bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Mechanisms of Adenosine Stress T1 Mapping
Authors: Shah Soham A. , Reagan Claire E. , French Brent A. , Epstein Frederick H. 
Published: March 2021

Background:
Adenosine stress T1 mapping is an emerging magnetic resonance imaging method to investigate coronary vascular function and myocardial ischemia without application of a contrast agent. Using gene-modified mice and 2 vasodilators, we elucidated and compared the mechanisms of adenosine myocardial perfusion imaging and adenosine T1 mapping.

Methods:

Wild-type (WT), A
2A
AR
−/−
(adenosine A
2A
receptor knockout), A
2B
AR
−/−
(adenosine A
2B
receptor knockout), A
3
AR
−/−
(adenosine A
3
receptor knockout), and eNOS
−/−
(endothelial nitric oxide synthase knockout) mice underwent rest and stress perfusion magnetic resonance imaging (n=8) and T1 mapping (n=10) using either adenosine, regadenoson (a selective A
2A
AR agonist), or saline. Myocardial blood flow and T1 were computed from perfusion imaging and T1 mapping, respectively, at rest and stress to assess myocardial perfusion reserve and T1 reactivity (ΔT1). Changes in heart rate for each stress agent were also calculated. Two-way ANOVA was used to detect differences in each parameter between the different groups of mice.

Results:

Myocardial perfusion reserve was significantly reduced only in A
2A
AR
−/−
compared to WT mice using adenosine (1.06±0.16 versus 2.03±0.52,
P
<0.05) and regadenoson (0.98±026 versus 2.13±0.75,
P
<0.05). In contrast, adenosine ΔT1 was reduced compared with WT mice (3.88±1.58) in both A
2A
AR
−/−
(1.63±1.32,
P
<0.05) and A
2B
AR
−/−
(1.55±1.35,
P
<0.05). Furthermore, adenosine ΔT1 was halved in eNOS
−/−
(1.76±1.46,
P
<0.05) versus WT mice. Regadenoson ΔT1 was approximately half of adenosine ΔT1 in WT mice (1.97±1.50,
P
<0.05), and additionally, it was significantly reduced in eNOS
−/−
mice (−0.22±1.46,
P
<0.05). Lastly, changes in heart rate was 2× greater using regadenoson versus adenosine in all groups except A
2A
AR
−/−
, where heart rate remained constant.

Conclusions:

The major findings are that (1) although adenosine myocardial perfusion reserve is mediated through the A
2A
receptor, adenosine ΔT1 is mediated through the A
2A
and A
2B
receptors, (2) adenosine myocardial perfusion reserve is endothelial independent while adenosine ΔT1 is partially endothelial dependent, and (3) ΔT1 mediated through the A
2A
receptor is endothelial dependent while ΔT1 mediated through the A
2B
receptor is endothelial independent.
‘It’s the economy, stupid’: Lessons of a longitudinal study of depression in Argentina
Authors: Badellino Héctor , Gobbo María Emilia , Torres Eduardo , Aschieri María Emilia , Biotti Martín , Alvarez Valentina , Gigante Camila , Cachiarelli Mabel 
Published: March 2021

Background: On March 20, 2020, the Argentine Ministry of Health imposed a mandatory quarantine, which still persists. Aim: The aim of this study is to determine the variation in the prevalence of depression since the beginning of the quarantine and the evolution of risk factors, with special emphasis on the population’s concerns. Methods: A longitudinal study was carried out using a digital questionnaire disseminated in social networks. The first stage (T1) was carried out from March 29 to April 12 and the second stage (T2) from May 23 to June 12, 2020. The prevalence of depression was measured using the 9-item Patients Health Questionnaire (PHQ-9). Results: The prevalence of moderate/severe depression increased from 24.3% in T1 to 47.8% in T2 (p: 0.000). Risk factors increased significantly: age 18–27, female, primary and secondary school, smoking and having a poor sleep quality (p: 0.000). The concerns about ‘a family member getting sick’ (OR: 1.28; CI: 1.04–1.58; p: 0.016), ‘changes at work’ (OR: 2.24; CI: 1.79–2.81; p: 0.000), ‘running out of money’ (OR: 1.43; CI: 1.20–1.71; p: 0.000) and ‘being unemployed’ (OR: 2.99; CI: 2.55–3.52; p: 0.000) were risk factors for depression. On the other hand, the concern about ‘getting the virus’ (OR: 0.73; CI: 0.61–0.87; p: 0.001) was not a risk factor. Conclusions: The extended quarantine in Argentina is associated with an increase in the prevalence of depression; the high impact of economic and social concerns on mental health must be considered in order to avoid long-term effects.
How can subnational governments develop and deliver distinctive policy agendas?
Authors: Connell Andrew , St Denny Emily , Martin Steve 
Published: March 2021

