bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Isolated Digital Flexor Tenolysis: A Systematic Review
Authors: Kher Sachin , Graham David J. , Symes Michael , Lawson Richard , Sivakumar Brahman S. 
Published: July 2021

Background: Flexor tendon injuries form a significant proportion of hand trauma presentations. Insult to the flexor tendon and surrounding sheath may lead to the formation of adhesions between these structures during the repair process. Tenolysis is a surgical release of these adhesions which requires careful consideration. This systematic review aims to report on the functional outcomes following isolated digital flexor tenolysis. Methods: We searched four online databases in December 2019. Eligibility criteria for studies were: English language; described patients undergoing digital flexor tenolysis; reported functional outcomes such as total active motion (TAM). Five articles were included. The selected studies were of limited quality (level IV evidence). Results: Of the final cohort 79.4% were male. Three studies reported patient age, with a mean age of 36.8 years [4 years to 58 years] in that subset. One hundred and three digits underwent flexor tenolysis only. Mean duration to surgery from the index operation or injury was 15.1 months [2.3 months–240 months]. Average follow-up from the tenolysis procedure was 18.6 months [3 months to 120 months]. Four studies assessing motion via Strickland classification reported 78.9% excellent or good outcomes. The remaining study reported 80% of patients reporting excellent or good motion as per Buck-Gramcko score. The complication rate reported was 15.3%. Conclusions: This review found digital flexor tenolysis significantly improves ROM, however these benefits must be considered in the light of potential complications. A detailed discussion with each individual patient must occur prior to such an undertaking.
Overproduction of Gastrointestinal 5-HT Promotes Colitis-Associated Colorectal Cancer Progression via Enhancing NLRP3 Inflammasome Activation
Authors: Li Tao , Fu Bin , Zhang Xin , Zhou Yunjiang , Yang Mengdi , Cao Mengran , Chen Yaxin , Tan Yingying , Hu Rong 
Published: July 2021

Abstract

Chronic inflammation is a key driver for colitis-associated colorectal cancer. 5-hydroxytryptamine (5-HT), a neurotransmitter, has been reported to promote inflammation in the gastrointestinal tract. However, the mechanism behind this remains unclear. In this study, we found that 5-HT levels, as well as the expression of tryptophan hydroxylase 1 (TPH1), the 5-HT biosynthesis rate-limiting enzyme, were significantly upregulated in colorectal tumor tissues from patients with colorectal cancer, colorectal cancer mouse models, and colorectal cancer cell lines when compared with normal colorectal tissues or epithelial cell lines. Colorectal cancer cell–originated 5-HT enhanced NLRP3 inflammasome activation in THP-1 cells and immortalized bone marrow–derived macrophages (iBMDM) via its ion channel receptor, HTR3A. Mechanistically, HTR3A activation led to Ca2+ influx, followed by CaMKIIα phosphorylation (Thr286) and activation, which then induced NLRP3 phosphorylation at Ser198 (mouse: Ser194) and inflammasome assembling. The NLRP3 inflammasome mediated IL1β maturation, and release upregulated 5-HT biosynthesis in colorectal cancer cells by inducing TPH1 transcription, revealing a positive feedback loop between 5-HT and NLRP3 signaling. Silencing TPH1 or HTR3A by short hairpin RNA slowed down tumor growth in an established CT26 and iBMDM coimplanted subcutaneous allograft colorectal cancer mouse model, whereas treatment with TPH1 inhibitor 4-chloro-DL-phenylalanine or HTR3A antagonist tropisetron alleviated tumor progression in an azoxymethane/dextran sodium sulfate–induced colorectal cancer mouse model. Addressing the positive feedback loop between 5-HT and NLRP3 signaling could provide potential therapeutic targets for colorectal cancer.
Obesity and Risk for First Ischemic Stroke Depends on Metabolic Syndrome: The HUNT Study
Authors: Horn Jens W. , Feng Tingting , Mørkedal Bjørn , Strand Linn Beate , Horn Julie , Mukamal Kenneth , Janszky Imre 
Published: July 2021

Background and Purpose:
Obesity is one of the most prevalent modifiable risk factors of ischemic stroke. However, it is still unclear whether obesity itself or the metabolic abnormalities due to obesity increase the risk of ischemic stroke. We therefore investigated the association between metabolic health, weight, and risk of ischemic stroke in a large prospective cohort study.

