bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exercise training ameliorates early diabetic kidney injury by regulating the H2S/SIRT1/p53 pathway
Authors: Yang Lu , Li Dong‐Xia , Cao Bu‐Qing , Liu Shu‐Juan , Xu Dan‐Hong , Zhu Xiao‐Yan , Liu Yu‐Jian 
Published: August 2021

AbstractExercise training exerts protective effects against diabetic nephropathy. This study aimed to investigate whether exercise training could attenuate diabetic renal injury via regulating endogenous hydrogen sulfide (H2S) production. First, C57BL/6 mice were allocated into the control, diabetes, exercise, and diabetes + exercise groups. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ). Treadmill exercise continued for four weeks. Second, mice was allocated into the control, diabetes, H2S and diabetes + H2S groups. H2S donor sodium hydrosulfide (NaHS) was intraperitoneally injected once daily for four weeks. STZ‐induced diabetic mice exhibited glomerular hypertrophy, tissue fibrosis and increased urine albumin levels, urine protein‐ and albumin‐to‐creatinine ratios, which were relieved by exercise training. Diabetic renal injury was associated with apoptotic cell death, as evidenced by the enhanced caspase‐3 activity, the increased TdT‐mediated dUTP nick‐end labeling ‐positive cells and the reduced expression of anti‐apoptotic proteins, all of which were attenuated by exercise training. Exercise training enhanced renal sirtuin 1 (SIRT1) expression in diabetic mice, accompanied by an inhibition of the p53‐#ediated pro‐apoptotic pathway. Furthermore, exercise training restored the STZ‐mediated downregulation of cystathionine‐β‐synthase (CBS) and cystathionine‐γ‐lyase (CSE) and the reduced renal H2S production. NaHS treatment restored SIRT1 expression, inhibited the p53‐mediated pro‐apoptotic pathway and attenuated diabetes‐associated apoptosis and renal injury. In high glucose‐treated MPC5 podocytes, NaHS treatment inhibited the p53‐mediated pro‐apoptotic pathway and podocyte apoptosis in a SIRT1‐dependent manner. Collectively, exercise training upregulated CBS/CSE expression and enhanced the endogenous H2S production in renal tissues, thereby contributing to the modulation of the SIRT1/p53 apoptosis pathway and improvement of diabetic nephropathy.
Does Transvaginal Ultrasound at 13–15 Weeks Improve Anatomic Survey Completion Rates in Obese Gravidas?
Authors: Toscano Marika , Grace Daniel , Pressman Eva K. , Thornburg Loralei L. 
Published: August 2021

(Abstracted from J Matern Fetal Neonatal Med 2021;34:803–809)
The fetal anatomic survey is less likely to be completed or is completed at a later gestational age in pregnant women who are obese. This reduces the likelihood of detecting fetal anomalies at an earlier stage of pregnancy.
Chimeric Contribution of Human Extended Pluripotent Stem Cells to Monkey Embryos Ex Vivo
Authors: Tan Tao , Wu Jun , Si Chenyang , Dai Shaoxing , Zhang Youyue , Sun Nianqin , Zhang E. , Shao Honglian , Si Wei , Yang Pengpeng , Wang Hong , Chen Zhenzhen , Zhu Ran , Kang Yu , Hernandez-Benitez Reyna , Martinez Martinez Llanos , Nuñez Delicado Estrella , Berggren W. Travis , Schwarz May , Ai Zongyong , Li Tianqing , Rodriguez Esteban Concepcion , Ji Weizhi , Niu Yuyu , Belmonte Juan Carlos Izpisua 
Published: August 2021

(Abstracted from Cell 2021;184:2020–2032)
Pluripotent stem cells (PSCs) have demonstrated the ability to be used in interspecies organogenesis through blastocyst complementation, opening the door for production of large quantities of in vivo generated human tissue for regenerative medicine applications. A critical step in this process is the ability of human PSCs (hPSCs) to contribute to chimera formation; however, some studies have shown that hPSCs have little chimeric competency in species evolutionarily distant to humans (eg, mice and pigs).
Use of Telehealth by Surgical Specialties During the COVID-19 Pandemic
Authors: Chao Grace F. , Li Kathleen Y. , Zhu Ziwei , McCullough Jeff , Thompson Mike , Claflin Jake , Fliegner Maximilian , Steppe Emma , Ryan Andrew , Ellimoottil Chad 
Published: August 2021