The ways in which subnational governments develop and deliver distinctive policies is central to our understanding of effective multi-level governance systems. The existing literature focuses on institutional autonomy and the formal powers given to subnational governments but this is only one side of the story. Success also depends on the way in which policy actors deploy their powers, resources and legitimacy. This article presents an empirical analysis of two contrasting attempts to develop distinctive policy frameworks at the subnational level. It demonstrates the importance of looking beyond formal institutional powers and paying attention to policymakers’ political skills and visibility, as well as the strategies and tactics that they employ in deploying formal powers. It highlights, in particular, the need for subnational governments to focus on those issues where they can make a difference and to exploit their nodality within policy networks to foster collaboration with state and non-state actors who bring complementary resources. Points for practitioners A subnational government’s success in pursuing distinctive policy agendas depends on the issues it decides to focus on and the way it chooses to deploy the formal powers and resources available to it. There is little point in investing time and efforts in pursuing issues that national governments are unwilling to cede control over. However, where they are given a degree of autonomy, subnational governments need to exploit their pivotal position in policy networks to foster collaboration with a range of state and non-state actors who bring complementary resources.
Effects of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients: A systematic review and meta-analysis
Authors: Zhang Jun , Zhong Dongling , Xiao Xili , Yuan Li , Li Yuxi , Zheng Yaling , Li Juan , Liu Tianyu , Jin Rongjiang 
Published: March 2021

Objective: To evaluate the effects and safety of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients. Methods: We searched databases from inception to January 28, 2021. Randomized control trials investigating the effects and safety of rTMS for aphasia patients after stroke were included. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Review Manager 5.3 software. The quality of the evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Twenty-eight studies with 1287 patients were included. All studies were assessed at low or unclear risk of bias in one or more domains. The meta-analysis exhibited rTMS was better than sham rTMS and conventional rehabilitation in language recovery. Low-frequency rTMS showed greater improvement in language recovery except for comprehension than sham rTMS. Low-frequency and bilateral rTMS were superior to conventional rehabilitation in language recovery. High-frequency rTMS was no better than sham rTMS and conventional rehabilitation for improving aphasia. The rTMS had better effects in naming, comprehension and aphasia quotient at 20 sessions. Eleven studies reported rTMS was safe for aphasia patients after stroke. The quality of evidence for all outcomes was low or very low, and publication bias may exist. Conclusions: rTMS may be relatively effective and safe for aphasia patients after stroke. However, these findings should be treated with caution due to high heterogeneity and potential biases.
Analysis of transcriptome in the relationship between expression of PRC1 protein and prognosis of patients with cholangiocarcinoma
Authors: Wang Qing , Lu Shaoqiong , Chen Ying , He Hua , Lu Weihui , Lin Kanru 
Published: March 2021

