bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Strength Versus Strength and Endurance Upper Limb Exercise Training in Patients With Chronic Obstructive Pulmonary Disease
Authors: Karagiannis Christos , Savva Christos , Korakakis Vasileios , Adamide Tonia , Georgiou Andreas , Matheou Ioanna , Prodromou Aleka , Xanthos Theodoros 
Published: June 2021

Purpose:
Pulmonary rehabilitation (PR) including exercise training improves muscle strength, exercise capacity, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). However, the evidence of the effect of upper limb exercise training (ULET) on activities of daily living (ADL) is sparse. This study investigated the effect of two different types of ULET on ADL in addition to standard PR.

Methods:
Patients were randomly assigned to a strength or a combined ULET group. Both groups exercised 2 d/wk for 12 wk. Outcome measures were handgrip strength and muscle strength of biceps and triceps muscles. Moreover, health-related quality of life was assessed through the COPD assessment test (CAT) and Saint George Respiratory Questionnaire. Ability to perform ADL was evaluated through an ADL simulation test. Dyspnea was evaluated by a modified Medical Research Council scale, whereas dyspnea and fatigue perception during strength and ADL tests were measured through a modified Borg scale.

Results:
Thirty-six patients with COPD (67.4 ± 5.3 yr) participated in the study. Significant improvements in upper limb strength and CAT were found within both groups. At the end of the study period, patients in the combined group improved time of the ADL test (P = .02) with reduced perception of fatigue (P = .03) compared with patients in the strength group.

Conclusions:
In addition to standard PR of patients with COPD, the combined endurance and resistance ULET program improved ADL and muscle strength, whereas resistance training only increased strength.
Clinical outcomes of a monofocal intraocular lens with enhanced intermediate function compared with an extended depth-of-focus intraocular lens
Authors: Lee Jae Hyuck , Moon Su Young , Chung Ho Seok , Park So Young , Lee Hun , Kim Jae Yong , Tchah Hungwon 
Published: June 2021

Purpose:
To compare clinical outcomes of a new monofocal intraocular lens (IOL) with enhanced intermediate function and an extended depth-of-focus (EDoF) IOL.

Setting:
Asan Medical Center, Seoul, Korea.

Design:
Nonrandomized prospective comparative case series.

Methods:
Patients presenting for cataract surgery and meeting all inclusion and exclusion criteria were implanted with a new monofocal IOL with enhanced intermediate function (Tecnis Eyhance ICB00) or an EDoF IOL (Tecnis Symfony ZXR00) bilaterally. Uncorrected (UDVA), uncorrected intermediate (UIVA), uncorrected near (UNVA), and corrected distance visual acuity (CDVA), defocus curves, and contrast sensitivity were compared after 3 months. Patients were administered questionnaires regarding visual symptoms, spectacle independence, overall satisfaction, and lens recommendations.

Results:
24 patients (48 eyes) were enrolled in the Eyhance group and 20 patients (40 eyes) in the Symfony group. Monocular and binocular UDVA, UIVA, and CDVA were similar in the 2 groups. Monocular UNVA and spectacle independence for near distance were better in the Symfony group, whereas binocular UNVA did not differ significantly in the 2 groups. Contrast sensitivity, glare and halo, satisfaction, and recommendation rates were similar in the 2 groups. Although some dissatisfaction and severe glare and halo were reported in the Symfony group, none of these was reported in the Eyhance group.

Conclusions:
Bilateral implantation of the Eyhance ICB00 IOL provided comparable clinical performances as bilateral implantation of the Symfony ZXR00 IOL. Binocular UNVA was similar, although spectacle independence was higher in the Symfony group, but this was at the expense of more glare and halos.
Influence of anterior capsulorhexis shape, centration, size, and location on intraocular lens position: finite element model
Authors: Rossi Tommaso , Ceccacci Andrea , Testa Gabriel , Ruggiero Andrew , Bonora Nicola , D'Agostino Isabella , Telani Serena , Ripandelli Guido 
Published: June 2021

Purpose:
To evaluate the influence of anterior capsulorhexis shape, dimension, and eccentricity on intraocular lens (IOL) position.

