bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra-Articular Synovial Fluid With Hematoma After Ankle Fracture Promotes Cartilage Damage In Vitro Partially Attenuated by Anti-Inflammatory Agents
Authors: Allen Nicholas B. , Abar Bijan , Danilkowicz Richard M. , Kraus Virginia B. , Olson Steven A. , Adams Samuel B. 
Published: October 2021

Background: Intra-articular ankle fracture (IAF) causes posttraumatic osteoarthritis (PTOA), but the exact mechanism is unknown. Proinflammatory mediators have been shown to be present in the synovial fluid fracture hematoma (SFFH) but have not been linked to cartilage damage. The purpose of this study was to determine if the SFFH causes cartilage damage and whether this damage can be attenuated by commercially available therapeutic agents. Methods: Synovial fluid was obtained from 54 IAFs and cultured with cartilage discs from the dome of fresh allograft human tali and randomly assigned to one of the following groups: (A) control—media only, (B) SFFH from days 0 to 2 after fracture, (C) SFFH from days 3 to 9, (D) SFFH from days 10 to 14, (E) group B + interleukin 1 receptor antagonist (IL-1Ra), and (F) group B + doxycycline. The cartilage discs underwent histological evaluation for cell survival and cartilage matrix components. The spent media were analyzed for inflammatory mediators. Results: Cartilage discs cultured with SFFH in groups B, C, and D demonstrated significantly increased production of cytokines, metalloproteinases (MMPs), and extracellular matrix breakdown products. Safranin O staining was significantly decreased in group B. The negative effects on cartilage were partially attenuated with the addition of either IL-1RA or doxycycline. There was no difference in chondrocyte survival among the groups. Conclusion: Exposure of uninjured cartilage to IAF SFFH caused activation of cartilage damage pathways evident through cartilage disc secretion of inflammatory cytokines, MMPs, and cartilage matrix fragments. The addition of IL-1Ra or doxycycline to SFFH culture partially attenuated this response. Clinical Relevance: IAFs create an adverse intra-articular environment consisting of significantly increased levels of inflammatory cytokines and MMPs able to damage cartilage throughout the joint. These data suggest that the acute addition of specific inflammatory inhibitors may decrease the levels of these proinflammatory mediators.
Cerebral Abnormalities in Spina Bifida: A Neuropathological Study
Authors: Paschereit Fabienne , Schindelmann Kim Hannah , Hummel Michael , Schneider Joanna , Stoltenburg-Didinger Gisela , Kaindl Angela M 
Published: October 2021

Introduction Spina bifida (SB) is the most common neural tube defect in humans. Here, we analyzed systematically the neuropathological findings of the brain in SB cases. Methods 79 cases with SB aperta (SBA) and 6 cases with SB occulta (SBO) autopsied at the Charité Neuropathology from 1974 to 2000 were re-evaluated retrospectively. For this, case files and spinal cord as well as brain sections were studied. Results While no brain malformations were detected in SBO cases, 95% of SBA cases had brain malformations. Main brain anomalies identified were hydrocephalus (71%), Chiari II malformation (36%), heterotopia (34%), other cerebellar anomalies (36%), gyrification defects (33%), and ependymal denudation (29%). Hydrocephalus was observed as early as gestational week 17 and was highly associated to Chiari II and ependymal denudation. In 55% SBA was accompanied by further anomalies not primarily affecting the CNS. Conclusion We confirm using neuropathologic methods brain malformations in most SBA but none in SBO cases. In addition to our previous radiologic study, we now demonstrate the high prevalence of cerebellar malformations and cerebral heterotopias in SBA. The early detection of hydrocephalus and Chiari II malformation in fetuses raises the question whether these arise parallel rather than in strict temporal sequence.
Prevalence of depression and anxiety in patients with chronic obstructive pulmonary disease and their association with psychosocial outcomes: A cross-sectional study from Pakistan
Authors: Husain Muhammad Omair , Chaudhry Imran B , Blakemore Amy , Shakoor Suleman , Husain Muhammad Ali , Lane Steven , Kiran Tayyeba , Jafri Farhat , Memon Rakhshi , Panagioti Maria , Husain Nusrat 
Published: October 2021

