bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinoic Acid Receptor Agonists Suppress Muscle Fatty Infiltration in Mice
Authors: Shirasawa Hideyuki , Matsumura Noboru , Yoda Masaki , Okubo Kazumasa , Shimoda Masayuki , Uezumi Akiyoshi , Matsumoto Morio , Nakamura Masaya , Horiuchi Keisuke 
Published: January 2021

Background: The infiltration of fat tissue into skeletal muscle, a condition referred to as muscle fatty infiltration or fatty degeneration, is regarded as an irreversible event that significantly compromises the motor function of skeletal muscle. Purpose: To investigate the effect of retinoic acid receptor (RAR) agonists in suppressing the adipogenic differentiation of fibroadipogenic progenitors (FAPs) in vitro and fatty infiltration after rotator cuff tear in mice. Study Design: Controlled laboratory study. Methods: FAPs isolated from mouse skeletal muscle were cultured in adipogenic differentiation medium in the presence or absence of an RAR agonist. At the end of cell culture, adipogenic differentiation was evaluated by gene expression analysis and oil red O staining. A mouse model of fatty infiltration—which includes the resection of the rotator cuff, removal of the humeral head, and denervation the supraspinatus muscle—was used to induce fatty infiltration in the supraspinatus muscle. The mice were orally or intramuscularly administered with an RAR agonist after the surgery. Muscle fatty infiltration was evaluated by histology and gene expression analysis. Results: RAR agonists effectively inhibited the adipogenic differentiation of FAPs in vitro. Oral and intramuscular administration of RAR agonists suppressed the development of muscle fatty infiltration in the mice after rotator cuff tear. In accordance, we found a significant decrease in the number of intramuscular fat cells and suppressed expression in adipogenic markers. RAR agonists also increased the expression of the transcripts for collagens; however, an accumulation of collagenous tissues was not histologically evident in the present model. Conclusion: Muscle fatty infiltration can be alleviated by RAR agonists through suppressing the adipogenic differentiation of FAPs. The results also suggest that RAR agonists are potential therapeutic agents for treating patients who are at risk of developing muscle fatty infiltration. The consequence of the increased expression of collagen transcripts by RAR agonists needs to be clarified. Clinical Relevance: RAR agonists can be used to prevent the development of muscle fatty infiltration after rotator cuff tear. Nevertheless, further studies are mandatory in a large animal model to examine the safety and efficacy of intramuscular injection of RAR agonists.
The General Movements Assessment in Neonates With Hypoxic Ischemic Encephalopathy
Authors: Pouppirt Nicole R. , Martin Valerie , Pagnotto-Hammitt Linda , Spittle Alicia J. , Flibotte John , DeMauro Sara B. 
Published: January 2021

Background: Clinical measures after birth and studies such as electroencephalogram (EEG) and brain imaging do not fully predict neurodevelopmental outcomes of infants with hypoxic-ischemic encephalopathy. Early detection of adverse neurologic outcomes, and cerebral palsy in particular, in high-risk infants is essential for ensuring timely management. The General Movements Assessment is a tool that can be used in the early detection of cerebral palsy in infants with brain injury. The majority of studies on the General Movements Assessment in the late preterm and term population were performed prior to the introduction of therapeutic hypothermia. Aims: To apply the General Movements Assessment in late preterm and term infants with hypoxic-ischemic encephalopathy (including those who received therapeutic hypothermia), to determine if clinical markers of hypoxic-ischemic encephalopathy predict abnormal General Movements Assessment findings, and to evaluate interrater reliability of the General Movements Assessment in this population. Study design: Pilot prospective cohort study Subjects: We assessed 29 late preterm and full-term infants with mild, moderate, and severe hypoxic-ischemic encephalopathy in Philadelphia, PA. Results: Most infants’ general movements normalized by the fidgety age. Only infants with moderate or severe hypoxic-ischemic encephalopathy had abnormal general movements in both the writhing and the fidgety ages (n = 6). Seizure at any point during the initial hospitalization was the clinical sign most predictive of abnormal general movements in the fidgety age (sensitivity 100%, specificity 55%, positive predictive value 40%, negative predictive value 100%). Interrater reliability was greatest during the fidgety age (κ = 0.67). Conclusions: Seizures were the clinical predictor most closely associated with abnormal findings on the General Movements Assessment. However, clinical markers of hypoxic-ischemic encephalopathy are not fully predictive of abnormal General Movements Assessment findings. Larger future studies are needed to evaluate the associations between the General Movements Assessment and childhood neurologic outcomes in patients with hypoxic-ischemic encephalopathy who received therapeutic hypothermia.
Development of biological meniscus scaffold: Decellularization method and recellularization with meniscal cell population derived from mesenchymal stem cells
Authors: Kara Aylin , Koçtürk Semra , Bilici Gokcen , Havitcioglu Hasan 
Published: January 2021

