaning group). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to identify and analyze microorganisms; the relationships of MDRO colonization with infection and environmental bacteria were analyzed. Results In total, 196 patients were enrolled in the study (104 and 92 in control and cleaning groups, respectively); 1042 MDROs were subjected to screening before and after cleaning. After cleaning, the rate of MDRO detection on surfaces of frequently touched objects in ICUs decreased from 31.77% to 13.32%. There were fewer MDRO homologues in the cleaning group than in the control group. Moreover, the cleaning group had a shorter ICU stay and significantly lower mortality rate. Conclusions Enhanced environmental cleaning and disinfection could reduce environmental MDRO accumulation and suppress MDRO colonization in ICUs, thereby reducing nosocomial infections and improving adverse patient outcomes.
Adverse event profile differences between rituximab and ocrelizumab: Findings from the FDA Adverse Event Reporting Database
Authors: Caldito Natalia Gonzalez , Shirani Afsaneh , Salter Amber , Stuve Olaf 
Published: August 2020

Background: Rituximab and ocrelizumab are anti-CD20 monoclonal antibodies that have shown a marked reduction in multiple sclerosis (MS) inflammatory activity. However, their real-world safety profile has not been adequately compared. Objective: To investigate the adverse event (AE) profile of rituximab and ocrelizumab reported to the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: The FAERS database was filtered by indication (MS) and drug (rituximab or ocrelizumab). Disproportionality analyses including but not limited to reporting odds ratio (ROR) were conducted to identify drug–AE associations. A signal was detected if the lower limit of the 95% confidence interval of ROR (ROR025) exceeded 1. Results: There were 623 and 7948 reports for rituximab and ocrelizumab, respectively. The most frequent AEs with rituximab and ocrelizumab were infusion-related reaction (4.82%) and urinary tract infection (10.52%), respectively. The strongest drug–AE association for rituximab and ocrelizumab were ear pruritus (ROR025: 47.53) and oral herpes (ROR025: 38.99), respectively. Ocrelizumab was associated with an almost two times higher frequency of infections than rituximab (21.93% vs 11.05%, respectively). Conclusion: This study revealed differences in reporting AEs between rituximab and ocrelizumab. Infections were reported more frequently with ocrelizumab. Although speculative, a potentially different or more extensive B-cell depletion by ocrelizumab might explain these findings. Additional pharmacovigilance studies need to be performed to better characterize differences in the AE profile in B-cell-depleting therapies.
The use of wearable devices in chronic disease management to enhance adherence and improve telehealth outcomes: A systematic review and meta-analysis
Authors: Kamei Tomoko , Kanamori Takuya , Yamamoto Yuko , Edirippulige Sisira 
Published: August 2020

Introduction Wearable device (WD) interventions are rapidly growing in chronic disease management; nevertheless, the effectiveness of these technologies to monitor telehealth outcomes has not been adequately discussed. This study aims to evaluate the effects of WDs in adherence and other health outcomes for people with chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and cardiac disease (CD). Methods CINAHL, PsycINFO, CENTRAL, and EMBASE were searched for randomized controlled trials (RCTs) and non-RCTs from 1937 to February 2020. Studies comparing interventions with the use of WD were assessed for quality in RCTs and a meta-analysis was performed. Results Eleven studies were included in this review. All of the interventions involved WD use with educational support such as goal setting, virtual social support, e-health program, real-time feedback, written information, maintain diary, and text messaging. The meta-analysis showed no difference in adherence ( p = .38). The DM group showed effects of more than a 2% reduction in weight when WDs were implemented for three months (risk ratio = 2.20; 95% confidence interval (CI) 1.38 to 3.50; p = .0009), as well as blood glucose (mean difference (MD) = –32.39; 95% CI = –48.07 to –16.72; p < .0001), haemoglobin A1c (MD = –0.69; 95% CI = –1.28 to –0.10; p = .02), and physical exercise time in the CD group (MD = 9.53; 95% CI = 0.59 to 18.47; p = .04). Discussion WD with educational support may be particularly useful for people with DM and CD to enhance support beyond usual care. The results of this review showed insufficient evidence to support the use of WD for COPD to enhance telehealth outcomes for disease management.
Symptom experience as a predictor of cardiac rehabilitation education programme attendance after percutaneous coronary intervention: A prospective questionnaire survey
Authors: Kim Ji-Su , Kim Gwang S , Kang Seok-Min , Chu Sang H 
Published: August 2020

Abstract

Background
Despite evidence that participation in cardiac rehabilitation programmes after percutaneous coronary intervention is associated with better clinical outcomes, many patients with coronary artery disease do not participate in such programmes. A traditional educational approach is recommended to provide patients with information regarding the benefits of cardiac rehabilitation in relation to their underlying coronary artery disease and modification of risk factors.

