bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Ventromedial Hypothalamus in Sucrose-Induced Obesity on Metabolic Parameters
Authors: Gaur Archana , Pal G.K. , Pal Pravati 
Published: May 2021

Background: Obesity is because of excessive fat accumulation that affects health adversely in the form of various diseases such as diabetes, hypertension, cardiovascular diseases, and many other disorders. Our Indian diet is rich in carbohydrates, and hence the sucrose-induced obesity is an apt model to mimic this. Ventromedial hypothalamus (VMH) is linked to the regulation of food intake in animals as well as humans. Purpose: To understand the role of VMHin sucrose-induced obesity on metabolic parameters. Methods: A total of 24 adult rats were made obese by feeding them on a 32% sucrose solution for 10 weeks. The VMH nucleus was ablated in the experimental group and sham lesions were made in the control group. Food intake, body weight, and biochemical parameters were compared before and after the lesion. Results: Male rats had a significant weight gain along with hyperphagia, whereas female rats did not have a significant weight gain inspite of hyperphagia. Insulin resistance and dyslipidemia were seen in both the experimental and control groups. Conclusion: A sucrose diet produces obesity which is similar to the metabolic syndrome with insulin resistance and dyslipidemia, and a VMH lesion further exaggerates it. Males are more prone to this exaggeration.
Evaluation of Serum Sodium Correction Rates for Management of Hyponatremia in Hospitalized Patients
Authors: Pham Christine T. , Kassab Hagar S. , Johnston Jackie P. 
Published: May 2021

Background: Appropriate correction of hyponatremia can reduce complications such as osmotic demyelination syndrome (ODS). Objective: To evaluate rates of serum sodium correction in hyponatremic hospitalized patients and identify factors associated with higher rates of overcorrection. Methods: This is an institutional review board–approved single-center, retrospective chart review of patients ≥18 years of age with at least 1 serum sodium <130 mEq/L during hospitalization. The primary end point was percentage of patients appropriately corrected for hyponatremia. Appropriate correction was defined as a sodium change ≤12 mEq/L over 24 hours and 18 mEq/L over 48 hours, and overcorrection was defined as an increase in serum sodium exceeding these cutoffs. Secondary end points included incidence of ODS, poor neurological outcome, intensive care unit (ICU) and hospital lengths of stay (LOSs), and in-hospital mortality. Results: Of 234 patients evaluated, 100 were included. Mean age was 72 ± 16 years, and 47% were male. Overcorrection occurred in 14 patients. There was no incidence of ODS. Rates of poor neurological outcome ( P = 0.77), ICU ( P = 0.09) and hospital LOS ( P = 0.13), and in-hospital mortality ( P = 0.20) were similar between appropriately corrected and overcorrected patients. Using a logistic regression analysis, severe hyponatremia (serum sodium < 120 mEq/L; P = 0.0122) and history of alcohol use disorder ( P < 0.001) were risk factors found to be associated with overcorrection. Conclusion and Relevance: Overcorrection of hyponatremia occurred in 14% of patients in this study. To minimize this risk, further caution should be taken when managing patients presenting with identified risk factors.
Sex-Specific Differences Following Lateral Ankle Ligament Repair
Authors: Goodrich Ezra , Vopat Matthew L. , Baker Jordan , Tarakemeh Armin , Templeton Kimberly , Mulcahey Mary K. , Schroeppel J. Paul , Mullen Scott , Vopat Bryan G. 
Published: May 2021

