bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-dose Buprenorphine Initiation in Hospitalized Adults With Opioid Use Disorder: A Retrospective Cohort Analysis
Authors: Button Dana , Hartley Jennifer , Robbins Jonathan , Levander Ximena A. , Smith Natashia J. , Englander Honora 
Published: May 2021

Objectives:
Patients with opioid use disorder (OUD) can initiate buprenorphine without requiring a withdrawal period through a low-dose (sometimes referred to as “micro-induction”) approach. Although there is growing interest in low-dose buprenorphine initiation, current evidence is limited to case reports and small case series.

Methods:
We performed a retrospective cohort study of patients with OUD seen by a hospital-based addiction medicine consult service who underwent low-dose buprenorphine initiation starting during hospital admission. We then integrated our practice-based experiences with results from the existing literature to create practice considerations.

Results:
Sixty-eight individuals underwent 72 low-dose buprenorphine initiations between July 2019 and July 2020. Reasons for low-dose versus standard buprenorphine initiation included co-occurring pain (91.7%), patient anxiety around the possibility of withdrawal (69.4%), history of precipitated withdrawal (9.7%), opioid withdrawal intolerance (6.9%), and other reason/not specified (18.1%). Of the 72 low-dose buprenorphine initiations, 50 (69.4%) were completed in the hospital, 9 (12.5%) transitioned to complete as an outpatient, and 13 (18.1%) were terminated early. We apply our experiences and findings from literature to recommendations for varied clinical scenarios, including acute illness, co-occurring pain, opioid withdrawal intolerance, transition from high dose methadone to buprenorphine, history of precipitated withdrawal, and rapid hospital discharge. We share a standard low-dose initiation protocol with potential modifications based on above scenarios.

Conclusions:
Low-dose buprenorphine initiation offers a well-tolerated and versatile approach for hospitalized patients with OUD. We share lessons from our experiences and the literature, and provide practical considerations for providers.
Cannabis Use and Stroke: Does a Risk Exist?
Authors: Swetlik Carol , Migdady Ibrahim , Hasan Leen Z. , Buletko Andrew Blake , Price Carrie , Cho Sung-Min 
Published: May 2021

Aims:
Cannabis use has been reported as a risk factor for stroke. We systematically review the prevalence and outcomes of stroke in people with cannabis use.

Methods:
We searched MEDLINE and 6 other databases from inception to January 2020 for studies on the relationship between cannabis use and stroke. We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Two independent reviewers extracted the data. Study quality was assessed by the Newcastle-Ottawa Scale for cohort and case-control studies.

Results:
Seventeen studies involving 3,185,560 people with cannabis use were included. Descriptive statistics demonstrated 18,676 (median 1.1%, interquartile range [IQR] 0.3%–1.3%) experienced stroke compared with 0.8% of those without use (Odds Ratio 1.17, 95% CI 1.10–1.25). Among people with cannabis use, median age was 26.2 years (IQR 25.2–34.3 years) and mostly male (median 57.8%). Of stroke subtypes, ischemic stroke was most prevalent (median 1.2%, IQR 0.4%–1.9%), followed by undefined stroke subtype (median 1.2%, IQR 1.1%–1.2%) and hemorrhagic stroke (median 0.3%, IQR 0.1%–0.6%). The majority of people with cannabis use who experienced stroke survived (median: 85.1%, IQR 83%–87.5%) and 64.0% of people experienced a good neurologic outcome, defined as modified Rankin Scale of 0 to 3. Few studies included outcomes of vasospasm or seizure.

Conclusions:
In people with cannabis use, the prevalence of ischemic stroke and hemorrhagic stroke was 1.2% and 0.3%, respectively, higher than the prevalence of people without use (0.8% and 0.2%). There is insufficient information on timing, exposure, duration, and dose-responsive relationship.
Efficacy and Safety of Simultaneous Application of HIFEM and Synchronized Radiofrequency for Abdominal Fat Reduction and Muscle Toning: A Multicenter Magnetic Resonance Imaging Evaluation Study
Authors: Jacob Carolyn , Kent David , Ibrahim Omer 
Published: May 2021

BACKGROUND
Radiofrequency and high-Intensity Focused Electromagnetic (HIFEM) field procedure are well-known, stand-alone, body-shaping modalities, yet their simultaneous application has not been investigated.

