bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 100: Clinical impact of United States Preventive Services Task Force screening recommendations for abdominal aortic aneurysm: Analysis of Nationwide Inpatient Sample data
Authors: Aggarwal Sourabh , Malik Devin , Schauer Mark 
Published: December 2021

Introduction:
An abdominal aortic aneurysm (AAA) is defined when infra-renal aortic diameter is at least 3.0 cm. The United States Preventive Services Task Force recommended in 2005 that all men between the ages of 65 to 75 years who have ever smoked should be screened once for AAA by abdominal ultrasonography. However, the clinical impact of these recommendations are unknown.

Methods:
We queried Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) data for AAA and AAA rupture using ICD9 codes 441.4 and 441.3 respectively. The NIS represents 20% of all hospitals data in the US. All the data was extracted for years 2000-2010. Total hospitalizations and in-hospital mortality for pre-screening years (2000-2004) was compared with post-screening years (2006-2010) for both AAA and AAA rupture.

Results:
A total of 527,801 hospitalizations secondary to AAA and AAA rupture were analyzed for the study period.

Hospitalizations from AAA decreased from 61.72 to 58.77 per 10,000 total hospitalizations with in-hospital mortality decreasing from 3.5% to 2.12% (p value <0.001). On sub-analysis, the decrease in hospitalizations was significant in 65-84 age group (77.19 to 74.54 per 100 AAA admissions, p <0.001), with significant increase in 84+ age group (6.37 to 8.6 per 100 AAA admissions, p<0.001) and non-significant increase in 45-64 age group (16.16 to 16.51 per 100 AAA admissions, p value >0.05). Decrease in mortality was uniform in all age and gender sub-groups.
The hospitalizations from AAA rupture decreased from 9.51 to 7.03 per 10,000 total hospitalizations (p<0.001) with mortality decreasing from 49.9% to 44.6% (p value <0.001). On sub-analysis decrease in hospitalizations was reciprocated in 65-84 age group (70.08 to 64.94 per 100 AAA rupture admissions, p value <0.001) and males (73.23 to 71.7 per 100 AAA rupture admissions, p value <0.001). However, hospitalizations from AAA rupture increased in age group 45-64 (14.41 to 15.43 per 100 AAA rupture admissions, p value <0.001), age 84+ (15.21 to 19.2 per 100 AAA rupture admissions, p value < 0.001) and females (26.28 to 28.28 per 100 AAA rupture admissions, p value <0.001). In-hospital mortality from AAA rupture decreased in all age and gender sub-groups independently.

Conclusion:
Our study reveals that post screening recommendations, hospitalizations for AAA decreased significantly in the age group 65-84 years. Also, hospitalizations from AAA rupture decreased in males and age group 65-84, with increase in other age sub groups (45-64 and 84+) and females. Thus, screening recommendations have resulted in decreased hospitalizations in specified age-gender subgroup likely from early recognition and better control of risk factors as outpatient. Our study also makes case to consider extension of recommendations to include other susceptible groups though prospective studies might be needed to support the data.
Abstract 105: Obesity Paradox in Patients with Non-Hemorrhagic Stroke: Increased Short-Term Survival with Decreased Longevity
Authors: Ashamalla Michael , Yager Neil , Pieper Justin , Sedhom Daniel , Ghate Ketan , Shkolnik Boris , Torosoff Mikhail 
Published: December 2021

Background:
Obesity is associated with improved outcomes in patients with congestive heart failure and/or coronary artery disease; the obesity paradox. Effects of obesity on mortality in non-hemorrhagic stroke patients have not been well investigated.

Material and Methods:
Retrospective chart review was performed in 146 consecutive patients treated for non-hemorrhagic stroke at a single academic medical center. Patients were divided in to 4 groups according to their BMI: Group I with BMI (0-18.5 kg/m
2
)-4 patients (3%) Group II BMI (18.6-25 kg/m
2
)-51 patients (35%), Group III BMI (26-30 kg/m
2
)-46 patients (32%), and Group IV BMI (31+)-45 patients (31%). Long-term outcomes were ascertained through the National Death Index. This study was approved by the institutional IRB.