Background: Chronic ankle instability is a common condition that can be treated with lateral ankle ligament repair. These procedures have a reported success rate greater than 85% in the literature, but little has been reported about the differences in postoperative outcomes between males and females. The purpose of this study was to evaluate sex-specific outcomes following lateral ankle ligament repair. Methods: In this systematic review and meta-analysis, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to search for articles on electronic databases and included studies in which study participants underwent primary lateral ligament repair and sex-specific outcomes were evaluated. Functional postoperative outcomes for males and females were recorded and statistically analyzed. Results: Out of 2768 studies, 7 (0.25%) met inclusion criteria and were analyzed in this review. These studies included 618 patients (402 males [65%] and 216 females [35%]) who underwent primary lateral ligament repair for ankle instability. Karlsson score ( P = .1582) and American Orthopaedic Foot & Ankle Society (AOFAS) score ( P = .1586) analyses found no statistically significant difference between males and females. Postoperative success rate—defined as a “good” or “excellent” Karlsson score (>81)—was not found to be significantly different between males and females ( P = .9374). Conclusion: There was no difference in postoperative mean Karlsson scores, AOFAS scores, or success rates between males and females who underwent primary lateral ankle ligament repair. Level of Evidence: Level IV, therapeutic.
Two-Year Outcomes After Total Ankle Replacement With a Novel Fixed-Bearing Implant
Authors: Kooner Sahil , Kayum Shahin , Pinsker Ellie B. , Al Khalifa Ahmed , Khan Ryan M. , Halai Mansur , Daniels Timothy R. 
Published: May 2021

Background: The Integra Cadence total ankle replacement (TAR) is a fourth-generation anatomic, fixed-bearing implant requiring minimal tibial and talar resection, which has been in clinical use since June 2016. The primary purpose of this study is to assess its short-term clinical and radiographic outcomes after TAR using this prosthesis. Methods: This is a prospective case series of consecutive patients that underwent TAR using this novel fourth-generation prosthesis between June 2016 and November 2017. The primary outcome of interest was the Ankle Osteoarthritis Scale (AOS). Secondary outcomes included Short Form Health Survey–36 (SF-36) scores, radiographic alignment, complications, reoperations, and revisions. Results: In total, 69 patients were included in our study. Fifty-one patients (73.9%) required a total of 91 ancillary procedures. Postoperatively, AOS pain scores decreased significantly by an average of 17.8±30.1 points from 45.9±18.2 to 28.4±27.3 ( P < .001). AOS disability scores also decreased significantly following surgery by an average of 22.0±30.5 points from 53.9±18.5 to 32.5±27.9 ( P < .001). The SF-36 physical component summary score improved 10.4±9.8 points from 33.1±9.1 to 42.6±9.1 ( P < .001). Radiographic analysis demonstrated significant improvement to neutral coronal plane alignment, which was achieved in 97% of patients ( P < .01) with no cyst formation at 2 years. There was 1 reported complication, 9 reoperations, and no metal or polyethylene component revisions. Overall, the 2-year implant survivorship was 100% in our cohort. Eighteen patients (26.1%) demonstrated fibrous ingrowth of the tibial component. However, outcome scores for these patients did not demonstrate any negative effects. Conclusion: In our hands, this TAR system demonstrated excellent early clinical and radiographic outcomes. Patients reported improved physical health status, pain, and disability in the postoperative period. Total ankle instrumentation allowed for accurate and reproducible implantation with correction of coronal and sagittal plane deformities. Early results for the clinical use of this TAR system are promising, but further long-term prospective outcome studies are necessary. Level of Evidence: Level IV, case series.
Nutrient Intake During School Lunch in Title I Elementary Schools With Universal Free Meals
Authors: Adams Elizabeth L. , Raynor Hollie A. , Thornton Laura M. , Mazzeo Suzanne E. , Bean Melanie K. 
Published: May 2021