OBJECTIVE
The aim is to evaluate the efficacy of a novel device simultaneously delivering HIFEM and radiofrequency for subcutaneous fat reduction and muscle toning.

MATERIALS AND METHODS
Forty-one subjects with an average age of 39.7 ± 11.5 years were recruited. The subjects received 3 abdominal treatments (one per week). Magnetic resonance imaging images of the treated area were evaluated at baseline and at 1-, 3-, and 6-month visits for changes in subcutaneous fat, muscle thickness, and abdominal separation (AS). Anthropometric data and digital photographs were collected. Subject satisfaction and therapy comfort were evaluated.

RESULTS
The muscle mass increase peaked at 3 months, showing 26.1% thickening. The fat thickness reduction was most prominent at 3 months, showing a 30.8% reduction. The AS decreased by 18.8% at 3 months after treatment. The waist circumference reduced by 5.87 ± 3.64 cm at a 3-month follow-up. Six-month data showed maintenance of these outcomes. The treatment was considered as comfortable with high patient satisfaction.

CONCLUSION
The analysis of magnetic resonance imaging images and waist measurements showed that the therapy combining HIFEM and radiofrequency is highly effective in reducing subcutaneous fat and muscle thickening.
Contribution of lncRNA CASC8, CASC11, and PVT1 Genetic Variants to the Susceptibility of Coronary Heart Disease
Authors: Lu Yan , Yuan Wei , Wang Lan , Ning Mingan , Han Yuan , Gu Wenjuan , Zhao Tingting , Shang Fenqing , Guo Xuan 
Published: May 2021

Abstract:
The purpose of this study was to explore the relationship between lncRNA CASC8, CASC11, and plasmacytoma variant translocation 1 (PVT1). genetic variants and coronary heart disease (CHD) susceptibility among a Chinese Han population. Five single nucleotide polymorphisms were genotyped by Agena MassARRAY platform among 464 CHD patients and 510 healthy controls. Binary logistic regression models by calculating odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between selected single nucleotide polymorphisms and CHD risk. Multifactor dimensionality reduction analysis was performed to analyze gene–gene interaction. PVT1 rs4410871 (OR = 0.77, P = 0.040) was associated with a reduced risk of CHD occurrence in the Chinese population. CASC11 rs9642880 (OR = 1.49, P = 0.021) was a risk factor for increased CHD susceptibility in subjects over 60 years old, and PVT1 rs4410871 was a protective factor for CHD susceptibility in males (OR = 0.67, P = 0.015) and smokers (OR = 0.62, P = 0.047). Complications (hypertension or diabetes) of CHD influenced the association between CASC8, CASC11, and PVT1 genetic polymorphisms and CHD predisposition. Moreover, CASC8, CASC11, and PVT1 polymorphisms were related to the number of pathological branches and Gensini score in CHD patients. The study displayed the contribution of CASC8, CASC11, and PVT1 genetic polymorphisms to CHD predisposition, and these variants could serve as potential biomarkers of CHD susceptibility. These findings contribute to enhancing the understanding of the role of lncRNA polymorphisms in CHD risk.
Recent Insights Into the Protective Mechanisms of Paeoniflorin in Neurological, Cardiovascular, and Renal Diseases
Authors: Jiao Feng , Varghese Kevin , Wang Shaoxun , Liu Yedan , Yu Hongwei , Booz George W. , Roman Richard J. , Liu Ruen , Fan Fan 
Published: May 2021

Abstract:
The monoterpene glycoside paeoniflorin (PF) is the principal active constituent of the traditional Chinese herbal medicines, Radix Paeoniae Alba and Radix Paeoniae Rubra, which have been used for millennia to treat cardiovascular diseases (eg, hypertension, bleeding, and atherosclerosis) and neurological ailments (eg, headaches, vertigo, dementia, and pain). Recent evidence has revealed that PF exerts inhibitory effects on inflammation, fibrosis, and apoptosis by targeting several intracellular signaling cascades. In this review, we address the current knowledge about the pharmacokinetic properties of PF and its molecular mechanisms of action. We also present results from recent preclinical studies supporting the utility of PF for the treatment of pain, cerebral ischemic injury, and neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. Moreover, new evidence suggests a general protective role of PF in heart attack, diabetic kidney, and atherosclerosis. Mechanistically, PF exerts multiple anti-inflammatory actions by targeting toll-like receptor-mediated signaling in both parenchymal and immune cells (in particular, macrophages and dendritic cells). A better understanding of the molecular actions of PF may lead to the expansion of its therapeutic uses.
Carbon Monoxide–Saturated Polymerized Placenta Hemoglobin Optimizes Mitochondrial Function and Protects Heart Against Ischemia–Reperfusion Injury
Authors: Zhang Yarong , Nie Hongfei , Li Shen , Deng Yan , Zhou Wentao , Wu Wei , Xu Xuewen , Yu Haiyang , Li Tao 
Published: May 2021

