bluuebunny/crossref_metadata_2025_split huggingface dataset:
The natural anti-inflammatory sesquiterpene lactone achillolide A reduces atopic dermatitis in a murine model
Authors: Telerman Alona , Kashman Yoel , Ofir Rivka , Elmann Anat 
Published: July 2021

Abstract
Plant-derived substances have been shown to affect potential targets in inflammatory diseases. We have previously purified from the desert plant Achillea fragrantissima, a sesquiterpene lactone named achillolide A, and demonstrated its anti-inflammatory activities in cultured brain macrophages named microglial cells. In the present study, we further investigated achillolide A in alleviating atopic dermatitis, a chronic and recurring inflammatory skin disease. We investigated achillolide A for its in vivo anti-inflammatory activity using the oxazolone model of atopic dermatitis in mice, in which oxazolone induces ear swelling. Our results show that mice treated with achillolide A showed a significant decrease in the oxazolone-induced ear swelling. Since macrophages are inflammatory cells that play a pivotal role in the pathogenesis of atopic dermatitis, the anti-inflammatory effects of achillolide A were also studied in spleen cells. We demonstrated that achillolide A reduced the levels of LPS-induced inflammatory cytokines IL-2, IL-6, TNFα, IFNγ and IL-12 that were secreted from cultured splenocytes. These data suggest that achillolide A should be considered for further research in treating atopic dermatitis.
The Inclusion of Sexual Orientation and Gender Identity in Relationships Education
Authors: Johnson Paul , Falcetta Silvia 
Published: July 2021

Abstract
All primary schools in England are under a statutory requirement to provide ‘relationships education’, which includes ‘lgbt content’. The inclusion of content relating to sexual orientation and gender identity has attracted faith-based opposition. Such opposition, which is based on assertions about relationships education interfering with the right of parents to ensure that the education of their children is in conformity with their religious convictions, is likely to lead to legal action in the English courts and perhaps the European Court of Human Rights. This article anticipates the claims that would be made in any such legal action and critically interrogates them through the lens of the European Convention on Human Rights.
Perceived Impact of USMLE Step 1 Score Reporting to Pass/Fail on Otolaryngology Applicant Selection
Authors: Mamidi Ishwarya S. , Gu Alex , Mulcahy Collin F. , Wei Chapman , Zapanta Philip E. 
Published: July 2021

Objectives: Recently, the decision was made to transition the United States Medical Licensing Examination (USMLE) Step 1 score from a three-digit numerical score to a pass/fail system. Historically, Step 1 scores have been important for otolaryngology resident applicant selection. The purpose of this study was to understand and evaluate otolaryngology residency program directors’ (OPDs) opinions on the impact following the change in Step 1 score reporting. Methods: A 22-question survey administered through Qualtrics was sent to 113 academic otolaryngology residency program directors in April 2020. Information about demographics, impressions on the new Step 1 score format, anticipated changes in applicant selection, impact on mental health, and importance of various other factors in selecting applicants were queried. Descriptive statistics were used to analyze survey results. Results: A total of 41 out of 113 (36.3%) OPDs completed this survey. A majority of surveyed OPDs (80.5%) do not support the decision to change Step 1 to a pass/fail system. In the absence of a three digit numeric USMLE Step 1 score, OPDs indicated prioritization of away rotations, letters of recommendation (LORs), personal prior knowledge of the applicant, grades in required clerkship, and class ranking or quartile. 53.7% of OPDs anticipate requiring USMLE Step 2 Clinical Knowledge for interview consideration following this change. Conclusion: OPDs believe a pass/fail Step 1 score will decrease the importance of this exam and that this change will lead to the implementation and evaluation of additional metrics such as a required Step 2 CK score.
Cyclosporine A-enhanced cardioplegia preserves mitochondrial basal respiration after ischemic arrest
Authors: Hoyer Alexandro A , Klaeske Kristin , Garnham Jack , Kiefer Philipp , Salameh Aida , Witte Klaus , Borger Michael , Dieterlen Maja-Theresa 
Published: July 2021