Objectives: Chronic obstructive pulmonary disease contributes to substantial health and economic burden worldwide. Co-morbid depression and anxiety are highly prevalent in patients with chronic obstructive pulmonary disease. Depressive symptoms in chronic obstructive pulmonary disease are associated with poorer survival, longer hospitalisation and impaired quality of life. Literature on chronic obstructive pulmonary disease is largely derived from high-income countries; yet 90% of deaths related to chronic obstructive pulmonary disease occur in low- and middle-income countries. We aimed to establish the prevalence of anxiety and depression in patients with chronic obstructive pulmonary disease, as well as the association with psychosocial outcomes. Methods: This was a cross-sectional study of chronic obstructive pulmonary disease patients attending outpatient primary care clinics in Karachi, Pakistan. The Patient Health Questionnaire-9 was used to assess depression and the Generalised Anxiety Disorder-7 scale was used for the assessment of anxiety. Health-related quality of life was assessed with EuroQol–Five Dimensions, social support with Oslo-3 and social stress with Life Events Checklist. We recruited 293 subjects. Results: The prevalence of depression and anxiety in the sample was 51% ( n = 149) and 20% ( n = 59), respectively. Depressed chronic obstructive pulmonary disease patients reported significantly lower health-related quality of life scores as compared to non-depressed patients. Participants with depression had significantly higher levels of anxiety, less social support, higher social stress and more subjective impairment in quality of life. Conclusion: Given the association with reduced social support and increased perceived stress, the role of psychosocial interventions must be explored in improving outcomes of chronic obstructive pulmonary disease patients in Pakistan.
Utility of Point‐of‐Care COVID‐19 Testing in an Outpatient Otolaryngology clinic
Authors: Ganesh Meera , Brawley Craig Cameron , Khanwalkar Ashoke , Mycanka John , Conley David B. , Kern Robert C. , Tan Bruce K. 
Published: October 2021

ObjectiveTo evaluate the utility of point‐of‐care COVID‐19 testing for identifying infected patients in an otolaryngology practice.Study DesignRetrospective review of 947 patients tested with a point‐of‐care nucleic acid amplification test for SARS‐CoV‐2 (Abbott ID Now).SettingTertiary otolaryngology clinic setting from July to November 2020.MethodsTests were characterized by provider‐specified indication (symptomatic, preprocedural, and universal), subspecialty, provider type, and contemporaneous regional COVID‐19 positivity rate, defined as 12%. Positive results were further classified as true or false positive (TP or FP) based on repeat polymerase chain reaction testing wherever available, and true positivity rates were compared among groups by multiway chi‐square and Fisher’s exact tests. FP rates within 48 hours of a TP result were also evaluated to assess for batch contamination.ResultsA total of 947 SARS‐CoV‐2 nucleic acid amplification tests were performed, yielding 9 TPs (0.95%) and 5 FPs (0.53%). TP rates were significantly different by testing indication, with higher rates among symptomatic patients (P =. 012; vs universal, odds ratio = 7.86 [95% CI, 1.27‐83.52]; vs preprocedural, odds ratio = 4.91 [95% CI, 0.79‐52.17]); by subspecialty (P =. 011), as driven by higher positivity rates in laryngology; and by encounter, with higher rates among advanced practice practitioners than physicians (P =. 002; odds ratio = 9.97 [95% CI, 2.11‐51.16]). TP rates were not significantly different during periods of uncontrolled local outbreak (P =. 660). FP rates were not significantly higher within a 48‐hour window of a TP (P =. 192).ConclusionPoint‐of‐care COVID‐19 nucleic acid amplification tests in an outpatient otolaryngology clinic identified a low TP rate (<1%) with most cases being clinically suspected. Laryngology and advanced practice practitioner encounters may have higher positivity rates.Level of evidence: 3.
Effectiveness of a community-delivered pneumatic machine resistance training programme (Gym Tonic) for older adults at neighbourhood senior centres – a randomized controlled trial
Authors: Lee Shuen Yee , Goh Alycia , Tan Ken , Choo Pei Ling , Ong Peck Hoon , Wong Wai Pong , Wee Shiou-Liang 
Published: October 2021

Abstract
Background
Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. However, effectiveness of scaled-up pneumatic machine resistance training in the community is not known. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults.

Methods
Three hundred eighteen community-dwelling older adults aged ≥65 years were randomized into 12-week (twice/week) coach-supervised-community-based-GT-programme(n = 168) and wait-list control groups(n = 150). After 12 weeks, the intervention group continued with GT-training and the control group received supervised-GT-programme for further 12 weeks (partial-crossover-design). Fried frailty score, lower-extremity muscle strength and physical function (i.e., fast and habitual gait-speed, balance, repeated-chair-sit-to-stand, short physical performance battery (SPPB)) were determined at baseline, 12 and 24 weeks. Analysis adopted a modified-intention-to-treat-approach.