Aims
The purpose of this study was to examine the role of patient factors (symptom experience and health belief) on cardiac rehabilitation education programme attendance among Korean patients subjected to percutaneous coronary intervention.

Methods
A prospective survey was conducted enrolling 173 patients who underwent percutaneous coronary intervention. Information on symptom experience, health belief (perceived susceptibility/severity/benefits/ barriers) and sociodemographic and clinical characteristics was collected at baseline (after percutaneous coronary intervention). Three to four weeks later, information on disease-related knowledge and health behaviour was compared between cardiac rehabilitation education programme attendees and non-attendees.

Results
Eighty of 173 (46.2%) patients surveyed attended the cardiac rehabilitation education programme. Symptom experience before percutaneous coronary intervention was the most significant predictor of programme attendance (odds ratio = 3.46; 95% confidence interval 1.45–8.27), followed by higher perceived socioeconomic status (odds ratio = 2.90; 95% confidence interval 1.28–6.58), perceived susceptibility (odds ratio = 1.22, 95% confidence interval 1.08–1.39), perceived benefits (odds ratio = 1.09; 95% confidence interval 1.02–1.17) and perceived severity (odds ratio = 1.04; 95% confidence interval 1.00–1.08). Better disease-related knowledge and health behaviour were significantly associated with cardiac rehabilitation education programme attendance.

Conclusion
This study provides evidence that educational programmes to help improve patients’ perceptions of their disease susceptibility and severity, especially health behaviour benefits in patients without symptom experience before percutaneous coronary intervention, are necessary.
Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites
Authors: De Alba Rosales Armando , Schober Daniel , Johansson Patrik 
Published: August 2020

Background Nationally, Hispanics experience health disparities manifested as a higher prevalence of chronic diseases in comparison to non-Hispanic Whites. Factors that influence health disparities in this population include inadequate dissemination of culturally and linguistically appropriate health information. Method Our qualitative analysis is based on data obtained from three focus groups with Spanish-speaking Hispanic adults conducted at a clinic in Nebraska. Participants were asked about their perceptions of health information in the form of videos, brochures, and websites. We followed the consolidated criteria for reporting qualitative research and used the theoretical framework of content analysis. Results For videos, attributes associated with higher levels of trust included a friendly health professional, the logo or name of a health care institute, and a reference specifying “se habla Español.” For brochures, attributes associated with trust included use of visual aids, use of numerous colors and big font sizes, the year of printing, and a health care agency logo. For websites, characteristics associated with trust were inclusion of plain language, use of pictures and videos, and date of last update. In all focus groups, participants perceived the use of mixed English/Spanish language in health information from pamphlets and websites as unprofessional. The use of unknown governmental logos in health promotional videos and websites was perceived as untrustworthy information. Conclusions Spanish-speaking Hispanics prefer health information supported by a health care agency or delivered by a health care professional. Health communication strategies should avoid the use of mixed English/Spanish language in sensitive information especially when combined with governmental logos.
Ultrasound of the adrenal gland in children
Authors: Aderotimi Tobi SM , Kraft Jeannette K 
Published: August 2020

Introduction Ultrasound is the modality of choice in the evaluation of neonates and young children with suspected adrenal lesions including adrenal haemorrhage and congenital adrenal hyperplasia. It is also the initial imaging modality in children presenting with an upper abdominal mass, which may be adrenal in origin. Topic discussion: This paper shows adrenal anatomy and demonstrates how the sonographic features change with age. It reviews the imaging features of congenital adrenal lesions, as well as benign and malignant conditions affecting the adrenal gland in childhood. Discussion and Conclusion: Ultrasound is a useful primary imaging modality in the assessment of the adrenal gland in children. Knowledge of the changes of the adrenal gland with age is important when assessing the adrenal gland. Ultrasound is also useful for assessing abdominal masses. However, it cannot differentiate adrenal masses, therefore correlation with biochemical findings, multimodality imaging, and histology is usually required.
Distribution of High-Volume Ankle Replacement Surgeons in United States Metropolitan Areas
Authors: Stein Brandon , Somerson Jeremy , Janney Cory , Panchbhavi Vinod 
Published: August 2020