Objective To investigate whether protein regulator of cytokinesis 1 ( PRC1), which is involved in the regulation of human carcinogenesis, contributes to poor prognosis in patients with cholangiocarcinoma (CCA). Methods Data and tissues from patients with CCA were retrospectively studied. Immunohistochemical staining and western blotting were used to evaluate and contrast the PRC1 expression profile at the protein level in CCA tumour and pericarcinomatous tissues from the same study population. Relationships between clinical characteristics and patient survival were observed using univariate and multivariate analyses. Correlations between PRC1 expression and clinical characteristics were analysed by logistic regression. Results A total of 45 patients were included. PRC1 expression was found to be upregulated in CCA cancer tissues versus pericarcinomatous tissues. Overexpression of PRC1 was shown to be related to tumour differentiation, tumour node metastasis staging and lymph node metastasis, and was also revealed to be an independent marker of poor CCA prognosis. Conclusions The present results suggest that PRC1 may be a prognostic and therapeutic biomarker for patients with CCA.
Characteristics and long-term mortality of patients with ST-elevation or non-ST-elevation myocardial infarction after orthopaedic surgery
Authors: Hu Wenlan , Zhao Kaiping , Chen Youzhou , Wang Jihong , Zheng Mei , Zhao Ying , Zhao Qiong , Zhao Xingshan 
Published: March 2021

Objective To investigate the clinical characteristics and long-term mortality of patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) after orthopaedic surgery. Methods This retrospective, single-centre study enrolled patients that underwent inpatient orthopaedic surgery from 2009 to 2017 in Beijing Jishuitan Hospital. The patients were screened for a cardiac troponin I elevation and fulfilled the Fourth Universal Definition of Myocardial Infarction within 30 days of surgery. Results A total of 180 patients that developed perioperative myocardial infarction (MI) were included in the study. Among them, 14 patients (7.8%) were classified as STEMI, and 166 (92.2%) had NSTEMI. Compared with those with NSTEMI, STEMI patients had significantly higher 30-day and long-term mortality rates (50.0% versus 5.4%; 71.4% versus 22.3%; respectively). Multivariate Cox regression model analysis among the entire cohort demonstrated that STEMI (hazard ratio [HR] 5.78, 95% confidence interval [CI] 2.50, 13.38) and prior MI (HR 2.35, 95% CI 1.02, 5.38) were the most significant independent predictors of long-term mortality. Conclusion Perioperative MI after orthopaedic surgery was associated with a high mortality rate. STEMI was independently associated with a significant increase in short- and long-term mortality.
Analgesic effects of erector spinae plane block for patients after breast surgery: a systematic review and meta-analysis
Authors: Li Hui-fang , Shen Qi-hong , Zhou Xu-yan , Shen Xu 
Published: March 2021

Objective This meta-analysis investigated the analgesic effects of erector spinae plane block (ESPB) in patients undergoing breast surgery. Methods PubMed, Embase, Web of Science, and the Cochrane Library were searched from database establishment to January 31, 2020. Two reviewers independently extracted the data. The primary outcomes were pain scores and opioid consumption during the first 24 hours after surgery. The risk of bias of the included studies was assessed according to the Cochrane Handbook. Results Six randomized controlled trials of 415 patients were included. Compared with the control value, the pain score was significantly lower in the ESPB group at different time points postoperatively. Patients who underwent ESPB required lower opioid consumption (standardized mean difference = −2.02, 95% confidence interval [CI] = −2.85 to −1.20, I2= 91%. The rates of postoperative nausea (risk ratio [RR] = 0.79, 95% CI = 0.48–1.30, I2 = 47%) and postoperative vomiting (RR = 0.76, 95% CI = 0.30–1.96, I2 = 33%) did not differ between the groups. The quality of evidence was low or very low. Conclusions ESPB significantly alleviated pain and reduced opioid consumption after breast surgery. Further research is needed to expand its clinical application. PROSPERO registration number CRD42020167900
Need for Assessment of MDS Paper I Examination at the End of the First Year of MDS: A Survey
Authors: Kolhe Shweta A. , Khandelwal Shivani S. , Verulkar Amol A. , Bajaj Twinkle D. , Potode Niyati Bhupesh 
Published: March 2021

