bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sonographic Cardiovascular Assessment of the Aorta: Pilot of a Modified Image Grading System
Authors: Stigall-Weikle Nicole , Brady Austin N. , Yang Qian , Bloom Isaiah W. , Evans Kevin D. 
Published: February 2021

Objective: Atherosclerosis is a chronic inflammatory disease that can be undetected in middle-aged patients. Abdominal aortic calcifications (AACs) are one form of cardiovascular disease (CVD), and these can go undetected during a routine physician visit. Sonography has the potential to assess CVD progression, quantify plaque in the aorta, and help to quantify risk in asymptomatic patients. Methodology: This pilot study modified a current AAC grading system to create a scoring method for sonographic images among a small cohort of asymptomatic participants. A traditional portable ultrasound unit was used to image participants, and a subset underwent the same imaging with a handheld transducer and tablet. Results: In this cohort, six males and five females, it was possible to adequately visualize and assess plaque, utilizing both types of ultrasound equipment. The abdominal aorta was divided into segments on the sonogram for quality of grading. Ten participants were categorized with a grade II and one participant was given a grade IIIA. Conclusion: Replication of this modified grading system is needed to better understand the clinical utilization of sonography as a risk assessment tool. The risk assessment scoring was not dependent on the type of device used.
Alternative donor transplantation for myelodysplastic syndromes: haploidentical relative and matched unrelated donors
Authors: Grunwald Michael R. , Zhang Mei-Jie , Elmariah Hany , Johnson Mariam H. , St. Martin Andrew , Bashey Asad , Battiwalla Minoo , Bredeson Christopher N. , Copelan Edward , Cutler Corey S. , George Biju R. , Gupta Vikas , Kanakry Christopher , Mehta Rohtesh S. , Milano Filippo , Mussetti Alberto , Nakamura Ryotaro , Nishihori Taiga , Saber Wael , Solh Melhem , Weisdorf Daniel J. , Eapen Mary 
Published: February 2021

AbstractWe compared outcomes in 603 patients with myelodysplastic syndrome (MDS) after HLA-haploidentical relative (n = 176) and HLA-matched unrelated (n = 427) donor hematopoietic cell transplantation (HCT) from 2012 to 2017, using the Center for International Blood and Marrow Transplant Research database. All transplantations used reduced-intensity conditioning regimens. Total-body irradiation plus cyclophosphamide and fludarabine was the predominant regimen for HLA-haploidentical relative donor HCT, and graft-versus-host disease (GVHD) prophylaxis was uniformly posttransplantation cyclophosphamide, calcineurin inhibitor, and mycophenolate. Fludarabine with busulfan or melphalan was the predominant regimen for HLA-matched unrelated donor HCT, and GVHD prophylaxis was calcineurin inhibitor with mycophenolate or methotrexate. Results of multivariate analysis revealed higher relapse (hazard ratio [HR], 1.56; P = .0055; 2-year relapse rate, 48% vs 33%) and lower disease-free survival (DFS) rates after HLA-haploidentical relative donor HCT (HR, 1.29; P = .042; 2-year DFS, 29% vs 36%). However, overall survival (OS) rates did not differ between donor type (HR, 0.94; P = .65; 2-year OS, 46% for HLA-haploidentical and 44% for HLA-matched unrelated donor HCT) because of mortality associated with chronic GVHD. Acute grade 2 to 4 GVHD (HR, 0.44; P &lt; .0001) and chronic GVHD (HR, 0.36; P &lt; .0001) were lower after HLA-haploidentical relative donor HCT. By 2 years, probability of death resulting from chronic GVHD was lower after HLA-haploidentical relative compared with HLA-matched unrelated donor HCT (6% vs 21%), negating any potential survival advantage from better relapse control. Both donor types extend access to transplantation for patients with MDS; strategies for better relapse control are desirable for HLA-haploidentical relative donor HCT, and effective GVHD prophylaxis regimens are needed for unrelated donor HCT.
Selection for social genetic effects in purebreds increases growth in crossbreds
Authors: Ask Birgitte , Pedersen Lizette Vestergaard , Christensen Ole Fredslund , Nielsen Hanne Marie , Turner Simon P. , Nielsen Bjarne 
Published: February 2021

