bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clozapine-induced myocarditis: electronic health register analysis of incidence, timing, clinical markers and diagnostic accuracy
Authors: Segev Aviv , Iqbal Ehtesham , McDonagh Theresa A. , Casetta Cecilia , Oloyede Ebenezer , Piper Susan , Plymen Carla M. , MacCabe James H. 
Published: June 2021

BackgroundClozapine is associated with increased risk of myocarditis. However, many common side-effects of clozapine overlap with the clinical manifestations of myocarditis. As a result, there is uncertainty about which signs, symptoms and investigations are important in distinguishing myocarditis from benign adverse effects of clozapine. Clarity on this issue is important, since missing a diagnosis of myocarditis or discontinuing clozapine unnecessarily may both have devastating consequences.AimsTo examine the clinical characteristics of clozapine-induced myocarditis and to identify which signs and symptoms distinguish true myocarditis from other clozapine adverse effects.MethodA retrospective analysis of the record database for 247 621 patients was performed. A natural language processing algorithm identified the instances of patients in which myocarditis was suspected. The anonymised case notes for the patients of each suspected instance were then manually examined, and those whose instances were ambiguous were referred for an independent assessment by up to three cardiologists. Patients with suspected instances were classified as having confirmed myocarditis, myocarditis ruled out or undetermined.ResultsOf 254 instances in 228 patients with suspected myocarditis, 11.4% (n = 29 instances) were confirmed as probable myocarditis. Troponin and C-reactive protein (CRP) had excellent diagnostic value (area under the curve 0.975 and 0.896, respectively), whereas tachycardia was of little diagnostic value. All confirmed instances occurred within 42 days of clozapine initiation.ConclusionsSuspicion of myocarditis can lead to unnecessary discontinuation of clozapine. The ‘critical period’ for myocarditis emergence is the first 6 weeks, and clinical signs including tachycardia are of low specificity. Elevated CRP and troponin are the best markers for the need for further evaluation.
Concomitant Peripheral Neuropathy and Type 2 Diabetes Impairs Postexercise Cutaneous Perfusion and Flowmotion
Authors: Reynès Cécile , Beaume Jean-Baptiste , Latil-Plat Françoise , Ennaifer Houda , Rocher Laure , Antoine-Jonville Sophie , Benamo Eric , Knapp Yannick , Vinet Agnès 
Published: June 2021

Abstract

Context
Type 2 diabetes and peripheral neuropathy exhibit microvascular dysfunction at rest. However, data regarding their microvascular perfusion during exercise remain scarce.

Objective
This study investigated changes in microvascular perfusion during postexercise recovery in those with type 2 diabetes, with or without peripheral neuropathy, as well as in healthy controls and those with obesity.

Methods
Skin blood perfusion was assessed in each group using laser Doppler flowmetry (LDF) and laser speckle contrast imaging before and immediately after a 6-minute walking test. LDF recordings underwent wavelet transformation to allow specific control mechanisms of blood perfusion to be studied (eg, endothelial nitric oxide–independent and –dependent, neurogenic, myogenic, respiratory, and cardiac mechanisms).

Results
Skin blood perfusion increased after exercise in all groups (22.3 ± 28.1% with laser speckle contrast imaging and 22.1 ± 52.5% with LDF). Throughout postexercise recovery, the decrease was blunted in those with subclinical peripheral neuropathy and confirmed peripheral neuropathy when compared to the other 3 groups. After exercise, total spectral power increased in all groups. The relative contributions of each endothelial band was lower in those with confirmed peripheral neuropathy than in the healthy controls and those with obesity (nitric oxide–dependent function: 23.6 ± 8.9% vs 35.5 ± 5.8% and 29.3 ± 8.8%, respectively; nitric oxide–independent function: 49.1 ± 23.7% vs 53.3 ± 10.4% and 64.6 ± 11.4%, respectively). The neurogenic contribution decreased less in those with confirmed peripheral neuropathy and in those with type 2 diabetes alone, compared to those with subclinical peripheral neuropathy and those with obesity (–14.5 ± 9.9% and –12.2 ± 6.1% vs –26.5 ± 4.7% and –21.7 ± 9.4%, respectively).