Results
After 12 weeks, lower-extremity muscle strength improved by 11–26%(all p < 0.05) and fast gait-speed improved by 7%(p = 0.008) in GT-intervention group(n = 132) than controls(n = 118), regardless of frailty status. Other physical function performance did not differ between control and intervention groups after 12 weeks (all p > 0.05). Frailty score improved by 0.5 in the intervention but not control group(p = 0.004). Within the intervention group, lower-extremity muscle strength and physical function outcomes improved at 24 weeks compared with baseline (all p < 0.001). Within controls, lower-extremity muscle strength, SPPB, repeated-chair-sit-to-stand and fast gait-speed improved post-GT (24-week) compared to both pre-GT (12-week) and baseline. Programme adherence was high in intervention [0–12-weeks,90%(SD,13%); 12–24-weeks,89%(SD,17%)] and control [12–24-weeks,90%(SD,19%)] groups.

Conclusion
Community-delivered GT resistance training programme with pneumatic machines has high adherence, improves muscle strength and fast gait-speed, and can be effectively implemented at scale for older adults. Future studies could examine if including other multi-modal function-specific training to complement GT can achieve better physical/functional performance in power, balance and endurance tasks.

Trial registration
ClinicalTrials.gov, NCT04661618, Registered 10 December 2020 - Retrospectively registered.
Global trend of clinical biomarkers of health and disease during the period (1913–2021): systematic review and bibliometric analysis
Authors: Jovicic Snezana M. 
Published: October 2021

Abstract
Background
The literature review provides a concise and detailed description of the available and published data on the investigated research problem. The study summarizes findings over the last 100 years regarding clinical biomarkers during health and disease. Research expanded to present the range of enzyme acetylcholinesterase in human blood utilizing diverse methodology during the 1949–2021 year.

Main body
Data analysis includes program SPSS v23.0, frequency, percentage, numbers and graphical presentation of results. Information from the papers gathers in Microsoft Excel 2007 and contains information: study type, journal, publisher, year of publication, continent, the health status of respondents, biomarkers, number and age of participants, types of samples, methodology, goals and conclusions. Data collection includes electronic databases, the National Center for Biotechnology Information and Google Scholar, with several inclusion criteria: (1) anthropometry (2) urine (3) blood in the healthy and diseased population parameters during different physiological states of the organism. The initial number of collected and analyzed papers is 1900. The final analysis included 982 studies out of 1454 selected papers. After the selection process, 67.53% remains useful. The range of enzyme acetylcholinesterase included 107 publications.

Conclusion
The number of published scientific papers has been increasing over the years. Little practical information in scientific and clinical practice exists. There is an urgent need for concise highlighting of literature key arguments and ideas. Results apply to a specialized area of research.
Integrated analysis of lncRNA-miRNA-mRNA ceRNA network in human aortic dissection
Authors: Zhang Hao , Bian Ce , Tu Simei , Yin Fanxing , Guo Panpan , Zhang Jian , Song Xiaotong , Liu Qingyang , Chen Chen , Han Yanshuo 
Published: October 2021

Abstract
Background
Many studies on long chain non-coding RNAs (lncRNAs) are published in recent years. But the roles of lncRNAs in aortic dissection (AD) are still unclear and should be further examined. The present work focused on determining the molecular mechanisms underlying lncRNAs regulation in aortic dissection on the basis of the lncRNA-miRNA-mRNA competing endogenous RNA (ceRNA) network.

Methods
This study collected the lncRNAs (GSE52093), mRNAs (GSE52093) and miRNAs (GSE92427) expression data within human tissue samples with aortic dissection group and normal group based on Gene Expression Omnibus (GEO) database.

Results
This study identified three differentially expressed lncRNAs (DELs), 19 differentially expressed miRNAs (DEmiRs) and 1046 differentially expressed mRNAs (DEGs) identified regarding aortic dissection. Furthermore, we constructed a lncRNA-miRNA-mRNA network through three lncRNAs (including two with up-regulation and one with down-regulation), five miRNAs (five with up-regulation), as well as 211 mRNAs (including 103 with up-regulation and 108 with down-regulation). Simultaneously, we conducted functional enrichment and pathway analyses on genes within the as-constructed ceRNA network. According to our PPI/ceRNA network and functional enrichment analysis results, four critical genes were found (E2F2, IGF1R, BDNF and PPP2R1B). In addition, E2F2 level was possibly modulated via lncRNA FAM87A-hsa-miR-31-5p/hsa-miR-7-5p or lncRNA C9orf106-hsa-miR-7-5p. The expression of IGF1R may be regulated by lncRNA FAM87A-hsa-miR-16-5p/hsa-miR-7-5p or lncRNA C9orf106-hsa-miR-7-5p.