Abstract:
Ischemia–reperfusion (I-R) injury is detrimental to cardiovascular system. This study was designed to investigate whether carbon monoxide–saturated polymerized human placenta hemoglobin (CO-PolyPHb) attenuates cardiac I-R injury and to elucidate the underlying mechanism(s). Sixty male adult Sprague-Dawley rats were randomly divided into 6 groups: saline + sham group, PolyPHb + sham group, CO-PolyPHb + sham group, saline + I-R group, PolyPHb + I-R group, and CO-PolyPHb + I-R group. Rats were pretreated with injection of PolyPHb, CO-PolyPHb (0.5 g Hb/kg/d), or an equivalent volume of saline via caudal vein for 3 days. After pretreatment, hearts were isolated Langendorff perfused and subjected to 30-minute no-flow ischemia and 120-minute reperfusion. As compared with the saline + I-R group, pretreatment with CO-PolyPHb greatly improved the recovery of cardiac function, reduced infarct size, and suppressed the release of cardiac enzyme. Importantly, CO-PolyPHb showed more prominent cardioprotective effect than PolyPHb, exhibiting a promising therapeutic potential in cardiac I-R injury. Further study demonstrated that CO-PolyPHb activated molecular signaling toward mitophagy and significantly elevated the mitochondrial respiratory function in the heart. In addition, CO-PolyPHb upregulated the phosphorylation of the proteins in insulin signaling pathway and increased the glucose uptake rate in cardiomyocytes. Pharmacological inhibition of this pathway by wortmannin abrogated the anti-I-R effect of CO-PolyPHb. In conclusion, using an isolated rat heart model, we have demonstrated that pretreatment with CO-PolyPHb provided protective effect against cardiac I-R injury, and this protection was mediated by the improvement of mitochondrial function and activation of insulin signaling pathway in the heart.
Altered Properties of Neurons and Astrocytes and the Effects of Food Components in Stroke-Prone Spontaneously Hypertensive Rats
Authors: Yamagata Kazuo , Yamori Yukio 
Published: May 2021

Abstract:
In stroke-prone spontaneously hypertensive rats (SHRSP), stroke induces neuronal vulnerability and neuronal death, while astrocytes show a weakened support function toward neurons. Moreover, certain food components have been demonstrated to prevent the occurrence of stroke. This review aims to explain the stroke-related properties of SHRSP-derived neurons and astrocytes. In addition, it describes the effects of particular dietary phytochemicals on SHRSP. In this study, we obtained information using PubMed, ScienceDirect, and Web of Science. We searched for the functions of neurons and astrocytes and the molecular mechanism of ischemic stroke induction. We summarized the recent literature on the underlying mechanisms of stroke onset in SHRSP and the alleviating effects of typical food-derived phytochemical components. Neuronal death in SHRSP is induced by hypoxia-reoxygenation, suggesting the involvement of oxidative stress. Furthermore, the production of lactate, l-serine, and glial cell line-derived neurotrophic factor in SHRSP-derived astrocytes was reduced compared with that in control Wistar–Kyoto rats. Vitamin E exerts an inhibitory effect on hypoxia-reoxygenation–induced neuronal death in SHRSP. Curcumin, epigallocatechin gallate, resveratrol, and carotenoids can prevent the development of stroke in SHRSP. In particular, the properties of SHRSP-derived neurons and astrocytes affect stroke-induced neuronal death. This review suggests the potential and therapeutic applications of dietary phytochemicals in reducing stroke risk and lowering blood pressure in SHRSP, respectively, by targeting various processes, including oxidative stress, apoptosis, and inflammation. Thus, future research on SHRSP brain cells with a genetic predisposition to stroke can consider using these food ingredients to develop approaches for stroke prevention.
Temporoparietal Fascia Flaps in Children Under 15 Years of Age: An Anatomic Investigation and Its Clinical Implications in Auricular Reconstruction
Authors: Kim Young Soo 
Published: May 2021

Background:
The temporoparietal fascia (TPF) flap has been successfully used in the treatment of microtia with primary or secondary cases. The literature contains numerous studies about its structure and vascular anatomy in adults. However, it is rare to study its vasculature and characteristics in children.