Setting:
Laboratory investigation.

Design:
Computational model.

Methods:
A finite element model of the human crystalline lens capsule and zonule was created and the anterior capsule opened to simulate centered and decentered circular and elliptic rhexis. The model calculated capsular bag stress, IOL rotation, tilt, decentration, and vaulting, related to both capsular landmarks (absolute) and a reference IOL position defined as that obtained with a 5.0 mm circular and centered rhexis.

Results:
Mean von Mises stress along the IOL major z-axis was significantly higher than that along the perpendicular x-axis in all cases (P < .001), both at the equator and at the rhexis edge. Stress at the equator was always greater than that at the rhexis edge (P < .001) regardless of the rhexis shape and position. As rhexis eccentricity increased, the stress difference between the z- and x-axes increased. Absolute IOL tilt (range 10−1 to 10−7 degrees), decentration (10−3 to 10−7 mm), rotation (10−2 to 10-3 degrees), and vaulting (10−1 mm) were negligible from an optical standpoint, but all of them were significantly greater for decentered rhexis (both round and elliptic) compared with centered (P < .05).

Conclusions:
Anterior capsulorhexis irregularity and/or eccentricity increase IOL tilt, decentration, rotation, and vaulting in a numerically significant but optically negligible way. Von Mises stress is much greater at the capsular bag equator compared with the rhexis edge and highly asymmetrically distributed in all cases. Stress asymmetry may influence postoperative biologic processes of capsular bag shrinking and further IOL tilting or decentration.
Indoor Air Quality and Environmental Sampling as Support Tools to Detect SARS-CoV-2 in the Healthcare Setting
Authors: Gregorio Paulo Henrique Peitl , Mariani Alessandro Wasum , Brito João Marcelo Lopes Toscano , Santos Bruno José Martini , Pêgo-Fernandes Paulo Manuel 
Published: June 2021

Objectives:
To evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread inside the healthcare setting using environmental sampling and indoor air quality (IAQ) parameters.

Methods:
Ward/ICU rooms had IAQ parameters monitored in real-time, including volatile organic compounds and particulate matter. Surface and three air samples with different exposure times were collected in each room and tested for SARS-CoV-2 using quantitative Rt-PCR. Environmental sampling and IAQ data were compared to provide information about viral spread.

Results:
SARS-CoV-2 RNA was detected in 6/10 rooms and 9/30 air samples, which is proportionally higher than previous studies. Sampling time confirmed to be crucial to viral detection. No correlations between IAQ parameters could be associated with positive/negative samples even when aerosol-generating procedures were performed.

Conclusion:
Environmental sampling of SARS-CoV-2 RNA may be used as an indicator of occupational safety. IAQ is also a potential tool but requires further research.
Respiratory Outcomes of Firefighter Exposures in the Fort McMurray Fire
Authors: Cherry Nicola , Barrie James R. , Beach Jeremy , Galarneau Jean-Michel , Mhonde Trish , Wong Eric 
Published: June 2021

Objective:
Determine effects on respiratory health of firefighters attending a catastrophic wildfire.

Methods:
Within the Alberta Administrative Health Database, we identified five community-based controls for each firefighter in a cohort of 1234 deployed to the 2016 Fort McMurray fire. Spirometry records were identified and a stratified sample assessed clinically. We estimated PM2.5 particles exposure.

Results:
Firefighters had an increased risk of asthma consultation post-fire (OR new onset asthma = 2.56; 95%CI 1.75 to 3.74). Spirometry showed decreased FEV1 and FVC with increasing exposure. In the clinical assessment, 20% had a positive MCT and 21% BWT. Those with ongoing fire-related symptoms had a higher concurrence of positive MCT and BWT (OR = 4.35; 95%CI 1.11 to 17.12). Lower diffusion capacity related to higher exposure.

