bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the associations between a posteriori dietary patterns and obesity indexes: Systematic review of observational studies
Authors: Koutras Yiannis , Chrysostomou Stavri , Poulimeneas Dimitrios , Yannakoulia Mary 
Published: June 2021

Background: Few reports on the association of population-derived dietary patterns with excess body weight, using the approach of a systematic review currently exist. Aim: The aim of the present systematic review was to identify dietary patterns associated with body mass index (BMI), body weight (BW)/BMI change, weight status and weight loss maintenance status. Methods: Using MEDLINE (via PubMed) and EBSCO Host databases, we systematically reviewed studies from 1980 to 2020, which included men and women, aged ≥18 years. Primary outcome was BMI or the longitudinal change of individuals’ BW or BMI, or weight status (normal weight/overweight/obesity) or weight loss maintenance status. We included observational studies, with or without a prospective design. Studies which met the inclusion criteria were evaluated based on the Newcastle–Ottawa Scale; only a posteriori dietary patterns were evaluated. Results: Twenty-six studies were eligible for inclusion in the current analysis. The results indicate a relationship between adherence to a lacto-vegetarian dietary pattern, characterized by high intake of fruits, vegetables, whole grains, unprocessed cereals, dairy and low intake of high-fat foods and sweets, and longitudinal change of individuals’ BW or BMI, or the risk of overweight/obesity. Conclusions: Promotion of this healthy dietary pattern, as an alternative to focusing on specific nutrients or foods, may be a promising approach to be included in future long-term weight maintenance interventions.
Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis
Authors: Reid Gregory , Mork Constantin , Gahl Brigita , Appenzeller-Herzog Christian , von Segesser Ludwig K , Eckstein Friedrich , Berdajs Denis A 
Published: June 2021

Objectives: The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation. Methods: This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE. The primary endpoint was mortality at the hospital stay and at follow-up. Pooled incidence of defined endpoints was calculated by using random effects models. Results: A total of 35 retrospective studies that included 3260 patients were analyzed. 30 days mortality was in favour of isolated LVAD implantation 6.74% (1.98–11.5%) versus 31.9% (19.78–44.02%) p = 0.001 in LVAD with temporary need for RVAD. During the hospital stay the incidence of major bleeding was 18.7% (18.2–19.4%) versus 40.0% (36.3–48.8%) and stroke rate was 5.6% (5.4–5.8%) versus 20.9% (16.8–28.3%) and was in favour of isolated LVAD implantation. Mortality reported at short-term as well at long-term was 19.66% (CI 15.73–23.59%) and 33.90% (CI 8.84–59.96%) in LVAD respectively versus 45.35% (CI 35.31–55.4%) p ⩽ 0.001 and 48.23% (CI 16.01–80.45%) p = 0.686 in LVAD/RVAD group respectively. Conclusion: Implantation of a temporary RVAD is allied with a worse outcome during the primary hospitalization and at follow-up. Compared to isolated LVAD support, biventricular mechanical circulatory support leads to an elevated mortality and higher incidence of adverse events such as bleeding and stroke.
Monitoring nociception and awareness during palliative sedation: A systematic review
Authors: Dieudonné Rahm Nathalie , Morawska Ghizlaine , Pautex Sophie , Elia Nadia 
Published: June 2021

Background: Providing unawareness and pain relief are core elements of palliative sedation. In addition to clinical scales, nociception and electroencephalogram-based depth of sedation monitoring are used to assess the level of consciousness and analgesia during sedation in intensive care units and during procedures. Aim: To determine whether reported devices impact the outcomes of palliative sedation. Design: Systematic review and narrative synthesis of research published between January 2000 and December 2020. Data sources: Embase, Google Scholar, PubMed, CENTRAL, and the Cochrane Library. All reports describing the use of any monitoring device to assess the level of consciousness or analgesia during palliative sedation were screened for inclusion. Data concerning safety and efficacy were extracted. Patient comfort was the primary outcome of interest. Articles reporting sedation but that did not meet guidelines of the European Association for Palliative Care were excluded. Results: Six reports of five studies were identified. Four of these were case series and two were case reports. Together, these six reports involved a total of 67 sedated adults. Methodological quality was assessed fair to good. Medication regimens were adjusted to bispectral index monitoring values in two studies, which found poor correlation between monitoring values and observational scores. In another study, high nociception index values, representing absence of pain, were used to detect opioid overdosing. Relatives and caregivers found the procedures feasible and acceptable.
Wedging of vertebral bodies at the thoracolumbar spine in healthy individuals on whole body MRI screening: correlation with disc degeneration and disc herniation
Authors: Kim Jinhui , Park Hee Jin , Kim Myung Sub , Kim Ji Na , Choi Yoon Jung , Rho Myung Ho , Park Ji Yeon 
Published: June 2021