AbstractBackgroundAverage daily gain (ADG) in pigs is affected by both direct and social genetic effects (SGE). However, selection for SGE in purebreds has not conclusively been shown to improve ADG in crossbreds, and it is unknown whether SGE in purebreds are equal to those in crossbreds. Moreover, SGE may reflect dominance related behaviour, which is affected by the variation in body weight within a group. Therefore, we hypothesized that (a) there is a positive effect of parent average SGE estimated in purebred pigs on phenotypic ADG in crossbred offspring, and (b) there is an interaction between SGE on ADG and standard deviation in starting weight of pigs within the group. We also hypothesized that (c) social genetic variance for ADG exists in crossbred pigs, and (d) there is a favourable genetic correlation between SGE on ADG in purebred and crossbred pigs.ResultsWe found a statistically significant interaction between the standard deviation in starting weight and SGE within groups, and conditioning on the mean standard deviation in starting weight, we found a favourable regression coefficient (0.37 ± 0.21) of ADG in crossbreds on SGE in purebreds. Variances for SGE were small in both Landrace (L) and Yorkshire (Y), and higher for SGE in both the dam and sire component of crossbred YL. The genetic correlations between SGE in purebreds and the dam or sire component of SGE in crossbreds were also favourable (0.52 ± 0.48 and 0.34 ± 0.42, respectively), although not significantly different from 0.ConclusionsWe confirmed that there is a positive effect of SGE estimated using purebred information on phenotypic ADG in crossbreds, and that the largest effect is achieved when the within-group variation in starting weight is small. Our results indicate that social genetic variance in crossbreds exists and that there is a favourable genetic correlation between social genetic effects in purebreds and crossbreds. Collectively, our results indicate that selection for SGE on ADG in purebreds in a nucleus farm environment with little competition for resources can improve ADG in crossbreds in a commercial environment.
Comparative study of analgesia nociception index (ANI) vs. standard pharmacokinetic pattern for guiding intraoperative fentanyl administration among mastectomy patients
Authors: Tribuddharat Sirirat , Sathitkarnmanee Thepakorn , Sukhong Pornlada , Thananun Maneerat , Promkhote Parinda , Nonlhaopol Duangthida 
Published: February 2021

Abstract
Background
The Analgesia Nociception Index (ANI) has been suggested as a non-invasive guide for analgesia. Our objective was to compare the efficacy of ANI vs. standard pharmacokinetic pattern for guiding intraoperative fentanyl administration.

Methods
This was a prospective, randomized, controlled study of adult female patients undergoing elective mastectomy under general anesthesia. The patients were randomized to the ANI-guided group receiving a loading dose of 75 μg of fentanyl followed by 25 μg when the ANI score was under 50. The Control group received the same loading dose followed by 25 μg every 30 min with additional doses when there were signs of inadequate analgesia (viz., tachycardia or hypertension).

Results
Sixty patients—30 in each group—were recruited. Although the actual mean ANI score was higher in the ANI-guided than in the Control group (mean difference 2.2; 95% CI: 0.3 to 4.0, P = 0.022), there was no difference in the primary outcome—i.e., intraoperative fentanyl consumption (mean difference − 4.2 μg; 95% CI: − 24.7 to 16.4, P = 0.686 and − 0.14 μg·kg− 1·h− 1; 95% CI: − 0.31 to 0.03, P = 0.105). No difference between groups was shown for either intraoperative blood pressure and heart rate, or for postoperative outcomes (i.e., pain scores, morphine consumption, or sedation scores) in the postanesthesia care unit.

Conclusions
Intraoperative fentanyl administration guided by ANI was equivalent to that guided by a modified pharmacologic pattern. In a surgical model of mastectomy, the ANI-guided intraoperative administration of fentanyl had no impact on clinical outcomes.