(Abstracted from JAMA Surg 2021;e210979. doi:10.1001/jamasurg.2021.0979)
Given the US health care system mandates to minimize patient and clinician exposure to COVID-19, telehealth use across all specialties increased dramatically in the COVID-19 pandemic. Telehealth for preoperative and postoperative surgical follow-up patient visits had started to occur at low levels before the pandemic.
“When Is Health Care Actually Going to Be Care?” The Lived Experience of Family Planning Care Among Young Black Women
Authors: Logan Rachel G. , Daley Ellen M. , Vamos Cheryl A. , Louis-Jacques Adetola , Marhefka Stephanie L. 
Published: August 2021

(Abstracted from Qual Health Res 2021;31:1169–1182)
Family planning care (FPC) visits are intended to provide education and opportunities for women to obtain family planning services, including hormonal medications. Structural barriers, sociocultural barriers, and mistreatment by the health care system may perpetuate the numerous health inequities surrounding reproductive health and pregnancy among young Black women.
Neurolytic Splanchnic Nerve Block and Pain Relief, Survival, and Quality of Life in Unresectable Pancreatic Cancer: A Randomized Controlled Trial
Authors: Dong Daosong , Zhao Mingfang , Zhang Jingmei , Huang Ming , Wang Yanwei , Qi Liang , Wan Cheng-fu , Yu Xue , Song Tao 
Published: August 2021

Background
Neurolytic splanchnic nerve block is used to manage pancreatic cancer pain. However, its impact on survival and quality of life remains controversial. The authors’ primary hypothesis was that pain relief would be better with a nerve block. Secondarily, they hypothesized that analgesic use, survival, and quality of life might be affected.

Methods
This randomized, double-blind, parallel-armed trial was conducted in five Chinese centers. Eligible patients suffering from moderate to severe pain conditions were randomly assigned to receive splanchnic nerve block with either absolute alcohol (neurolysis) or normal saline (control). The primary outcome was pain relief measured on a visual analogue scale. Opioid consumption, survival, quality of life, and adverse effects were also documented. Analgesics were managed using a protocol common to all centers. Patients were followed up for 8 months or until death.

Results
Ninety-six patients (48 for each group) were included in the analysis. Pain relief with neurolysis was greater for the first 3 months (largest at the first month; mean difference, 0.7 [95% CI, 0.3 to 1.0]; adjusted P < 0.001) compared with placebo injection. Opioid consumption with neurolysis was lower for the first 5 months (largest at the first month; mean difference, 95.8 [95% CI, 67.4 to 124.1]; adjusted P < 0.001) compared with placebo injection. There was a significant difference in survival (hazard ratio, 1.56 [95% CI, 1.03 to 2.35]; P = 0.036) between groups. A significant reduction in survival in neurolysis was found for stage IV patients (hazard ratio, 1.94 [95% CI, 1.29 to 2.93]; P = 0.001), but not for stage III patients (hazard ratio, 1.08 [95% CI, 0.59 to 1.97]; P = 0.809). No differences in quality of life were observed.

Conclusions
Neurolytic splanchnic nerve block appears to be an effective option for controlling pain and reducing opioid requirements in patients with unresectable pancreatic cancer.

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Preoperative Biliary Drainage Does Not Independently Reduce Survival After Pancreaticoduodenectomy Among Patients With Pancreatic Ductal Adenocarcinoma
Authors: Johansen Karin , Khodakaram Kaveh , Lundgren Linda , Hasselgren Kristina , Gasslander Thomas , Sandström Per , Bratlie Svein Olav , Björnsson Bergthor 
Published: August 2021

Objective:
This study aimed to explore a possible relationship between preoperative biliary drainage (PBD) and overall survival in a national cohort of Swedish patients who underwent pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC).

Background:
PBD has been shown to increase postoperative complications after PD, but its use is steadily increasing. There are a few small studies that have indicated that PBD might in itself negatively affect overall survival after PD.

Methods:
Patients from the Swedish National Registry for tumors in the pancreatic and periampullary region diagnosed from 2010 to 2019 who underwent PD for PDAC were included. Kaplan-Meier curves, log-rank tests and Cox proportional hazards analyses were performed to investigate survival.

Results:
Out of 15,818 patients in the registry, 3113 had undergone PD, of whom 1471 had a histopathological diagnosis of PDAC. Patients who had undergone PBD had significantly worse survival, but the effect of PBD disappeared in the multivariable analysis when elevated bilirubin at any time was included.