Background There have been no reports on the relationship between wedging of vertebral bodies at the thoracolumbar spine and disc herniation in healthy individuals on magnetic resonance imaging (MRI). Purpose To investigate the degree of wedging of vertebral bodies at the thoracolumbar spine in healthy individuals who underwent whole-body (WB) MRI. We also assessed the correlation between wedging and adjacent disc pathology. Material and Methods This retrospective study comprised 200 healthy patients who underwent WB MRI as part of a regular health check from January 2019 to February 2019. We measured anterior and posterior vertical heights of each vertebral body between T10 and L2. The ratio of anterior height to posterior height (APR) was calculated, and we evaluated disc degeneration or disc herniation using WB MRI. Results The APR of T10 was significantly higher than at the other levels ( P < 0.05), and the APR of L1 was significantly lower ( P < 0.05). Men had a significantly smaller APR than women at T12 to L2 ( P < 0.05). Regarding the relationship between APR and disc degeneration, the group without disc degeneration had a higher APR, with statistical significance at T12, L1, and L2. Regarding the relationship between APR and disc herniation, the group without disc herniation had a higher APR, with statistical significance at T11, T12, L1, and L2. Conclusion Wedging of vertebral bodies is most prominent at L1. Although the values were statistically significant only at some levels, the patients with disc degeneration or herniation had more prominent wedge deformity of thoracolumbar spine.
Hyaluronan-mediated motility receptor expression functions as a prognostic biomarker in uterine carcinosarcoma based on bioinformatics analysis
Authors: Sun Hui , Ma Li , Chen Jie 
Published: June 2021

Objective Uterine carcinosarcoma (UCS) is a rare, aggressive tumour with a high metastasis rate and poor prognosis. This study aimed to explore potential key genes associated with the prognosis of UCS. Methods Transcriptional expression data were downloaded from the Gene Expression Profiling Interactive Analysis database and differentially expressed genes (DEGs) were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses using Metascape. A protein–protein interaction network was constructed using the STRING website and Cytoscape software, and the top 30 genes obtained through the Maximal Clique Centrality algorithm were selected as hub genes. These hub genes were validated by clinicopathological and sequencing data for 56 patients with UCS from The Cancer Genome Atlas database. Results A total of 1894 DEGs were identified, and the top 30 genes were considered as hub genes. Hyaluronan-mediated motility receptor (HMMR) expression was significantly higher in UCS tissues compared with normal tissues, and elevated expression of HMMR was identified as an independent prognostic factor for shorter survival in patients with UCS. Conclusions These results suggest that HMMR may be a potential biomarker for predicting the prognosis of patients with UCS.
Comparison of high-flow nasal oxygen cannula therapy versus a standard oxygen face mask in patients with hypostatic pneumonia
Authors: Song Yamei , Zhang Jinchao , Xing Jia , Wang Ning , Wang Jing 
Published: June 2021