Background: Mitochondrial permeability transition pore (mPTP) opening plays a crucial role in cell death during ischemia-reperfusion injury (IRI). Cyclosporine A (CsA) inhibits mPTP opening. This study aimed to investigate the effects of CsA treatment during cardioplegia on the mitochondrial function and cardiac IRI. Methods: Landrace pigs (52.9 ± 3.7 kg) were subjected to midline sternotomy, cardiopulmonary bypass at 34°C and 90 minutes of cardiac arrest. They received either a single shot of standard 4°C cold histidine-tryptophan-α-ketoglutarate (HTK)-Bretschneider solution ( n = 11) or HTK-Bretschneider plus 1.2 mg/L CsA (histidine-tryptophan-α-ketoglutarate plus cyclosporine A (HTK/CsA); n = 11). During reperfusion global left-ventricular function was assessed and myocardial biopsies were harvested at baseline, during ischemia and 45 minutes following reperfusion. High-resolution respirometry and hydrogen peroxide production were measured. Immunohistochemical stainings for apoptosis-inducing factor and hypoxia-inducible factor-1α as well as a flow cytometry-based JC-1 mitochondrial membrane potential assay were performed. Results: Hemodynamic parameters were comparable between both groups. The cytochrome C release (HTK: 930.3 ± 804.4 pg/mg, HTK/CsA: 699.7 ± 394.0 pg/mg, p = 0.457) as well as PGC1α content (HTK: 66.7%, HTK/CsA: 33.3%, p = 0.284) was lower in the HTK/CsA group. Respiratory measurements revealed that the oxygen flux under basal respiration was higher in the HTK/CsA group (8.2 ± 1.3 pmol·O2·s−1·mg−1·ww) than in the HTK group (3.8 ± 1.4 pmol·O2·s−1·mg−1·ww, p = 0.045). There were no significant differences regarding histological surrogates of apoptosis and necrosis. Conclusions: Supplementing cardioplegic solutions with CsA enhances the basal mitochondrial respiration thereby exerting a cardioprotective effect and diminishing IRI-induced damage. CsA seems to preserve mitochondrial function via non-ROS related pathways.
Associations between physicians’ global assessment of disease activity and patient-reported outcomes in patients with systemic lupus erythematosus: A longitudinal study
Authors: Louthrenoo Worawit , Kasitanon Nuntana , Morand Eric , Kandane-Rathnayake Rangi 
Published: July 2021

Objective To determine longitudinal associations between Physician Global Assessment (PGA) and patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE). Methods Patients attending a rheumatology clinic between 2013 and 2017 completed specific (SLEQOL) and generic (SF36) health-related quality of life (HRQoL) surveys and rated their global rating of change (GRC) at each visit. PGA, SLEDAI-2K and SLE Flare Index (SFI) were also captured on all visits. Generalised estimating equations (GEE) methods were used to examine longitudinal associations of PGA with PROs and clinical indicators. Results 337 patients were followed for a median [IQR] of 3.2 [1.6, 3.4] years (2,059 visits). High PGA (>1) was strongly associated with high SLEDAI-2K scores, the presence of flares and poor PROs. Odd ratios (OR) [95% CI] of PGA > 1 in patients with SLEDAI-2K >4 & <10 and SLEDAI-2K ≥10, compared to SLEDAI-2K ≤ 4, were 3.46 [2.36, 5.08], p < 0.001 and 6.39 [4.30, 9.49], p < 0.001, respectively. OR [95% CI] of PGA > 1 in patients with mild-to-moderate or severe flares were 2.09 [1.62, 2.71], p < 0.001 and 4.42 [3.21, 6.07], p < 0.001, respectively. Mental components of both SLEQOL (mood, self-image) and SF36 (MCS) surveys demonstrated significant associations with high PGA. After adjusting for SLEDAI-2K, one-point increase in PGA was associated with reductions in SLEQOL total score and SF36-MCS by 2.33 (regression coefficient (RC) [95% CI] = −2.33 [−3.77, −0.88], p = 0.002), and 4.16 (RC [95% CI] = −4.16 [−5.19, −3.13], p < 0.001) points, respectively. Associations of some physical components (SLEQOL-symptoms, and SF36-PCS) with PGA attenuated when adjusted for SLEDAI-2K. Patients who rated low scores of GRC, which indicate health deterioration, were twice as likely to have PGA > 1 (OR [95%CI] 1.99 [1.25, 3.16], p = 0.004). Conclusion High PGA was strongly associated with poor mental health, high disease activity and flares. This study confirms the value of PGA as an efficient assessment tool for SLE.
Reliability of a Modified Medication Appropriateness Index in Community Pharmacies
Authors: Kassam Rosemin , Martin Linda G , Farris Karen B , Monsanto Homero A , Kaiser Jean-Marie 
Published: July 2021