Methods:
In the Norwegian HUNT study (Trøndelag Health Study), we included 35 105 participants with complete information on metabolic risk factors and relevant covariates. Metabolically unhealthy state was defined as sex specific increased waist circumference in addition to 2 or more of the following criteria: hypertension, increased blood pressure, decreased high-density lipoprotein, triglycerides or glucose, or self-reported diagnosis of diabetes. We then applied Cox proportional hazard models to estimate the risk for ischemic stroke among overweight and obese metabolically healthy and unhealthy participants compared with metabolically healthy, normal weight participants.

Results:
A total of 1161 ischemic stroke cases occurred after an average observation time of 11.9 years. In general, metabolically unhealthy participants were at increased risk of ischemic stroke (for obese participants: hazard ratio, 1.30 [95% CI, 1.09–1.56] compared with metabolically healthy participants with a normal body mass index). Hypertension appeared to be the most important metabolic risk factor. Metabolically healthy participants with overweight or obesity were at similar risk of ischemic stroke compared with normal weight participants (hazard ratio, 1.02 [95% CI, 0.81–1.28] for participants with obesity). Obesity and overweight even over an extended period of time seems to be benign about ischemic stroke, as long as it was not associated with metabolic abnormalities.

Conclusions:
Obesity was not an independent ischemic stroke risk factor in this cohort, and the risk depended more on the metabolic consequences of obesity.
Association of Chronic Liver Disease and Mortality in Patients With Aneurysmal Subarachnoid Hemorrhage
Authors: Zhang Yu , Li Linjie , Jia Lu , Chong Weelic , Hai Yang , Lunsford L. Dade , You Chao , Cheng Yongzhong , Fang Fang 
Published: July 2021

Background and Purpose:
Chronic liver disease (CLD) is a risk factor for increased morbidity and mortality in acutely ill patients. For patients with aneurysmal subarachnoid hemorrhage (aSAH), the association between CLD and mortality remains unknown.

Methods:
In this retrospective cohort study, we analyzed consecutive aSAH patients admitted to the West China Hospital between 2009 and 2019. The primary outcome was in-hospital all-cause mortality.

Results:
This study included 6228 cases of aSAH, 489 (7.9%) of whom also had CLD. In a propensity-matched analysis, CLD was associated with increased mortality in patients with aSAH compared with non-CLD (odds ratio, 2.04 [95% CI, 1.43–2.92]). In aSAH patients with CLD, a high Model for End-Stage Liver Disease score was still associated with an increased odds of mortality.

Conclusions:
Among aSAH patients, CLD was associated with increased mortality compared with non-CLD. Among aSAH patients with CLD, a higher Model for End-Stage Liver Disease score was associated with an increased odds of mortality.
Aerosol and Cloud Experiments in the Eastern North Atlantic (ACE-ENA)
Authors: Wang Jian , Wood Rob , Jensen Michael P. , Chiu J. Christine , Liu Yangang , Lamer Katia , Desai Neel , Giangrande Scott E. , Knopf Daniel A. , Kollias Pavlos , Laskin Alexander , Liu Xiaohong , Lu Chunsong , Mechem David , Mei Fan , Starzec Mariusz , Tomlinson Jason , Wang Yang , Yum Seong Soo , Zheng Guangjie , Aiken Allison C. , Azevedo Eduardo B. , Blanchard Yann , China Swarup , Dong Xiquan , Gallo Francesca , Gao Sinan , Ghate Virendra P. , Glienke Susanne , Goldberger Lexie , Hardin Joseph C. , Kuang Chongai , Luke Edward P. , Matthews Alyssa A. , Miller Mark A. , Moffet Ryan , Pekour Mikhail , Schmid Beat , Sedlacek Arthur J. , Shaw Raymond A. , Shilling John E. , Sullivan Amy , Suski Kaitlyn , Veghte Daniel P. , Weber Rodney , Wyant Matt , Yeom Jaemin , Zawadowicz Maria , Zhang Zhibo 
Published: July 2021