Conclusion
Peripheral neuropathy, whatever the stage, altered the microvascular response to exercise via impaired endothelial and neurogenic mechanisms.
Relationship Between Insulin Sensitivity and Menstrual Cycle Is Modified by BMI, Fitness, and Physical Activity in NHANES
Authors: MacGregor Kirstin A , Gallagher Iain J , Moran Colin N 
Published: June 2021

Abstract

Context
There is evidence demonstrating variation in insulin sensitivity across the menstrual cycle. However, to date, research has yielded inconsistent results.

Objective
This study investigated variation in insulin sensitivity across the menstrual cycle and associations with body mass index (BMI), physical activity, and cardiorespiratory fitness (CRF).

Methods
Data from 1906 premenopausal women in NHANES cycles 1999 to 2006 were analyzed. Menstrual cycle day was assessed using questionnaire responses recording days since last period. Rhythmic variation of plasma glucose, triglycerides, and insulin, homeostatic model of insulin resistance (HOMA-IR), and adipose tissue insulin resistance index (ADIPO-IR) across the menstrual cycle were analyzed using cosinor rhythmometry. Participants were assigned low or high categories of BMI, physical activity, and CRF, and category membership included in cosinor models as covariates.

Results
Rhythmicity was demonstrated by a significant cosine fit for glucose (P = .014) but not triglycerides (P = .369), insulin (P = .470), HOMA-IR (P = .461), and ADIPO-IR (P = .335). When covariates were included, rhythmicity was observed when adjusting for: 1) BMI: glucose (P &lt; .001), triglycerides (P &lt; .001), insulin (P &lt; .001), HOMA-IR (P &lt; .001), and ADIPO-IR (P &lt; .001); 2) physical activity: glucose (P &lt; .001), triglycerides (P = .006), and ADIPO-IR (P = .038); and 3) CRF: triglycerides (P = .041), insulin (P = .002), HOMA-IR (P = .004), and ADIPO-IR (P = .004). Triglyceride amplitude, but not acrophase, was greater in the high physical activity category compared to low (P = .018).

Conclusion
Rhythmicity in insulin sensitivity and associated metabolites across the menstrual cycle are modified by BMI, physical activity, and CRF.
Enhancing Gonadotrope Gene Expression Through Regulatory lncRNAs
Authors: Refael Tal , Melamed Philippa 
Published: June 2021

Abstract
The world of long non-coding RNAs (lncRNAs) has opened up massive new prospects in understanding the regulation of gene expression. Not only are there seemingly almost infinite numbers of lncRNAs in the mammalian cell, but they have highly diverse mechanisms of action. In the nucleus, some are chromatin-associated, transcribed from transcriptional enhancers (eRNAs) and/or direct changes in the epigenetic landscape with profound effects on gene expression. The pituitary gonadotrope is responsible for activation of reproduction through production and secretion of appropriate levels of the gonadotropic hormones. As such, it exemplifies a cell whose function is defined through changes in developmental and temporal patterns of gene expression, including those that are hormonally induced. Roles for diverse distal regulatory elements and eRNAs in gonadotrope biology have only just begun to emerge. Here, we will present an overview of the different kinds of lncRNAs that alter gene expression, and what is known about their roles in regulating some of the key gonadotrope genes. We will also review various screens that have detected differentially expressed pituitary lncRNAs associated with changes in reproductive state and those whose expression is found to play a role in gonadotrope-derived nonfunctioning pituitary adenomas. We hope to shed light on this exciting new field, emphasize the open questions, and encourage research to illuminate the roles of lncRNAs in various endocrine systems.
Exorbitant Dust
Authors: León Christina A. 
Published: June 2021