Tissue engineering approaches which include a combination of cells and scaffold materials provide an alternative treatment for meniscus regeneration. Decellularization and recellularization techniques are potential treatment options for transplantation. Maintenance of the ultrastructure composition of the extracellular matrix and repopulation with cells are important factors in constructing a biological scaffold and eliminating immunological reactions. The aim of the study is to develop a method to obtain biological functional meniscus scaffolds for meniscus regeneration. For this purpose, meniscus tissue was decellularized by our modified method, a combination of physical, chemical, and enzymatic methods and then recellularized with a meniscal cell population composed of fibroblasts, chondrocytes and fibrochondrocytes that obtained from mesenchymal stem cells. Decellularized and recellularized meniscus scaffolds were analysed biochemically, biomechanically and histologically. Our results revealed that cellular components of the meniscus were successfully removed by preserving collagen and GAG structures without any significant loss in biomechanical properties. Recellularization results showed that the meniscal cells were localized in the empty lacuna on the decellularized meniscus, and also well distributed and proliferated consistently during the cell culture period (p < 0.05). Furthermore, a high amount of DNA, collagen, and GAG contents (p < 0.05) were obtained with the meniscal cell population in recellularized meniscus tissue. The study demonstrates that our decellularization and recellularization methods were effective to develop a biological functional meniscus scaffold and can mimic the meniscus tissue with structural and biochemical features. We predict that the obtained biological meniscus scaffolds may provide avoidance of adverse immune reactions and an appropriate microenvironment for allogeneic or xenogeneic recipients in the transplantation process. Therefore, as a promising candidate, the obtained biological meniscus scaffolds might be verified with a transplantation experiment.
Physical Activity, Sedentary Time, and Diet as Mediators of the Association Between TV Time and BMI in Youth
Authors: Bejarano Carolina M. , Carlson Jordan A. , Conway Terry L. , Saelens Brian E. , Glanz Karen , Couch Sarah C. , Cain Kelli L. , Sallis James F. 
Published: January 2021

Purpose: This study examined dietary indicators, sedentary time, and physical activity as potential mediators of the association between TV time and BMIz in youth. Design: Cross-sectional study in 2 independent samples of youth. Setting: Data collection occurred by mail and telephone for adolescents and either at home or in medical settings for children. Sample: 928 youth ages 12-16 and 756 youth ages 6-12 and a parent. Measures: TV time, snacking/eating while watching TV, and a 3-day dietary recall were assessed via child/parent report. Physical activity and sedentary time were assessed by accelerometer wear. Analysis: Direct and indirect associations (through 8 diet and activity variables) of TV time with BMIz were tested in boys and girls in each sample. Results: TV time had a positive association with BMIz in 6-12 year old boys and girls. Direct associations emerged between TV time and the diet/activity variables, and between diet/activity variables and BMIz. Snacking/eating while watching TV had a significant positive association with BMIz in younger boys and mediated the association between TV time and BMIz ( β = .06, p = .019; 25% attenuation). Conclusions: Snacking/eating while watching TV may be a possible reason TV time is consistently associated with obesity in youth. Targeting reductions in TV time and associated snacking could improve health impacts.
Newborn in Neonatal Intensive Care Unit: Parental Concerns
Authors: Dhingra Pardeep 
Published: January 2021

Background: Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents. Objectives: This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at discharge Study Design: Semiqualitative interview. Participants: Parents of 100 (56 M, 44 F) neonates. Intervention: We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ). Results: Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors. Conclusions: This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.
Situating the Local in Bilateralism: Assessing Local Impacts of the India–Bangladesh Enclave Exchange
Authors: Sen Surya Sankar 
Published: January 2021

In its fundamental essence, bilateral relations outline a mechanism through which two countries seek to actualize their individual national interests through collaboration on select issues. Such conceptualizations often obscure the relevance of issues and narratives at local levels, which constitute the sites of its practicalization. The predominance of national interest-focused approaches in negotiating bilateral relations, particularly in the sphere of conflict management, often casts aside local narratives underlying the issues and conflicts it seeks to address. The resultant gap between the advocated and actual necessities of resolution at the ground may lead to the persistence and emergence of local tensions subsequent to its ‘settlement’ at the national and bilateral levels. The bilateral resolution of the India–Bangladesh enclave issue presents an interesting case to engage with the conceptual and practical facets of this mechanism of state action and its impacts at the local level. Based on an ethnographic survey of local perceptions of residents of three enclaves in Cooch Behar district, West Bengal, this article will examine the impacts of national interest-based mediation in localized conflicts, to engage the problematic of the ‘local’s absence from bilateralism’s conceptualization in international relations.
Pediatric Nurses’ Experiences in Caring for Non–English Speaking Patients and Families
Authors: Stephen Jennifer M. 
Published: January 2021