Background The National School Lunch Program (NSLP) provides >30 million meals to children daily; however, the specific nutrient composition of NSLP-selected and consumed meals for students from lower income and racial/ethnic minoritized backgrounds is unknown. Aims To quantify the nutrients in school lunch selection and consumption among students participating in the NSLP and compare these values to nutrient recommendations. Method Students (1st–5th graders; 98.6% from racial/ethnic minoritized backgrounds; 92.5% NSLP participation) from six Title I elementary schools serving universal free meals participated. Digital images of students’ lunch meal selection and consumption were obtained ( n = 1,102 image pairs). Plate waste analyses quantified portions consumed. Nutrient composition of students’ lunch selection and consumption were calculated and compared with the 2010 Healthy Hunger-Free Kids Act and 2009 Institute of Medicine recommendations. Results Most lunches selected (59%–97%) met recommendations for all nutrients except for total calories (23%), vitamin C (46%), and dietary fiber (48%). Based on lunch consumption, most students’ lunches met recommendations for sodium (98%), protein (55%), calories from fat (82%), and saturated fat (89%); however, few met recommendations for total calories (5%), calcium (8%), iron (11%), vitamin A (18%), vitamin C (16%), and fiber (7%). Discussion Meals selected met most nutrient recommendations for the majority of children; yet overall consumption patterns reflect suboptimal nutrient intake. Conclusion Meals served under the NSLP policy mandates align with recommended nutrient patterns, highlighting the importance of maintaining these standards. Strategies to optimize children’s intake of nutrient-rich portions of these meals are needed to optimize policy impact.
In-vitro assessment of release of silicone oil droplets with the use of variety of syringes and needles used in intravitreal injections
Authors: da Cruz Natasha Ferreira Santos , Agra Lydianne Lumack do Monte , Probst Christine , Lima Luiz Henrique , Carpenter John F. , Maia Mauricio , Farah Michel Eid , Melo Gustavo Barreto 
Published: May 2021

Purpose: To assess the variability of silicone oil (SO) particles released across syringes from the same lot and the role of different needle gauges. Materials and methods: Four syringe models and six needle models were assessed for SO release. About 50 microliters of a buffer solution were loaded into the syringe, needle or syringe/needle setup. The data were analyzed by imaging flow cytometry with fluorescently labeling for SO. Results: All syringe models had a high coefficient of variation in SO release across syringes from the same lot. The amount of SO was significantly greater in the syringe when the needle was attached. SO particles with the BD 30G needle attached to the syringe were statistically greater than the 27G counterpart ( p = 0.005). None of the other comparisons was statistically different. Finally, the number of SO particles was higher in the syringe/needle setup than in needles only ( p = 0.0024). Conclusion: We found a high variability in SO content across syringes from the same lot. Additionally, there was no clear association between needle gauge and the number of SO particles, as well as their coefficient of variation. Finally, the needles accounted for a small number of SO particles in comparison to the combined syringe-needle setup.
The utility of universal screening for somatization in a pediatric emergency department: A prospective evaluation
Authors: Virk Punit , Ellis Jacob , Dhariwal Amrit , Chapman Andrea , Doan Quynh 
Published: May 2021

Objective: To evaluate clinical utility and feasibility of universal somatization screening in the pediatric emergency department (ED) using a standardized approach of (1) identifying potential somatizing symptoms within the ED, (2) introducing these patients and their caregivers to the concept of the ‘mind-body connection’, (3) corroborating the likelihood of a somatization diagnosis via brief psychiatric assessment, and (4) inviting families to a psychoeducational follow-up session. Methods: We conducted a cross-sectional study to carry out this approach with families visiting a pediatric ED. Our primary outcome of screening utility was measured as the proportion of youth who screened positive for somatization by the ED clinician. Our secondary outcome of screening feasibility was measured as the proportion of patients with positives who (1) agreed to meet with the study psychiatrist, (2) consented to an ED psychiatric assessment, (3) were assessed by the study psychiatrist as likely experiencing somatization, and (4) were invited for follow-up and attended. Results: Of the 344 screened patients, 27 (7.8%) screened positive for somatization. Of these, 25 (92.6%) families verbally consented to meet the study psychiatrist to learn about the mind-body connection, and 21 (77.8%) consented to further psychiatric assessment. Upon assessment, the somatization likelihood was supported for all 21 youth. Twenty families were invited to follow-up and ultimately two (10%) attended. Conclusions: Somatization can be detected through ED-based universal screening. Few families attended psychoeducational follow-up. Further research is needed to determine appropriate ED-initiated pediatric somatization intervention.
Impact of Perioperative Immunonutrition on Complications in Patients Undergoing Radical Cystectomy: A Retrospective Analysis
Authors: Cozzi Gabriele , Musi Gennaro , Milani Martina , Jemos Costantino , Gandini Sara , Mazzoleni Ludovica , Ferro Matteo , Luzzago Stefano , Bianchi Roberto , Omodeo Salé Emanuela , de Cobelli Ottavio 
Published: May 2021