Conclusions:
PBD does not independently influence survival after PD for PDAC, but this study implies that even a nominally increased preoperative bilirubin level might impair long-term survival.
Defining Potential Therapeutic Targets in Coronavirus Disease 2019: A Cross-Sectional Analysis of a Single-Center Cohort
Authors: Arulkumaran Nishkantha , Snow Timothy Arthur Chandos , Kulkarni Adarsh , Brealey David , Rickman Hannah , Rees-Spear Chloe , Spyer Moira J. , Heaney Judith , Garr Edmund , Williams Bryan , Cherepanov Peter , Kassiotis George , Lunn Michael , Houlihan Catherine , McCoy Laura E. , Nastouli Eleni , Singer Mervyn 
Published: August 2021

OBJECTIVES:
Multiple mechanisms have been proposed to explain disease severity in coronavirus disease 2019. Therapeutic approaches need to be underpinned by sound biological rationale. We evaluated whether serum levels of a range of proposed coronavirus disease 2019 therapeutic targets discriminated between patients with mild or severe disease.

DESIGN:
A search of ClinicalTrials.gov identified coronavirus disease 2019 immunological drug targets. We subsequently conducted a retrospective observational cohort study investigating the association of serum biomarkers within the first 5 days of hospital admission relating to putative therapeutic biomarkers with illness severity and outcome.

SETTING:
University College London, a tertiary academic medical center in the United Kingdom.

PATIENTS:
Patients admitted to hospital with a diagnosis of coronavirus disease 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Eighty-six patients were recruited, 44 (51%) with mild disease and 42 (49%) with severe disease. We measured levels of 10 cytokines/signaling proteins related to the most common therapeutic targets (granulocyte-macrophage colony-stimulating factor, interferon-α2a, interferon-β, interferon-γ, interleukin-1β, interleukin-1 receptor antagonist, interleukin-6, interleukin-7, interleukin-8, tumor necrosis factor-α), immunoglobulin G antibodies directed against either coronavirus disease 2019 spike protein or nucleocapsid protein, and neutralization titers of antibodies. Four-hundred seventy-seven randomized trials, including 168 different therapies against 83 different pathways, were identified. Six of the 10 markers (interleukin-6, interleukin-7, interleukin-8, interferon-α2a, interferon-β, interleukin-1 receptor antagonist) discriminated between patients with mild and severe disease, although most were similar or only modestly raised above that seen in healthy volunteers. A similar proportion of patients with mild or severe disease had detectable spike protein or nucleocapsid protein immunoglobulin G antibodies with equivalent levels between groups. Neutralization titers were higher among patients with severe disease.

CONCLUSIONS:
Some therapeutic and prognostic biomarkers may be useful in identifying coronavirus disease 2019 patients who may benefit from specific immunomodulatory therapies, particularly interleukin-6. However, biomarker absolute values often did not discriminate between patients with mild and severe disease or death, implying that these immunomodulatory treatments may be of limited benefit.
Analysis of 30 anaesthesia-related deaths in Germany between 2006 and 2015
Authors: Koppenberg Joachim , Stoevesandt Dietrich , Watzke Stefan , Schwappach David , Bucher Michael 
Published: August 2021

BACKGROUND
Anaesthesiology is one of the safest fields in medicine today in relation to mortality. Deaths directly because of anaesthesia have fortunately now become rare exceptions. Nevertheless, important findings can still be drawn from the rare deaths that still occur.

OBJECTIVE
The aim of this study was to identify and analyse the causes of deaths related to anaesthesia alone over a 10-year period.

DESIGN
Retrospective structured analysis of a database of medical liability claims.

SETTING
Hospitals at all levels of care in Germany.

PATIENTS
The database of a large insurance broker included data for 81 413 completed liability claims over the 10-year period from 2006 to 2015. Among 1914 cases associated with anaesthetic procedures, 56 deaths were identified. Of these, 30 clearly involved anaesthesia (Edwards category 1) and were included in the evaluation.

INTERVENTIONS
None (retrospective database analysis).

MAIN OUTCOME MEASURES
Causes of anaesthesia-related death identified from medical records, court records, expert opinions and autopsy reports.

RESULTS
The 30 deaths were analysed in detail at the case and document level. They included high proportions of ‘potentially avoidable’ deaths, at 86.6%, and what are termed ‘never events’, at 66.7%. Problems with the airway were the cause in 40% and problems with correct monitoring in 20%. In addition, communication problems were identified as a ‘human factor’ in 50% of the cases.