Methods:
From September of 2013 to May of 2020, 188 patients with average age of 9.8 years (range, 5–14 years) underwent total ear reconstruction with costal cartilage in 67 patients (68 ears) or porous polyethylene framework in 121 patients (128 ears) using 196 TPF flaps. The TPF flap was most commonly used in second-stage operations to elevate the reconstructed auricle in the costal cartilage group. Contrastingly, the TPF flap was routinely used in the porous polyethylene framework group. The vascular pattern and characteristics of the TPF flap were evaluated during flap elevation.

Results:
Only 140/196 cases (71.4%) showed a typical pattern with the superficial temporal artery and the superficial temporal vein in this study; others (28.6%) were supplied by combinations of the posterior auricular artery or vein, occipital vein, diploic vein, and superficial artery or vein. Meanwhile, there are variants of the STA and posterior origin-superficial temporal artery, which originates posterior to the lobule beneath the cartilage remnant (3/196, 1.5%).

Conclusion:
Surgeons should inspect the pattern of the TPF flap thoroughly before elevation in children, because of the variety of the vessels and anatomic patterns of TPF.
Impact of visit-to-visit blood pressure variability on hypertensive-mediated target organ damage and future cardiovascular events: the Campania salute network
Authors: Mancusi Costantino , Trimarco Valentina , Losi Maria Angela , Canciello Grazia , Morisco Carmine , Manzi Maria Virginia , Arnone Maria Immacolata , Fucile Ilaria , de Simone Giovanni , Izzo Raffaele , De Luca Nicola , Trimarco Bruno 
Published: May 2021

Background:
Exaggerated variability of blood pressure (BP) poses additional stress on cardiovascular system independent of BP average value, increasing risk of target organ damage (HMOD) and cardiovascular events. We assessed the impact of visit-to-visit variability (VVV) of BP on development of cardiovascular events and HMOD.

Methods:
Standard deviation (SD) and coefficient of variability of mean SBP and DBP were calculated in 3555 patients from the Campania Salute Network registry, with available echocardiogram and more than six visits during follow-up. Values from the first visit were excluded. The impact of VVV of BP on cardiovascular events, and mediation of HMOD were assessed at final visit.

Results:
Mean number of visits was 11 ± 6 with mean interval between visits of 9.1 ± 3.7 months. Mean visit-to-visit SD during follow-up was 13 ± 5 for systolic and 8 ± 3 mmHg for DBP; coefficients of variability were 9.7 ± 3.5 and of 9.6 ± 3.2, respectively. In multivariable analysis, left ventricular mass at follow-up was correlated with systolic VVV of BP independently of significant effect of age, BMI, mean SBP during follow-up and initial left ventricular mass. Follow-up GFR was inversely associated with systolic and diastolic VVV, independently of significant effect of age, mean glucose and SBP during follow-up, and initial GFR. In Cox regression, high VVV of BP was also associated with increased risk of cardiovascular events (hazard ratio 1.49, 95% confidence interval 1.08–2.06, P = 0.015), independently of significant effect of HMOD.

Conclusion:
VVV is associated with prevalent HMOD and development of cardiovascular events, independently of mean BP value during follow-up and HMOD.
Predictive value of within-visit and visit-to-visit blood pressure variability for all-cause mortality: the Minhang Study
Authors: Cai Enheng , Chen Ling , Wang Yajuan , An Dewei , Zhang Jin , Tang Xiaofeng , Li Yan , Wang Yan , Zhu Dingliang 
Published: May 2021

Background:
Blood pressure variability is a common physiological phenomenon; however, the association between within-visit and visit-to-visit variability in blood pressure and all-cause mortality remains uncertain.

Methods:
We conducted a retrospective analysis of blood pressure variability among 11 721 adults who underwent blood pressure measurement on three occasions within a period of 6 months. Within-visit and visit-to-visit variability was quantified using the standard deviation and maximum--minimum difference between measures. The predictive effect of this variability on all-cause mortality was evaluated using Kaplan--Meier survival curves and Cox regression analysis.

