bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between plant-based diet indices and metabolic syndrome in Iranian older adults
Authors: Amini* Mohammad Reza , Shahinfar Hossein , Djafari Farhang , Sheikhhossein Fatemeh , Naghshi Sina , Djafarian Kurosh , Clark Cain CC , Shab-Bidar Sakineh 
Published: February 2021

Background: We investigated the association between plant-based diets indices – an overall plant-based diet index; a healthful plant-based diet index; and an unhealthful plant-based diet index – and metabolic syndrome among Iranian older adults. Aim: We aimed to examine the relationship between plant-based diet indices and metabolic syndrome. Methods: This cross-sectional study included 178 older adults (51 men and 127 women), with a mean age of 67.04 (60–83) who were referred to health centers in Tehran, Iran. Blood and urine samples were collected to measure serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. We created an overall plant-based diet index, healthful plant-based diet index, and unhealthful plant-based diet index from semi-quantitative food-frequency questionnaire data. Anthropometric measures were done. Results: Our crude model results showed that triglycerides, systolic and diastolic blood pressure, fasting blood sugar, high-density lipoprotein cholesterol, and waist circumference did not significantly differ between tertiles of plant-based diet index and healthful plant-based diet index; also triglycerides, systolic and diastolic blood pressure, fasting blood sugar, and waist circumference did not significantly differ between tertiles of unhealthful plant-based diet index, but high-density lipoprotein cholesterol significantly differed between tertiles of unhealthful plant-based diet index. After adjusting for confounders the results remained non-significant for plant-based diet index but high-density lipoprotein cholesterol was significant for healthful and unhealthful plant-based diet indices. There was also no significant association between plant-based diet index (OR: 1.11; 95% CI: 0.53–2.33), healthful plant-based diet index (OR: 0.81; 95% CI: 0.39–1.68), and unhealthful plant-based diet index (OR: 0.81; 95% CI: 0.38–1.72) with metabolic syndrome, even after adjustment for confounders. Conclusions: Our findings showed that plant-based diets are not significantly associated with risk of metabolic syndrome in older adults. To confirm the veracity of these findings, more studies should be conducted.
Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: first results and outcomes of a newly established ECPR program in a large population area
Authors: Djordjevic Ilija , Gaisendrees Christopher , Adler Christoph , Eghbalzadeh Kaveh , Braumann Simon , Ivanov Borko , Merkle Julia , Deppe Antje-Christin , Kuhn Elmar , Stangl Robert , Lechleuthner Alex , Miller Christian , Pfister Roman , Mader Navid , Baldus Stephan , Sabashnikov Anton , Wahlers Thorsten 
Published: February 2021

Objectives: Out-of-hospital cardiac arrest (OHCA) is associated with excessively high mortality rates. Recent studies suggest benefits from extracorporeal cardiopulmonary resuscitation (ECPR) performed in selected patients. We sought to present the first results from our interdisciplinary ECPR program with a particular focus on early outcomes and potential risk factors associated with in-hospital mortality. Methods: Between January 2016 and December 2019, 44 patients who underwent ECPR selected according to our institutional ECPR protocol were retrospectively analyzed regarding pre-hospital, in-hospital, and early outcome parameters. Patients were divided into survivors (S) and non-survivors (NS). Statistical analysis of risk factors regarding in-hospital mortality of the patient cohort analyzed was performed. Results: The mean age of the population was 53 ± 12 years, with most patients being male ( n = 40). The leading cause of cardiac arrest (CA) was myocardial infarction ( n = 24, 55%). The median hospital stay was 1 (1;13) day. Twenty-three percent of patients ( n = 10) were discharged from hospital including eight patients (18%) with CPC 1–2. Survivors showed a trend toward shorter pre-hospital CPR duration (60 (59;60) min (S) vs 60 (55;90) min (NS), p = 0.07). Conclusion: Establishing ECPR programs in large population areas offers the option to improve survival rates for OHCA patients. Stringent compliance of institutional criteria (mainly age, witnessed arrest, and time of pre-hospital resuscitation) and providing ECPR to strictly selected patients seems to be a vital factor for such programs’ success. Pre-clinical settings and therapeutic measures must be adjusted in this regard to improve outcomes for this highly demanding patient cohort.
Pancreas preservation time as a predictor of prolonged hospital stay after pancreas transplantation
Authors: Mei Shengmin , Huang Zhichao , Dong Yinlei , Chen Zheng , Xiang Jie , Zhou Jie , Li Zhiwei , Zheng Shusen , Hu Zhenhua 
Published: February 2021