AbstractThis article traces the figure of polvo (dust) across the writing career of Puerto Rican and New York writer Manuel Ramos Otero. Polvo heralds the macabre sensuality of his early short stories, long before his diagnosis with HIV, and persists and morphs through his later essays and poetry up until his eventual death in 1990 from AIDS complications. Writing defiantly as a queer, a feminist, a Puerto Rican, and a sidoso, he produced work that invites death and desire to commingle through a figuration of dust, as a scattered substance that covers skin, coats translation, and dirties conventional genres. Polvo illuminates the dimensions and risks of relation as a particulate matter that exposes our porosity—clinging and hovering in the space between bodies, between the past and the future, between life and death. As the dust settles in the wake of Hurricane María, so too can polvo be read as prescient for how coloniality lingers as enduring conditions of debility and precarity. Ramos Otero's affinity for finitude, figured through polvo, counterintuitively conjures a relational desire that privileges the porous, the marginal, and the always precarious possibility of survival. Polvo moves across the different genres and phases of Ramos Otero's work as a matter that refuses to disentangle the material realities of queerness and coloniality.
Juvenile hormone affects age polyethism, ovarian status and cuticular hydrocarbon profile in workers of the waspPolybia occidentalis
Authors: Prato Amanda , da Silva Rafael C. , Assis Diego S. , Mateus Sidnei , Hartfelder Klaus , do Nascimento Fabio S. 
Published: June 2021

ABSTRACTDivision of labor is one of the most striking features in the evolution of eusociality. Juvenile hormone (JH) mediates reproductive status and aggression among nestmates in primitively eusocial Hymenoptera (species without morphologically distinct castes). In highly social species it has apparently lost its gonadotropic role and primarily regulates the division of labor in the worker caste. Polybia occidentalis, a Neotropical swarm-founding wasp, is an ideal model to understand how JH levels mirror social context and reproductive opportunities because of the absence of a clear morphological caste dimorphism. In this study, we tested the hypothesis that JH influences division of labor, ovary activation and cuticular hydrocarbon profiles of workers. Our observations confirmed that a JH analog (methoprene) and an inhibitor of JH biosynthesis (precocene) affected the cuticular chemical profile associated with age polyethism. Also, methoprene and precocene-I treatment of females influenced ovarian activation differently (individuals treated with methoprene expressed more activated ovaries while precocene treatment did not have significant effect). These results suggest that different hormonal levels induce a differential expression of cuticular chemicals associated with workers’ age polyethism, which may be essential for keeping the social cohesion among workers throughout their lives in the colony. Furthermore, JH is likely to play a gonadotropic role in P. occidentalis. JH has apparently undergone certain modifications in social Hymenoptera, presenting multifaceted functions in different species.
CT findings of acute radiation-induced pneumonitis in breast cancer
Authors: Jung Wonguen , Shim Sung Shine , Kim Kyubo 
Published: June 2021

Objectives: To evaluate the CT findings of acute radiation pneumonitis (RP) in breast cancer patients undergoing post-operative radiotherapy, and to analyze clinicodosimetric factors associated with acute RP. Methods: Between 2015 and 2017, 61 patients with breast cancer who underwent follow-up chest CT at 3 months after radiotherapy were analyzed. The degree of acute RP on CT was evaluated by the change of extent and scoring system (grade 0, no RP; Grade 1, ground-glass opacities (GGOs); Grade 2, GGOs and/or consolidations; Grade 3, clear focal consolidation; Grade 4, dense consolidation). The dosimetric parameters were calculated from the dose–volume histogram of RT. Results: The acute RP on CT was scored as follows: Grade 0, in 37.7%, Grade 1 in 13.1%, Grade 2 in 44.3%, and Grade 3 in 4.9%. The median extent of RP in patients with Grades 1 to 3 was 6.2 ml (range, 0.2–95.9). There were no clinicodosimetric factors significantly associated with the presence of RP or its severity. One patient developed symptomatic RP. Conclusion: This study showed no correlation between acute RP and clinicodosimetric factors, and acute RP based on CT findings were much more common than symptomatic RP. Advances in knowledge: CT findings of acute RP or extent of RP were not significantly related to clinicodosimetric factors in breast cancer patients.
In vitro assessment of periapical lesions created in sheep mandibles by using high resolution ultrasonography and cone beam computed tomography
Authors: Kamburoğlu Kıvanç , Çakmak Esra Ece , Eratam Nejlan , Sönmez Gül , Karahan Sevilay 
Published: June 2021