Background The medication appropriateness index (MAI) has demonstrated reliability in selected outpatient clinics where medical data were easily accessible from medical charts. However, its use in the community setting where patient data may be limited has not been examined. Objective To evaluate the usefulness of a modified MAI for use in the community pharmacy setting by testing interrater reliability using 3 different rating schemes. Methods Two raters evaluated 160 medications for 32 elderly ambulatory patients. Patient information was acquired using community pharmacist-collected medication histories. A summated MAI score, percent agreement, κ, positive agreement, negative agreement, and intraclass correlation coefficient were calculated for each criterion using 3 scoring schemes. A paired samples t-test (95% CI) was used to test interrater reliability. Results The κ statistics were >0.75 for indication and effectiveness, but good (0.41–0.66) for the remaining criteria using the Hanlon scoring scheme. The intraclass coefficients (0.82, 0.86, 0.87) and overall κ (0.65, 0.66, 0.61) were similar for the 3 schemes. Conclusions This study suggests that the modified MAI has the potential to detect medication appropriateness and inappropriateness in the community pharmacy setting; however, it is not without limitations. Because the MAI has the most clinimetric and psychometric data available, the instrument should be studied further to increase its reliability and generalizability.
The Impact of COVID-19 on Social Workers: An Assessment of Peritraumatic Distress
Authors: Miller J Jay , Grise-Owens Erlene 
Published: July 2021

Summary There is broad consensus that COVID-19 has had a pernicious impact on social work, in general, and among social work practitioners, more specifically. However, at present, very few, if any, empirical examinations of this impact exist. This exploratory study examined peritraumatic distress among a sample of social workers ( N = 3920) in one southeastern state in the United States. Findings Analysis suggests that distress is impacted by several variables. In general, participants identifying as male, married, reporting good physical and mental health, working in microcontexts, and who were finically secure tended to experience less COVID-19 associated distress. In addition, social workers identifying as LGBTQ* and who had been working mostly remotely experienced higher levels of distress. Applications Overall, findings indicate the need to provide adept support to social workers practicing during the pandemic. Data suggest the need for targeted support initiatives, typically for those who are from underrepresented groups (e.g., LGBTQ*) or experiencing financial or mental/physical health issues. Certainly, researchers should continue to examine the impact of COVID-19 on social work practitioners and service delivery.
Parenting in migration: Critical aspects and challenges of “doing family” of refugee families and social workers
Authors: Rania Nadia , Pinna Laura , Coppola Ilaria 
Published: July 2021

Summary Although migrant families comprise a small number of immigrants, they present a significant challenge for the host community. In the Italian context, social services support migrant families through paths to autonomy and integration in the community. The purpose of this study was to investigate perceptions that families and social workers have of “parenting” and “doing family” (training and management of family identity, roles and daily practices) in the complexity of migration. The study involved 15 immigrant parental couples, using family interview techniques and 12 social workers in 3 mini-focus groups. The collected materials were transcribed verbatim and analyzed using grounded theory. Findings The main results are identified and discussed as strengths, critical points and challenges. Some of the themes such as “willingness to work” or “lack of job opportunities” are common to both family members and social workers. Other themes are relevant to one group only. Among these, “availability and support of social workers” only emerged among families, whereas “education and respecting the rules” only emerged among social workers. Applications The results indicate that it is necessary for social workers to engage in a meaningful helping relationship with families, build networks of inclusion services, and also with the support of mediators overcome linguistic and cultural barriers. Social workers should involve families throughout he integration process. Furthermore, social services must also consider how families experience the difficulty of relating to social workers, which represents an obstacle to support for social integration.
Flow redirection endoluminal device (FRED) for treatment of intracranial aneurysms: A systematic review
Authors: Waqas Muhammad , Dossani Rimal H , Alkhaldi Modhi , Neveu Jocelyn , Cappuzzo Justin M , Lim Jaims , Khan Asham , Lazarov Victoria , Monteiro Andre , Davies Jason M , Siddiqui Adnan H , Levy Elad I 
Published: July 2021