Objective Length of hospital stay is a sensitive indicator of short-term prognosis. In this retrospective study, we investigated how pancreas preservation time affects length of hospital stay after pancreas transplantation. Methods Patients receiving pancreas transplantation (1998.7–2018.6) were identified from the Scientific Registry of Transplant Recipients database and grouped according to pancreas preservation time. We analyzed the relationship of pancreas preservation time with graft and patient survival and prolonged length of stay (PLOS; i.e., hospital stay ≥20 days). Results We included 18,099 pancreas transplants in the survival analysis. Pancreas preservation time >20 hours had a significantly higher risk of graft failure than 8 to 12 hours. Pancreas preservation time was not significantly associated with patient survival. We included 17,567 pancreas transplants in the analysis for PLOS. Compared with 8 to 12 hours, pancreas preservation time >12 hours had a significantly higher PLOS risk, which increased with increased pancreas preservation time. In simultaneous pancreas–kidney transplantation, we also found that pancreas preservation time was positively associated with PLOS risk with pancreas preservation time >12 hours. Conclusion Pancreas preservation time is a sensitive predictor of PLOS. Transplant centers should minimize pancreas preservation time to optimize patient outcomes.
Sudden sensorineural hearing loss during pregnancy: etiology, treatment, and outcome
Authors: Qian Yi , Kang Houyong , Hu Guohua , Zhong Shixun , Zuo Wenqi , Lei Yan , Xu Zhengyan , Chen Tao , Zeng Jihong 
Published: February 2021

Objective To analyze the etiologies, treatments, and outcomes of sensorineural hearing loss (SSNHL) during pregnancy. Study design Retrospective chart review of 25 pregnant patients treated for SSNHL between January 2012 and September 2019. Forty-nine age matched non-pregnant women with severe and profound hearing loss diagnosed with SSNHL during the same period served as controls. Data were recorded on age, symptoms, onset of hearing loss, audiometric results, treatments, and outcomes. Results The mean age was 29.6 years (range 23–38 years). Intratympanic steroids (ITS) were administered in 15 (60.0%) pregnant women with SSNHL. Three women were treated with postauricular steroids only, while another woman was treated with intravenous ginkgo leaf extract and dipyridamole. The remaining six women received no medications. More than half (8/15, 53.3%) of pregnant women with SSNHL receiving ITS experienced hearing improvement. Pregnant women with profound hearing loss who received no medication had no hearing improvement. Most pregnant women with SSNHL (12/15, 80.0%) had higher fibrinogen levels than controls (mean values 3.77±0.71 g/L and 2.54±0.48 g/L, respectively). Conclusion Fibrinogen could be a risk factor for SSNHL during pregnancy. ITS may benefit pregnant women with severe and profound SSNHL.
Migraine therapeutics differentially modulate the CGRP pathway
Authors: Bhakta Minoti , Vuong Trang , Taura Tetsuya , Wilson David S , Stratton Jennifer R , Mackenzie Kimberly D 
Published: February 2021

Background The clinical efficacy of migraine therapeutic agents directed towards the calcitonin-gene related peptide (CGRP) pathway has confirmed the key role of this axis in migraine pathogenesis. Three antibodies against CGRP – fremanezumab, galcanezumab and eptinezumab – and one antibody against the CGRP receptor, erenumab, are clinically approved therapeutics for the prevention of migraine. In addition, two small molecule CGRP receptor antagonists, ubrogepant and rimegepant, are approved for acute migraine treatment. Targeting either the CGRP ligand or receptor is efficacious for migraine treatment; however, a comparison of the mechanism of action of these therapeutic agents is lacking in the literature. Methods To gain insights into the potential differences between these CGRP pathway therapeutics, we compared the effect of a CGRP ligand antibody (fremanezumab), a CGRP receptor antibody (erenumab) and a CGRP receptor small molecule antagonist (telcagepant) using a combination of binding, functional and imaging assays. Results Erenumab and telcagepant antagonized CGRP, adrenomedullin and intermedin cAMP signaling at the canonical human CGRP receptor. In contrast, fremanezumab only antagonized CGRP-induced cAMP signaling at the human CGRP receptor. In addition, erenumab, but not fremanezumab, bound and internalized at the canonical human CGRP receptor. Interestingly, erenumab also bound and internalized at the human AMY1 receptor, a CGRP receptor family member. Both erenumab and telcagepant antagonized amylin-induced cAMP signaling at the AMY1 receptor while fremanezumab did not affect amylin responses. Conclusion The therapeutic effect of agents targeting the CGRP ligand versus receptor for migraine prevention (antibodies) or acute treatment (gepants) may involve distinct mechanisms of action. These findings suggest that differing mechanisms could affect efficacy, safety, and/or tolerability in migraine patients.
Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis
Authors: Johns William L. , Walley Kempland C. , Hammoud Sommer , Gonzalez Tyler A. , Ciccotti Michael G. , Patel Nirav K. 
Published: February 2021

