bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipid-Lowering Therapy and Hemorrhagic Stroke Risk
Authors: Sanz-Cuesta Borja E. , Saver Jeffrey L. 
Published: June 2021

Background and Purpose:
Statins were shown to increase hemorrhagic stroke (HS) in patients with a first cerebrovascular event in 2006 (SPARCL), likely due to off-target antithrombotic effects, but continued to sometimes be used in patients with elevated HS risk due to absence of alternative medications. Recently, the PCSK9Is (proprotein convertase subtilisin kexin 9 inhibitors) have become available as a potent lipid-lowering class with potentially less hemorrhagic propensity.

Methods:
We performed a systematic comparative meta-analysis assessing HS rates across all completed statin and PCSK9I randomized clinical trials with treatment >3 months, following PRISMA guidelines. In addition to HS rates across all trials, causal relation was probed by evaluating for dose-response relationships by medication (low versus high medication dose/potency) and by presence and type of preceding brain vascular events at inception (none versus ischemic stroke/transient ischemic attack versus HS).

Results:

The systematic review identified 36 statin randomized clinical trials (204 918 patients) and 5 PCSK9I randomized clinical trials (76 140 patients). Across all patient types and all medication doses/potencies, statins were associated with increased HS: relative risk 1.15,
P
=0.04; PCSK9Is were not (
P
=0.77). In the medication dose/potency analysis, higher dose/potency statins (7 trials, 62 204 patients) were associated with magnified HS risk: relative risk, 1.53;
P
=0.002; higher dose/potency PCSK9Is (1 trial, 27 564 patients) were not (
P
=0.99). In the type of index brain vascular injury analysis for statins (5 trials, 9772 patients), prior ischemic stroke/transient ischemic attack was associated with a magnified risk of HS: relative risk, 1.43;
P
=0.04; and index intracerebral hemorrhage was associated with an extremely high effect estimate of risk of recurrent HS: hazard ratio, 4.06. For PCSK9Is, prior ischemic stroke/transient ischemic attack (1 trial, 5337 patients) was not associated with increased HS risk (
P
=0.97).

Conclusions:
Statins increase the risk of HS in a medication dose- and type of index brain vascular injury-dependent manner; PCSK9Is do not increase HS risk. PCSK9Is may be a preferred lipid-lowering medication class in patients with elevated HS risk, including patients with prior HS.
Observation on the morphological and gonadal aspects of Cladonema radiatum (Class: Hydrozoa) from Tuticorin Bay, Southeast coast of India
Authors: RANJITH L. , KALIDAS C. , SARAVANAN R. , JAGADIS I. , PRABU D. LINGA , KAVITHA M. , BABU A. MATHAN , JOSHI K.K. , MANOJKUMAR P.P. 
Published: June 2021

Studies on the hydrozoan fauna (Phylum: Cnidaria; Class: Hydrozoa) of the Indian waters during the 20th century were few in number (Nagale and Apte, 2013a, b). They originated in the early 1900s (Annandale, 1907; Ritchie, 1910, Thornely, 1916, Gravely, 1927), focussing on the taxonomy of hydroids in the 1960s along the southern coast, including Lakshadweep and Andaman Islands (Mammen, 1963, 1965a, b) and in the 1980s along the northern coast (Venugopalan & Wagh, 1986). Species of the hydrozoan family Cladonematidae (Anthoathecata; Capitata) include benthic, creeping and swimming hydroids comprising four genera viz., Cladonema, Eleutheria, Staurocladia and the nomen dubium Dendronema (Schuchert, 2021). Cladonema differs from other genera of Cladonematidae by the branched tentacles either with an adhesive structure or cnidocytes and having nematocysts in oral knobs (Ghory et al., 2020 & Farias et al., 2020). The taxonomy of Cladonema is uncertain and species in the genus have undergone several rounds of grouping and splitting. Gershwin & Zeidler (2008) gave a detailed account of 13 putative species of Cladonema. However, Schuchert (2021) considered six species to be valid viz., C. radiatum, C. californicum, C. myersi, C. novaezelandiae, C. pacificum and C. timmsii. Studies on the genus Cladonema from Indian waters are patchy, with a brief report of its occurrence among other hydroids (Sastry and Chandramohan, 1989; Santhakumari and Nair, 1999; Arun et al., 2018). Among these records from India, C. myersi was collected from an experimental aquarium with seawater from an unknown location (Prasad, 1961). The present study documents the occurrence and describes the morphology and gonadal features of Cladonema radiatum from Tuticorin Bay, Gulf of Mannar, Southeast coast of India.
Synopsis of Lestes from Brazil with description of Lestes demarcoi sp. nov. (Zygoptera: Lestidae)
Authors: LENCIONI F.A.A. , NEISS U.G. , DUTRA S.L. , FURIERI K.S. , JUEN L. , BATISTA J.D. , VILELA DIOGO S. 
Published: June 2021