Results:
Prevalence of CAD, female gender, hypertension, atrial fibrillation, hyperlipidemia, PVD and chronic kidney disease were similar between BMI groups.

Overweight patients with non-hemorrhagic stroke were younger, with an increased incidence of diabetes (4% in Group II, 25% in Group III, and 37% in Group IV, p<0.0016). There was a trend of increased prevalence of hypertension in overweight patients with non-hemorrhagic stroke (51% in Group II, 55% in Group III, and 70% in Group IV, p=0.3146).
Lower BMI was associated with increased short-term mortality (52% in Group II, 33% in Group III and 12% in Group IV, p <0.004). Despite improved short term mortality, the overall longevity in obese stroke patients were significantly reduced, as compared to patients with normal weight. Average age at time of death was 86+/- 9.6 years old in Group II patients, 76 +/- 15 years old in Group III, and 76 +/- 9.8 years old in Group IV patients, p<0.003 for Group III vs. II and p<0.001 in Group IV vs. II)

Conclusions:
Obese patients present with non-hemorrhagic stroke at a younger age. Despite short term improved outcomes, obesity is not associated with improved overall longevity.
Public servants working from home: Exploring managers’ changing allowance decisions in a COVID-19 context
Authors: Williamson Sue , Colley Linda , Foley Meraiah 
Published: December 2021

AbstractBefore the COVID-19 pandemic forced large sections of the workforce to work from home, the uptake of working from home in the public sector had been limited and subject to the discretion or ‘allowance decisions’ of individual managers. Allowance decisions are influenced by factors at the organisational, group and individual levels. This research examines managers’ allowance decisions on working from home at each of these levels. It compares two qualitative datasets: one exploring managerial attitudes to working from home in 2018 and another dataset collected in mid-2020, as Australia transitioned out of the initial pandemic lockdown. The findings suggest a change in the factors influencing managers’ allowance decisions. We have identified a new factor at the organisational level, in the form of local organisational criteria. At the group level, previous concerns about employee productivity largely vanished, and managers experienced an epiphany that working from home could be productive. At the individual level, a new form of managerial discretion emerged as managers attempted to reassert authority over employees working remotely. These levels intersect, and we conclude that allowance decisions are fluid and not made solely by managers but are the result of the interactions between the organisational, group and individual levels.
Anti-inflammatory and protective effects of combined treatment with sitagliptin and melatonin in cardiac ischemia reperfusion injury in obese rats: Involvement of TLR-4/NF-κB pathway
Authors: Sun Hailei , Zhou Zhengchun , Xuan Haiyang , Yan Zhongya 
Published: December 2021

Background: Obesity is associated with an augmented risk of myocardial ischemia/reperfusion (I/R) injury. Reduction of I/R injury by effective cardioprotective strategies needs to be investigated in obese subjects. This study aimed to evaluate the combined effects of sitagliptin and melatonin on inflammatory response and TLR4/IκBα/NF-κB signaling following cardiac I/R damage in obese rats. Methods: Sixty-six male Wistar rats (180–200 g) were fed a low fat diet (10% Kcal from lipids) or high fat (45% Kcal from lipids) diets for 12 weeks. High fat-fed (obese) rats experienced 30 min left anterior descending occlusion followed by 24 h reperfusion. Obese rats received sitagliptin (20 mg/kg/day) for 1 month before I/R surgery. Melatonin (10 mg/kg) was injected at early reperfusion. Myocardial infarct size (IS), cTn-I release, pro-inflammatory cytokines, myeloperoxidase (MPO), COX-2 and iNOS, and the protein expressions of TLR4, p-NF-κB/p65, and p-IκBα were evaluated. Results: Monotherapies with sitagliptin-preconditioning or melatonin-postconditioning had no cardioprotective effects in obese rats. However, combined therapy with sitagliptin and melatonin significantly reduced IS, and the release of cTn-I, in comparison to untreated obese rats ( p < .01) Moreover, this combination decreased the production of pro-inflammatory cytokines, MPO, COX-2 and iNOS, and the expression of TLR4 and p-NF-κB/p65, while reduced the expression of p-IκBα, in comparison with untreated or monotherapies-received obese rats ( p < .01 for all). Conclusion: Combination therapy with sitagliptin and melatonin was a good cardioprotective strategy to modulate the inflammatory responses and TLR4/NF-κB signaling pathway in obese patients with cardiac I/R injury.
Longitudinal Effects of Supported Exercise on Elevated Anxiety and Depression Scores in Formerly Sedentary Adults With Severe Obesity
Authors: Annesi James J. 
Published: December 2021