Background Ankle osteoarthritis is increasing, thus creating greater demand for high-volume total ankle arthroplasty (TAA) surgeons. The Medicare Provider Utilization and Payment Data Public Use File (MPUPD-PUF) provides volume and reimbursement data for procedures performed by physicians participating in Medicare. This study analyzes surgeon prevalence, surgeon distribution, and factors affecting surgeon prevalence in metropolitan areas. Methods The MPUPD-PUF was reviewed from 2012 to 2015, and data were extracted for physicians performing ≥11 TAA procedures. Physicians in metropolitan areas (population >1 million) were grouped together, and reimbursement, number of high-volume surgeons, and procedures were calculated. Presence of an American Orthopaedic Foot and Ankle Society (AOFAS) fellowship program was analyzed for associations with high-volume TAA surgeons. Results Fifty-three surgeons performed ≥11 TAA procedures (1,960 total) covered by Medicare. Of these surgeons, 66% practice in metropolitan areas with a population >1 million. Fifty-one percent of US major metropolitan areas contained no surgeon who submitted >10 traditional Medicare claims for TAA. Areas with an AOFAS fellowship had nominally more TAA claims submitted. Conclusions The distribution of high-volume TAA surgeons among major metropolitan areas in the United States is highly unequal. Analyzing the data with this method aids in targeting TAA surgeons to currently underserved areas. Levels of Evidence Level IV: Retrospective-comparative study
The impact of the COVID-19 pandemic on patients awaiting spinal cord stimulation surgery in the United Kingdom: a multi-centre patient survey
Authors: Baranidharan Ganesan , Bretherton Beatrice , Eldabe Sam , Mehta Vivek , Thomson Simon , Sharma Manohar Lal , Vajramani Girish , Bojanic Stana , Gulve Ashish , FitzGerald James , Hall Samuel , Firth Julie 
Published: August 2020

Introduction: Spinal cord stimulation (SCS) is a recommended treatment for chronic refractory neuropathic pain. During the COVID-19 pandemic, elective procedures have been postponed indefinitely both to provide capacity to deal with the emergency caseload and to avoid exposure of elective patients to COVID-19. This survey aimed to explore the effect of the pandemic on chronic pain in this group and the views of patients towards undergoing SCS treatment when routine services should resume. Methods: This was a prospective, multi-centre telephone patient survey that analysed data from 330 patients with chronic pain who were on an SCS waiting list. Questions focussed on severity of pain, effect on mental health, medication consumption and reliance on support networks during the COVID-19 pandemic. Views towards undergoing SCS therapy were also ascertained. Counts and percentages were generated, and chi-square tests of independence explored the impact of COVID-19 risk (very high, high, low) on survey responses. Results: Pain, mental health and patient’s ability to self-manage pain deteriorated in around 47%, 50% and 38% of patients, respectively. Some patients reported increases in pain medication consumption (37%) and reliance on support network (41%). Patients showed a willingness to attend for COVID-19 testing (92%), self-isolate prior to SCS (94%) and undergo the procedure as soon as possible (76%). Conclusion: Our findings suggest that even during the COVID-19 pandemic, there remains a strong clinical need for patients with chronic pain identified as likely SCS responders to be treated quickly. The current prioritisation of new SCS at category 4 (delayed more than 3 months) is challenged judging by this national survey. These patients are awaiting SCS surgery to relieve severe intractable neuropathic pain. A priority at category 3 (delayed up to 3 months) or in some selected cases, at category 2 are the appropriate priority categories.
Clinical features as predictors of histologically confirmed inflammation in patients with lumbar disc herniation with associated radiculopathy
Authors: Ford Jon J. , Kaddour Omar , Gonzales Michael , Page Patrick , Hahne Andrew J. 
Published: August 2020

Abstract
Background
An understanding of the clinical features of inflammation in low back pain with or without leg symptoms may allow targeted evaluations of anti-inflammatory treatment in randomised-controlled-trials and clinical practice.