The Brazilian fauna of Lestidae contains two genera (Archilestes Selys, 1862 and Lestes Leach in Brewster, 1815) with 14 species, many of which are poorly defined and/or known only by primary literature. To improve the knowledge of the Brazilian species of the genus Lestes we examined 97 specimens pertaining to 11 of the 13 described species. Additionally, a new species is described here in honor to Prof. Dr. Paulo De Marco Júnior: Lestes demarcoi (Holotype and Allotype: Brazil: Amazonas, Manaus, Reserva Adolpho Ducke, Acará trail, 02º55’46” S & 59º58’22” W, 62 m, 13.iv.2009, collected in tandem, U.G. Neiss leg. and deposited in FAAL).
Diagnostic illustrations of all species are provided. Color photographs of live individuals of Lestes dichrostigma Calvert, 1909, Lestes forficula Rambur, 1842 and Lestes paulistus Calvert, 1909 are also presented.
The current pandemic, a complex emergency? Mental health impact of the COVID-19 pandemic on highly vulnerable communities in Guatemala
Authors: Alonzo Dana , Popescu Marciana , Zubaroglu-Ioannides Pinar 
Published: June 2021

Background: On March 5th, Guatemala declared a ‘State of Calamity’ in response to the COVID-19 pandemic and strict lockdown measures were initiated. The psychological consequences of these measures are yet to be fully understood. There is limited research on the psychological impact of the virus in the general population, and even less focused on Latin America and high-risk communities characterized by poverty, limited mental health resources, and high rates of stigma around mental illness. The goal of this study is to examine the psychological impact of COVID-19 across several highly vulnerable districts in Guatemala. Methods: A semi-structured phone interview was conducted of 295 individuals in multiple districts in Guatemala City to assess self-perceived mental health consequences related to the pandemic. Sociodemographic, medical, and mental health data were collected. Chisquares and t-tests used for categorical and continuous variables, as appropriate, to describe the sample. Binary logistic regressions were estimated to examine associations between sociodemographic characteristics and mental health symptoms (anxiety, stress, depression, burnout, escalation of pre-existing mental health symptoms, and a sense of safety). Results: The results indicate high levels of anxiety and stress in all target communities. Significant differences based on gender, age, and the number of children in the household were identified: women and older adults experience higher rates of stress and anxiety associated with the pandemic; while families with greater number of children experience higher levels of burnout. Conclusion: Contextualizing the current pandemic as a complex emergency can help inform further studies focusing on socioeconomic challenges and higher vulnerabilities as preconditions affecting the impact of the pandemic on mental health. Given the limited available resources for mental health care in Guatemala, informal networks of care may play an important role in meeting the needs of those individuals experiencing increased psychological distress resulting from the pandemic.
Aspiration and Opportunity: First-Generation Immigrants and Refugees at Community College
Authors: Leo Aaron 
Published: June 2021

Objective: This article explores the experiences of 32 first-generation immigrant and refugee students as they transition into and out of community college. The challenges students face and the resources on which they draw in their educational pursuits are viewed through Bourdieu’s theory of cultural capital. Method: This project utilizes an applied ethnographic approach that primarily elicited participant-observation and interview data. Results: Findings demonstrate that prospective community college students articulated uncertainty about the college process and concern over the quality of community colleges. Current and former community college students validated these concerns as they described their struggles to overcome both in- and out-of-school challenges. In many cases, such obstacles resulted in the leveling of previously high aspirations. Contribution: Although the growing number of immigrant and refugee students in the United States are disproportionately represented at community colleges, little is known about their experiences in these institutions. This article adds to our understanding of immigrant and refugee students’ experiences in community colleges through their own words.
Comparison of antinuclear antibody profiles obtained using line immunoassay and fluorescence enzyme immunoassay
Authors: Jang Jaehyeok , Kim Sinyoung , Kim Hyon-Suk , Lee Kyung-A , Park Jungyong , Park Younhee 
Published: June 2021