Conclusion
In conclusion, the ceRNA interaction axis we identified is a potentially critical target for treating AD. Our results shed more lights on the possible pathogenic mechanism in AD using a lncRNA-associated ceRNA network.
Antibiotic resistance in the pathogenic foodborne bacteria isolated from raw kebab and hamburger: phenotypic and genotypic study
Authors: Rajaei Maryam , Moosavy Mir-Hassan , Gharajalar Sahar Nouri , Khatibi Seyed Amin 
Published: October 2021

Abstract
Background
In recent years, interest in the consumption of ready-to-eat (RTE) food products has been increased in many countries. However, RTE products particularly those prepared by meat may be potential vehicles of antibiotic-resistance foodborne pathogens. Considering kebab and hamburger are the most popular RTE meat products in Iran, this study aimed to investigate the prevalence and antimicrobial resistance of common foodborne pathogens (Escherichia coli, Salmonella spp., Staphylococcus aureus, and Listeria monocytogenes) in raw kebab and hamburger samples collected from fast-food centers and restaurants. Therefore, total bacterial count (TBC), as well as the prevalence rates and antibiogram patterns of foodborne pathogens in the samples were investigated. Also, the presence of antibiotic-resistance genes (blaSHV, blaTEM,blaZ, and mecA) was studied in the isolates by PCR.

Results
The mean value of TBC in raw kebab and hamburger samples was 6.72 ± 0.68 log CFU/g and 6.64 ± 0.66 log CFU/g, respectively. E. coli had the highest prevalence rate among the investigated pathogenic bacteria in kebab (70%) and hamburger samples (48%). Salmonella spp., L. monocytogenes, and S. aureus were also recovered from 58, 50, and 36% of kebab samples, respectively. The contamination of hamburger samples was detected to S. aureus (22%), L. monocytogenes (22%), and Salmonella spp. (10%). In the antimicrobial susceptibility tests, all isolates exhibited high rates of antibiotic resistance, particularly against amoxicillin, penicillin, and cefalexin (79.66–100%). The blaTEM was the most common resistant gene in the isolates of E. coli (52.54%) and Salmonella spp. (44.11%). Fourteen isolates (23.72%) of E. coli and 10 isolates (29.41%) of Salmonella spp. were positive for blaSHV. Also, 16 isolates (55.17%) of S. aureus and 10 isolates (27.27%) of L. monocytogenes were positive for mecA gene.

Conclusions
The findings of this study showed that raw kebab and hamburger are potential carriers of antibiotic-resistance pathogenic bacteria, which can be a serious threat to public health.
Comparison of a metronome-guided prehospital medication infusion technique with standard calculation: a simulated randomized, controlled, cross-over study
Authors: Galvagno Samuel M. , Cloepin James , Hannas Jeannie , Rubach Kurt S. , Naumann Andrew , Wendell Jonathan 
Published: October 2021

Abstract
Background
Limited research regarding administration of timed medication infusions in the prehospital environment has identified wide variability with accuracy, timing, and overall feasibility. This study was a quality improvement project that utilized a randomized, controlled, crossover study design to compare two different educational techniques for medication infusion administration. We hypothesized that the use of a metronome-based technique would decrease medication dosage errors and reduce time to administration for intravenous medication infusions.

Methods
Forty-two nationally registered paramedics were randomized to either a metronome-based technique versus a standard stopwatch-based technique. Each subject served as a control. Subjects were asked to establish an infusion of amiodarone at a dose of 150 mg administered over 10 min, simulating treatment of a hemodynamically stable patient with sustained monomorphic ventricular tachycardia. Descriptive statistics and a repeated measures mixed linear regression model were used for data analysis.

Results
When compared to a standard stopwatch-based technique, a metronome-based technique was associated with faster time to goal (median 34 s [IQR, 22–54] vs 50 s; [IQR 38–61 s], P = 0.006) and fewer mid-infusion adjustments. Ease of use was reported to be significantly higher for the metronome group (median ranking 5, IQR 4–5) compared to the standard group (median ranking 2, IQR 2–3; P < 0.001).

