bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 3′ Untranslated Region Polymorphism of <b><i>CTNNB1</i></b> (Rs2953) Alters MiR-3161 Binding and Affects the Risk of Ischemic Stroke and Coronary Artery Disease in Chinese Han Population
Authors: Zhao Xin-Yi , Hu Shu-Yan , Yang Jia-Lei , Chen Xing-Mei , Huang Xian-Li , Tang Lue-Jun , Gu Lian , Su Li 
Published: March 2021

<b><i>Background:</i></b> <i>CTNNB1</i> is reported to be related to the pathological process of ischemic stroke (IS) and coronary artery disease (CAD). Polymorphism located in the 3′ untranslated region (3′UTR) of a gene might affect gene expression by modifying binding sites for microRNAs (miRNAs). This study aimed to analyze the association between polymorphism rs2953, which locates in the 3′UTR of <i>CTNNB1,</i> and the risk of IS and CAD. <b><i>Methods:</i></b> The <i>CTNNB1</i> messenger RNA (mRNA) expression level in peripheral venous blood was measured. In total, 533 patients with IS, 500 patients with CAD, and 531 healthy individuals were genotyped by Sequenom Mass­Array technology. The binding of miR-3161 to <i>CTNNB1</i> was determined by dual-luciferase reporter assay. <b><i>Results:</i></b> The <i>CTNNB1</i> mRNA expression level for the IS group was significantly lower than that for the control group. Rs2953 was significantly associated with both IS risk and CAD risk. Significant association was also found between polymorphism rs2953 and many conventional factors, such as serum lipid level, blood coagulation markers, blood glucose level, and homocysteine level in patients. Rs2953 T allele introduced a binding site to miRNA-3161 and thus decreased luciferase activity. <b><i>Conclusion:</i></b> Polymorphism rs2953 is associated with the risk of both IS and CAD. Moreover, polymorphism rs2953 (T) introduces a binding site to miRNA-3161 and thus decreases luciferase activity in cell lines.
Optimal Threshold of Left Ventricular Ejection Fraction for Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta‐Analysis
Authors: Perry Andrew S. , Li Song 
Published: March 2021

Background
The optimal threshold of left ventricular ejection fraction (LVEF) that should prompt aortic valve replacement (AVR) in asymptomatic patients with high‐gradient severe aortic stenosis (AS) is controversial. The aim of this study was to assess the relationship between LVEF and mortality benefit in comparing early AVR versus watchful waiting in asymptomatic patients with severe AS.

Methods and Results

MEDLINE, Embase, Web of Science, and Google Scholar were searched for observational studies and randomized controlled trials on adults with asymptomatic severe AS. Severe AS was defined by a peak aortic velocity ≥4 m/s and/or mean aortic valve gradient ≥40 mm Hg and/or calculated aortic valve area <1.0 cm
2
or an indexed valve area <0.6 cm
2
. Studies comparing AVR with conservative management were included and meta‐analysis on all‐cause mortality was performed. Ten eligible studies were identified with a total of 3332 patients. In 5 observational studies comparing early AVR versus watchful waiting, our meta‐analysis showed early AVR was associated with lower mortality with a hazard ratio (HR) of 0.41 (CI, 0.23–0.71;
P
<0.01). In 4 observational studies comparing AVR versus no AVR, our meta‐analysis showed AVR was associated with lower mortality with a HR of 0.31 (CI, 0.17–0.58;
P
<0.001). In a meta‐regression analysis pooling all 10 studies, there was no statistically significant correlation between study mean LVEF and the size of mortality benefit of AVR (
P
=0.83).

Conclusions
Among asymptomatic patients with high‐gradient severe AS, AVR was associated with a mortality benefit across the spectrum of LVEF. Our study calls into question the need of an LVEF threshold for recommending AVR in this patient population.
Animism, Aristotelianism, and the Legacy of William Gilbert’sDe Magnete
Authors: Kochan Jeff 
Published: March 2021

AbstractWilliam Gilbert’s 1600 book, De magnete, greatly influenced early modern natural philosophy. The book describes an impressive array of physical experiments, but it also advances a metaphysical view at odds with the soon to emerge mechanical philosophy. That view was animism. I distinguish two kinds of animism – Aristotelian and Platonic – and argue that Gilbert was an Aristotelian animist. Taking Robert Boyle as an example, I then show that early modern arguments against animism were often effective only against Platonic animism. In fact, unacknowledged traces of Aristotelian animism can be found in Boyle’s mechanical account of nature. This was Gilbert’s legacy.
Towards Climate Change Mitigation and Adaptation
Authors: Khayyam Umer , Bano Rida , Alvi Shahzad 
Published: March 2021