Trial registration
The study was registered with ClinicalTrials.gov (NCT03716453) on 21/10/2018.
68Ga-NOTA PET imaging for gastric emptying assessment in mice
Authors: Chen Xueyan , Liu Yu , Pan Donghui , Cao Maoyu , Wang Xinyu , Wang Lizhen , Xu Yuping , Wang Yan , Yan Junjie , Liu Juan , Yang Min 
Published: February 2021

AbstractBackgroundPositron emission tomography (PET) has the potential for visualization and quantification of gastric emptying (GE). The traditional Chinese medicine (TCM) has been recognized promising for constipation. This study aimed to establish a PET imaging method for noninvasive GE measurement and to evaluate the efficacy of a TCM on delayed GE caused by constipation using PET imaging.Methods[68Ga]Ga-NOTA was synthesized as the tracer and sesame paste with different viscosity were selected as test meals. The dynamic PET scans were performed after [68Ga]Ga-NOTA mixed with test meals were administered to normal mice. Two methods were utilized for the quantification of PET imaging. A constipation mouse model was treated with maren chengqi decoction (MCD), and the established PET imaging scans were performed after the treatment.Results[68Ga]Ga-NOTA was synthesized within 20 min, and its radiochemical purity was > 95%. PET images showed the dynamic process of GE. %ID/g, volume, and total activity correlated well with each other. Among which, the half of GE time derived from %ID/g for 4 test meals were 3.92 ± 0.87 min, 13.1 ± 1.25 min, 17.8 ± 1.31 min, and 59.7 ± 3.11 min, respectively. Constipation mice treated with MCD showed improved body weight and fecal conditions as well as ameliorated GE measured by [68Ga]Ga-NOTA PET.ConclusionsA PET imaging method for noninvasive GE measurement was established with stable radiotracer, high image quality, and reliable quantification methods. The efficacy of MCD on delayed GE was demonstrated using PET.
Physical activity profiles in Parkinson’s disease
Authors: von Rosen Philip , Hagströmer Maria , Franzén Erika , Leavy Breiffni 
Published: February 2021

Abstract
Background
Identifying physical activity (PA) profiles of people with Parkinson’s Disease (PD) could provide clinically meaningful knowledge concerning how to tailor PA interventions. Our objectives were therefore to i) identify distinct PA profiles in people with PD based on accelerometer data, ii) explore differences between the profiles regarding personal characteristics and physical function.

Methods
Accelerometer data from 301 participants (43% women, mean age: 71 years) was analysed using latent profile analyses of 15 derived PA variables. Physical function measurements included balance performance, comfortable gait speed and single and dual-task functional mobility.

Results
Three distinct profiles were identified; “Sedentary” (N = 68), “Light Movers” (N = 115), “Steady Movers” (N = 118). “Sedentary” included people with PD with high absolute and relative time spent in Sedentary behaviour (SB), little time light intensity physical activity (LIPA) and negligible moderate-to-vigorous physical activity (MVPA). “Light Movers” were people with PD with values close to the mean for all activity variables. “Steady Movers” spent less time in SB during midday, and more time in LIPA and MVPA throughout the day, compared to the other profiles. “Sedentary” people had poorer balance (P = 0.006), poorer functional mobility (P = 0.027) and were more likely to have fallen previously (P = 0.027), compared to “Light Movers. The Timed Up and Go test, an easily performed clinical test of functional mobility, was the only test that could distinguish between all three profiles.

Conclusion
Distinct PA profiles, with clear differences in how the time awake is spent exist among people with mild-moderate PD.
Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis
Authors: Kim Byoung-Gwon , Kim Ga Yeon , Cha Jae-Kwan 
Published: February 2021

Abstract
Backgrounds
Pre-diabetes is an intermediate state between normal glucose metabolism and diabetes. Recent studies suggest that the presence of pre-diabetes is associated with poor outcomes after AIS. However, the results have been controversial. This study examines whether pre-diabetes influences the patients’ short and long-term outcomes for AIS using IV thrombolysis.

Methods
We enrolled 661 AIS patients with IV thrombolysis. Based on the 2010 ADA guidelines, patients were classified as pre-diabetes, with HbA1c levels of 5.7–6.4%; diabetes, with HbA1c levels more than 6.5%; and NGM (normal glucose metabolism), with HbA1c levels less than 5.7%. We investigated short-term outcomes, including early neurologic deterioration (END), in-hospital death, and poor functional outcomes (mRS > 2) at 90 days. As for long-term outcomes, poor functional outcomes were measured at 1 year.