Abstract
With their extensive coverage, marine low clouds greatly impact global climate. Presently, marine low clouds are poorly represented in global climate models, and the response of marine low clouds to changes in atmospheric greenhouse gases and aerosols remains the major source of uncertainty in climate simulations. The eastern North Atlantic (ENA) is a region of persistent but diverse subtropical marine boundary layer clouds, whose albedo and precipitation are highly susceptible to perturbations in aerosol properties. In addition, the ENA is periodically impacted by continental aerosols, making it an excellent location to study the cloud condensation nuclei (CCN) budget in a remote marine region periodically perturbed by anthropogenic emissions, and to investigate the impacts of long-range transport of aerosols on remote marine clouds. The Aerosol and Cloud Experiments in Eastern North Atlantic (ACE-ENA) campaign was motivated by the need of comprehensive in situ measurements for improving the understanding of marine boundary layer CCN budget, cloud and drizzle microphysics, and the impact of aerosol on marine low cloud and precipitation. The airborne deployments took place from 21 June to 20 July 2017 and from 15 January to 18 February 2018 in the Azores. The flights were designed to maximize the synergy between in situ airborne measurements and ongoing long-term observations at a ground site. Here we present measurements, observation strategy, meteorological conditions during the campaign, and preliminary findings. Finally, we discuss future analyses and modeling studies that improve the understanding and representation of marine boundary layer aerosols, clouds, precipitation, and the interactions among them.
Staff recruitment and geographical representation in international organizations
Authors: Eckhard Steffen , Steinebach Yves 
Published: July 2021

What explains geographical representation in the professional staff of intergovernmental organizations (IOs)? We address this question from an organizational perspective by considering IO recruitment processes. In the United Nations (UN) system, recruitment processes are designed to ensure bureaucratic merit, with experience and education being the relevant merit criteria. We develop and test a supply-side theory, postulating that differences in countries’ supply of well-educated and highly experienced candidates can explain geographical representation. Drawing on staff data from 34 IOs and supply data from 174 member states, and controlling for endogeneity and alternative explanations, we find no such relationship for education. However, countries with a high supply of candidates with relevant working and regional experiences have significantly higher representation values. These findings offer a complementary narrative as to why some countries are more strongly represented in the international professional staff than others. Findings also unveil the nature of bureaucratic merit in the UN, which seems to emphasize local knowledge and working experience over formal (Western) education. Points for practitioners What explains member states’ representation in the staff bodies of organizations in the UN system? Previous work has shown that member state power is a good predictor. But what about bureaucratic merit? The paper demonstrates that representation patterns can also be explained when measuring states’ supply of candidates with relevant working and regional experience. Supply of educated candidates plays no significant role. Bureaucratic merit in the UN seems to emphasize local knowledge and working experience over formal (Western) education.
What the Doctor Would Prescribe: Physician Experiences of Providing Voluntary Assisted Dying in Australia
Authors: Rutherford Jodhi , Willmott Lindy , White Ben P. 
Published: July 2021

Background Like many countries where voluntary assisted dying (VAD) is legal, eligible doctors in Victoria, Australia, have sole legal authority to provide it. Doctors’ attitudes towards legalised VAD have direct bearing on their willingness to participate in VAD and consequently, on whether permissive laws can effectively facilitate access to VAD. The study aimed to explore how some Victorian doctors are perceiving and experiencing the provision of legalised VAD under a recently commenced law. Methods Semi-structured interviews with 25 Victorian doctors with no in-principle objection to legalised VAD were conducted between July 2019-February 2020. Interviews were recorded, transcribed, and analysed using thematic analysis. Ethical approval from the relevant institution was obtained. Results Doctors perceive or experience VAD to fundamentally challenge traditional medical practice. Barriers to access to VAD derive from applicant, communication, and doctor-related factors. Doctors’ willingness to participate in VAD is situation specific.
Predictors of Taste Dysfunction and Its Severity Among Patients With Chronic Kidney Disease
Authors: Yusuf Tajudeen , Raji Yemi R. , Lasisi Taye J. , Daniel Adekunle , Bamidele O. T. , Fasunla Ayotunde J. , Lasisi Akeem. O. 
Published: July 2021