Abstract
Global climate change is one of the main threats facing humanity and the impacts on natural systems as well as humans are expected to be severe. People can take action against these threats through two approaches: mitigation and adaptation. However, mitigations and adaptations are contingent on the level of motivation and awareness, as well as socio-economic and environmental conditions. This study examined personal perception and motivation to mitigate and adapt to climate change among the university students in the capital city of Pakistan. We divided the respondents into social sciences, applied sciences and natural sciences, using logistic regression analysis. The results indicated that students who perceive severity, benefits from preparation, and have more information about climate change were 1.57, 4.98 and 1.63 times more likely to take mitigation and 1.47, 1.14 and 1.17 times more likely to take adaptation measures, respectively. Students who perceived self-efficacy, obstacles to protect from the negative consequences of climate change and who belonged to affluent families were more likely to take mitigation measures and less likely to take adaptation strategies. However, mitigation and adaptation were unaffected by age, gender and study discipline.
Difference Relates: Allegory, Ideology, and the Anthropocene
Authors: Lesjak Carolyn 
Published: March 2021

Abstract
Fredric Jameson’s recent book, Allegory and Ideology, argues that allegory has become a ‘social symptom’, an attempt during moments of historical crisis to represent reality even as that reality, rife with contradictory levels, eludes representation. Mobilising the fourfold medieval system of allegory he first introduced in The Political Unconscious, Jameson traces a formal history of attempts to come to terms with the ‘multiplicities’ and incommensurable levels that emerge within modernity and postmodernity. This article identifies the complexities of Jameson’s understanding of allegory and draws on the brief moments when Jameson references the Anthropocene to argue for an allegorical reading of our contemporary environmental crisis that would allow us to see the problem the Anthropocene names as truly contradictory: at one and the same time, the world we inhabit appears to us as a world of our own making and as a world that has become truly alien to us.
The effectiveness of hope-fostering interventions in palliative care: A systematic review and meta-analysis
Authors: Salamanca-Balen Natalia , Merluzzi Thomas V , Chen Man 
Published: March 2021

Background: The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases. Aim: To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome. Design: This systematic review and meta-analysis was pre-registered (Prospero ID: CRD42019119956). Data sources: Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies. Results: Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size ( g = 0.61, 95% confidence interval (CI) = 0.28–0.93) but did not significantly reduce hopelessness ( g = −0.08, 95% CI = −0.18 to 0.02). It was found that interventions significantly increase spirituality ( g = 0.70, 95% CI = 0.02–1.37) and decrease depression ( g = −0.29, 95% CI = −0.51 to −0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low. Conclusions: Evidence suggests that interventions can be effective in increasing hope in palliative care patients.
Regional citrate anticoagulation versus low molecular weight heparin for CRRT in hyperlactatemia patients: A retrospective case-control study
Authors: Li Lu , Bai Ming , Zhang Wei , Zhao Lijuan , Yu Yan , Sun Shiren 
Published: March 2021

Introduction: There were controversial opinions on the use of regional citrate anticoagulation (RCA) versus low molecular weight heparin (LMWH) for continuous renal replacement therapy (CRRT) in hyperlactatemia patients, which was considered as one of the contraindications of citrate. The aim of our present study is to evaluate the efficacy and safety of RCA versus LMWH for CRRT in hyperlactatemia patients. Methods: Adult patients with hyperlactatemia who underwent RCA or LMWH CRRT in our center between January 2014 and March 2018 were retrospectively recruited. Filter lifespan, ultrafiltration, purification, bleeding, citrate accumulation, filter clot, and the infusion of blood production were evaluated as endpoints. Results: Of the 127 patients included in the original cohort, 81 and 46 accepted RCA and LMWH CRRT, respectively. The filter lifespan was significantly prolonged in the RCA group compared to the LMWH group (44.25 h [2 -83] vs. 24 h [4 -67], p < 0.001). The accumulated filter survival proportions were significantly improved in the RCA group compared to the LMWH group in the original cohort ( p < 0.001) as well as the matched group ( p < 0.001). The filters clotted more frequently in the LMWH group than in the RCA group in both of the original (52.2% vs 26.8%, p = 0.001) and matched cohort (58.6% vs 19.4%, p = 0.001). The bleeding complication was significantly reduced in the RCA group than in the LMWH group in the matched cohort (28.6% vs 4.5%, p = 0.04). Conclusion: In critically ill patients with hyperlactatemia requiring CRRT, RCA is superior to LMWH in terms of filter lifespan and bleeding risk without significantly increased risk of citrate accumulation and citrate related metabolic complications. RCA most likely is a safe and effective anticoagulation method for CRRT in patients with hyperlactatemia.
LAMB1 Is Related to the T Stage and Indicates Poor Prognosis in Gastric Cancer
Authors: Ran Tao , Chen ZhiJi , Zhao LiWen , Ran Wei , Fan JinYu , Hong SiYa , Yang ZhaoXia 
Published: March 2021