Results:
The incidence of all-cause mortality was significantly higher for participants in the top quintile of within-visit and visit-to-visit blood pressure variability and for those with sustained high within-visit variability. Within-visit variability was not retained as a risk factor after adjustment in Cox regression models. The hazard ratio for mortality increased from 48 to 55% for the top quintile of visit-to-visit blood pressure variability and from 56 to 61% for sustained high within-visit variability. The risk of mortality remained statistically higher even if visit-to-visit blood pressure variability was added to the model, including consistency of within-visit blood pressure variability and vice versa.

Conclusion:
Visit-to-visit and sustained high within-visit blood pressure variability were significant positive prognostic factors for all-cause mortality. Our findings underlined the clinical significance of achieving stable blood pressure in an effective plan of hypertension management.
Birth weight, childhood obesity and risk of hypertension: a Mendelian randomization study
Authors: Fan Jingwen , Shi Xuezhong , Jia Xiaocan , Wang Yuping , Zhao Yang , Bao Junzhe , Zhang Haomin , Yang Yongli 
Published: May 2021

Purposes:
Observational studies indicate that birth weight and childhood obesity are associated with essential hypertension, but their causal effect on essential hypertension remains unclear. The aim of our study is to elucidate the causal relationship between birth weight, childhood obesity, and essential hypertension by Mendelian randomization (MR) with genetic variants as instrumental variables (IVs).

Methods:
We identified IVs based on single nucleotide polymorphisms (SNPs) associated with birth weight (n = 160 295) and childhood obesity (n = 6889, 1509 cases and 5380 controls) from the meta-analysis of a genome-wide association study. Summary level data from the UK Biobank essential hypertension consortium (n = 463 010, 54 358 cases and 408 652 controls) was used to analyze the relationship between IVs and essential hypertension. Two MR analysis methods, two threshold values of selecting IVs, and leave-one-out analysis were used to ensure the robustness of the results.

Results:
Genetic predisposition to higher birth weight did not increase the risk of essential hypertension. In contrast, per one standard deviation increase in childhood body mass index was significantly associated with an increased risk of essential hypertension (odds ratio = 1.0075, 95% confidence interval: 1.0035–1.0116) when using seven SNPs that achieved genome-wide significance (P < 5 × 10−8). Sensitivity analysis and MR-Egger regression indicated that the results were robust and not influenced by pleiotropy.

Conclusions:
No evidence of an association between birth weight and essential hypertension was found. Childhood obesity, however, showed a causal relationship with the risk of essential hypertension, which was helpful to understand the mechanisms of essential hypertension and develop strategies for its prevention.
Efficacy and Safety of Contact Lens–Assisted Corneal Crosslinking in the Treatment of Keratoconus With Thin Corneas
Authors: Nour Mostafa Mahmoud , El-Agha Mohamed-Sameh H. , Sherif Ahmed M. , Shousha Shireen Mostafa 
Published: May 2021

Objective:
To evaluate the safety and efficacy of contact lens–assisted crosslinking (CA-CXL) in progressive keratoconus with thin corneas (350–400 µm).

Methods:
Forty eyes (30 patients) underwent epithelium-off CA-CXL with iso-osmolar riboflavin and ultraviolet-A irradiation for 30 min (fluence, 3 mW/cm2). A non–ultra-violet-absorbing soft contact lens (sCL) soaked in riboflavin was applied over the cornea during irradiation. Demarcation line (DL) depth was measured 1 month postoperatively. Endothelial cell count (ECC) was measured preoperatively and 3 months postoperatively. Distance uncorrected visual acuity (UDVA) and best spectacle–corrected visual acuity (BDVA), and maximum keratometric values (K max) were evaluated preoperatively and 9 months postoperatively.

Results:
The sCL added a mean thickness of 100.05±1.23 µm. The mean ECC was 2,982±165 cell/mm2 preoperatively and 2,955±125 cell/mm2 postoperatively (endothelial cell loss, 0.9%, P=0.21). The mean DL depth was 204.8±20.2 µm. There was significant improvement in UDVA (P<0.001) and BDVA (P=0.011) with a stable K max (P
=0.06).

Conclusion:
Contact lens–assisted crosslinking was safe and effective, with endothelial loss less than 1% after 3 months and stable corneal tomography over 9 months, with improved visual acuity. Demarcation line depth was found to be shallower than conventional CXL. Therefore, the long-term efficacy of CA-CXL requires further study.

Clinical Trial Registry Number:
NCT04504578 Clinical trials.gov.