bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased INR Values Predict Accelerating Deterioration and High Short-Term Mortality Among Patients Hospitalized With Cirrhosis or Advanced Fibrosis
Authors: Wang Ying , Dong Fuchen , Sun Shuning , Wang Xianbo , Zheng Xin , Huang Yan , Li Beiling , Gao Yanhang , Qian Zhiping , Liu Feng , Lu Xiaobo , Liu Junping , Ren Haotang , Zheng Yubao , Yan Huadong , Deng Guohong , Qiao Liang , Zhang Yan , Gu Wenyi , Xiang Xiaomei , Zhou Yi , Xu Baoyan , Hou Yixin , Zhang Qun , Xiong Yan , Zou Congcong , Chen Jun , Huang Zebing , Jiang Xiuhua , Qi Tingting , Luo Sen , Chen Yuanyuan , Gao Na , Liu Chunyan , Yuan Wei , Mei Xue , Li Jing , Li Tao , Zheng Rongjiong , Zhou Xinyi , Zhang Weituo , Li Hai , Meng Zhongji 
Published: November 2021

Background and Objective: An increase in the international normalized ratio (INR) is associated with increased mortality in patients with cirrhosis and other chronic liver diseases, while little is known about the quantitative relationship. This study aimed to investigate the quantitative relationship between the INR and short-term prognosis among patients hospitalized with cirrhosis or advanced fibrosis and to evaluate the role of the INR as a risk factor for short-term liver transplant (LT)-free mortality in these patients.Patients and Methods: This study prospectively analyzed multicenter cohorts established by the Chinese Acute-on-Chronic Liver Failure (CATCH-LIFE) study. Cox regression was used to describe the relationship between the INR and independent risk factors for short-term LT-free mortality. Forest plots were used in the subgroup analysis. Generalized additive models (GAMs) and splines were used to illustrate the quantitative curve relationship between the INR and the outcome and inflection point on the curve.Results: A total of 2,567 patients with cirrhosis and 924 patients with advanced fibrosis were included in the study. The 90-day LT-free mortality of patients with cirrhosis and advanced fibrosis was 16.7% (428/2,567) and 7.5% (69/924), respectively. In the multivariable Cox regression analysis, the increase in the INR was independently associated with the risk of 90-day LT-free mortality both in patients with cirrhosis (HR, 1.06; 95% CI, 1.04–1.07, p &lt; 0.001) and in patients with advanced fibrosis (HR, 1.09; 95% CI, 1.06–1.12, p &lt; 0.001). An INR of 1.6/1.7 was found to be the starting point of coagulation dysfunction with a rapid increase in mortality in patients with cirrhosis or in patients with advanced fibrosis, respectively. A 28-day LT-free mortality of 15% was associated with an INR value of 2.1 in both cirrhosis and advanced fibrosis patients.Conclusions: This study was the first to quantitatively describe the relationship between the INR and short-term LT-free mortality in patients with cirrhosis or advanced fibrosis. The starting points of INR indicating the rapid increase in mortality and the unified cutoff value of coagulation failure in cirrhosis and advanced fibrosis, will help clinicians accurately recognize early disease deterioration.
Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation
Authors: Kautzky-Willer Alexandra , Harreiter Jürgen , Thomas Anita , Burger Johannes , Schneeweiß Ulrich , Deischinger Carola , Klein Wolfhard , Moser Hermann 
Published: November 2021