Background: Patients with chronic kidney disease (CKD) often complain of taste dysfunction. The prevalent taste dysfunction among patients with CKD predisposes them to malnutrition, poor quality of life, and worsen disease prognoses. To appropriately treat the taste dysfunction in this group of patients, it’s imperative that factors that predict taste dysfunction and its severity are identified for prompt treatment. Aim: To identify factors associated with taste dysfunction and its severity among patients with CKD. Materials and Methods: This was a hospital-based case–control study of adult patients with CKD at the University College Hospital, Ibadan, Nigeria. The control group was made up of age- and gender-matched healthy volunteers with no clinical and laboratory evidence of CKD. Relevant clinical and social data obtained include demographics, symptoms, and signs of taste dysfunction and its risk factors. The 4 basic taste modalities namely sweet, sour, bitter, and salt taste senses of the participants were tested with validated “taste strips.” Factors that predict taste dysfunction were identified among the spectrum of the disease. Results: There were 100 patients with CKD and 100 healthy controls, age ranges between 19 and 86 years (mean ± standard deviation [SD] = 46.3 ± 13.9 years) and 20 and 85 years (mean ± SD = 43.4 ± 14.9 years), respectively. There was no statistically significant difference between cases and control gender distribution ( P = .57). Hypogeusia was found in 27.0% of patients with CKD, while total taste function score of all the control was within normal range. Increasing duration of CKD was identified as a predictor of taste dysfunction among patients with CKD (odds ratio: 4.889, P = .038). The stages of CKD had no statistically significant relationship with the severity of taste dysfunction ( P = .629). Conclusion: The prevalence of taste dysfunction among patients with CKD was high and this showed significant correlation with increasing duration of CKD; in contrast, the severity of CKD is not significant in the development of taste dysfunction.
Pediatric Bilateral Sensorineural Hearing Loss: Minimum Test Battery and Referral Criteria for Cochlear Implant Candidacy Evaluation
Authors: Anne Samantha , Brown Kevin D. , Goldberg Donald M. , Adunka Oliver F. , Kenna Margaret , Chien Wade , Teagle Holly , Zwolan Teresa A. , Sydlowski Sarah A. , Roush Patricia , Buchman Craig A. 
Published: July 2021

Among the various cochlear implant systems approved by the Food and Drug Administration, current labeling for pediatric usage encompasses (1) bilateral profound bilateral sensorineural hearing loss in children aged 9 to 24 months and bilateral severe to profound sensorineural hearing loss in children older than 2 years; (2) use of appropriately fitted hearing aids for 3 months (this can be waived if there is evidence of ossification); and (3) demonstration of limited progress with auditory, speech, and language development. Pediatric guidelines require children to have significantly worse speech understanding before qualifying for cochlear implantation. The early years of life have been shown to be critical for speech and language development, and auditory deprivation is especially detrimental during this crucial time.Level of evidence: 2.
Lateral Ligament Reconstruction With Hamstring Graft for Ankle Instability: Outcomes for Primary and Revision Cases
Authors: Eble Stephanie K. , Hansen Oliver B. , Patel Karan A. , Drakos Mark C. 
Published: July 2021