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.
Impact of Age on Consent in a Geriatric Orthopaedic Trauma Patient Population
Authors: McGovern Madeline M. , McTague Michael F. , Stevens Erin , Medina Juan Carlos Nunez , Franco-Garcia Esteban , Heng Marilyn 
Published: March 2021

Introduction: Persistent misconceptions of frailty and dementia in geriatric patients impact physician-patient communication and leave patients vulnerable to disempowerment. Physicians may inappropriately focus the discussion of treatment options to health care proxies instead of patients. Our study explores the consenting process in a decision-making capable orthogeriatric trauma patient population to determine if there is a relationship between increased patient age and surgical consent by health care proxy. Methods: Patients aged 65 and older who underwent operative orthopaedic fracture fixation between 1 of 2 Level 1 Trauma Centers were retrospectively reviewed. Decision-making capable status was defined as an absence of patient history of cognitive impairment and a negative patient pre-surgical Confusion Assessment Method (CAM) and Mini-Cog Assessment screen. Provider of surgical consent was the main outcome and was determined by signature on the consent form. Results: 510 patients were included, and 276 (54.1%) patients were deemed capable of consent. In 27 (9.8%) of 276 decision-capable patients, physicians obtained consent from health care proxies. 20 of these 27 patients (74.1%) were 80 years of age or older. However, in patients aged 70 to 79, only 7 health care proxies provided consent. (p = 0.07). For every unit increase in age, the log odds of proxy consent increased by .0008 (p < 0.001). Age (p < 0.001), income level (p = 0.03), and physical presence of proxy at consult (p < 0.001) were factors associated with significantly increased utilization of health care proxy provided consent. Language other than English was a significant predictor of proxy-provided consent (p = 0.035). 48 (22%) decision-making incapable patients provided their own surgical consent. Discussion: The positive linear association between age and health care proxy provided consent in cognitively intact geriatric orthopaedic patients indicates that increased patient age impacts the consenting process. Increased physician vigilance and adoption of institutional consenting guidelines can reinforce appropriate respect of geriatric patients’ consenting capacity.
Interest in Telehealth Among Patients With Chronic Retinal Conditions
Authors: Karthik Naveen , Shields Ryan A. , Brown Meghan M. , Aoun Mariam , Wolfe Jeremy D. , Drenser Kimberly A. , Capone Antonio , Williams George A. 
Published: March 2021

Purpose: This work investigated interest in telehealth services for patients with chronic retinal conditions. Methods: A single-center, multi-office study was conducted of patients with chronic retinal conditions who were seen by 1 of 4 physicians during June 2020. Patients whose next appointment was 6 months or later were telephoned. Patients completed a phone interest survey about their interest in a hybrid telehealth evaluation instead of a complete office evaluation with their provider. Results: Of 2136 patients reviewed, 453 met eligibility to participate in the survey. A total of 159 patients (35.1%) participated, of whom 91 (57.2%) indicated an interest in telehealth at their next follow-up visit. Of the 68 (42.8%) patients without a current interest in telehealth, 13 (19.1%) expressed interest in pursuing telehealth in the future. Age ( P = .19), sex ( P = .22), race ( P = .79), office location ( P = .19), number of prior visits ( P = .58), and median household income by patient’s zip code ( P = .14) were not predictors of telehealth interest. Among diagnoses, dry age-related macular degeneration was associated ( P = .04) with increased interest in telehealth. An increased number of ocular diagnoses were also found to predict a decreased ( P = .04) interest in telehealth. multivariable analysis revealed healthcare provider as the only significant predictor for interest in telehealth ( P = .03). Conclusions: Most patients with chronic retinal conditions may be interested in incorporating telehealth into routine care. Considerations should be made to evaluate interest in telehealth to guide patients to clinical experiences that best suit their needs.
Autoimmune hypoglycemia expands the biological spectrum of HHV8+ multicentric Castleman disease
Authors: Arnautou Pierre , Auclair Martine , Fellahi Soraya , Bouché Clara , Fieschi Claire , Barrak Elias , Queyrel-Moranne Viviane , Chaillous Lucy , Blin Nicolas , Malphettes Marion , Fadlallah Jehane , Bertinchamp Remi , Gérard Laurence , Bengoufa Djaouida , Galicier Lionel , Oksenhendler Eric , Vigouroux Corinne , Boutboul David 
Published: March 2021