Objective LIA-ANA-Profile-17S is a multiplex line immunoassay that simultaneously detects 17 antinuclear antibodies (ANAs) against extractable nuclear antigens (ENAs). We evaluated the utility of LIA-ANA-Profile-17S as a supplement to ANA indirect immunofluorescence (IIF) and EliA ENA (a fluorescence enzyme immunoassay) for diagnosis of ANA-associated rheumatic diseases. Methods Sera were collected from 245 patients referred for an ANA IIF test. LIA-ANA-Profile-17S results were compared with those of EliA ENA. The kappa coefficients, agreement rates, and diagnostic performance of these tests were assessed for systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SjS). Results We observed almost perfect interassay agreement for antibodies against Ro52/Ro60, CENP-B, and Scl-70 (kappa = 0.91, 0.97, and 1.00, respectively); strong agreement for anti-SS-B/La antibody (kappa = 0.81); and relatively low agreement for other antibodies, including those against dsDNA, Sm, RNP, and Jo-1. For SLE diagnosis, LIA-ANA-Profile-17S showed lower sensitivity and similar specificity compared with EliA ENA. The sensitivity and specificity of these two assays were similar for SjS diagnosis. Conclusions The specificity of LIA-ANA-Profile-17S was enhanced when combined with ANA IIF and was comparable with that of EliA ENA. LIA-ANA-Profile-17S showed relatively good agreement with EliA ENA. In combination with ANA IIF, these assays showed enhanced diagnostic performance.
Reduction in post-spinal cord injury spasticity by combination of peripheral nerve grafting and acidic fibroblast growth factor infusion in monkeys
Authors: Sun Wei-Ming , Ma Chao-Lin , Xu Jiang , He Ji-Ping 
Published: June 2021

Objective Spasticity is a frequent complication after spinal cord injury (SCI), but the existing therapies provide only limited relief and are associated with adverse reactions. Therefore, we aimed to develop a novel strategy to ameliorate the spasticity induced by SCI. Methods This nonrandomized controlled study used a repeated measurement design. The study involved four monkeys, two of which served as controls and only underwent spinal cord hemisection surgery at the T8 spine level. The other two monkeys underwent transplantation of sural nerve segments into the injured sites and long-term infusion of acidic fibroblast growth factor (aFGF). All monkeys received postoperative exercise training and therapy. Results The combined therapy substantially reduced the spasticity in leg muscle tone, patella tendon reflex, and fanning of toes. Although all monkeys showed spontaneous recovery of function over time, the recovery in the controls reached a plateau and started to decline after 11 weeks. Conclusions The combination of peripheral nerve grafting and aFGF infusion may serve as a complementary approach to reduce the signs of spasticity in patients with SCI.
Remimazolam: A Novel Option for Procedural Sedation in High Risk Patients
Authors: Pantos Megan M. , Kennedy Daniel R. , Nemec Eric C. 
Published: June 2021

Purpose: The purpose of this drug review was to explore the safety and efficacy of the newly approved benzodiazepine, remimazolam, in order to evaluate its place in therapy. Summary: Remimazolam has a faster onset of action and recovery time than midazolam when given as single IV doses. Additionally, it has no known CYP450 interactions that would contribute to drug-drug interactions. Patients with severe hepatic impairment may require dose titration as well as the elderly who should be closely monitored. Although remimazolam vials should be protected from light and must be reconstituted immediately before use, the reconstituted vial may be stored for later use at room temperature for up to 8 hours. Remimazolam is more expensive than current options used in practice, as such individual institutional formulary and provider preference will require review to see if its advantages are worth the additional cost and to determine its place in therapy. Conclusion: Remimazolam is a novel option when choosing a benzodiazepine for procedural sedation that has pharmacokinetic and pharmacodynamic advantages when compared to other commonly prescribed sedatives. Remimazolam has proved superior to midazolam when analyzing drug-drug interactions, onset, and time to alertness. Remimazolam also has a shorter elimination half-life and decreased volume of distribution when compared to midazolam.
A Psychoeducational Group Intervention for Nurses: Rationale, Theoretical Framework, and Development
Authors: Bailey Amanda K. , Sawyer Amanda T. , Robinson Patricia Stearnes 
Published: June 2021