Results
Of the 661 AIS patients treated with IV thrombolysis, 197 patients (29.8%) were diagnosed with pre-diabetes, and 210 (31.8%) were diagnosed with diabetes. In a multivariate analysis, pre-diabetes was an independent predictor for END (OR = 2.02; 95% CI 1.12–3.62; p = 0.02) and in-hospital death (OR = 3.12; 95% CI 1.06–9.09; p = 0.04). On the other hand, diabetes was a significant independent factor for poor long-term outcomes (OR = 1.75; 95% CI 1.09–2.78; p = 0.02) after correcting confounding factors.

Conclusions
Unlike diabetes, pre-diabetes can be an important predictor of short-term outcomes after AIS. However, a more detailed research is needed to specify the precise mechanisms through which pre-diabetes affects the prognosis of acute ischemic stroke.
Feasibility of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer
Authors: Ester Manuel , Culos-Reed S. Nicole , Abdul-Razzak Amane , Daun Julia T. , Duchek Delaney , Francis George , Bebb Gwyn , Black Jennifer , Arlain Audra , Gillis Chelsia , Galloway Lyle , Capozzi Lauren C. 
Published: February 2021

Abstract
Background
Advanced lung cancer patients face significant physical and psychological burden leading to reduced physical function and quality of life. Separately, physical activity, nutrition, and palliative symptom management interventions have been shown to improve functioning in this population, however no study has combined all three in a multimodal intervention. Therefore, we assessed the feasibility of a multimodal physical activity, nutrition, and palliative symptom management intervention in advanced lung cancer.

Methods
Participants received an individually tailored 12-week intervention featuring in-person group-based exercise classes, at-home physical activity prescription, behaviour change education, and nutrition and palliative care consultations. Patients reported symptom burden, energy, and fatigue before and after each class. At baseline and post-intervention, symptom burden, quality of life, fatigue, physical activity, dietary intake, and physical function were assessed. Post-intervention interviews examined participant perspectives.

Results
The multimodal program was feasible, with 44% (10/23) recruitment, 75% (75/100) class attendance, 89% (8/9) nutrition and palliative consult attendance, and 85% (17/20) assessment completion. Of ten participants, 70% (7/10) completed the post-intervention follow-up. Participants perceived the intervention as feasible and valuable. Physical activity, symptom burden, and quality of life were maintained, while tiredness decreased significantly. Exercise classes prompted acute clinically meaningful reductions in fatigue, tiredness, depression, pain, and increases in energy and well-being.

Conclusion
A multimodal physical activity, nutrition, and palliative symptom management intervention is feasible and shows potential benefits on quality of life that warrant further investigation in a larger cohort trial.

Trial registration
NCT04575831, Registered 05 October 2020 – Retrospectively registered.
Lipid profile of Mexican children with Down syndrome
Authors: Garcia-de la Puente Silvestre , Flores-Arizmendi Karla A. , Delgado-Montemayor María J. , Vargas-Robledo Tania T. 
Published: February 2021

Abstract
Introduction
Down syndrome (DS) is associated with various congenital anomalies and metabolic alterations, such as dyslipidemias, that can lead to cardiovascular disease in adulthood. This study was designed to describe the lipid concentrations and the frequency of dyslipidemias in children with DS.

Materials and methods
The sample included 386 patients, 52.4% male. The study was carried out on children with DS, aged 2–18 years old, who were patients at the Mexican National Institute of Pediatrics between May 2016 and June 2017. Their height and weight were recorded, and their serum cholesterol, HDL cholesterol, and triglyceride levels were determined.

Results
Of the total patients included, 57.5% had some type of dyslipidemia, 32.6% isolated and 24.9% combined. The most common alteration, considering both isolated and combined dyslipidemias, was low HDL, in 45.9%, followed by hypertriglyceridemia, in 26.2%. Among those with combined dyslipidemia, high TG with low HDL-c was the most common, in 17.9%. A significant association was found between dyslipidemia and obesity, as well as between dyslipidemia and central obesity. The percentiles of lipid values are reported.