Introduction: Radical cystectomy (RC) is the gold standard treatment for patients with muscle-invasive or refractory non-muscle invasive bladder cancer. It is estimated that approximately 64% and 13% of RC patients experience any complication and major complications, respectively. Specialized immunonutrition (SIM) aims to reduce the rates of complications after RC. We reported surgical complication rates in RC patients who received (SIM group) versus who did not receive (no-SIM group) perioperative SIM. Moreover, we investigated factors associated with complications after RC. Material and Methods: This is a retrospective cohort study of 52 patients who underwent RC between April 2016 and December 2017. Overall, 26 (50%) patients received perioperative SIM. We recorded age, gender, Charlson Comorbidity Index (CCI), body mass index (BMI), Malnutrition Universal Screening Tool (MUST) score, unintentional weight loss (UWL), SIM drinks consume, surgical approach, urinary diversion, neoadjuvant chemotherapy (NAC), use of total parenteral nutrition (TPN), final pathology, length of stay (LOS), and complications. Results: SIM was associated with higher rates of documented infections ( P = .03). Conversely, post-operative ileus was associated with higher rates of overall infections ( P = .03). Median LOS was comparable within the 2 groups. Overall, 4 (15.38%) versus 0 (0%) patients in SIM versus no-SIM group were readmitted to hospital ( P = .03). Age, CCI, NAC, and TPN were not associated with complication rates. Conclusions: SIM is not associated with lower rates of post-operative complications in RC candidates. Moreover, higher rates of documented infections were observed in the SIM group. Patients with post-operative ileus experienced more infections. Age, CCI, NAC, and TPN were not predictive of complications.
Cognitive Recovery After Stroke: A Meta-analysis and Metaregression of Intervention and Cohort Studies
Authors: Saa Juan Pablo , Tse Tamara , Baum Carolyn M. , Cumming Toby , Josman Naomi , Rose Miranda , O’Keefe Sophie , Sewell Katherine , Nguyen Vinh , Carey Leeanne M. 
Published: May 2021

Background Cognition affects poststroke recovery, but meta-analyses of cognition have not yet provided a comparison of observational and intervention evidence. Objective To describe the trajectory of poststroke cognition and the factors that moderate it across intervention and observational cohorts. Methods Six databases were searched up to January 2020. Studies describing quantitative changes in cognition in adults poststroke were included. Interventions were classified into pharmacological, therapist-led, nonroutine/alternative, and usual care. Summary estimates were compared via hierarchical mixed-effects models. Age, recovery stage, stroke etiology, cognitive domain targeted in studies, and intervention types were investigated as moderators of cognition. Recovery stage and intervention were further analyzed in a multiplicative metaregression model. Results A total of 43 intervention trials and 79 observation cohorts involving 28 222 stroke participants were included. Heterogeneity was significant (τ2 = 0.09; CI = 0.01-0.21, P < .001) with no evidence of publication bias. Cognitive recovery was greater in intervention trials ( g = 0.47; CI = 0.37-0.58) than observational cohorts ( g = 0.28; CI = 0.20-0.36) across all moderators analyzed. Nonroutine/alternative and pharmacological trials achieved the best overall results ( g = 0.57, CI = 0.42-0.73, and g = 0.52, CI = 0.30-0.74, respectively), followed by therapist-led ( g = 0.46; CI = 0.17-0.74), and usual care ( g = 0.28; CI = 0.11-0.45) interventions. Medium recovery effects (ie, g ≥ 0.5) were observed in examining first-ever stroke, executive function, visuo-perceptual, consciousness, and psychomotor skills, 61 to 180 days poststroke, in participants aged 65 to 70 years. Conclusion Cognitive recovery is possible using different controlled interventions in all recovery stages, with smaller benefits ≥2 years poststroke. Longer-term studies are needed to determine the role of nonroutine/alternative therapies and the association between cognitive recovery and performance in everyday activities.
Recruiting Low-Income African American Men in Mental Health Research: A Community-Based Participatory Research Feasibility Study
Authors: Tchouankam Tatiana , Estabrooks Paul , Cloyd Anthony , Notice Maxine , Teel-Williams Maria , Smolsky Ann , Burnett Paul , Alexis Geraldine , Conley Tori , Partridge EJay , Hogan Payton , Thorpe Roland , King Keyonna M. 
Published: May 2021