Objective: Little is known about possible sex and gender differences in post-stroke neurorehabilitation outcomes. We aimed to analyze if functional performance, prevalence and impact of comorbidities at admission, and success of inpatient stroke-neurorehabilitation differ between men and women.Methods: Retrospective cohort analysis of 1,437 men and 907 women with prior cerebral infarction treated at a neurorehabilitation clinic between 2012 and 2017; multiple linear regression was used to examine the influence of sex/gender as well as multiple confounders on health and functional outcomes. The main outcome measures were Barthel index (BI) at admission and its change during 4 weeks inpatient neurorehabilitation.Results: Men had been diagnosed with osteoporosis less frequently than women but more often with type 2 diabetes mellitus, coronary artery or chronic kidney disease (p ≤ 0.01). Although twice as many women presented with pre-stroke depression compared to men, the risk of post-stroke depression detected during rehabilitation was comparable. Men were more likely to have less than 30 days between diagnosis and neurorehabilitation start than women (p &lt; 0.03). At admission, women exhibited less autonomy, a lower BI, a higher pain score and worse 2-min walk test (2′WT) compared to men (p &lt; 0.001). Among males osteoporosis and peripheral artery disease independently predicted BI at admission, in women it was pre-stroke depression, dementia, and arterial fibrillation. During neurorehabilitation, both sexes improved regarding BI, pain and walk tests (p &lt; 0.001). Despite comparable rehabilitation effectiveness, women still had worse functional outcomes than males at discharge. Time after stroke to start of neurorehabilitation and length of the stay but, most strongly, the simple 2′WT at admission, and in women, pain intensity independently predicted post-stroke functional status and recovery.Conclusion: Women presented with worse functional status at admission to neurorehabilitation. Although men and women showed similar rehabilitation effectiveness, women still displayed worse clinical outcome measures and higher levels of pain at discharge. Early access and gender-sensitive, personalized post-stroke care with more focus on different comorbidities and psychosocial factors like pain levels and management, could further improve neurorehabilitation outcomes.
Development of Licorice Flavonoids Loaded Microemulsion for Transdermal Delivery Using CCD-Optimal Experimental Approach: Formulation Development and Characterization
Authors: Xin Yang , Yun Shi , Yuhe Lu , Yinxue Mao , Shurui Niu , Yue Zhou , Kunming Qin , Weidong Li 
Published: November 2021

In this research, we sought to surmount the poor dissolvability and transdermal absorption rate of licorice flavonoids (LFs) by fabricating a LFs microemulsion. LFs content was determined using high performance liquid chromatography. Initial studies such as dissolution testing, emulsification testing, and pseudo ternary phase diagram generation were implemented for screening components and optimized adopting the central composite design. While the tested responses were solubility, droplet size and PDI, thirteen trials were performed using two different variables, oil percentage and optimized emulsifier and co-emulsifier ratio. Microemulsions were then characterized for droplet size, PDI, transmission electron microscopy, viscosity, electrical conductivity, pH, entrapment efficiency, drug content and stability. Additionally, skin release profile, percutaneous absorption and retention were investigated adopting Franz diffusion cell. The optimal formulation was found to compose of laureth-9 (emulsifier, 6.72 g), propylene glycol (co-emulsifier, 1.80 g), isopropyl myristate (IPM, oil, 1.48 g), LFs (1.50 g) and at least more than 85% deionized water. The optimized and storage for 3 months of microemulsion was found to clear, light yellow color without phase separation or precipitation indicated the stability of the preparation to long-term placement. The mean droplet size, PDI, entrapment efficiency and drug content were discovered as 12.68 ± 0.12 nm, 0.049 ± 0.005, 97.28 ± 0.13% and 122.67 ± 0.40 mg·g−1, respectively. Furthermore, the optimal formulation sustained release LFs, remarkably deliver more LFs through the skin layer (644.95 ± 6.73 μg cm−2) and significantly retained LFs in the skin layer (9.98 μg cm−2). The study concluded that optimized microemulsion has potential and enhanced the dissolvability and cumulative penetration amount of LFs.
Safety and Tolerability of a Wearable, Vibrotactile Stimulation Device for Parkinson’s Disease
Authors: Tabacof Laura , Braren Stephen , Patterson Taylor , Fry Adam , Putrino David 
Published: November 2021

Background: Resting tremor is a cardinal symptom of Parkinson’s disease (PD) that contributes to the physical, emotional, and economic burden of the disease.Objective: The goal of this study was to investigate the safety, tolerability, and preliminary effectiveness of a novel wearable vibrotactile stimulation device on resting tremor in individuals with PD.Methods: Using a randomized cross-over design, subjects received two different vibrotactile stimulation paradigms (high amplitude patterned and low amplitude continuous) on two separate laboratory visits. On each visit, resting tremor was video recorded for 10 min at baseline and while the vibrotactile stimulation was applied. Tremor severity was scored by a blinded clinician.Results: Both vibration paradigms were well safe and well tolerated and resulted in a reduction in resting tremor severity with a moderate effect size (n = 44, p &lt; 0.001, r = 0.37–0.54). There was no significant difference between the two vibration paradigms (p = 0.14).Conclusion: Short durations of vibrotactile stimulation delivered via wearable devices were safe and well tolerated and may attenuate resting tremor severity in individuals with PD. The sample size as well as the potential preliminary effectiveness revealed by two arms of the study could not eliminate the potential for a placebo effect.
Bridging Myositis Ossificans After Supracondylar Humeral Fracture in a Child: A Case Report
Authors: Chen Jiayuan , Li Qilin , Liu Tianjing , Jia Guoqiang , Wang Enbo 
Published: November 2021