Objectives: Providing ultrasound images of periapical lesions may be problematic depending on the thickness of the overlying cortical bone. Clinically, it is crucial to determine the cut-off value of overlaying bone thickness in terms of interference with ultrasound imaging in conjunction with assessment of changes in periapical jaw bone lesions. Our aim was to determine the minimum amount of overlaying buccal bone thickness of artificial periapical lesions in order to be visible by ultrasound imaging and to compare width, height, depth, surface area and volume measurements of detectable periapical lesions obtained from ultrasound and CBCT images. Methods: Periapical lesions were created in 16 molar teeth of sheep mandibles. Cavities were enlarged until the borders of lesions were visible on 14 MHz hockey probe ultrasound imaging. CBCT and ultrasound images were obtained simultaneously after drilling and enlarging each size of the cavities and replacing the teeth in their sockets. two observers separately assessed images twice within 2 weeks of interval. By using CBCT and ultrasound images, buccal bone thickness, maximum width, height, depth, surface area and volume of periapical lesions were measured. Intraclass correlation coefficient (ICC) was utilized and significance level was set at p < 0.05. Results: The mean buccal bone thickness ranged between 1.21 mm and 1.31 mm for both imaging techniques. For the measurement of buccal bone thickness, periapical lesion width, height, depth, surface area, and volume excellent ICC values were found in terms of intrarater (ranging between 0.907 and 1) and inter-rater (ranging between 0.864 and 1) reliability for both observers and their readings. There were no statistically significant differences for both observers and for their two readings between ultrasound and CBCT measurements of buccal bone thickness, and periapical lesion width and height (p > 0.05). Conclusions: We suggested that a buccal thickness of approximately 1.28 mm might be accepted as a cut-off value for the detection of periapical lesions with 14 MHz hockey probe ultrasound. High resolution ultrasound provided accurate information for the measurement of buccal bone thickness and lesion width and height.
A new analysis approach for single nephron GFR in intravital microscopy of mice
Authors: Kessel Friederike , Kröger Hannah , Gerlach Michael , Sradnick Jan , Gembardt Florian , Todorov Vladimir , Hugo Christian 
Published: June 2021

Background: Intravital microscopy is an emerging technique in life science with applications in kidney research. Longitudinal observation of (patho-)physiological processes in living mice is possible in the smallest functional unit of the kidney, a single nephron (sn). In particular, effects on glomerular filtration rate (GFR) - a key parameter of renal function - can be assessed. Methods: After intravenous injection of a freely filtered, non-resorbable, fluorescent dye in C57BL/6 mice, a time series was captured by multiphoton microsopy. Filtration was observed from the glomerular capillaries to the proximal tubule (PT) and the tubular signal intensity shift was analyzed to calculate the snGFR. Results: Previously described methods for snGFR analysis relied on two manually defined measurement points in the PT and the tubular volume was merely estimated in 2D images. We present an extended image processing workflow by adding continuous measurement of intensity along the PT in every frame of the time series using ImageJ. Automatic modelling of actual PT volume in a 3D dataset replaced 2D volume estimation. Subsequent data analysis in R, with a calculation of intensity shifts in every frame and normalization against tubular volume, allowed exact assessment of snGFR by linear regression. Repeated analysis of image data obtained in healthy mice showed a striking increase of reproducibility by reduction of user interaction. Conclusions: These improvements in image processing and data analysis maximize the reliability of a sophisticated intravital microscopy technique for the precise assessment of snGFR, a highly relevant predictor of kidney function.
Effects of Remote Ischemic Conditioning on Hand Engagement in individuals with Spinal cord Injury (RICHES): protocol for a pilot crossover study
Authors: Wu Yu-Kuang , Harel Noam Y. , Wecht Jill M. , Bloom Ona E. 
Published: June 2021