African Americans (AAs) are 20% more likely to develop serious psychological distress compared to Whites but are less likely to use mental health services. The study objective was to evaluate the effectiveness of recruitment strategies to engage AA fathers in a mental health intervention. Using the community-based participatory research (CBPR) approach, a community-academic partnership (CAP) developed and implemented direct and indirect referral strategies to engage AA fathers in a mental health intervention. Direct referral strategies focused on community partner identification of potentially eligible participants, providing information about the study (i.e., study flyer), and referring potential participants to the study. Indirect referrals included posting flyers in local businesses frequented by AA men, radio advertisements, and social media posts from community organizations. From January to October 2019, 50 direct and 1388 indirect referrals were documented, yielding 24 participants screened and 15 enrolled. Of all participants screened, 58% were referred through indirect referral, 38% were referred directly by community partners, and 4% of the participants were referred through both direct and indirect referrals. Twenty percent of those exposed to the direct referral methods and 1% of those exposed to the indirect referral methods were enrolled. The indirect referrals accounted for 60% of enrollment, whereas the direct referrals accounted for 33.3% of enrollment. Collaborating with the community partners to engage hard-to-reach populations in mental health studies allowed for broad dissemination of recruitment methods, but still resulted in low participant accrual. Additional focus on increasing direct referral methods appears to be a fruitful area of CBPR.
Management of external jugular vein aneurysm: a systematic review
Authors: Nana Petroula , Gkrinia Eleni , Maiou Chara , Karyda Ourania , Korais Christos , Spanos Konstantinos , Kouvelos Georgios 
Published: May 2021

Introduction Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs. Methods A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed. Results Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1–72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%). Conclusions Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.
Orchid drug-coated balloon versus standard percutaneous transluminal angioplasty for the treatment of femoropopliteal artery disease: 12-month result of the randomized controlled trial
Authors: Liao Chuan-Jun , Song Sheng-Han , Li Tan , Zhang Yang Zhang and Wang-de 
Published: May 2021

Purpose To assess the efficacy and safety of the Orchid drug-coated balloon (coated with paclitaxel) for the treatment of femoropopliteal artery disease versus percutaneous transluminal angioplasty in Chinese population. Methods This is a prospective, single center, single-blinded, randomized controlled trial that randomized (1:1) 60 patients (38 men; mean age 68.7 ± 8.8) to drug-coated balloon group ( n = 30) or percutaneous transluminal angioplasty group ( n = 30). The primary efficacy endpoint was primary patency of the target lesion and clinically driven target lesion revascularization (CD-TLR) at 12 months. The primary safety end point was freedom from perioperative death at 30 days and freedom from limb-related death and major amputation at 12 months. Results Baseline characteristics were similar between the two groups. Drug-coated balloon group resulted in higher primary patency (82.8% vs. 48.3%, p = 0.005) and lower CD-TLR rates (3.5% vs. 27.6%; p = 0.001) versus percutaneous transluminal angioplasty group at 12 months. The ABI was significantly higher in drug-coated balloon group than percutaneous transluminal angioplasty group (0.86 ± 0.13 vs. 0.72 ± 0.18, p = 0.025). There were no perioperative death at 30 days, no limb-related death and no major amputation at 12 months in either group. Conclusions The randomized controlled trial showed superior treatment effect with drug-coated balloon versus percutaneous transluminal angioplasty, with remarkably higher patency and lower CD-TLR rates. The result is consistent with other study and demonstrates the safety and efficacy of the Orchid drug-coated balloon for the treatment of femoropopliteal artery disease.