Conclusions
Knowledge regarding a metronome technique may help EMS clinicians provide safe and effective IV infusions. Such a technique may be beneficial for learners and educators alike.
C-reactive protein is associated with postoperative outcomes in patients with intestinal Behçet’s disease
Authors: Kang Eun Ae , Park Jung Won , Park Yehyun , Park Soo Jung , Kim Tae Il , Kim Won Ho , Cho Min Soo , Cheon Jae Hee 
Published: October 2021

Abstract
Background
Patients with intestinal Behçet’s disease (BD) frequently undergo intestinal resections, which significantly affects postoperative morbidity and mortality. The aim of this study was to identify the association between C-reactive protein (CRP) levels and postoperative outcomes in patients with intestinal BD who underwent surgical bowel resection.

Methods
Patients who were diagnosed with intestinal BD and underwent intestinal surgery due to BD at Severance Hospital between November 2005 and April 2018 were retrospectively investigated. Clinical relapse was defined as a disease activity index of BD (DAIBD) > 40, existence of newly added medications, re-hospitalization, or re-operation related to intestinal BD. The relationship between CRP level and postoperative outcomes was analyzed, and a receiver operating characteristic (ROC) curve was drawn to specify a cut-off value.

Results
Ninety patients with intestinal BD were included. Among them, 44 were male (48.9%), and the median age at diagnosis was 38 years (range, 11–69 years). The median total disease follow-up duration was 130 months (range, 3–460 months). Forty patients (44.4%) underwent laparoscopic surgery. A higher CRP level immediately after surgery was significantly associated with postoperative complications (OR 1.01, 95% CI 1.004–1.018, p < 0.01), re-operation (hazard ratio [HR] 1.01, 95% CI 1.005–1.020, p < 0.01), and re-admission (HR 1.01, 95% CI 1.006–1.017 p < 0.01). The ROC curve showed that CRP predicts the risk of postoperative complications (p < 0.01) at a cut-off value of 41.9% with a sensitivity of 60.0% and specificity of 67.7%.

Conclusions
Postoperative CRP levels in patients with intestinal BD undergoing surgical resection were associated with postoperative outcomes.
Vitamin D status and obesity markers in older adults: results from West China Health and Aging Trends study
Authors: Zhao Yunli , Zhao Wanyu , Hao Qiukui , Ge Meiling , Zhang Yan , Hu Fengjuan , Lu Ying , Zhou Lixing , Liu Xiaolei , Dong Birong 
Published: October 2021

Abstract
Backgrounds
Vitamin D deficiency and insufficiency in older adults seems to be common, but the prevalence estimates are lacking in West China. Previous studies suggested that low vitamin D status was associated with obesity. However, most of them evaluated obesity based on body mass index (BMI) and there are no studies at present exploring the association between vitamin D status and different obesity markers. The present study aims to investigate the prevalence of low vitamin D status and evaluate the association between the vitamin D status and different obesity markers among older adults in West China.

Methods
Data was based on the baseline of West China Health and Aging Trends study (WCHAT). All of the participants were older than 60 years old in the present study. Vitamin D status was based on laboratory data, and obesity markers were assessed by bioelectrical impedance analysis (BIA) using the InBody 770 analyzer. Multiple linear regression was performed to find the association between the vitamin D status and various obesity markers.

Results
The study included 2661 individuals (mean age: 67.7 ± 6.0 years; males: 41 %). The mean vitamin D level was 18.8 ± 6.3 ng/ml (range: 5 to 59 ng/ml); 5.2 % of participants had a sufficient level of vitamin D, 31.8 % had vitamin D insufficiency, and 63.0 % had vitamin D deficiency. Our results showed that vitamin D status was negatively associated with fat mass index (FMI), visceral fat area (VFA), and waist-hip ratio (WHR) in both sexes. Comparing to other obesity markers, WHR had the strongest correlation with vitamin D status in both sexes (β = -6.090, P = 0.046 in males; β = -11.253, P < 0.001 in females). No significant association was found between vitamin D status and BMI in males.

Conclusion
The prevalence of vitamin D insufficiency and deficiency among older adults in West China was high. Among the older adults in west China, WHR showed stronger association with vitamin D status and was better for the prediction of vitamin D insufficiency or deficiency in both sexes, compared to BMI.

Trial registration
Chinese Clinical Trial Registry: ChiCTR1800018895.