Purpose
This study evaluated the diagnostic accuracy of clinical features to predict the presence/absence of histologically confirmed inflammation in herniated disc specimens removed at surgery in patients with lumbar disc herniation and associated radiculopathy (DHR).

Study design
Cohort Study.

Methods
Disc material from patients with DHR undergoing lumbar discectomy was sampled and underwent histological/immunohistochemistry analyses. Control discs were sampled from patients undergoing surgical correction for scoliosis. Baseline assessment comprising sociodemographic factors, subjective examination, physical examination and psychosocial screening was conducted and a range of potential clinical predictors of inflammation developed based on the existing literature. Multi-variate analysis was undertaken to determine diagnostic accuracy.

Results
Forty patients with DHR and three control patients were recruited. None of the control discs had evidence of inflammation compared to 28% of patients with DHR. Predictors of the presence of histologically confirmed inflammation included back pain < 5/10, symptoms worse the next day after injury, lumbar flexion range between 0 and 30° and a positive clinical inflammation score (at least 3 of: constant symptoms, morning pain/stiffness greater than 60-min, short walking not easing symptoms and significant night symptoms). The model achieved a sensitivity of 90.9%, a specificity of 92.9%, and a predictive accuracy of 92.3%.

Conclusion
In a sample of patients with lumbar DHR a combination of clinical features predicted the presence or absence of histologically confirmed inflammation.

Clinical relevance
These clinical features may enable targeted anti-inflammatory treatment in future RCTs and in clinical practice.
Two weeks of western diet disrupts liver molecular markers of cholesterol metabolism in rats
Authors: St-Amand Roxane , Ngo Sock Émilienne T. , Quinn Samantha , Lavoie Jean-Marc , St-Pierre David H. 
Published: August 2020

Abstract
Background
The present study was designed to test the hypothesis that in the liver, excessive fat accumulation impairs cholesterol metabolism mainly by altering the low-density lipoprotein-receptor (LDL-R) pathway.

Method
Young male Wistar rats were fed standard (SD), high fat (HFD; 60% kcal) or Western (WD; 40% fat + 35% sucrose (17.5% fructose)) diets for 2 or 6 weeks.

Results
Weight gain (~ 40 g) was observed only following 6 weeks of the obesogenic diets (P < 0.01). Compared to the 2-week treatment, obesogenic diets tripled fat pad weight (~ 20 vs 7 g) after 6 weeks. Hepatic triglyceride (TG) levels were greater in response to both the WD and HFD compared to the SD (P < 0.01) at 2 and 6 weeks and their concentrations were greater (P < 0.05) in WD than HFD at 2 weeks. Plasma total cholesterol levels were higher (P < 0.05) in animals submitted to WD. After 2 and 6 weeks, liver expression of LDL-R, proprotein convertase subtilisin/kexin 9 (PCSKk9) and sterol regulatory element binding protein 2 (SREBP2), involved in LDL-cholesterol uptake, was lower in animals submitted to WD than in others treated with HFD or SD (P < 0.01). Similarly, low-density lipoprotein-receptor-related protein 1 (LRP1) and acyl-CoA cholesterol acyltransferase-2 (ACAT-2) mRNA levels were lower (P < 0.01) among WD compared to SD-fed rats. Expression of the gene coding the main regulator of endogenous cholesterol synthesis, 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMGCoAR) was reduced in response to WD compared to SD and HFD at 2 (P < 0.001) and 6 (P < 0.05) weeks. Being enriched in fructose, the WD strongly promoted the expression of carbohydrate-response element binding protein (ChREBP) and acetyl-CoA carboxylase (ACC), two key regulators of de novo lipogenesis.

Conclusion
These results show that the WD promptly increased TG levels in the liver by potentiating fat storage. This impaired the pathway of hepatic cholesterol uptake via the LDL-R axis, promoting a rapid increase in plasma total cholesterol levels. These results indicate that liver fat content is a factor involved in the regulation of plasma cholesterol.