Background: Myositis ossificans is an uncommon complication of trauma and surgery, defined as ossifying changes in a non-osseous tissue such as muscles. It happens after tissue injury, with or without fractures. When myositis ossificans occurs around a joint, it can cause ankylosis, leading to complete dysfunction of the joint. Though it has been described in most parts of the body, bridging myositis ossificans involving the elbow joint were scarcely reported.Case Presentation: We report a severe case of myositis ossificans after a supracondylar humerus fracture in a 9-year-old child. In this case a palpable painless mass appeared following the fracture and surgical trauma. Ultrasound or X-ray is of significant diagnostic value. The brachialis was completely ossified and formed a bony bridge around the elbow, causing complete ankylosis. The bone mass was surgically removed through a bilateral less-invasive approach with less surgical trauma 9 months after initial presentation. we applied bone wax to the fresh bone wounds to prevent the formation of hematocele. Indomethacin, a non-steroidal anti-inflammatory drug, was administered after the operation to suppress bone proliferation in our case. Our patient had the best possible functional status and no recurrence at 2 years' follow-up.Conclusion: Elbow myositis ossificans in children may mainly affects the brachialis. A bilateral less-invasive approach is sufficient to remove the bone mass with less surgical trauma. This case also provides a new reference for the treatment of myositis ossificans after the elbow injuries.
Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
Authors: Chen Yang , Wang Zhiyong , Xiao Dong , Zeng Hongwu , Ma Xiaopeng 
Published: November 2021

Objective: There is a lack of assessment methods of acute appendicitis in little children. The purpose of this study was to develop and internally validate a nomogram for predicting the severity of acute appendicitis of young children (&lt;3 years old).Methods: We develop a prediction model based on a training dataset of 121 patients (&lt;3 years old) with acute appendicitis. Admission information was collected between January 2010 and January 2021, which contained demographic characteristic, laboratory examinations, treatment and pathology type, etc. Logistic regression analysis was used to identify independent risk factors and establish the predictive model. C-index and calibration curves were applied to evaluate the performance of the nomogram. Then corrected C-index was calculated to conduct internal verification by using the bootstrapping validation. Decision curve analysis determined clinical application of the prediction model.Results: Predictors contained in the prediction nomogram included weight for age, onset time (from developing symptoms to hospital), admission temperature, leukocyte count, neutrophil ratio, and total bilirubin. Logistic regression analysis showed that weight for age (X1) &lt; -2.32 SD (P = 0.046), onset time (X2) &gt; 2.5 days (P = 0.044), admission temperature (X3) &gt; 38.5°C (P = 0.009), leukocyte count (X4) &gt; 12.185*109/L (P = 0.045), neutrophil ratio (X5) &gt; 68.7% (P = 0.029), and total bilirubin (X6) &gt; 9.05 μmol/L (P = 0.035) were found to be significant for predicting the severity of appendicitis. The logistic regression equation was logit (P) = −0.149X1 + 0.51X2 + 1.734X3 + 0.238X4 + 0.061X5 + 0.098X6 – 75.229. C-index of nomogram was calculated at 0.8948 (95% Cl: 0.8332–0.9567) and it still was 0.8867 through bootstrapping validation. Decision curve analysis showed that when the threshold probability ranged from 14 to 88%, there is a net benefit of using this prediction model for severity of appendicitis in little children.Conclusion: This novel nomogram incorporating the weight for age, onset time, admission temperature, leukocyte count, neutrophil ratio, and total bilirubin could be conveniently used to estimate the severity of appendicitis of young children &lt;3 years old) and determine appropriate treatment options in time.
Precise Investigation of the Efficacy of Multicomponent Drugs Against Pneumonia Infected With Influenza Virus
Authors: Wei Junying , Sun Jianhui , Zeng Jiawei , Ji Enhui , Xu Jing , Tang Chunyu , Huo Hairu , Zhang Yi , Li Hongmei , Yang Hongjun 
Published: November 2021