Introduction: Pursuant to the notification published by Dental Council of India, dated May 17, 2018, no. DE-14-MDS-2018/2131, the committee amended the regulation on postgraduate (PG) Masters of Dental Surgery (MDS) students and made provision of giving MDS paper I at the end of the first year. Assessment of this survey will provide clear information between the responses of PG students and teachers. The focus of this article is to report and discuss the characteristics of new learning process. Material Method: A total of 150 sample sizes and 50 PG teachers were included. Questions were generated using Google Form to gain access and establish rapport with participants and to obtain open, honest understanding of the participants’ “learning experience.” The link was sent to the participants, using emails or WhatsApp number. Result: The analysis of survey data was carried out using Likert scale. The comparison of mean scores was carried out using unpaired t-test. Figures 1 to 10 provide responses of participants. Conclusion: Postgraduate students and PG guides are neutral toward the initial protocol of examination. The participants have a positive attitude toward new framework. But curriculum activities such as library dissertation (LD), dissertation selection, and patient work get disturbed somewhere. It might take time for both students and guides to get familiar with the new framework.
Graphene nanoplatelet, multiwall carbon nanotube, and hybrid multiwall carbon nanotube–graphene nanoplatelet epoxy nanocomposites as strain sensing coatings
Authors: Bragaglia Mario , Paleari Lorenzo , Lamastra Francesca R , Puglia Debora , Fabbrocino Francesco , Nanni Francesca 
Published: March 2021

Strain monitoring is of great interest in order to check components structural life, to prevent catastrophic failures, and, possibly, to predict residual life in case of unexpected events. In this study, strain sensing epoxy-based coatings containing carbon nanotubes (MWCNTs), graphene nanoplatelets (GNPs), and a mix of the two (MWCNT+GNP) have been produced, with the same initial electrical resistivity, and applied on glass fiber reinforced composites. Morphological, mechanical, and electrical tests have been then performed evaluating the resistance variation and the strain sensing performance of the sensors. A theoretical model to relate the resulting gauge factors to the different types of nanofillers has been applied. The results showed that all systems present a strain sensing performance with different gauge factors (and hence sensitivity) at low strain: GNP samples showed the highest gauge factor (10.3), MWCNT samples the lowest (1.5), and the mixed system lies in the middle (4.3). From analytical analysis, the value of initial distance among conductive particles was found to be 0.3 nm in the case of MWCNT and 1.2 nm for GNP, explaining why the gauge factors of the produced sensors are different.
Chemokine CXCL1 in serum mediates the antinociceptive effect of manual acupuncture at ST36
Authors: Hong Shou-Hai , Ding Sha-Sha , Xu Yuan , Zhang Kuo , Zhao Xue , Liu Yang-Yang , Xuan Li-Hua , Guo Yong-Ming , Guo Yi 
Published: March 2021

Background: Inflammatory pain is the most common type of pain encountered clinically. The analgesic effect of acupuncture has been well-documented. Objective: The aim of this study was to investigate the involvement of chemokine CXCL1 in the serum on manual acupuncture (MA)-induced antinociception. Methods: Rats with inflammatory pain of the right hind paw were induced by intraplantar (i.pl.) administration of complete Freund’s adjuvant (CFA). After wards, the CFA-injected rats were treated daily with MA at ST36 from Day 1 to Day 7, and thermal nociceptive thresholds (paw withdrawal latency; PWL) were analyzed. The concentration of CXCL1 in the serum of the rats was measured by enzyme-linked immunosorbent assay (ELISA) after the first and the last MA treatment. Subsequently, the rats were injected with two doses (5 or 10 μg) of recombinant CXCL1 through the tail vein daily from Day 1 to Day 7 or injected with two doses (6.4 or 16 μg) of anti-CXCL1 antibody using the same methods and course at 30 min before MA, and the PWLs were measured again. Finally, naloxone (500 μg, 0.1 mL) was administered by i.pl. injection into the inflamed paw 5 min before the last MA treatment or last injection of recombinant CXCL1. Results: MA significantly increased the PWLs and upregulated the expression of serum CXCL1 in the CFA-injected rats. Without acupuncture, repeated tail vein injection of recombinant CXCL1 showed an analgesic effect on CFA-induced inflammatory pain. Conversely, the neutralization of serum CXCL1 by anti-CXCL1 antibody decreased MA-induced antinociception in a time-dependent manner. Anti-CXCL1 antibody injected just once before the first MA did not affect MA-induced antinociception. The analgesic effects of MA and recombinant CXCL1 were reversed by an i.pl. injection of naloxone. Conclusion: This study indicates MA at ST36 had an analgesic effect on inflammatory pain and found a novel function of CXCL1. Increased serum CXCL1 had an antinociceptive effect on inflammatory pain induced by CFA. CXCL1 in serum appeared to be a key molecule involved in the peripheral mechanism of MA-induced antinociception. The analgesic effect of MA or recombinant CXCL1 on inflammatory pain might be mediated through a peripheral opioid pathway, which needs further investigation.
An examination of the moral habitability of resource-constrained obstetrical settings
Authors: Boakye Priscilla N , Peter Elizabeth , Simmonds Anne , Richter Solina 
Published: March 2021