Persistent anxiety and depression may be particularly high in individuals with obesity. Increasing exercise reliably improves mood in the general population; however, it has rarely been tested specifically in adults with severe obesity. Volunteer participants (60% women) of a theory-based cognitive-behavioral weight-management treatment with severe obesity and elevated (highest 10% based on normative values) depression ( N = 89) or anxiety ( N = 60) were assessed at baseline and Month 6 on measures of exercise output (overall, and whether the equivalent of three moderate sessions/week [i.e., ≥ 15 METs/week] were completed), corresponding mood, and exercise barriers self-efficacy. There were significant improvements (large effect sizes) in exercise outputs and mood. Increase in exercise outputs was significantly associated with reduced depression (β = −.52) and anxiety (β = −.67) scores. At least 15 METs/week of exercise was reached by 61% and 60% of participants, respectively. Participants demonstrated significantly greater reductions in depression and anxiety scores over 6 months than those completing lower amounts. Change in exercise barriers self-efficacy significantly mediated the following: (a) the prediction of depression change by change in exercise output and (b) the prediction of change in anxiety by completion/non-completion of ≥ 15 METs/week of exercise. Findings suggest substantial benefits for depression and anxiety in adults with severe obesity under conditions of moderate exercise supported by a community-based cognitive-behavioral treatment. Because of its identified mediation properties, future behavioral treatments should seek to increase barriers self-efficacy to maximize effects on elevated depression and anxiety and possibly weight.
Clinical characteristics and outcome of genitourinary tuberculosis in Sri Lanka: an observational study
Authors: Jayarajah Umesh , Gunawardene Milan , Willaraarachchi Munipriya , Chandrasiri Shirani , Udayakumaran Perumal , Sosai Cherine , Abeygunasekera Anuruddha 
Published: December 2021

Abstract
Background
Although genitourinary Tuberculosis (GUTB) is the second commonest source of extrapulmonary TB in most countries, the reported rate of GUTB in Sri Lanka remains low. The characteristics of GUTB in Sri Lanka have not been studied and documented so far. We aimed to study the clinical and imaging characteristics, treatment modalities and outcome of GUTB in Sri Lanka.

Methods
Data collected from patients treated by a single urological surgeon in two institutes consecutively over a period of 21 years were analysed. All patients with a microbiological and/or histopathological diagnosis of GUTB were included. Median duration of follow-up was 24 months (range: 6–96).

Results
There were 82 patients and 45 (54.9%) were men. The median age was 51 (range: 26–75) years. Most patients (39%, n = 32) had vague non-specific symptoms at presentation. Common specific symptoms at presentation were haematuria (15.8%, n = 13) and scrotal manifestations (15.8%, n = 13). Mantoux test was done in 70 patients and was > 10 mm in 62 (88.5%). Erythrocyte sedimentation rate was available in 69 patients and was > 30 mm in 54 (78.3%) patients. Chest x-ray and x-ray kidney-ureter-bladder (KUB) abnormalities were detected in 9 (11%) and 6 (7.3%) respectively. CT-urography was performed in 72 patients and abnormalities were detected in 57 (79%) patients. Forty-two patients underwent cystoscopy and 73.8% (n = 31) had abnormal findings. Microbiological diagnosis was feasible in 43 (52.4%) and rest were diagnosed histopathologically. Commonest organs involved were kidney (64.6%, n = 53), ureter (51.2%, n = 42), bladder (43.9%, n = 36) and testis/epididymis (15.8%, n = 13). One patient had TB of the prostate. All were treated primarily with anti-TB drugs however, 50 (61%) required ancillary therapeutic interventions. The majority of interventions were reconstructive surgeries (n = 20, 24.4%) followed by excisional surgeries (n = 19, 23.2%) and drainage procedures (n = 11, 13.4%). Seven patients developed serious adverse reactions to anti-TB drugs. Five patients developed a thimble bladder with disabling storage symptoms. Eight patients had deranged renal functions at diagnosis and three patients developed progressive deterioration of renal function and two patients died of end stage renal disease.