Background:Viral pneumonia is one of the most serious respiratory diseases, and multicomponent traditional Chinese medicines have been applied in the management of infected patients. As a representative TCM, HouYanQing (HYQ) oral liquid shows antiviral activity. However, the unclear mechanisms, as well as the ambiguous clinical effects, limit widespread application of this treatment. Therefore, in this study, a proteomics-based approach was utilized to precisely investigate its efficacy.Methods:Based on the efficacy evaluation of HYQ in a mouse model of pneumonia caused by influenza A virus (H1N1) and the subsequent proteomics analysis, specific signatures regulated by HYQ treatment of viral pneumonia were identified.Results:Experimental verifications indicate that HYQ may show distinctive effects in viral pneumonia patients, such as elevated galectin-3-binding protein and glutathione peroxidase 3 levels.Conclusion:This study provides a precise investigation of the efficacy of a multicomponent drug against viral pneumonia and offers a promising alternative for personalized management of viral pneumonia.
The Efficacy and Safety of Mirabegron for the Treatment of Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review and Meta-analysis
Authors: Zhang Dongxu , Sun Fengze , Yao Huibao , Bao Xingjun , Wang Di , Cui Yuanshan , Wu Jitao 
Published: November 2021

Background and Objective: Over the past few years, mirabegron has been increasingly used as a therapeutic option for neurogenic lower urinary tract dysfunction. Here, we carried out a meta-analysis to investigate the efficacy and safety of mirabegron for the treatment of neurogenic lower urinary tract dysfunction.Methods: We used a range of databases to retrieve randomized controlled trials (RCTs) relating to mirabegron in patients with neurogenic lower urinary tract dysfunction: PubMed, Embase, and Cochrane Library; our strategy conformed to the PICOS (populations, interventions, comparators, outcomes, and study designs) strategy.Results: Our analyses involved four RCTs involving 245 patients. We found that mirabegron treatment resulted in a significant improvement in bladder compliance [mean difference (MD) = 19.53, 95% confidence interval (CI): 14.19 to 24.87, P &lt; 0.00001], urinary incontinence episodes (MD = −0.78, 95% CI: −0.89 to −0.67, P &lt; 0.00001) and Incontinence Quality of Life (I-QOL) (MD = 8.02, 95% CI: 3.20 to 12.84, P = 0.001). Significant differences were detected in terms of Patient Perception of Bladder Condition (PPBC) (MD = −0.54, 95% CI: −1.46 to 0.39, P = 0.26) and urinary urgency episodes (MD = −0.72, 95% CI: −3.1 to 1.66, P = 0.55). With regard to safety, there were no significant differences between mirabegron and control groups in terms of the incidence of drug-related adverse events [odds ratio (OR): 0.83, 95% CI: 0.43 to 1.59, P = 0.57], arrhythmias (OR: 1.27, 95% CI: 0.37 to 4.38, P = 0.70), hypertension (OR: 0.70, 95% CI: 0.13 to 3.82, P = 0.68), or post-voiding residual volume (MD: 1.62, 95% CI: −9.00 to 12.24, P = 0.77).Conclusion: Mirabegron is an efficacious and safe treatment for patients with neurogenic lower urinary tract dysfunction.
Drug-Drug Interaction Potential, Cytotoxicity, and Reactive Oxygen Species Production of Salix Cortex Extracts Using Human Hepatocyte-Like HepaRG Cells
Authors: Gomes João Victor Dutra , Herz Corinna , Helmig Simone , Förster Nadja , Mewis Inga , Lamy Evelyn 
Published: November 2021