Background: Optimal treatment for patients with severe ankle instability or failed previous ankle stabilization is not well defined, and newer techniques have limited presence in the literature. Purpose/Hypothesis: The purpose of this study was to evaluate clinical and radiographic outcomes after modified anatomic lateral ligament reconstruction using hamstring auto- or allograft in primary cases versus revision cases. We hypothesized that patients undergoing a revision procedure would demonstrate inferior patient-reported and radiographic outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent modified anatomic lateral ligament reconstruction by a single surgeon between 2010 and 2017 were identified. Indications included failure of previous ankle stabilization or severe ankle laxity. Patients completed preoperative and minimum 1-year postoperative Foot and Ankle Outcome Score (FAOS) surveys. They also underwent pre- and postoperative stress radiographs using the Telos Stress Device. Results: A total of 41 patients (42 ankles) were identified. The mean age was 32.1 years, and 36 patients (88%) were women. There were 25 primary procedures and 17 revision procedures. Hamstring autograft was utilized in 35 ankles and hamstring allograft in 7 ankles. A total of 34 patients (83%) provided postoperative patient-reported outcome scores at a mean of 26 months (range, 12-65 months). When comparing primary versus revision procedures, revision patients had significantly lower FAOS Pain (77.14 vs 90.66; P = .009), Sports (63.46 vs 82.16; P = .008), and Quality of Life (53.53 vs 76.70; P = .002) scores. In total, 34 patients (83%) had stress radiographs at a mean of 14 months (range, 3-62 months) postoperatively. Revision patients also had lower, though statistically insignificant, postoperative talar tilt measurements on average (5.73° vs 7.10°; P = .252), and pre- to postoperative change in talar tilt was not significantly different between groups (−4.94° vs −7.03°; P = .415). Conclusion: Revision procedures had significantly lower postoperative patient-reported outcome scores and lower talar tilt compared with patients undergoing a primary procedure, although the pre- to postoperative change in the talar tilt was not significantly different between groups.
Sibling Inequalities in Overweight and the Role of Mother’s Education: Evidence From the Indonesian Family Life Survey
Authors: Kunto Yohanes Sondang , Bras Hilde 
Published: July 2021

Background: Previous studies have shown that sibling inequalities in overweight vary across contexts. Furthermore, research on the extent to which parental factors such as mother’s education can compensate for or reinforce such disparities is considerably rare. Objective: This study analyzes to what extent and how the chances of overweight among children (0-19 years of age) vary systematically by gender, birth order, and number of siblings. We also look at whether mother’s education buffers or aggravates sibling inequalities in overweight. Methods: Data were from the fifth wave of the Indonesian Family Life Survey-5 2014/2015, which comprised 6723 children born in 4784 families. We applied within-family centered birth order dummies to disentangle the effects of birth order from those of number of siblings. Cluster-robust logistic regressions were conducted. Results: Overweight occurred more in eldest and youngest children, and in children of smaller families. Mother’s education amplified sibling inequalities. Odds of overweight in children increased along with more years of education the mothers had. This was greater for boys and eldest children. Further analyses indicated that boys whose mothers spent more years in school consumed high-calorie foods more often. Conclusion: The overall results indicate that mother’s education aggravates sibling inequalities in overweight. Nutrition interventions to reduce overweight in children should target the eldest and the youngest children and children of smaller families. Mothers who had more school years, and particularly their sons, should also be in the target group. Boys should be advised to consume high-calorie foods less often.
The Association of Body Image Perception With Dietary and Physical Activity Behaviors Among Adolescents in Indonesia
Authors: Niswah Ilyatun , Rah Jee Hyun , Roshita Airin 
Published: July 2021

Background: Growing evidence highlights the linkage between body image, eating, and exercise behaviors among adolescents. Objective: This study aims to determine the association between body image perception, nutritional status, and dietary and physical activity behaviors among adolescents in Indonesia. Methods: A cross-sectional household survey was conducted among a representative sample (n = 2160) of adolescent girls and boys aged 12 to 18 years in Klaten and Lombok Barat districts. The association between adolescents’ body image, their diets, and physical activity patterns was determined using complex samples Cox’s regression analysis. Separate multivariate models were developed for adolescent girls and boys. Results: Physical appearance was considered important to nearly all adolescents. Approximately 11% of girls and 14% of boys were overweight or obese, the majority of whom (∼70%) correctly perceived themselves as overweight or obese. More of overweight or obese adolescents felt unhappy about their perceived weight than their thin counterparts. With respect to the overweight/obese girls, the adolescents’ perceptions of being overweight or obese was associated with a 63% reduction in the prevalence of overweight/obese girls consuming fatty snacks, such as deep-fried crackers (adjusted prevalence ratio (PR): 0.37, 95% confidence interval (CI): 0.19-0.71) and a 40% reduction in the prevalence of overweight/obese girls engaging in moderate-intensity physical activity (adjusted PR: 0.60, 95% CI: 0.38-0.94), after adjusting for potential confounders. No association between body image and eating and physical activity behaviors was observed among adolescent boys. Conclusions: Body image may be one of the most important determinants of dietary and physical activity behaviors, and thus future efforts to foster healthy eating and physical activity behaviors among Indonesian adolescents need to address body image concerns.