bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk stratification and mortality prediction in octo- and nonagenarians with peripheral artery disease: a retrospective analysis
Authors: Rammos Christos , Kontogiannis Aristotelis , Mahabadi Amir A. , Steinmetz Martin , Messiha Daniel , Lortz Julia , Rassaf Tienush 
Published: August 2021

Abstract
Objectives
Among changes in demographics, aging is the most relevant cardiovascular risk factor. The prevalence of peripheral artery disease (PAD) is high in elderly patients and is associated with a worse prognosis. Despite optimal treatments, mortality in the high-risk population of octo- and nonagenarians with PAD remains excessive, and predictive factors need to be identified. The objective of this study was to investigate predictors of mortality in octo- and nonagenarians with PAD.

Methods
Cases of treated octo- and nonagenarians, including the clinical characteristics and markers of myocardial injury and heart failure, were studied retrospectively with respect to all-cause mortality. Hazard ratios [HR] were calculated and survival was analyzed by Kaplan-Meyer curves and receiver operating characteristic curved were assessed for troponin-ultra and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and chronic limb-threatening ischemia (CLTI).

Results
A total of 123 octo- and nonagenarians admitted for PAD were eligible. The troponin level was the major predictor of all-cause mortality (HR: 4.6, 95% confidence interval [CI]: 1.4–15.3), followed by the NT-proBNP level (HR: 3.9, 95% CI 1.8–8.8) and CLTI (HR: 3.1, 95% CI 1.6–5.9). Multivariate regression revealed that each increment of 1 standard deviation in log troponin and log NT-proBNP was associated with a 2.7-fold (95% CI 1.8–4.1) and a 1.9-fold (95% CI 1.2–2.9) increased risk of all-cause death. Receiver operating characteristic curve analysis using a combination of all predictors yielded an improved area under the curve of 0.888. In a control group of an equal number of younger individuals, only NT-proBNP (HR: 4.2, 95% CI 1.2–14.1) and CLTI (HR: 6.1, 95% CI 1.6–23.4) were predictive of mortality.

Conclusion
Our study demonstrates that cardiovascular biomarkers and CLTI are the primary predictors of increased mortality in elderly PAD patients. Further risk stratification through biomarkers in this high-risk population of octo- and nonagenarians with PAD is necessary.
The direct and indirect effects of clinical empathy on well-being among pre-medical students: a structural equation model approach
Authors: MacArthur Kelly Rhea , Stacey Clare L. , Harvey Sarah , Markle Jonathan 
Published: August 2021

Abstract
Background
Empathy is a well-established facet of clinical competency that research suggests is associated with enhanced medical student well-being. Since little is known about empathy and well-being before students enter medical school—during pre-medical education—the main goal of this study is to test a conceptual model of how clinical empathy is related to two indicators of well-being, depression, and burnout among pre-medical students. The theoretical model hypothesizes that three dimensions of clinical empathy—Perspective-Taking, Compassionate Care, and Standing in Patients’ Shoes— will be directly and negatively related to depression, as well as indirectly through its inverse relationship with three facets of burnout, Emotional Exhaustion, Poor Academic Efficacy, and Cynicism.

Methods
Using survey data from a sample of 132 pre-medical students at an American Midwestern university, this study employs structural equation modeling (SEM) to test the theoretical model of the relationships between empathy, burnout, and depression among pre-medical students. We identify the direct effects of the three dimensions of the Jefferson Scale of Physician Empathy (JSE-S) on depression (CES-D), as well as the indirect effects of clinical empathy on depression through the three dimensions of the Maslach Burnout Inventory (MBI-S).

Results
SEM analyses show that while none of the three dimensions of the JSE-S are directly related to depression, clinical empathy does significantly affect depression indirectly through burnout. Specifically, as predicted, we find that Perspective-Taking decreases Emotional Exhaustion, but, contrary to expectations, Compassionate Care increases it. And, the positive relationship between Compassionate Care and Emotional Exhaustion is particularly strong. In turn, Perspective-Taking and Compassionate Care are associated with depression in opposite directions and to different degrees.

Conclusions
Findings suggest that clinical empathy as measured by the JSE-S produces both positive and negative effects on personal well-being. We conclude that further conceptual clarity of clinical empathy is needed to better discern how the different dimensions impact different indicators of well-being. Given that pre-medical education is a crucial time for emotional socialization, the challenge for medical education will be fostering the positive, cognitive aspects of clinical empathy while simultaneously mitigating the adverse effects of affective empathy on medical student well-being.
Evaluating the success of the tele-pathology system in governmental hospitals in Kuwait: an explanatory sequential mixed methods design
Authors: Buabbas Ali Jasem , Mohammad Tareq , Ayed Adel K. , Mallah Hawraa , Al-Shawaf Hamza , Khalfan Abdulwahed Mohammed 
Published: August 2021

Abstract
Background
Telepathology is the practice of reviewing and exchanging pathological images through telecommunication systems to obtain diagnoses remotely. Studying the factors that make such a system successful and favourable is important to ensure the merits of its implementation in clinical practice.