OBJECTIVE Nursing is a demanding profession with constant stressors, which makes nurses vulnerable to the detrimental effects of high stress, burnout, and compassion fatigue. There is a need for a multidimensional group intervention facilitated by a licensed mental health professional to improve mental health and well-being in nurses. An intervention called RISE, which is an acronym for resilience, insight, self-compassion, and empowerment, was developed to promote self-care, protect against burnout, and improve indicators of well-being among nurses. We explain the rationale, theoretical framework, and development of RISE. METHODS RISE is based on an integrative theoretical framework of mindfulness, acceptance and commitment therapy, and cognitive-behavioral therapy. It consists of eight psychoeducational group sessions with topics related to the four RISE themes of resilience, insight, self-compassion, and empowerment. RESULTS RISE is a contribution to the literature on well-being interventions for nurses. It will further the understanding of effective interventions to mediate the detrimental effects of stress and burnout in nursing and to improve the mental health and well-being of nurses amid the complex interplay of factors at the individual, unit, and organizational levels. CONCLUSIONS As an approach that combines education with therapeutic process and support to improve coping and well-being inside and outside of the workplace, RISE addresses the underlying causes and effects of high stress, burnout, and compassion fatigue.
Microbiota or placebo after antimicrobial therapy for recurrent Clostridioides difficile at home: A clinical trial with novel home-based enrollment
Authors: Drekonja Dimitri M , Shaukat Aasma , Zhang Jane H , Reinink Andrew R , Nugent Sean , Dominitz Jason A , Davis-Karim Anne , Gerding Dale N , Kyriakides Tassos C 
Published: June 2021

Introduction: Clostridiodes difficile infection is the leading cause of infectious diarrhea in the United States, with substantial morbidity and mortality. Recurrent infection is especially challenging, with each recurrence increasing the likelihood of a successive recurrence, leading to cycles of prolonged symptoms, frequent antimicrobial use, and decreased quality of life. Fecal microbiota transplantation to prevent recurrent infection is a promising intervention with a large effect size in observational studies, but with conflicting results from randomized controlled trials. We are conducting a Veterans Affairs-wide randomized controlled trial utilizing centralized case identification, with enrollment and fecal microbiota transplant administration occurring at the participant’s home. This type of trial design significantly improves trial efficiency, greatly decreases trial cost, increases consistency of trial administration, and most importantly makes nationwide clinical trials in less-common diseases possible. Methods: This is a randomized comparison of capsule-delivered fecal microbiota transplant for the prevention of recurrent Clostridiodes difficile infection, administered after successful initial treatment of recurrent C. difficile infection with standard therapy. The primary endpoint is the incidence of recurrent C. difficile infection or death. Cases are identified by searching the Veterans Affairs Corporate Data Warehouse, with central study coordinators then reaching out to potential participants. Individuals meeting inclusion criteria and interested in participation are scheduled for in-home consent, randomization, and capsule administration, followed by telephone follow-up for 6 months. To mitigate risks of COVID-19, enrollment via video visits has been implemented. Results: A total of 102 participants have been enrolled through January 2021. Centralized case identification and in-home enrollment has facilitated enrollment from 34 unique states, with 38% being from rural or highly rural areas. Discussion: Centralized case identification and in-home enrollment is a feasible and innovative method of conducting randomized controlled trials in the Veterans Affairs system, improving access to clinical research for populations who may have difficulty engaging with the traditional model of clinical trials where enrollment is based at large hospitals in major metropolitan areas.
Pulmonary hypertension associated with neurofibromatosis type 2
Authors: Taniguchi Hirohisa , Takashima Tomoya , Tu Ly , Thuillet Raphaël , Furukawa Asuka , Furukawa Yoshiko , Kawamura Akio , Humbert Marc , Guignabert Christophe , Tamura Yuichi 
Published: June 2021