Conclusions:
Massive exposures during a wildfire are associated with non-resolving airways damage.
Impact and Management of COVID-19 Among Healthcare Workers in Two Acute Care Hospitals and Two Associated Long-term Care Centres in Barcelona, Spain
Authors: Montero-Moraga Jose Maria , Buron Andrea , Sala Maria , Santia Paula , Lupia Martina , Beltrán Ana , Villar Rocío , Horcajada Juan Pablo , Castells Xavier , Gil Oscar Díaz , León Eduardo Padilla , Serra Consol 
Published: June 2021

Objective:
To describe the characteristics of COVID-19-related episodes in healthcare workers (HCW) of two hospitals.

Methods:
Prospective study of HCW with COVID-like symptoms and/or who were close contacts of confirmed COVID-19. The percentage of positive PCRs among those with symptoms was calculated, and symptom's positive predictive value and negative predictive value. The characteristics of contacts were described, as well as the secondary clinical attack rate.

Results:
We registered 1222 episodes of HCW with COVID-like symptoms; 340 (27.8%) had a positive PCR. In 885 episodes, a HCW was a close contact of a confirmed case. In 45.5% of these, the HCW had contact with another HCW. The secondary clinical attack rate of contacts of HCW was 14.5%.

Conclusion:
We found a high prevalence of disease and transmission between HCW during the first wave of the SARS-CoV-2 pandemic.
The Effect of Perceived Gratitude From Others on Work Engagement
Authors: Komase Yu , Watanabe Kazuhiro , Sasaki Natsu , Kawakami Norito 
Published: June 2021

Objective:
This study aimed to examine the effect of perceived gratitude from others on work engagement, adjusting for possible confounders: job demands, job resources (supervisor/coworker support), personal resources (resilience), and gratitude trait.

Methods:
This cross-sectional study conducted a secondary analysis of data from previously published research. Work engagement was measured using the Japanese version of the Utrecht Work Engagement Scale. An original one-item questionnaire measured perceived gratitude from others. A hierarchical linear regression analysis was conducted.

Results:
Hierarchical linear regression showed a significant association between perceived gratitude and work engagement even after controlling for the covariates of occupations, job demands, supervisor support, coworker support, resilience, and gratitude trait (N = 206).

Conclusions:
The association between perceived gratitude and work engagement was independent of job demands, job/personal resources, and gratitude trait, suggesting the direct association.
Contributions of Ergonomics, Psychological Factors, and Sleep Disturbances to Lower Back Pain Among Taiwanese Workers
Authors: Shih Ping , Chu Po-Ching , Liu Li-Wen , Chen Chih-Yong , Guo Yue Leon 
Published: June 2021

Objective:
We investigated the contributions of ergonomics, psychological factors, and sleep disturbances to lower back pain (LBP).

Methods:
A nationwide survey of sampled 27,508 (2.6‰) Taiwanese workers was conducted in 2010. Definition of outcome was LBP affecting work performance in the past year. Predictor variables included age, body mass index, ergonomic factors, job control, psychological demands, and sleep disturbances. Mutually adjusted relative risks were examined using general linear models, followed by aPAR.

Results:
18,353 workers were included in the multivariate regression model. The three first significant risk factors to LBP included heavy lifting or awkward posture, sleep disturbances, and high psychological demands (aPAR = 13.5%, 8.7%, 5.7% respectively in men and 6.1%, 11.8%, 5.9% in women).

Conclusions:
In addition to ergonomic exposure, sleep disturbances and high psychological demands significantly contributed to LBP.
Metastatic well-differentiated pancreatic neuroendocrine tumors to the liver: a narrative review of systemic and surgical management
Authors: Vaghaiwalla Tanaz , Memeh Kelvin , Liao Chih-Yi , Keutgen Xavier M. 
Published: June 2021