Background: Hemarthrosis after anterior cruciate ligament (ACL) reconstruction procedures can delay rehabilitation and have toxic effects on the cartilage and synovium. Tranexamic acid is widely used in adult reconstruction procedures; however, its use in ACL reconstruction is a novel topic of study. Purpose: To analyze the available literature on hemarthrosis, pain, functional outcomes, and complications after administration of tranexamic acid in ACL reconstruction procedures. Study Design: Meta-analysis. Methods: A literature search was performed to retrieve randomized controlled trials examining the use of tranexamic acid at the time of ACL reconstruction procedures. The studied outcomes included postoperative joint drain output, hemarthrosis grade, visual analog scale scores for pain, range of motion, Lysholm score, postoperative rates of deep venous thrombosis, and pulmonary embolism. Outcomes were pooled to perform a meta-analysis. Results: Five prospective randomized controlled trials met inclusion criteria for analysis. Four studies administered intravenous tranexamic acid in bolus or infusion form before ACL reconstruction, while 2 studies administered tranexamic acid via intra-articular injection. Specifically, tranexamic acid was administered intravenously (preoperative 15-mg/kg bolus 10 minutes before tourniquet inflation with or without 10 mg/kg/h for 3 hours postoperatively) or intra-articularly (10 mL [100 mg/mL] intraoperatively), and 1 study consisted of tranexamic acid administration in combined intravenous and intra-articular forms (15-mg/kg bolus 10 minutes before tourniquet inflation and intra-articular 3 g 10 minutes before tourniquet deflation). Tranexamic acid use in ACL reconstruction cases resulted in a mean reduction of 61.5 mL in postoperative drain output at 24 hours (95% CI, –95.51 to −27.46; P = .0004), lower hemarthrosis grade ( P < .00001), improved Lysholm scores, and reduction in visual analog scale scores for pain (−1.96 points; 95% CI, −2.19 to −1.73; P < .00001) extending to postoperative week 6. Range of motion was improved in the immediate postoperative period, and the need for joint aspiration within 2 weeks was reduced ( P < .001). There was no difference in venous thromboembolic event rate between the experimental and control groups. Conclusion: The use of intravenous tranexamic acid in ACL reconstruction surgery results in reduced joint drain output and hemarthrosis and improved pain scores and range of motion in the initial postoperative period without increased complications or thromboembolic events.
Magnetic Resonance Imaging 1 Year After Hamstring Autograft Anterior Cruciate Ligament Reconstruction Can Identify Those at Higher Risk of Graft Failure: An Analysis of 250 Cases
Authors: Putnis Sven E. , Oshima Takeshi , Klasan Antonio , Grasso Samuel , Neri Thomas , Fritsch Brett A. , Parker David A. 
Published: February 2021