Introduction: Language barriers challenge patient- and family-centered care. Literature guiding pediatric nurses caring for patients and families with limited English proficiency in the inpatient setting is nonexistent. The purposes of this phenomenological study were to understand pediatric nurses’ experiences in caring for patients and families with limited English proficiency and to explore how nurses navigate the communication gap. Method: A purposive sample of 15 pediatric Registered Nurses at a large urban children’s medical center participated in face-to-face semistructured interviews. Verbatim transcribed interviews were analyzed line-by-line and categorized into themes. Results: Themes included personal framework of care, consequences of caring, starting off right, nurse sensing, verbal/nonverbal methods, and interpreters. Discussion: Nurses did not perceive differences in task-oriented care; they described compromised personal paradigms, held negative feelings, and utilized verbal/nonverbal communication methods. Future research is needed exploring patients’ and families’ perceptions regarding care by other language–speaking nurses.
Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia
Authors: Datusanantyo Robertus Arian , Hutagalung Magda Rosalina , Rizaliyana Sitti , Marzoeki Djohansjah 
Published: January 2021

Objective: This study aimed to measure and analyze the outcome of primary unilateral cleft lip repair. Design: Observational cohort study. Setting: Surabaya Cleft Lip and Palate (CLP) Center, a major referral center for the Eastern part of Indonesia, affiliated with a tertiary center. Patients, Participants: From 69 patients who met the inclusion criteria, we excluded 31 patients who were more than 2 years of age and were operated on by junior residents under supervision. Interventions: We performed anthropometric measurements of the patients on photographs taken before, immediately after, and a year after the surgery. Main Outcome Measure(s): This study measured nasal width, vertical lip height, horizontal lip length, and philtral height ratios. Results: While nasal width and philtral height ratios decreased significantly ( P = .000 and P = .000, respectively) reaching symmetry immediately after surgery, the horizontal lip length, and vertical lip height ratios remained unchanged ( P = .862 and P = .981, respectively). A year after surgery, the nasal width and horizontal lip length ratios increased significantly ( P = .017 and P = .006, respectively), while philtral height and vertical lip height ratios remained unchanged ( P = .927 and P = .138, respectively). There was no difference in the ratios based on the initial size and completeness of the cleft. Conclusion: In Surabaya CLP Center, the symmetry of nasal width, philtral height, horizontal lip length, and vertical lip height were achieved by the unilateral cleft lip repair despite the initial size and completeness of the cleft.
Is Statin Use Associated With Risk of Thyroid Diseases? Results of a Retrospective Cohort Study
Authors: Trivedi Lakshya U. , Femnou Mbuntum Laurette , Halm Ethan A. , Mansi Ishak 
Published: January 2021

Background: Given the ubiquity of statin use and prevalence of thyroid diseases, such as thyroid cancer, hyperthyroidism, and thyroiditis, understanding their association deserves further attention. Objective: To examine the association between statin use and thyroid cancer, thyrotoxicosis, goiter, and thyroiditis. Methods: Using Tricare data, 2 propensity score (PS)-matched cohorts of statin users and nonusers were formed: (1) a PS-matched general cohort (all patients aged 30-85 years) and (2) a PS-matched healthy cohort (excluded patients with cardiovascular diseases or severe comorbidities). Outcomes were thyroid cancer, thyrotoxicosis, goiter, and thyroiditis. Odds ratios (ORs) and 95% CIs of outcomes were estimated using conditional regression analysis. Results: Of 43 438 patients, the PS-matched general cohort matched 6342 statin users to 6342 nonusers. The OR of thyroid cancer was 0.62 (95% CI = 0.39-0.996). There was no significant difference between statin users and nonusers in risk of thyrotoxicosis (OR = 0.88; 95% CI = 0.71-1.09), goiter (OR = 0.9; 95% CI = 0.77-1.03), or thyroiditis (OR = 0.78; 95% CI = 0.53-1.15). In the PS-matched healthy cohort (3351 statin users to 3351 nonusers), there was no difference between statin users and nonusers in any outcome. Limitations of the study include its retrospective observational design and use of administrative codes in outcomes ascertainment. Conclusion and Relevance: This study did not demonstrate any association of statins with harmful effects on thyroid diseases, which offers assurance to clinicians and patients. Furthermore, statin use appears to be associated with a decreased risk of thyroid cancer, but more studies are needed.
Vascular endothelial growth factor inhibitor induced hypertension: Retrospective analysis of the impact of blood pressure elevations on outcomes
Authors: Duco Marissa R , Murdock Joshua L , Reeves David J 
Published: January 2021