Herbal preparations of willow bark (Salix cortex) are available in many countries as non-prescription medicines for pain and inflammation, and also as dietary supplements. Currently only little information on toxicity and drug interaction potential of the extracts is available. This study now evaluated the effects of two Salix cortex extracts on human hepatocyte-like HepaRG cells, in view of clinically relevant CYP450 enzyme activity modulation, cytotoxicity and production of reactive oxygen species (ROS). Drug metabolism via the CYP450 enzyme system is considered an important parameter for the occurrence of drug-drug interactions, which can lead to toxicity, decreased pharmacological activity, and adverse drug reactions. We evaluated two different bark extracts standardized to 10 mg/ml phenolic content. Herein, extract S6 (S. pentandra, containing 8.15 mg/ml total salicylates and 0.08 mg/ml salicin) and extract B (industrial reference, containing 5.35 mg/ml total salicylates and 2.26 mg/ml salicin) were tested. Both Salix cortex extracts showed no relevant reduction in cell viability or increase in ROS production in hepatocyte-like HepaRG cells. However, they reduced CYP1A2 and CYP3A4 enzyme activity after 48 h at ≥25 μg/ml, this was statistically significant only for S6. CYP2C19 activity inhibition (0.5 h) was also observed at ≥25 μg/ml, mRNA expression inhibition by 48 h treatment with S6 at 25 μg/ml. In conclusion, at higher concentrations, the tested Salix cortex extracts showed a drug interaction potential, but with different potency. Given the high prevalence of polypharmacy, particularly in the elderly with chronic pain, further systematic studies of Salix species of medical interest should be conducted in the future to more accurately determine the risk of potential drug interactions.
Advanced Meditation Alters Resting-State Brain Network Connectivity Correlating With Improved Mindfulness
Authors: Vishnubhotla Ramana V. , Radhakrishnan Rupa , Kveraga Kestas , Deardorff Rachael , Ram Chithra , Pawale Dhanashri , Wu Yu-Chien , Renschler Janelle , Subramaniam Balachundhar , Sadhasivam Senthilkumar 
Published: November 2021

Purpose:The purpose of this study was to investigate the effect of an intensive 8-day Samyama meditation program on the brain functional connectivity using resting-state functional MRI (rs-fMRI).Methods:Thirteen Samyama program participants (meditators) and 4 controls underwent fMRI brain scans before and after the 8-day residential meditation program. Subjects underwent fMRI with a blood oxygen level dependent (BOLD) contrast at rest and during focused breathing. Changes in network connectivity before and after Samyama program were evaluated. In addition, validated psychological metrics were correlated with changes in functional connectivity.Results:Meditators showed significantly increased network connectivity between the salience network (SN) and default mode network (DMN) after the Samyama program (p&lt; 0.01). Increased connectivity within the SN correlated with an improvement in self-reported mindfulness scores (p&lt; 0.01).Conclusion:Samyama, an intensive silent meditation program, favorably increased the resting-state functional connectivity between the salience and default mode networks. During focused breath watching, meditators had lower intra-network connectivity in specific networks. Furthermore, increased intra-network connectivity correlated with improved self-reported mindfulness after Samyama.Clinical Trials Registration:[https://clinicaltrials.gov], Identifier: [NCT04366544]. Registered on 4/17/2020.
Inadequate Mental Health Literacy and Insufficient Physical Activity Potentially Increase the Risks of Anxiety and Depressive Symptoms in Chinese College Students
Authors: Huang Xuexue , Wang Xiaoqing , Hu Jie , Xue Yanni , Wei Yanyan , Wan Yuhui , Song Xianbing , Wang Rui , Zhang Bao , Fang Jun , Zhang Shichen 
Published: November 2021

Objective: The present study aimed to examine the interactive associations between physical activity and mental health literacy with anxiety and depressive symptoms in Chinese college students.Methods: A cross-sectional study was conducted from May to July 2020. A total of 7,512 students were recruited from two medical colleges in Hefei and Anqing city in Anhui Province, China. Physical activity, mental health literacy, anxiety and depressive symptoms were measured by self-reported validated instruments. Analyses were conducted with logistic regression models.Results: The prevalence of anxiety and depressive symptoms was 8.6% and 16.4%, respectively. Insufficient physical activity was significantly associated with depressive symptoms (OR = 1.359, 95%CI 1.184–1.561) and anxiety symptoms (OR = 1.492, 95%CI: 1.237–1.799). Inadequate mental health literacy was significantly associated with depressive symptoms (OR = 3.089, 95%CI: 2.607–3.662) and anxiety symptoms (OR = 3.675, 95%CI: 2.861–4.721). Low physical activity rank (OR = 1.438, 95%CI: 1.151–1.798) was significantly related with depressive symptoms but not anxiety symptoms. The students who had inadequate mental health literacy and insufficient physical activity had the highest risks of depressive symptoms (OR = 5.049, 95% CI: 3.649–6.987) and anxiety symptoms (OR = 5.270, 95% CI: 3.338–8.321).Conclusion: These finding indicated that Chinese college students having insufficient physical activity and inadequate mental health literacy are at risk of exhibiting anxiety and depressive symptoms. Early intervention programs for college students with mental health problems should be considered to enhance their mental health literacy and to increase their physical activities.