Conclusion
The presence of an unfavorable lipid profile is common in pediatric patients with Down syndrome, especially low HDL cholesterol and high triglycerides.
Factors associated with diarrhoea and acute respiratory infection in children under-5 years old in Ghana: an analysis of a national cross-sectional survey
Authors: Apanga Paschal Awingura , Kumbeni Maxwell Tii 
Published: February 2021

Abstract
Background
Diarrhoea and acute respiratory infection (ARI) are major causes of morbidity and mortality in children under-5 years old in Ghana. The aim of the study was to assess factors associated with diarrhoea and ARI in children under-5 years old.

Methods
We analysed nationally representative data from the 2017–2018 Ghana Multiple Indicator Cluster Survey (MICS) on 8879 children under-5 years old. Multivariable logistic regression was used to assess the factors associated with diarrhoea and ARI. We applied sample weights, stratification and clustering to account for the sampling design of the MICS.

Results
The prevalence of diarrhoea was 17.0% (95% CI: 15.70, 18.24%). Children aged 6–11 months [Adjusted prevalence odds ratio (aPOR): 2.06, 95% CI: 1.45, 2.92], and 12–23 months (aPOR: 2.37, 95% CI: 1.67, 3.35), had higher prevalence of diarrhoea compared to children aged 0–5 months. Children whose mothers had a college or higher education (aPOR: 0.41, 95% CI: 0.22, 0.78), and a secondary education (aPOR: 0.66, 95% CI: 0.51, 0.86), had 59% and 34% lower odds of diarrhoea respectively, compared to children whose mothers had no formal education. Children from the richest households (aPOR: 0.58, 95% CI: 0.39, 0.86), had 42% lower odds of diarrhoea compared to children from the poorest households. Children resident in rural areas had 22% lower odds of diarrhoea compared to their peers in urban areas (aPOR: 0.78, 95% CI: 0.63, 0.98). The prevalence of ARI was 33.3% (95% CI: 31.72, 34.82%). Children aged 6–11 months (aPOR: 1.43, 95% CI: 1.06, 1.93), and 12–23 months (aPOR: 1.41, 95% CI: 1.10, 1.82), had higher prevalence of ARI compared to children aged 0–5 months.

Conclusions
This study suggests that the prevalence of diarrhoea and ARI among children aged 6–11 and 12–23 months was higher compared to children aged 0–5 months. Children under-5 years old whose mothers had a secondary or higher education had a lower prevalence of diarrhoea compared to children whose mothers had no formal education.
Why is women’s utilization of a publicly funded health insurance low?: a qualitative study in Tamil Nadu, India
Authors: RamPrakash Rajalakshmi , Lingam Lakshmi 
Published: February 2021

Abstract
Background
The continuing impetus for universal health coverage has given rise to publicly funded health insurance schemes in lower-middle income countries. However, there is insufficient understanding of how universal health coverage schemes impact gender equality and equity. This paper attempts to understand why utilization of a publicly funded health insurance scheme has been found to be lower among women compared to men in a southern Indian state. It aims to identify the gender barriers across various social institutions that thwart the policy objectives of providing financial protection and improved access to inpatient care for women.

Methods
A qualitative study on the Chief Minister’s Comprehensive Health Insurance Scheme was carried out in urban and rural impoverished localities in Tamil Nadu, a southern state in India. Thirty-three women and 16 men who had a recent history of hospitalization and 14 stakeholders were purposefully interviewed. Transcribed interviews were content analyzed based on Naila Kabeer’s Social Relations Framework using gender as an analytical category.

Results
While unpacking the navigation pathways of women to utilize publicly funded health insurance to access inpatient care, gender barriers are found operating at the household, community, and programmatic levels. Unpaid care work, financial dependence, mobility constraints, and gender norms emerged as the major gender-specific barriers arising from the household. Exclusions from insurance enrollment activities at the community level were mediated by a variety of social inequities. Market ideologies in insurance and health, combined with poor governance by State, resulted in out-of-pocket health expenditures, acute information asymmetry, selective availability of care, and poor acceptability. These gender barriers were found to be mediated by all four institutions—household, community, market, and State—resulting in lower utilization of the scheme by women.

Conclusions
Health policies which aim to provide financial protection and improve access to healthcare services need to address gender as a crucial social determinant. A gender-blind health insurance can not only leave many pre-existing gender barriers unaddressed but also accentuate others. This paper stresses that universal health coverage policy and programs need to have an explicit focus on gender and other social determinants to promote access and equity.