Introduction The Flow Redirection Endoluminal Device (FRED; MicroVention) is a dual-layered flow diverter used for the treatment of intracranial aneurysms. The objective of this systematic review was to compile device-related safety and effectiveness data. Methods The literature from January 1, 2013 to April 30, 2021 was searched for studies describing use of the FRED for intracranial aneurysm treatment irrespective of aneurysm location and morphology. The review included anterior and posterior circulation ruptured and unruptured saccular, fusiform or dissection, and blister aneurysms. MeSH terms related to “flow re-direction endoluminal device” and “FRED for aneurysms” were used. Data related to indication, complications, and rates of aneurysm occlusion were retrieved and analyzed. Results Twenty-two studies with 1729 intracranial aneurysms were included in this review. Overall reported morbidity was 3.9% (range 0–20%). Overall procedure-related mortality was 1.4% (range 0–6%). Complication rates fell into 5 categories: technical (3.6%), ischemic (3.8%), thrombotic or stenotic (6%), hemorrhagic (1.5%), and non-neurological (0.8%). The aneurysm occlusion rate between 0 and 3 months (reported in 11 studies) was 47.8%. The occlusion rate between 4 and 6 months (reported in 14 studies) was 73.8%. Occlusion rates continued to increase to 75.1% at 7–12 months (reported in 10 studies) and 86.6% for follow-up beyond 1 year (reported in 10 studies). Conclusion This review indicated that the FRED is a safe and effective for the treatment of intracranial aneurysms. Future studies should directly compare the FRED with other flow diverters for a better understanding of comparative safety and effectiveness among the different devices.
Preoperative nutritional counselling in patients undergoing oesophagectomy
Authors: AlleaBelle Gongola M , Reif Rebecca J , Cosgrove Peggy C , Sexton Kevin W , Marino Katy A , Steliga Matthew A , Muesse Jason L 
Published: July 2021

Background Patients undergoing surgery for oesophageal cancer are at high risk of malnutrition due to pathology and neoadjuvent therapy. This study sought to determine if oesophageal cancer patients undergoing oesophagectomy achieve superior clinical outcomes when preoperative nutritional counselling is performed. Methods Oesophageal cancer patients undergoing oesophagectomy were retrospectively divided into cohorts based on those who received ( n = 48) and did not receive ( n = 58) preoperative nutritional counselling. We compared weight loss, length of stay, 30-day readmission related to nutrition or feeding tube problems, and 90-day mortality. Results Per cent weight loss was less in patients who received preoperative nutritional counselling. There was a trend toward decreased mean length of stay and there were fewer readmissions for feeding tube-related complications in patients who received counselling. Conclusions Nutritional counselling before surgery may lead to decreased weight loss and reduced readmissions for feeding tube-related complications in patients with oesophageal cancer undergoing oesophagectomy.
The Children's Anti-inflammatory Reliever (CARE) study: a protocol for a randomised controlled trial of budesonide-formoterol as sole reliever therapy in children with mild asthma
Authors: Hatter Lee , Bruce Pepa , Holliday Mark , Anderson Augustus J. , Braithwaite Irene , Corin Andrew , Eathorne Allie , Grimes Arthur , Harwood Matire , Hills Thomas , Kearns Ciléin , Kerse Kyley , Martindale John , Montgomery Barney , Riggs Lynn , Sheahan Davitt , Shortt Nick , Zazulia Katja , Weatherall Mark , McNamara David , Byrnes Catherine A. , Bush Andrew , Dalziel Stuart R. , Beasley Richard 
Published: July 2021