CONCLUSION
The majority of the anaesthesia-related deaths investigated could very probably have been avoided with simple anaesthesiological measures if routine guidelines had been followed and current standards observed. Actions to be taken are inferred from these results, and recommendations are made. In future, greater care must be taken to ensure that the level of safety already achieved in anaesthesiology can be maintained despite demographic developments and increasing economic pressures.
Inclination Angle in Greenstick Fracture of Mandibular Subcondyle Treated with Intermaxillary Fixation in an Elderly Patient
Authors: Hwang Kun , Ma Sung Hwan 
Published: August 2021

Summary:
This study presents the outcomes of a conservative approach to greenstick condylar fracture treatment in an elderly patient. Serial changes of the inclination angle were measured in a greenstick fracture of the mandibular subcondyle treated with intermaxillary fixation (IMF). A 64-year-old woman presented to an outpatient clinic complaining of pain on her chin. While waiting for an elevator, she lost consciousness and hit her face on the floor. She had a limited mouth-opening of 13 mm. Panoramic radiography and computed tomography confirmed a greenstick (incomplete) fracture of the left condyle, in which the lateral side of the bone was fractured and the medial side was bent. The medial inclination was approximately 40.4 degrees. On the second post-trauma day, IMF was performed using arch-bars and a prefabricated occlusal stop. Serial Towne’s views were taken. The inclination of the fractured condyle was measured and compared with the contralateral side. The difference in inclination angles (DI) between the fractured and contralateral sides was plotted over time. In SPSS version 19.0, an exponential regression model was constructed. In this patient, a greenstick (incomplete) fracture of the condyle (40.4 degree inclination) was treated with IMF and a pre-fabricated occlusal stop. On day 42 post-IMF, the inclination angle had decreased to 15.6 degrees, only 5.4 degrees greater than the contralateral side. The DI was fitted to exponential regression model (y = 25.111e−0.028x, P = 0.004). This case shows that even in an elderly patient, a greenstick fracture of the mandibular condyle can be treated by vertical lengthening using an occlusal stop and IMF.
Study of Frontal and Temporal Hairline Patterns in Japanese Subjects
Authors: Kashiyama Kazuya , Haraguchi Rina , Ban Fuko , Yoshida Daisaku , Fukuda Maimi , Date Naoto , Koga Koko , Koga Kazufumi , Tanaka Katsumi 
Published: August 2021

Background:
The shape of the hairline is very important in a person’s identity and in determining the impression they make. Reports on the morphology of a normal hairline are still scarce. Differences in the shape of male and female hairlines in Japanese subjects are discussed in this study.

Methods:
A questionnaire about hairline type, the presence or absence of a widow’s peak, and measurement of the width and height of the forehead was given to 456 healthy subjects, and their responses were recorded.

Results:
Percentages of frontal hairline types were found to be linear (women 36.1%, men 45.9%), triangular (7.2%, 0.82%), round (38.5%, 10.7%), and M- shaped (18.2%, 42.6%). Temporal hairline types: inverted triangle (20.3%, 65.6%), inverted round (27.8%, 17.2%), straight (24.8%, 10.6%), and convex (27.2%, 6.6%). The incidence of a widow’s peak was 29.6% in women and 32.8% in men. The mean length of the mid-frontal line was 6.2 cm in women and 6.65 cm in men.

Conclusions:
Regarding the hairline morphology of the frontal view, two types (linear and M-shaped) accounted for 88.5% of men. In women, linear accounted for 36.1%, being relatively high, but lower than the frequency in men. Round accounted for 38.5%, being the highest. Regarding the temporal hairline, a hairless region (inverted triangle and inverted round) was noted in 82.8% of men. In women, a hairless region was present in 48.1% and was absent (straight and convex) in 51.9%. A temporal hairline with a hairless region was noted in the majority of men, whereas it was absent in slightly more cases in women.
Within-visit SBP variability from childhood to adulthood and markers of cardiovascular end-organ damage in mid-life
Authors: Meng Yaxing , Magnussen Costan G. , Wu Feitong , Buscot Marie-Jeanne , Juonala Markus , Pahkala Katja , Hutri-Kähönen Nina , Kähönen Mika , Laitinen Tomi , Viikari Jorma S.A. , Raitakari Olli T. , Sharman James E. 
Published: August 2021

Background:
Within-visit SBP variability is associated with age and SBP, but its long-term clinical significance is unknown. We examined the association between child, adult, and life-time within-visit SBP variability with markers of end-organ damage using data from a 31-year longitudinal study.

Methods:
Within-visit SBP variability was calculated as the standard deviation of three sitting SBP readings among up to 3010 participants aged 6–18 years (childhood) who were re-measured up to seven times to mid-adulthood. Markers of cardiovascular end-organ damage in adulthood were carotid intima--media thickness, brachial flow-mediated dilatation, carotid distensibility, pulse wave velocity, left ventricular mass index, carotid plaque, and coronary artery calcification.