Background: There is currently no analysis of 1-year postoperative magnetic resonance imaging (MRI) that reproducibly evaluates the graft of a hamstring autograft anterior cruciate ligament reconstruction (ACLR) and helps to identify who is at a higher risk of graft rupture upon return to pivoting sports. Purpose: To ascertain whether a novel MRI analysis of ACLR at 1 year postoperatively can be used to predict graft rupture, sporting level, and clinical outcome at a 1-year and minimum 2-year follow-up. Study Design: Case-control study; Level of evidence, 3. Methods: Graft healing and integration after hamstring autograft ACLR were evaluated using the MRI signal intensity ratio at multiple areas using oblique reconstructions both parallel and perpendicular to the graft and tunnel apertures. Clinical outcomes were assessment of side-to-side laxity and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm, and Tegner activity level scores at 1 year. Repeat outcome measures and detection of graft rupture were evaluated at a minimum of 2 years. Results: A total of 250 patients (42.4% female) underwent MRI analysis at 1 year, and assessment of 211 patients between 1 year and the final follow-up (range, 24-36 months) detected 9 graft ruptures (4.3%; 5 in female patients). A significant predictor for graft rupture was a high signal parallel to the proximal intra-articular graft and perpendicular to the femoral tunnel aperture ( P = .032 and P = .049, respectively), with each proximal graft signal intensity ratio (SIR) increase by 1 corresponding to a 40% increased risk of graft rupture. A cutoff SIR of 4 had a sensitivity and specificity of 66% and 77%, respectively, in the proximal graft and 88% and 60% in the femoral aperture. In all patients, graft signal adjacent to and within the tibial tunnel aperture, and in the mid intra-articular portion, was significantly lower than that for the femoral aperture ( P < .001). A significant correlation was seen between the appearance of higher graft signal on MRI and those patients achieving top sporting levels by 1 year. Conclusion: ACLR graft rupture after 1 year is associated with MRI appearances of high graft signal adjacent to and within the femoral tunnel aperture. Patients with aspirations of quickly returning to a high sporting level may benefit from MRI analysis of graft signal. Graft signal was highest at the femoral tunnel aperture, adding further radiographic evidence that the rate-limiting step to graft healing occurs proximally.
The white mirror: Face to face with racism in group analysis part 1—mainly theory
Authors: Aiyegbusi Anne 
Published: February 2021

Group analysis privileges the social and political, aiming to address individual distress and ‘disturbance’ within a representation of the context it developed and persists in. Reproducing the presence and impact of racism in groups comes easily while creating conditions for reparation can be complicated. This is despite considerable contributions to the subject of racism by group analysts. By focusing on an unconscious, defensive manoeuvre I have observed in groups when black people describe racism in their lives, I hope to build upon the existing body of work. I will discuss the manoeuvre which I call the white mirror. I aim to theoretically elucidate the white mirror. I will argue that it can be understood as a vestigial trauma response with roots as far back as the invention of ‘race’. Through racialized sedimentation in the social unconscious, it has been generationally transmitted into the present day. It emerges in an exacerbated way within the amplified space of analytic groups when there is ethnically-diverse membership. I argue it is inevitable and even essential that racism emerges in groups as a manifestation of members’ racialized social unconscious including that of the conductor(s). This potentially offers opportunities for individual, group and societal reparation and healing. However, when narratives of racism are instead pushed to one side, regarded as a peripheral issue of concern only to minority black or other members of colour, I ask whether systems of segregation, ghettoization or colonization are replicated in analytic groups. This is the first of two articles about the white mirror. The second article which is also published in this issue highlights practice implications.
‘If you prick me, do I not bleed?’: Antisemitism, racism and group analysis —some thoughts
Authors: Bacha Claire , Einhorn Sue , Lieberman Sue 
Published: February 2021

The Merchant of Venice contains some of the most powerful depictions of Jewish–Christian relations in an era when Christian antisemitism dominated European life. It is one of the most difficult plays for Jews to watch: not only for Shylock’s torment at the treatment he is subjected to, particularly in the Christian characters’ relentless contempt for him, but for the depiction of his gradual descent into violent revenge, as a result of which he himself is crushed. The revenge part of Shylock’s speech is crucial. The anti-Semites in the play unconsciously fear their victim, especially after treating Shylock with cruelty and contempt. The racists then project hatred, consequently fearing that Shylock will hate them, that he will be filled with rage and seek a revenge even more cruel than that which has been perpetrated upon him. Shylock speaks the racist’s fear and then wants to carry it out. In Shakespeare’s play, Shylock becomes a justification for hatred. If we look at this as the unconscious of antisemitism, then Shakespeare is personifying this unconscious in the character of Shylock. Seen in this way, The Merchant of Venice is a dramatic depiction of the violent effects of antisemitism on the subjectivity and identity of both victims and perpetrators. We know that racism creates trauma. Sue Lieberman’s work on transmitted trauma (Lieberman, 2015) and Earl Hopper’s work on massification and aggregation both explored unprocessed trauma (Hopper, 2003). However, the permeating trauma of both racism and antisemitism has festered without being addressed adequately. Our purpose in this article is to begin to look at this disturbing truth. We will address the historical relationship between antisemitism and racism. We will make links to the development of psychoanalysis and group analysis. That Foulkes, himself was a victim of racism has always been present but largely unspoken. Unspoken, it has created blind spots, including our own racism.
Association Between Afterhours Discharge From the Intensive Care Unit and Hospital Mortality: A Multi-Center Retrospective Cohort Study
Authors: Hall Adam , Wang Xioaming , Zuege Danny J. , Opgenorth Dawn , Scales Damon C. , Stelfox H. Thomas , Bagshaw Sean M. 
Published: February 2021