Key Points
Autoimmune hypoglycemia belongs to the clinical spectrum of HHV8+ MCD and rituximab is an effective treatment of this condition. This rare complication is related to autoantibodies directed toward the insulin receptor and activating the insulin signaling pathway.
Effect of dural inflammatory soup application on activation and sensitization markers in the caudal trigeminal nucleus of the rat and the modulatory effects of sumatriptan and kynurenic acid
Authors: Spekker Eleonóra , Laborc Klaudia Flóra , Bohár Zsuzsanna , Nagy-Grócz Gábor , Fejes-Szabó Annamária , Szűcs Mónika , Vécsei László , Párdutz Árpád 
Published: March 2021

Abstract
Background
The topical inflammatory soup can model the inflammation of the dura mater causing hypersensitivity and activation of the trigeminal system, a phenomenon present in migraineurs. Calcitonin gene-related peptide, transient receptor potential vanilloid-1 receptor, and neuronal nitric oxide synthase are important in the sensitization process there.
5-HT1B/1D receptor agonists, triptans are used as a treatment of migraine. Kynurenic acid an NMDA antagonist can act on structures involved in trigeminal activation.

Aim
We investigated the effect of inflammatory soup induced dural inflammation on the calcitonin gene-related peptide, transient receptor potential vanilloid-1 receptor, and neuronal nitric oxide synthase levels in the caudal trigeminal nucleus. We also tested whether pretreatment with a well-known antimigraine drug, such as sumatriptan and kynurenic acid, a compound with a different mechanism of action, can affect these changes and if their modulatory effects are comparable.

Material and methods
After subcutaneous sumatriptan or intraperitoneal kynurenic acid the dura mater of adult male Sprague-Dawley rats (n = 72) was treated with inflammatory soup or its vehicle (synthetic interstitial fluid). Two and a half or four hours later perfusion was performed and the caudal trigeminal nucleus was removed for immunohistochemistry.

Results and conclusion
Inflammatory soup increased calcitonin gene-related peptide, transient receptor potential vanilloid-1 receptor, and neuronal nitric oxide synthase in the caudal trigeminal nucleus compared to placebo, which was attenuated by sumatriptan and kynurenic acid. This suggests the involvement of 5-HT1B/1D and NMDA receptors in neurogenic inflammation development of the dura and thus in migraine attacks.
Burden of oral anticoagulation in embolic stroke of undetermined source without atrial fibrillation
Authors: Witte Klaus K. , Tsivgoulis Georgios , Reynolds Matthew R. , Tsintzos Stelios I. , Eggington Simon , Ismyrloglou Eleni , Lyon Julie , Huynh Marianne , Egea Marta , de Brouwer Bonnie , Ziegler Paul D. , Franco Noreli , Joglekar Rashmi , Rosemas Sarah C. , Liu Shufeng , Thijs Vincent 
Published: March 2021

Abstract
Objective
Prevention of recurrent stroke in patients with embolic stroke of undetermined source (ESUS) is challenging. The advent of safer anticoagulation in the form of direct oral anticoagulants (DOACs) has prompted exploration of prophylactic anticoagulation for all ESUS patients, rather than anticoagulating just those with documented atrial fibrillation (AF). However, recent trials have failed to demonstrate a clinical benefit, while observing increased bleeding. We modeled the economic impact of anticoagulating ESUS patients without documented AF across multiple geographies.

Methods
CRYSTAL-AF trial data were used to assess ischaemic stroke event rates in ESUS patients confirmed AF-free after long-term monitoring. Anticipated bleeding event rates (including both minor and major bleeds) with aspirin, dabigatran 150 mg, and rivaroxaban 20 mg were sourced from published meta-analyses, whilst a 30% ischaemic stroke reduction for both DOACs was assumed. Cost data for clinical events and pharmaceuticals were collected from the local payer perspective.

Results
Compared with aspirin, dabigatran and rivaroxaban resulted in 17.9 and 29.9 additional bleeding events per 100 patients over a patient’s lifetime, respectively. Despite incorporating into our model the proposed 30% reduction in ischaemic stroke risk, both DOACs were cost-additive over patient lifetime, as the costs of bleeding events and pharmaceuticals outweighed cost savings associated with the reduction in ischaemic strokes. DOACs added £5953–£7018 per patient (UK), €6683–€7368 (Netherlands), €4933–€9378 (Spain), AUD$5353–6539 (Australia) and $26,768–$32,259 (US) of payer cost depending on the agent prescribed. Additionally, in the U.S. patient pharmacy co-payments ranged from $2468–$12,844 depending on agent and patient plan. In all settings, cost-savings could not be demonstrated even when the modelling assumed 100% protection from recurrent ischaemic strokes, due to the very low underlying risk of recurrent ischaemic stroke in this population (1.27 per 100 patient-years).

Conclusions
Anticoagulation of non-AF patients may cause excess bleeds and add substantial costs for uncertain benefits, suggesting a personalised approach to anticoagulation in ESUS patients.