Conclusions
The combination of urine for acid-fast bacilli, Mantoux test, CT-Urography, cystoscopy and histopathology is necessary to diagnose GUTB in resource-poor settings. Most ureteric strictures, non-functioning kidneys and epididymal masses need surgical treatment. Long-term follow up is essential to detect progressive deterioration of renal function.
Development of a novel multifocal lens using a polarization directed flat lens: possible candidate for a multifocal intraocular lens
Authors: Na Kyung-Sun , Lee Chang Su , Kim Da Ran , Song Seok Ho , Cho Soo Yeon , Kim Eun Chul , Kim Hyun Seung , Hwang Ho Sik 
Published: December 2021

Abstract
Background
A polarization-directed flat (PDF) lens acts as a converging lens with a focal length (f) > 0 and a diverging lens with f < 0, depending on the polarization state of the incidental light. To produce a multifocal lens with two focal lengths, a PDF and a converging lens having shorter focal length were combined. In this study, we tested a bifocal PDF to determine its potential as a new multifocal intraocular lens (IOL).

Methods
Constructed a multifocal lens with a PDF lens (f = +/− 100 mm) and a converging lens (f = + 25 mm). In an optical bench test, we measured the defocus curve to test the multifocal function. The multifocal function and optical quality of the lens in various situations were tested. An Early Treatment Diabetic Retinopathy Study (ETDRS) chart as a near target and a building as a distant target were photographed using a digital single-lens reflex (DSLR) camera. Both lenses (multifocal and monofocal) were tested under the same conditions.

Results
For the 0 D and − 20 D focal points, the multifocal lens showed sharp images in the optical bench test. In the DSLR test using the multifocal lens, the building appeared slightly blurry compared with the results using the monofocal lens. With the multifocal lens, the ETDRS chart’s images became blurry as the ETDRS chart’s distance decreased, but became very clear again at a certain position.

Conclusions
We confirmed the multifocal function of the multifocal lens using a PDF lens. This lens can be used as a multifocal IOL in the future.
Absorbance or organization into ankylosis: a microarray analysis of haemarthrosis in a sheep model of temporomandibular joint trauma
Authors: Jiao Mai-Ning , Zhang Tong-Mei , Yang Kun , Xu Zhao-Yuan , Zhang Guan-Meng , Tian Yuan-Yuan , Liu Hao , Yan Ying-Bin 
Published: December 2021

Abstract
Background
Traumatic haemarthrosis was hypothesized to be the etiology of temporomandibular (TMJ) ankylosis. Here, taking haematoma absorbance as a control, we aimed to reveal the molecular mechanisms involved in haematoma organizing into ankylosis using transcriptome microarray profiles.

Material/methods
Disk removal was performed to building haematoma absorbance (HA) in one side of TMJ, while removal of disk and articular fibrous layers was performed to induced TMJ ankylosis through haematoma organization (HO) in the contralateral side in a sheep model. Haematoma tissues harvested at days 1, 4 and 7 postoperatively were examined by histology, and analyzed by Affymetrix OviGene-1_0-ST microarrays. The DAVID were recruited to perform the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis for the different expression genes (DEGs). The DEGs were also typed into protein–protein interaction (PPI) networks to get the interaction data. Six significant genes screened from PPI analysis, were confirmed by real-time PCR.

Results
We found 268, 223 and 17 DEGs at least twofold at days 1, 4 and 7, respectively. At day 1, genes promoting collagen ossification (POSTN, BGN, LUM, SPARC), cell proliferation (TGF-β), and osteogenic differentiation of mesenchymal stem cells (BMP-2) were up-regulated in the HO side. At day 4, several genes involved in angiogenesis (KDR, FIT1, TEK) shower higher expression in the HO side. While HA was characterized by a continuous immune and inflammatory reaction.