Objective We assessed the clinical effects of high-flow nasal cannula (HFNC) oxygen therapy and a standard oxygen atomizer mask on the respiratory tract in patients with hypostatic pneumonia. Methods We included patients with hypostatic pneumonia in this retrospective cohort study. Patients were provided continuous airway humidification by continuous oxygen atomization using either an HFNC or standard oxygen mask. Arterial blood gas analysis, the dyspnea score, inflammatory-related parameters, and adverse events of patients in the two groups were compared. Results Fifty-five patients had HFNC delivery and 57 had a standard oxygen atomizer mask. After 7 days of treatment, patients in the HFNC group had a higher partial pressure of arterial blood oxygen/fraction of inspired oxygen ratio (268.12±28.44 vs 238.28±30.04) and lower partial pressure of arterial blood carbon dioxide (38.02±8.84 vs 49.27±7.84 mmHg) than those in the standard oxygen mask group. The dyspnea score and inflammatory-related parameters in the HFNC group were significantly lower than those in the standard oxygen mask group. The incidence of adverse events was lower in the HFNC group than in the standard oxygen mask group. Conclusion HFNC therapy relieves clinical symptoms more quickly than a standard oxygen mask and reduces the incidence of adverse events.
Blood Flow Restriction Training for the Shoulder: A Case for Proximal Benefit
Authors: Lambert Bradley , Hedt Corbin , Daum Joshua , Taft Carter , Chaliki Kalyan , Epner Eden , McCulloch Patrick 
Published: June 2021

Background: Although blood flow restriction (BFR) is becoming increasingly popular in physical therapy and athletic training settings, little is known about the effects of BFR combined with low-intensity exercise (LIX) on muscles proximal to the site of occlusion. Hypothesis/Purpose: Determine whether LIX combined with BFR applied distally to the shoulder on the brachial region of the arm (BFR-LIX) promotes greater increases in shoulder lean mass, rotator cuff strength, endurance, and acute increases in shoulder muscle activation compared with LIX alone. We hypothesized that BFR-LIX would elicit greater increases in rotator cuff strength, endurance, and muscle mass. We also hypothesized that the application of BFR would increase EMG amplitude in the shoulder muscles during acute exercise. Study Design: Controlled laboratory study. Methods: 32 healthy adults were randomized into 2 groups (BFR group, 13 men, 3 women; No-BFR group, 10 men, 6 women) who performed 8 weeks of shoulder LIX (2 times per week; 4 sets [30/15/15/fatigue]; 20% maximum) using common rotator cuff exercises (cable external rotation [ER], cable internal rotation [IR], dumbbell scaption, and side-lying dumbbell ER). The BFR group also trained with an automated tourniquet placed at the proximal arm (50% occlusion). Regional lean mass (dual-energy x-ray absorptiometry), isometric strength, and muscular endurance (repetitions to fatigue [RTF]; 20% maximum; with and without 50% occlusion) were measured before and after training. Electromyographic amplitude (EMGa) was recorded from target shoulder muscles during endurance testing. A mixed-model analysis of covariance (covaried on baseline measures) was used to detect within-group and between-group differences in primary outcome measures (α = .05). Results: The BFR group had greater increases in lean mass in the arm (mean ± 95% CI: BFR, 175 ± 54 g; No BFR, –17 ± 77 g; P < .01) and shoulder (mean ± 95% CI: BFR, 278 ± 90 g; No BFR, 96 ± 61 g; P < .01), isometric IR strength (mean ± 95% CI: BFR, 2.9 ± 1.3 kg; No BFR, 0.1 ± 1.3 kg; P < .01), single-set RTF volume (repetitions × resistance) for IR (~1.7- to 2.1-fold higher; P < .01), and weekly training volume (weeks 4, 6-8, ~5%-22%; P < .05). Acute occlusion (independent of group or timepoint) yielded increases in EMGa during RTF (~10%-20%; P < .05). Conclusion: Combined BFR-LIX may yield greater increases in shoulder and arm lean mass, strength, and muscular endurance compared with fatiguing LIX alone during rotator cuff exercises. These findings may be due, in part, to a greater activation of shoulder muscles while using BFR. Clinical Relevance: The present study demonstrates that BFR-LIX may be a suitable candidate for augmenting preventive training or rehabilitation outcomes for the shoulder.
Evaluation of the Intact Anterior Talofibular and Calcaneofibular Ligaments, Injuries, and Repairs With and Without Augmentation: A Biomechanical Robotic Study
Authors: Larkins Christopher G. , Brady Alex W. , Aman Zachary S. , Dornan Grant J. , Haytmanek Craig T. , Clanton Thomas O. 
Published: June 2021