Background: While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings. Research objective: The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker. Research design and participants: A critical moral ethnography was conducted through the analysis of interviews with 30 nurses and midwives, along with observation, and documentary materials. Ethical considerations: After receiving ethics approval, signed informed consent was obtained from participants before data collection. Results: Five themes were identified: (1) holding onto the values, identities, and responsibilities of being a midwife/nurse; (2) scarcity of resources as limiting capacity to meet caring responsibilities; (3) gender and socio-economic inequities shaping the moral-social context of practice; (4) working with incoherent moral understandings and damaged identities in the context of inter- and intra-professional relationships; and (5) surviving through adversity with renewed commitment and courage. Discussion: The nurses and midwives were found to work in an environment that was morally uninhabitable and dominated by the scarcity of resources, overwhelming and incoherent moral responsibilities, oppressive conditions, and workplace violence. These situations constrained their moral agency and provoked suffering and distress. The nurses and midwives negotiated their practice and navigated through morally uninhabitable work environment by holding onto their moral values and commitments to childbearing women. Conclusion: Creating morally habitable workplaces through the provision of adequate resources and instituting interprofessional practice guidelines and workplace violence prevention policies may promote safe and ethical nursing and midwifery practice.
Predictive factors for prolonged hospitalisation in acute pyelonephritis patients admitted to the emergency medicine ward
Authors: Chan Howard Tat Chun , Leung Ling Yan , Law Alex Kwok Keung , Cheng Chi Hung , Graham Colin A 
Published: March 2021

Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.
Two-year results of a treat and extend regimen with aflibercept in Caucasian patients with aneurysmal type 1 neovascularization
Authors: Montero Hernández Javier , Remolí Sargues Lidia , Monferrer Adsuara Clara , Castro Navarro Verónica , Navarro Palop Catalina , Cervera Taulet Enrique 
Published: March 2021

Introduction: There are a few reports investigating the treatment of aneurysmal type 1 neovascularization (AT1) in Caucasian patients. The aim of this study is to evaluate the 2-year results of a treat and extend regimen with aflibercept in Caucasian patients with AT1. Methods: We conducted an observational retrospective study in 28 eyes of 26 patients with naïve AT1 treated with a treat an extend regimen of intravitreal aflibercept. Best corrected visual acuity (BCVA), central macular thickness (CMT), pigment epithelium detachment (PED) height, presence of dry macula, and regression rate of polypoidal lesions were assessed at baseline and at 12 and 24 months. Results: BCVA was significantly increased by 9.03 ± 16 letters ( p < 0.01) and 9.2 ± 16.87 letters ( p < 0.01) after the 12 and 24 months follow-up. A significant decrease of CMT was found at 12 and 24 months ( p < 0.01). Nevertheless, significant changes in PED height were not observed (0.1 <  p > 0.05). At 12 and 24 months of follow-up, dry macula was achieved in a total of 10 eyes (35.71%) and 15 eyes (53.57%). The regression rate of polypoidal lesions was 25% (7 eyes) and 35.71% (10 eyes) after 12 and 24 months. The mean number of intravitreal injections was 7.81 ± 3.20 the first year and 6.11 ± 3.49 the second year. Conclusion: To the best of our knowledge, treat and extend regimen with intravitreal aflibercept in Caucasian patients may be effective for improving BCVA, CMT, wet macula, and regression rate of polypoidal lesions.