Background: There is conflicting evidence on the association between afterhours discharge from the intensive care unit (ICU) and hospital mortality. We examined the effects of afterhours discharge, including the potential effect of residual organ dysfunction, on hospital mortality in a large integrated health region. Methods: We performed a multi-center retrospective cohort study of 10,463 adults discharged from 9 mixed medical/surgical ICUs in Alberta from June 2012 to December 2014. We applied a 2-stage modeling strategy to investigate the association between afterhours discharge (19:00h to 07:59h) and post-ICU hospital mortality. We applied mixed-effect multi-variable linear regression to assess the relationship between discharge organ dysfunction and afterhours discharge. We then applied mixed-effect multi-variable logistic regression to evaluate the direct, indirect and integrated associations of afterhours discharge on hospital mortality and hospitalization duration. Results: Of 10,463 patients, 23.7% (n = 2,480) were discharged afterhours, of which 27.4% occurred on a holiday or weekend. This varied significantly by ICU size, type, and site. Patients discharged afterhours were more likely medical admissions, had greater multi-morbidity and illness acuity. A greater average SOFA score in the 72 hours prior to ICU discharge was not associated with afterhours discharge. However, a greater average SOFA score was associated with hospital mortality (adjusted-odds ratio [OR], 1.23; 95% CI, 1.18-1.28). Afterhours discharge was associated with higher hospital mortality (adjusted-OR, 1.19; 95% CI, 1.01-1.39), increased hospital stay (adjusted-risk ratio [RR], 1.10; 95% CI, 1.09-1.11) and increased post-ICU stay (adjusted-RR, 1.16; 95% CI, 1.14-1.17) when compared with workhours discharge. Conclusions: Afterhours discharge is common, occurring in 1 in 4 discharges, and is widely variable across ICUs. Patients discharged afterhours have greater risk of hospital mortality and prolonged hospitalization.
Novel signatures associated with systemic lupus erythematosus clinical response to IFN-α/-ω inhibition
Authors: Seridi Loqmane , Cesaroni Matteo , Orillion Ashley , Schreiter Jessica , Chevrier Marc , Marciniak Stanley , Migone Thi-Sau , Stohl William , Chatham Walter Winn , Furie Richard Alan , Benson Jacqueline , Jordan Jarrat 
Published: February 2021

Objectives We aimed to identify transcriptional gene signatures predictive of clinical response, for pharmacodynamic evaluation, and to provide mechanistic insight into JNJ-55920839, a human IgG1κ neutralizing mAb targeting IFN-α/IFN-ω, in participants with systemic lupus erythematosus (SLE). Methods Blood samples were obtained from SLE participants at baseline and up to Day 130, who received six 10 mg/kg IV doses of JNJ-55920839/placebo every 2 weeks. Participants with mild-to-moderate SLE who achieved clinical responses using SLE Disease Activity Index 2000 Responder Index 4-point change were considered responders. Transcriptional signatures from longitudinally collected blood were generated by RNA-Seq; signatures were generated by microarray from baseline blood samples exposed in vitro to JNJ-55920839 versus untreated. Results Two gene signatures (IFN-I Signaling and Immunoglobulin Immune Response) exhibited pharmacodynamic changes among JNJ-55920839 responders. The Immunoglobulin signature, but not the IFN-I signature, was elevated at baseline in JNJ-55920839 responders. A gene cluster associated with neutrophil-mediated immunity was reduced at baseline in JNJ-55920839 responders, substantiated by lower neutrophil counts in responders. An IFN-I signature was suppressed by JNJ-55920839 in vitro treatment versus untreated blood to a greater extent in responders before in vivo dosing. Conclusions These signatures may enable enrichment for treatment responders when using IFN-I-suppressing treatments in SLE.