Abstract
Pancreatic neuroendocrine tumors (PNETs) are a rare group of neoplasms originating from the endocrine pancreas. PNETs are classified as functional or non-functional tumors. PNETs are more often diagnosed at a higher stage with distant metastases or advanced locoregional disease. The majority of individuals with hepatic metastases will ultimately die of liver failure; therefore, the treatment of liver tumor burden is critical to providing a survival impact. While surgical resection remains the only chance of cure for disease confined to the pancreas or for locoregional disease, the treatment of advanced or metastatic PNETs is more complex and often requires a multimodal approach. This review focuses on treatment options for well and moderately differentiated PNETs with metastatic disease to the liver. These include surgery, liver-directed therapies including ablative and intra-arterial therapies, and systemic therapies such as somatostatin analogues, targeted therapies, chemotherapy, and peptide receptor radionuclide therapy. Developing an individualized treatment strategy requires careful assessment of liver tumor burden and predicted biological behavior. Aggressive surgical resection of hepatic metastases secondary to PNET primary tumors is associated with improved survival in multiple retrospective studies. General goals of treatment for metastatic disease include prolonging overall survival and progression free survival, improving quality of life, and control of symptoms.
Notch signaling inhibitor and anti-PD-L1 antibody combination therapies decelerate tumor progression in pancreatic cancer
Authors: Dai Hongmei , Hong Xiafei , Huang Dan , Wu Huanwen , Wang Xianze , Chen Hao , Jiang Rui , Chen Wenyan , Zhao Yupei , Wu Wenming 
Published: June 2021

Abstract

Objective:
Pancreatic cancer (PC) is a highly lethal malignancy with an immunosuppressive environment. Yet, current immune checkpoint inhibitor monotherapies have shown limited efficacy in PC, prompting the need for combination therapies. Herein, we hypothesized that combinations of Notch signaling inhibitor and anti-ligand programmed death-ligand 1 (PD-L1) antibody immunotherapy would show synergistic efficacy.

Methods:
The baseline expression of PD-L1 and HES1 was measured in PC cell lines, single-cell RNA-seq data of PC (GSA: CRA001160), and cBioPortal databases. In an in vitro study, MIA PaCa2 and SW1990 were used to explore the mechanism between Notch signaling and PD-L1. To study the effects in vivo, a subcutaneous tumor model was established using Pan02 cells treated with either anti-PD-L1 monoclonal antibody and/or Notch inhibitor DAPT. The study performed involving human samples was approved by the Ethics Committee of Peking Union Medical College Hospital (approval No. S-K460, approval date: April 23, 2018). Animal studies were approved by the Animal Research Ethics Committee of Peking Union Medical College Hospital (approval No. XHDW-2019-049, approval date: November 28, 2019).

Results:
The Notch signaling inhibitor upregulated PD-L1 expression in PC tumor cells both in vitro and in vivo. Notch effector HES1 knockdown produced PD-L1 upregulation in both MIA PaCa2 and SW1990 cells. Combined DAPT and anti-PD-L1 antibody treatment of Pan02 subcutaneous tumor model resulted in significantly reduced tumor weights compared to that with monotherapy, as well as significantly reduced Ki67 than that in the monotherapy group and control group. Flow cytometry analysis revealed significantly increased CD8+ T cell infiltration in tumors of the combination group compared with those of the monotherapy group.

Conclusion:
Notch signaling blockade might enhance the antitumor effect of anti-PD-L1 therapy in PC.
Agreement Between Clinical Examination and Magnetic Resonance Imaging in Acute Knee Trauma With Hemarthrosis
Authors: Brown Jamie Sutherland , Frobell Richard B. , Isacsson Anders , Englund Martin , Olsson Ola 
Published: June 2021

Objective:
Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.

Design:
Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.

Setting:
Helsingborg hospital.

Patients:
Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.

Interventions:
Clinical examination and MRI.

Main outcome measures:
agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard.

Results:
Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70% [95% confidence interval 67-73) and 66% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences.

Conclusions:
Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.
The effects of amiodarone on thyroid function in pediatric and adolescent patients
Authors: Barrett Brett , Bauer Andrew J. 
Published: June 2021

Purpose of review
Amiodarone-induced thyroid dysfunction is well established. The present review discusses recent literature related to the effects of amiodarone on the thyroid gland and thyroid function in pediatrics.