Results:
The mean (standard deviation) cumulative within-visit SBP variability was 2.7 (1.5) mmHg in childhood, 3.9 (1.9) mmHg in adulthood and 3.7 (1.5) mmHg across the observed life-time. Childhood within-visit SBP variability was not correlated with its subsequent values measured from 3 to 31 years later. With adjustment for age, sex, cumulative SBP, BMI and serum lipids, neither child, adult, or life-time cumulative within-visit SBP variability associated with markers of cardiovascular end-organ damage. However, higher child, adult, and life-time cumulative SBP significantly associated with higher carotid intima--media thickness, higher pulse wave velocity, lower brachial flow-mediated dilatation, lower carotid distensibility in adulthood.

Conclusion:
Within-visit SBP variability from childhood to adulthood does not provide additional predictive utility over SBP over the same period of the life course.
ANALYSIS OF TRANSFER LEARNING FOR SELECT RETINAL DISEASE CLASSIFICATION
Authors: Gelman Rony , Fernandez-Granda Carlos 
Published: August 2021

Purpose:
To analyze the effect of transfer learning for classification of diabetic retinopathy (DR) by fundus photography and select retinal diseases by spectral domain optical coherence tomography (SD-OCT).

Methods:
Five widely used open-source deep neural networks and four customized simpler and smaller networks, termed the CBR family, were trained and evaluated on two tasks: 1) classification of DR using fundus photography and 2) classification of drusen, choroidal neovascularization, and diabetic macular edema using SD-OCT. For DR classification, the quadratic weighted Kappa coefficient was used to measure the level of agreement between each network and ground truth–labeled test cases. For SD-OCT–based classification, accuracy was calculated for each network. Kappa and accuracy were compared between iterations with and without use of transfer learning for each network to assess for its effect.

Results:
For DR classification, Kappa increased with transfer learning for all networks (range of increase 0.152–0.556). For SD-OCT–based classification, accuracy increased for four of five open-source deep neural networks (range of increase 1.8%–3.5%), slightly decreased for the remaining deep neural network (−0.6%), decreased slightly for three of four CBR networks (range of decrease 0.9%–1.8%), and decreased by 9.6% for the remaining CBR network.

Conclusion:
Transfer learning improved performance, as measured by Kappa, for DR classification for all networks, although the effect ranged from small to substantial. Transfer learning had minimal effect on accuracy for SD-OCT–based classification for eight of the nine networks analyzed. These results imply that transfer learning may substantially increase performance for DR classification but may have minimal effect for SD-OCT–based classification.
Repeatability and agreement of wavefront aberrations of a new hybrid topographer and aberrometer in healthy eyes
Authors: Shetty Rohit , Trivedi Divya , Ranade Reshma , Arun Spriha , Khamar Pooja , Kundu Gairik 
Published: August 2021

Purpose:
To assess repeatability and agreement of the Pentacam AXL Wave with that of the iTrace aberrometer.

Setting:
Narayana Nethralaya, Bangalore, India.

Design:
Prospective, cross-sectional study.

Methods:
All eyes of patients underwent 3 sets of measurements at a single visit, using Pentacam AXL Wave and iTrace. Lower-order aberrations (LOAs), higher-order aberrations (HOAs), and coma and spherical aberrations (SAs) were analyzed. Repeatability was assessed using within-subject (Sw) SD, test–retest variability (TRT), Sw coefficient of variation (CoV), and intraclass correlation coefficient (ICC). The Bland-Altman analysis was used to assess 95% limits of agreement (LoA) and the correlation coefficient (r) to determine strength of relationship between measurements.

Results:
100 eyes of 100 patients underwent measurements. Pentacam AXL Wave had repeatability with an ICC for total ocular aberrations ranging from 0.84 for HOAs to 0.92 for LOAs and for corneal from 0.76 for HOAs to 0.86 for LOAs. The Sw, TRT, and CoV of all aberrations were significantly lower (better) than those of iTrace (P < .001). The mean differences between 2 devices were insignificant for the comparison of all parameters, except for spherical aberration (0.011 [0.002571 to 0.02008]; P = .01). Both devices showed excellent correlations for ocular aberrations (total HOAs [P = .12, LoA = −0.52 to 0.025; r = 0.89]; LOAs [P = .14, LoA = −2.71 to 2.61; r = 0.96]; coma [P = .27, LoA = −0.11 to 0.12; r = 0.89]; and SA [P = .01, LoA = −0.09 to 0.07; r = 0.97]).

Conclusions:
The repeatability estimates for wavefront aberrations using Pentacam AXL Wave were significantly better than those using iTrace. Both devices showed excellent correlations for total ocular aberrations.