​​​​​​Background: Most spinal cord injuries (SCI) are not full transections, indicating that residual nerve circuits are retained. Rehabilitation interventions have been shown to beneficially reorganize motor pathways in the brain, corticospinal tract, and at the spinal level. However, rehabilitation training require a large number of repetitions, and intervention effects may be absent or show transient retention. Therefore, the need remains for an effective approach to synergistically improve the amount and duration of neuroplasticity in combination with other interventions. Remote ischemic conditioning (RIC) demonstrates several potential advantages as a candidate for such an approach. Therefore, we propose a protocol to investigate RIC coupled with physical training to promote neuroplasticity in hand muscles. Methods: This will be a prospective randomized-order crossover trial to be performed in eight able-bodied participants and eight participants with chronic cervical SCI. Patients will participate in two experimental sessions consisting of either active or sham RIC preceding a bout of pinch movement exercise. Serial evaluations will be conducted at baseline, after RIC, immediately after pinch exercise, and follow up 15-minutes later. The primary outcome is the change in corticospinal excitability (primarily measured by the motor evoked potential of abductor pollicis brevis muscle). Secondary outcomes will include maximal volitional pinch force, and inflammatory biomarkers. To ensure safety, we will monitor tolerability and hemodynamic responses during RIC. Discussion: This protocol will be the first to test RIC in people with cervical SCI and to investigate whether RIC alters corticospinal excitability. By sharing the details of our protocol, we hope other interested researchers will seek to investigate similar approaches – depending on overlap with the current study and mutual sharing of participant-level data, this could increase the sample size, power, and generalizability of the analysis and results. Trial registration: ClinicalTrial.gov, ID: NCT03851302; Date of registration: February 22, 2019
Service evaluation of the bereavement care delivered in a UK intensive care unit
Authors: Harris Daniel , Polgarova Petra , Enoch Lisa 
Published: June 2021

Background:Losing a loved one in the intensive care unit (ICU) can be a traumatic experience. The literature highlights that relatives of those who have died in ICU can experience symptoms of stress, anxiety, depression, post-traumatic stress disorder (PTSD) and prolonged grief.Aim:To evaluate the service delivery of the bereavement care that is provided on a 20-bed general ICU.Methods and analysis:A literature review informing and supporting the service evaluation and development of the questionnaire. Thematic analysis was undertaken using the six-phase framework.Findings:Five main themes were found: timing; care, dignity and respect; support; information; and memory making. Bereavement care is described as after-death care. However, the participants stipulated that bereavement care should be discussed prior to the death. Participants described using a range of interventions, such as memorial services, condolence letters, follow-up meetings and diaries.Conclusion:Bereavement care was regarded as an important aspect of the care delivered in ICU. It was evident that participants strived to deliver an holistic approach, yet some found this difficult to achieve.
Dietary diversity among pregnant women and associated factors in Ethiopia: Systematic review and meta-analysis
Authors: Azene Abebaw Gedef , Aragaw Abiba Mihret , Wubetie Habtamu Tilaye , Wassie Gizachew Tadesse , Tsegaye Gebiyaw Wudie , Derebe Muluwork Ayele , Mitiku Habitamu Dessie 
Published: June 2021

BackgroundsPregnancy related complications are major causes of maternal morbidity and mortality worldwide. Diversified food consumption is essential to produce hormones during pregnancy and it reduced complications. In Ethiopia, many researchers were investigated about the proportion of pregnant women with dietary diversity and its determinant factors. However, those studies are inconsistent and fragmented. Therefore, the aim of this study was to estimate the pooled proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia.MethodsWe conducted a systematic electronic web-based search of PubMed/ /MEDLINE, EMBASE, Web of Science, Google Scholar and Google online databases for identifying studies on proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia using pre-defined quality and inclusion criteria. STATA version 14 statistical software was used to analyze the data. We extracted relevant data and presented in tabular form. The I2test was used to assess heterogeneity across studies. Funnel plot asymmetry and Begg’s test were used to check for publication bias. The final effect size was determined by applying a random-effects model.ResultsOur search identified 170 studies. Of which, 23 were included in the final analysis stage. The pooled proportion of dietary diversity among pregnant women in Ethiopia was 41% (95% CI: 33, 49). Mothers can read and write (OR = 1.82 (95% CI: 1.25, 2.64)), maternal primary school and above educated (OR = 2.11 (95% CI: 1.10, 4.05)), nutritional information (OR = 4.1 (95% CI: 2.1, 7.99), dietary diversity knowledge (OR = 3.4 (95% CI: 2.73, 4.73)) and household had rich wealth index (OR = 3.45 (95% CI: 1.19, 10.1)) were significantly associated with dietary diversity practice during pregnancy.ConclusionsIn this meta-analysis; we found that low proportion of pregnant women with adequate dietary diversity in Ethiopia (41%). Maternal education, nutritional information, dietary diversity knowledge and wealth index level of household were significantly associated factors of pregnant woman with dietary diversity practice. This finding implies that improving the awareness of woman about dietary diversity during pregnancy and empowering women economically would play a significant role to improve dietary diversity practice.