Conclusions
Our results provide a comprehensive understanding of the role of haematoma in the onset and progress of TMJ ankylosis. The study will contribute to explaining why few injured TMJs ankylose and most do not from the molecular level.
Examining transcranial random noise stimulation as an add-on treatment for persistent symptoms in schizophrenia (STIM’Zo): a study protocol for a multicentre, double-blind, randomized sham-controlled clinical trial
Authors: Brunelin Jerome , Mondino Marine , Haesebaert Julie , Attal Jerome , Benoit Michel , Chupin Marie , Dollfus Sonia , El-Hage Wissam , Galvao Filipe , Jardri Renaud , Llorca Pierre Michel , Magaud Laurent , Plaze Marion , Schott-Pethelaz Anne Marie , Suaud-Chagny Marie-Françoise , Szekely David , Fakra Eric , Poulet Emmanuel 
Published: December 2021

Abstract
Background
One out of three patients with schizophrenia failed to respond adequately to antipsychotics and continue to experience debilitating symptoms such as auditory hallucinations and negative symptoms. The development of additional therapeutic approaches for these persistent symptoms constitutes a major goal for patients. Here, we develop a randomized-controlled trial testing the efficacy of high-frequency transcranial random noise stimulation (hf-tRNS) for the treatment of resistant/persistent symptoms of schizophrenia in patients with various profiles of symptoms, cognitive deficits and illness duration. We also aim to investigate the biological and cognitive effects of hf-tRNS and to identify the predictors of clinical response.

Methods
In a randomized, double-blind, 2-arm parallel-group, controlled, multicentre study, 144 patients with schizophrenia and persistent symptoms despite the prescription of at least one antipsychotic treatment will be randomly allocated to receive either active (n = 72) or sham (n = 72) hf-tRNS. hf-tRNS (100–500 Hz) will be delivered for 20 min with a current intensity of 2 mA and a 1-mA offset twice a day on 5 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporoparietal junction. Patients’ symptoms will be assessed prior to hf-tRNS (baseline), after the 10 sessions, and at 1-, 3- and 6-month follow-up. The primary outcome will be the number of responders defined as a reduction of at least 25% from the baseline scores on the Positive and Negative Syndrome Scale (PANSS) after the 10 sessions. Secondary outcomes will include brain activity and connectivity, source monitoring performances, social cognition, other clinical (including auditory hallucinations) and biological variables, and attitude toward treatment.

Discussion
The results of this trial will constitute a first step toward establishing the usefulness of hf-tRNS in schizophrenia whatever the stage of the illness and the level of treatment resistance. We hypothesize a long-lasting effect of active hf-tRNS on the severity of schizophrenia symptoms as compared to sham. This trial will also have implications for the use of hf-tRNS as a preventive intervention of relapse in patients with schizophrenia.

Trial registration
ClinicalTrials.gov NCT02744989. Prospectively registered on 20 April 2016
Failure of a single day metronidazole desensitization protocol, and success of a modified two-day protocol in an outpatient setting
Authors: Cahill Julia A. , Sahota Preena Simritpreet , Kan Manstein 
Published: December 2021

Abstract
Background
True allergy to metronidazole, a common anti-infective in clinical practice, is rarely reported in the literature. In the case of Trichomonas, there are few alternatives to the nitrimidazole class of drugs, and the alternatives that do exist are associated with worse clinical outcomes. Accordingly, for the rare patients with Type 1 hypersensitivity reactions to metronidazole but compelling need, desensitization protocols have been adapted previously. Reactions during these protocols appear common. Patients in previous regimens have required higher level care for observation, which is costly and resource-intensive.

Case presentation
We report here on a successful outpatient two-day regimen for metronidazole desensitization. Our patient had compelling indication for metronidazole, but reacted after receiving the very first dose of a previously described desensitization protocol. Accordingly, the protocol was adapted further. Despite this, she went on to develop objective hives prior to reaching the full intended dose. With appropriate symptom management and pre-medication on the second day in clinic, she was successfully desensitized and able to complete a week of full-dose metronidazole. No acute care resources were needed.

Conclusion
We propose this two-day desensitization regimen for patients who react during the previously described desensitization protocols. This regimen was effective and safe, and did not necessitate the use of acute-care resources. Two-day desensitization protocols while relatively uncommon, can be successful.