Recent findings
Current guidelines in adults treated with amiodarone recommend baseline thyroid function testing followed by initiation of thyroid hormone monitoring after 3 months on therapy. Two retrospective studies to evaluate amiodarone-induced thyroid dysfunction in children and young adults reveal thyroid dysfunction as soon as 2 weeks after amiodarone initiation with a greater percentage of pediatric patients developing amiodarone-induced hypothyroidism rather than thyrotoxicosis. Although additional studies are needed to determine if AIH is associated with negative impact on growth and neurocognitive development, what is clear is that in both adults and pediatrics, there is low compliance with recommended side effect-monitoring guidelines.

Summary
Pediatric patients are at similarly high risk to develop amiodarone-induced thyroid dysfunction as are adults. It is hoped that through improved education of providers and patients further research into the incidence, the potential risks of amiodarone therapy and the potential benefits of thyroid hormone replacement therapy in patients with AIH will be investigated and reported.
Mucosal Invariant T cells are Diminished in Very Early-Onset Inflammatory Bowel Disease
Authors: Dou Ying , Maurer Kelly , Conrad Maire , Patel Trusha , Shraim Rawan , Sullivan Kathleen E. , Kelsen Judith 
Published: June 2021

ABSTRACT

Objectives:
Very early-onset inflammatory bowel disease (VEO-IBD) arises in children less than 6 years old, a critical time for immunologic development and maturation of the intestinal microbiome. Non-conventional lymphocytes, defined here as mucosal-associated invariant T cells and innate lymphocytes, require microbial products for either development or expansion, aspects that could be altered in very early-onset inflammatory bowel disease. Our objective was to define conventional leukocyte and non-conventional lymphocyte populations in controls and patients using multiparameter flow cytometry to test the hypothesis that their frequencies would be altered in a chronic inflammatory state associated with significant dysbiosis.

Methods:
Multiparameter flow cytometry was used in a control cohort of 105 subjects to define age-effects, not previously comprehensively examined for these cell types in humans. Differences were defined between 263 unique age-matched patients with VEO-IBD and 105 controls using Student t-test. Subjects were divided into two age groups at the time of sampling to control for age-related changes in immune composition.

Results:
Intermediate monocytes were consistently decreased in patients with VEO-IBD compared to controls. Mucosal-associated invariant T cells were significantly lower in patients with long-standing disease. Levels were less than half of those seen in the age-matched control cohort. The innate lymphoid cells type 2 population was expanded in the youngest patients.

Conclusion:
Mucosal-associated invariant T cells are diminished years after presentation with inflammatory bowel disease. This durable effect of early life intestinal inflammation may have long-term consequences. Diminished mucosal-associated invariant T cells could impact host defense of intestinal infections.
Secondary Hepatic Injury in Pediatric Intensive Care: Risk Factors and Prognostic Impact
Authors: Direito Joana , Fernandes Carla , Branquinho Rita G. , Ramos Daniela F. , Dionísio Teresa , Oliveira Guiomar G. , Pinto Carla R. 
Published: June 2021

ABSTRACT

Objectives:
The aim of this study was to assess the profile of secondary hepatic injury (SHI), to determine risk factors and to evaluate its impact on prognosis of pediatric intensive care patients.

Methods:
An exploratory observational and retrospective study was conducted in a Pediatric Intensive Care Unit. Two groups were defined: with SHI [alanine aminotransferase (ALT) ≥100 IU/L or gamma glutamyl transpeptidase (GGT)≥100 IU/L or direct bilirubin ≥30 μmol/L] and without. SHI was divided into 3 patterns: cytolysis, cholestasis, and mixed.

Results:
SHI occurred in 16.5%, cytolysis in 5%, cholestasis in 4%, and mixed pattern in 7%. Independent risk factors for SHI were: organ dysfunction score PELOD-2 in D1 in cytolysis (n = 28); total parenteral nutrition and Pediatric Index of Mortality 3 (PIM3) in cholestasis (n = 23); sepsis, oncologic comorbidities, PIM3, and respiratory dysfunction in mixed pattern (n = 37). The ALT was an independent risk factor and a good predictor of mortality (AUC = 0.865) with a cut-off of 137 IU/L.

Conclusions:
SHI was associated with worst prognostic. ALT may be useful for detecting patients at increased risk of death, probably being a surrogate marker of the illness severity, reflecting a secondary injury.