BackgroundAsthma is the most common chronic disease in children, many of whom are managed solely with a short-acting β2-agonist (SABA). In adults, the evidence that budesonide-formoterol as sole reliever therapy markedly reduces the risk of severe exacerbations compared with SABA alone has contributed to the Global Initiative for Asthma recommending against SABA monotherapy in this population. The current lack of evidence in children means it is unknown whether these findings are also relevant to this demographic. High-quality randomised controlled trials (RCTs) are needed.ObjectiveThe aim of this study is to determine the efficacy and safety of as-needed budesonide-formoterol therapy compared with as-needed salbutamol in children aged 5 to 15 years with mild asthma, who only use a SABA.MethodsA 52-week, open-label, parallel group, phase III RCT will recruit 380 children aged 5 to 15 years with mild asthma. Participants will be randomised 1:1 to either budesonide-formoterol (Symbicort Rapihaler®) 50/3 µg, two actuations as needed, or salbutamol (Ventolin®) 100  µg, two actuations as needed. The primary outcome is asthma attacks as rate per participant per year. Secondary outcomes assess asthma control, lung function, exhaled nitric oxide and treatment step change. A cost-effectiveness analysis is also planned.ConclusionThis is the first RCT to assess the safety and efficacy of as-needed budesonide-formoterol in children with mild asthma. The results will provide a much-needed evidence base for the treatment of mild asthma in children.
An adaptation strategy to urban heat: hospital rooms with radiant cooling accelerate patient recovery
Authors: Hoffmann Christina , Liebers Uta , Humbsch Philipp , Drozdek Marija , Bölke Georg , Hoffmann Peter , Holzgreve Adrien , Donaldson Gavin C. , Witt Christian 
Published: July 2021

BackgroundPatients with respiratory diseases are vulnerable to the effects of heat. Therefore, it is important to develop adaptation strategies for heat exposure. One option is to optimise the indoor environment. To this end, we equipped hospital patient rooms with radiant cooling. We performed a prospective randomised clinical trial to investigate potentially beneficial effects of the hospitalisation in rooms with radiant cooling on patients with a respiratory disease exacerbation.MethodsRecruitment took place in June, July and August 2014 to 2016 in the Charité – Universitätsmedizin Berlin, Germany. We included patients with COPD, asthma, pulmonary hypertension, interstitial lung disease and pneumonia. 62 patients were allocated to either a standard patient room without air conditioning or a room with radiant cooling set to 23°C (73°F). We analysed the patients’ length of stay with a Poisson regression. Physiological parameters, fluid intake and daily step counts were tested with mixed regression models.ResultsPatients hospitalised in a room with radiant cooling were discharged earlier than patients in standard rooms (p=0.003). The study participants in chambers with radiant cooling had a lower body temperature (p=0.002), lower daily fluid intake (p<0.001), higher systolic blood pressure (p<0.001) and an increased daily step count (p<0.001).ConclusionThe results indicate that a radiant cooling system in hospital patient rooms provides clinical benefits for patients with respiratory disease exacerbations during the warm summer months, which may contribute to an earlier mobilisation. Radiant cooling is commended as a suitable adaptation strategy to reduce the clinical impact of climate warming.
Angiotensin-converting enzyme 2 gene expression in human male urological tissues: implications for pathogenesis and virus transmission pathways
Authors: Al-Benna Sammy 
Published: July 2021

Abstract
Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection occurs through binding and internalization of the viral spike protein to the angiotensin-converting enzyme 2 (ACE2) receptor on the host cell membrane. Pathological changes are caused by damage and failure of vital organs that express high levels of ACE2, including the lungs, the heart and the kidneys. The aim of this study was to investigate ACE2 gene expression in the human male urogenital tract using a public database.

Methods
A search of transcriptomic datasets from a database to investigate ACE2 gene expression in human urogenital tract tissue.

Results
The gene expression profile demonstrated that ACE2 gene expression was higher in human kidney cortex and testis than human lung tissue. The gene expression profile demonstrated that ACE2 gene expression in the human bladder and prostate was comparable to human lung tissue.

Conclusions
Male urogenital tissues are directly susceptible to SARS-CoV-2 infection through the expression of ACE2. Moreover, the SARS-Cov-2/ACE2 interaction may disturb the male genital and reproductive functions.