Background: Acute ankle sprains are common injuries. The anterior talofibular (ATFL) and calcaneofibular ligaments (CFL) are the most injured lateral structures. However, controversy exists on the optimal surgical treatment when the injury is both acute and severe or becomes chronic and unstable. Studies have evaluated the biomechanics of these ligaments, but no studies have robotically evaluated injury effects and surgical treatment of ATFL or ATFL and CFL injuries. Purpose: To quantitatively evaluate biomechanical effects of ATFL and CFL lesions, ATFL repair, ATFL and CFL repair, and augmentation of ATFL on ankle stability. Study Design: Controlled laboratory study. Methods: Ten nonpaired cadaveric ankles were tested using a 6 degrees of freedom robot. Each ankle underwent testing in the following states sequentially: (1) intact, (2) ATFL cut, (3) CFL cut, (4) ATFL repair + CFL cut, (5) ATFL repair + CFL repair, and (6) ATFL repair with augmentation with suture tape + CFL repair. Testing included 88 N anterior drawer and 5 N·m varus talar tilt tests at 0° and 30° of plantarflexion, and 88 N Cotton test at 0° of plantarflexion. Results: After all surgical treatments ankles still had increased laxity compared with intact state testing, except after augmented ATFL repair + CFL repair in anterior drawer testing at 30° of plantarflexion ( P = .393). Sectioning the CFL caused a significant increase in talar tilt compared with the ATFL cut state at 0° ( P < .001) and 30° of plantarflexion ( P < .001), but no increase in anterior drawer or Cotton tests. Conclusion: Complete native stability may not be attainable at time zero repair with the tested treatments. The option that best returned stability in anterior translation was augmented ATFL repair with nonaugmented CFL repair. The importance of the CFL as a primary ligamentous stabilizer for talar tilt was confirmed. Clinical Relevance: Evaluating lateral ankle stability and treatment with a 6 degrees of freedom robot should help delineate optimal treatment options. Findings in this study show that none of the repair methods at time zero restored kinematics to the intact state. Of the tested states, the augmented ATFL repair with CFL repair was the best option for controlling anterior translation at time zero. The importance of addressing the CFL to correct talar tilt instability was suggested as was the importance of a period of immobilization before beginning protected rehabilitation. The benefit of ATFL repair augmentation with suture tape is in limiting the postoperative motion in an anterior drawer motion to just 0.5 to 1 mm, but there was no significant improvement to talar tilt even with CFL repair, suggesting that further consideration should be given to CFL augmentation in future studies.
Never again? The role of the global network of R2P focal points in preventing atrocity crimes
Authors: Mennecke Martin 
Published: June 2021

The Nuremberg judgement famously held that crimes against international law are committed by men, not by abstract entities – but who, then, is to prevent these crimes? In 2005, all UN Member States agreed that it was their responsibility to protect populations against atrocity crimes (short R2P). In 2010, the idea was born to appoint senior government officials to act as individual R2P Focal Points to help implement this historic pledge. This article critically examines the focal point idea and its practice, focusing on the experience of the Danish R2P Focal Point as well as the role of the Global Network of R2P Focal Point which today has members from 61 UN member states. The article highlights the significant potential of the R2P Focal Points but also a series of pre-conditions that need to be met if the appointment of a R2P Focal Point is not to remain a mere gesture.
Ethical challenges in end-stage dementia: Perspectives of professionals and family care-givers
Authors: Hochwald Inbal Halevi , Yakov Gila , Radomyslsky Zorian , Danon Yehuda , Nissanholtz-Gannot Rachel 
Published: June 2021