Background Vascular endothelial growth factor (VEGF) inhibitors are known to cause hypertension. The purpose of this study was to assess the impact of blood pressure (BP) elevations on outcomes in patients receiving VEGF inhibitors. Methods This retrospective chart review analyzed patients receiving treatment with VEGF inhibitors. The primary endpoint was time to progression (TTP) in those with or without significant increase in BP (increase in systolic BP greater than 20 mm Hg or greater than 10 mm Hg increase in diastolic BP). Secondary endpoints included treatment interruption, therapy discontinuation due to documented adverse effect, and time to BP elevation. Subgroup analyses were completed in those receiving bevacizumab and oral tyrosine kinase inhibitors. Results A total of 155 patients were included and 93 patients (60%) experienced a significant increase in BP. Median time to development of an elevated BP was 47 days. Patients with significant increases in BP had a longer median TTP compared to patients without (8.1 months vs 4.4 months, p = 0.002). No differences were present between groups in treatment interruption or discontinuation due to a documented adverse effect and outcomes were similar in those receiving bevacizumab and oral tyrosine kinase inhibitors. In the analysis of the impact of severity of BP elevations, those with severe BP elevations were more likely to have treatment interrupted but discontinuation rates were similar across groups. Conclusion Development of significant BP elevations may be a marker of therapeutic response to VEGF inhibitors and does not limit treatment duration, even in those with severe elevations.
Complementary and alternative medicine (CAM) in Turkish cutaneous melanoma patients: A prospective study from tertiary cancer center
Authors: Tas Faruk , Cinar Ebru , Erturk Kayhan 
Published: January 2021

Background Only a few studies assessed the prevalence and the predictors of complementary and alternative medicine (CAM) use specifically in melanoma patients. The aim of this study was to assess the extent of CAM use in Turkish melanoma patients. Objective To assess the extent of CAM use and to compare sociodemographic and clinical characteristics between users and non-users in melanoma patients. Methods One hundred melanoma patients who were seen in outpatient clinics were included in a survey using questionnaire on CAM use. Results Twenty-seven patients used at least one type of CAM, the majority of which were herbs (73%). Turmeric (curcumin) was the most popular herb that was used alone or in conjunction with various other herbs (41%). Living in rural areas was significantly associated with CAM use (p = 0.02). The most common reason for CAM use was intent to cure of the disease (52%). The primary source of information about CAM was a close friend or a family contact (44%). CAMs were generally used together with conventional anticancer treatment modalities (64%) and they were ingested on a regular base (72%). CAMs could easily be acquired at regular herbal stores (88%). The patients experienced almost no adverse effects with CAM use; and most cases (71%) had confidence in CAM. About half of the patients consulted with their physicians about CAM use. Conclusion Minority, nearly one fourth of the melanoma cases used at least one type of CAM, the majority of which were herbs and turmeric (curcumin) was the most popular agent.
Association of the Healthcare Effectiveness Data and Information Set (HEDIS) Follow-Up Care Measures and Medication Adherence Among Medicaid Insured Children with ADHD
Authors: Earla Jagadeswara Rao , Abughosh Susan , Chen Hua 
Published: January 2021

Objectives: To assess the association of HEDIS C&M phase follow-up measure with ADHD medication adherence. Methods: A retrospective study was conducted using Medicaid data (2014–2016) of children initiated with ADHD medication. Patients were categorized as meeting the C&M follow-up measure or not according to the HEDIS specifications. Medication adherence was measured using both Proportion of Days Covered (PDC) & Group-Based Trajectory Modeling (GBTM). The association of medication adherence with HEDIS measure was assessed using Chi-square test. Results: Nearly all (97%) children with PDC≥0.7 and 72% of patients following the late decliner adherence trajectory met the HEDIS C&M follow-up criteria. In contrast, none of the children with PDC<0.7 and only two following rapid and slow decliner trajectories met the criteria. Conclusion: ADHD medication adherence, regardless of how it was measured, clearly differentiated children with and without C&M phase follow-up, which essentially questions the implication of HEDIS C&M phase follow-up care measure.