Although precapillary pulmonary hypertension is a rare but severe complication of patients with neurofibromatosis type 1 (NF1), its association with NF2 remains unknown. Herein, we report a case of a 44‐year‐old woman who was initially diagnosed with idiopathic pulmonary arterial hypertension and treated with pulmonary arterial hypertension‐specific combination therapy. However, a careful assessment for a relevant family history of the disease and genetic testing reveal that this patient had a mutation in the NF2 gene. Using immunofluorescence and Western blotting, we demonstrated a decrease in endothelial NF2 protein in lungs from idiopathic pulmonary arterial hypertension patients compared to control lungs, suggesting a potential role of NF2 in pulmonary arterial hypertension development. To our knowledge, this is the first time that precapillary pulmonary hypertension has been described in a patient with NF2. The altered endothelial NF2 expression pattern in pulmonary arterial hypertension lungs should stimulate work to better understand how NF2 is contributing to the pulmonary vascular remodelling associated to these severe life‐threatening conditions.
Developing a Professionalism Manual for Nurse Managers to Improve Their Perception Regarding Professionalism and Professional Identity
Authors: Ageiz Marwa H. , Elshrief Hayam A. , Bakeer Huda M. 
Published: June 2021

Background Developing a professional identity is rooted in the dimensions of professionalism and professional development. Moreover, the need for teaching professionalism has a mutual relationship with the formation of a desirable professional identity. Aim The current study aimed at developing a professionalism manual for the nurse managers to improve their perception regarding professionalism and professional identity. Design Quasi-experimental research design with pre-test, post-test, and follow-up was used. Setting The study was conducted at two different hospitals; Menoufia University hospital and Al-helal Insurance hospital, Menoufia Governorate, Egypt. Subjects The participants included all nurse managers at different levels from the two different hospitals ( n =100). Tools: tool 1: Professionalism Questionnaire and tool 2: Professional Identity Assessment Questionnaire were used to collect data. Results there was a statistically significant improvement in professionalism perception and professional identity level immediately after administering the professionalism manual and after three months in the follow-up phase than the pre-test phase. Additionally, there was a statistically significant positive correlation between two variables of the study at the post and follow-up phases, but not significant at the pre-test phase. Conclusion the professionalism manual was effective in improving nurse managers’ perceptions regarding professionalism and professional identity. Recommendations: Incorporate the attributes of professionalism that were included in the professionalism manual as a guide for the performance review processes of nurses.
Identifying Novel Psoriatic Disease Drug Targets Using a Genetics-Based Priority Index Pipeline
Authors: Bui Audrey , Liu Jared , Hong Julie , Hadeler Edward , Mosca Megan , Brownstone Nicholas , Liao Wilson 
Published: June 2021

Background: Despite numerous genome-wide association studies conducted in psoriasis and psoriatic arthritis, only a small fraction of the identified genes has been therapeutically targeted. Objective: We sought to identify and analyze potential therapeutic targets for psoriasis and psoriatic arthritis (PsA) using the priority index (Pi), a genetics-dependent drug target prioritization approach. Methods: Significant genetic variants from GWAS for psoriasis, PsA, and combined psoriatic disease were annotated and run through the Pi pipeline. Potential drug targets were identified based on genomic predictors, annotation predictors, pathway enrichment, and pathway crosstalk. Results: Several gene targets were identified for psoriasis and PsA that demonstrated biological associations to their respective diseases. Some are currently being explored as potential therapeutic targets (i.e. ICAM1, NF-kB, REV3 L, ADRA1B for psoriasis; CCL11 for PsA); others have not yet been investigated (i.e. LNPEP, LCE3 for psoriasis; UBLCP1 for PsA). Additionally, many nodal points of potential intervention were identified as promising therapeutic targets. Of these, some are currently being studied such as TYK2 for psoriasis, and others have yet to be explored (i.e. PPP2CA, YAP1, PI3 K, AKT, FOXO1, RELA, CSF2, IFNGR1, IFNGR2 for psoriasis; GNAQ, PLCB1, GNAI2 for PsA). Conclusion: Through Pi, we identified data-driven candidate therapeutic gene targets and pathways for psoriasis and PsA. Given the sparse PsA specific genetic studies and PsA specific drug targets, this analysis could prove to be particularly valuable in the pipeline for novel psoriatic therapies.