Background: In Israel, caring for people with end-stage dementia confined to home is mainly done by home care units, and in some cases by home hospice units, an alternative palliative-care service. Because life expectancy is relatively unknown, and the patient’s decision-making ability is poor, caring for this unique population raises ethical dilemmas regarding when to define the disease as having reached a terminal stage, as well as choosing between palliative and life-prolonging-oriented care. Objectives: Exploring and describing differences and similarities of professional staff members’ (PSMs’) and family caregivers’ perceptions of caring for people with end-stage dementia in two different settings. Design: Qualitative research, using semi-structured interviews analyzed through a thematic content–analysis approach. Participants: Sixty-four interviews were conducted (24 PSMs and 40 family caregivers) in two care-settings—home hospice unit and home care unit. Ethical considerations: The study was approved by the Ethics Committee (BBL00118-17). Findings: We found dilemmas regarding palliative care to be the main theme, including definition of the disease as terminal, choosing “comfort” over “life-prolonging,” clarifying patients’ wishes and deciding whether or not to use artificial feeding. Discussion: Both PSMs and family caregivers deal with ethical dilemmas and have reached different conclusions, both legitimate. Comprehending dementia as a terminal disease influenced participants’ perceptions of the relevancy of palliative care for people with end-stage dementia. Discrepancies between PSMs and family caregivers in caring for people with end-stage dementia were found in both home hospice unit and home care unit environments, raising potential conflicts regarding decisions for end-of-life care. Conclusions: Communication between PSMs and family caregivers is crucial for the discussion about the discrepancies regarding the unique dilemmas of caring for people with end-stage dementia and bridging the gap between them. Lack of communication and resources can hamper the provision of an acceptable solution for quality and equality of care in the best interest of people with end-stage dementia.
Father Involvement in the First Year After Prison: Considerations for Social Work
Authors: Charles Pajarita , Frankham Emma , Garthe Rachel C. , Visher Christy A. , Kay Anna L. 
Published: June 2021

Purpose: Paternal incarceration poses significant concerns for fathers and their children. Despite the known negative consequences, little is understood about father involvement after prison. This study aims to further understanding of fatherhood following incarceration to inform future intervention strategies. Method: Using data from the Urban Institute’s Returning Home: Understanding the Challenges of Prisoner Reentry Study ( N = 326), we conduct bivariate and multivariate analyses to examine three dimensions of father involvement and predictors of involvement at two time points after prison. Results: Findings reveal generally high levels of father involvement in the first year following incarceration. Father-child contact during prison and increased work hours after prison showed positive effects on early father involvement, while post-prison engagement and contact following release were associated with later involvement. Conclusions: Promoting father-child contact and positive relationships during incarceration may be important for future father involvement after release. Potential social work and criminal justice practice and research opportunities are discussed.
Analysis of the Clinical Characteristics of Dipeptidyl Peptidase-4 Inhibitor–Induced Bullous Pemphigoid
Authors: Sun Linli , Wang Chunxia , Wu Cuifang , Zhou Yulu , Wang Chunjiang 
Published: June 2021

Objective To analyze and discuss the clinical characteristics of dipeptidyl peptidase-4 inhibitor (DPP4i)-induced bullous pemphigoid (BP). Data Sources We collected case reports of DPP4i-induced BP by searching databases from 2006 to mid-May 2021, as a retrospective analysis. Study Selection and Data Extraction Relevant case reports and case analyses of DPP4i-induced BP were included. Data Synthesis The median time of symptom onset was 9 months (range 0.5-59 months). BP most often occurred in patients receiving vildagliptin (52.63%) followed by linagliptin (27.19%) and sitagliptin (17.54%). Tense bullae and blisters (85.51%) and erythema (82.61%) on the extremities and trunk were the most common presenting symptoms. In total, 64.06% of BP patients were anti-BP180 autoantibody positive, 58.97% were BP180NC16a autoantibody positive, and 31.25% were anti-BP230 autoantibody positive. Skin biopsy revealed subepidermal bulla eosinophil infiltration in 93.85% of BP patients, lymphocyte infiltration in 56.93%, and neutrophil infiltration in 44.62%. Direct immunofluorescence was positive in 98.94% of BP patients with linear deposition of IgG (97.80%) and/or complement C3 (98.94%) along the basement membrane zone. Indirect immunofluorescence was positive in 87.88% of BP patients. Complete remission of BP was achieved in 83.64% of patients on DPP4i withdrawal and after 4 months (range 0.13-72 months) of follow-up. Relevance to Patient Care and Clinical Practice This review analyzes and discusses the clinical characteristics of DPP4i-induced BP and provides a reference for the safe and reasonable clinical application of DPP4i. Conclusions DPP4i drugs are related to the occurrence of BP in diabetic patients, especially elderly men taking vildagliptin.