Objective
This study aims to evaluate the success of a telepathology system from the users’ perspectives, using specific evaluation criteria, namely: system quality, information quality, technical service quality, user satisfaction, and benefits.

Methods
A sequential explanatory mixed methods design was adopted in this study, which consists of two phases. Initially, a questionnaire was distributed via WhatsApp to all of the pathologists (total: 45) working at governmental hospitals in Kuwait. Followed by, semi-structured interviews with ten senior pathologists.

Results
Forty pathologists responded to the questionnaire, giving an 89% response rate. There were 42.5% of the respondents aged between 35–44 years old, and 52.5% were male. The quantitative results reveal that most of the respondents were satisfied with the quality of the telepathology system with a mean of 2.6025 (Standard Deviation (SD) = 0.47176), whereas they were dissatisfied with the quality of the information with a mean of 2.4100 (SD = 1.580) and the technical support services with a mean of 2.2750 (SD = 0.99535). In addition, there was disagreement on the benefits of telepathology in clinical practice among the pathologists with a mean of 2.4667 (SD = 0.77552). The qualitative results indicate that the lack of interest in and little experience with using the system were behind the general dissatisfaction of most of the respondents. All of the interviewees were satisfied with the performance of the telepathology system and considered it successful; however, the quality of the technical support services, including training workshops, was deemed deficient.

Conclusion
This study concluded that telepathology system in Kuwait is functioning well and has been successful in its implementation; however, pathologists are dissatisfied with it, mainly due to the deficient quality of the technical support services provided. In addition, the successful implementation of such advanced technologies requires careful steps to be taken on multiple levels: technical, organisational, and managerial. Recommendations were suggested.
Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics
Authors: Lv Hong , Yang Ning 
Published: July 2021

AbstractObjectiveTo analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery.MethodsA total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing.ResultsPatients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher.ConclusionFollowing the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.
Acute effects of Square Stepping Exercise on cognitive and social functions in sedentary young adults: a home-based online trial
Authors: Kawabata Masato , Gan Su Ren , Goh Gint , Omar Siti Aisha Binte , Oh Ivan T. F. , Wee Wan Qi , Okura Tomohiro 
Published: August 2021

AbstractBackgroundThe Square Stepping Exercise (SSE) is an exercise training program incorporating cognitive and physical exercise components, which was originally developed for older adults to reduce falling risks. SSE’s potential in delaying cognitive decline in older adults seems to be promising. However, there is scarce research on the SSE program with young adults. Furthermore, the outbreak of coronavirus disease has imposed people to change their lifestyle and behaviors, including exercise behaviors. Hence, the purpose of this study was to examine the acute effects of a home-based online SSE trial on cognitive and social functions in sedentary young adults.MethodsA total of 18 young adults (6 males, 12 females) participated in the present study. They completed two exercise conditions (SSE and active control exercise), consisting of 3 sessions per week, over 2 weeks. A 2 times (pre vs. post) × 2 conditions (SSE vs. active control) repeated-measures ANCOVA was conducted on the score of the Modified Card Sorting Task with age and education year as covariates. A one-way repeated-measures MANOVA was performed on the subscale scores of the Physical Activity Group Environment Questionnaire to examine the effects of the exercise conditions (SSE vs. active control) on group cohesion.ResultsSSE was found effective to improve executive function such as abstract reasoning, mental flexibility, and problem-solving skills. Furthermore, participants’ perceptions of social interaction with their group, and closeness and bonding existing in their group were significantly higher in the SSE condition than the active control condition.ConclusionsIn the present study, SSE was conducted online and found to be effective to enhance executive function and group cohesion in sedentary young adults. These novel approach and findings are the strengths of the present study. People aged 60 years and over are more vulnerable to the coronavirus and at higher risk of developing serious illness. Given the coronavirus pandemic circumstances, it is worthwhile to explore the possibility of the online SSE approach to older adults in future research.
Loss with ageing but preservation of frontal cortical capillary pericytes in post-stroke dementia, vascular dementia and Alzheimer’s disease
Authors: Ding Ren , Hase Yoshiki , Burke Matthew , Foster Vincent , Stevenson William , Polvikoski Tuomo , Kalaria Raj N. 
Published: August 2021

AbstractCerebral pericytes are an integral component of the neurovascular unit, which governs the blood–brain barrier. There is paucity of knowledge on cortical pericytes across different dementias. We quantified cortical pericytes in capillaries in 124 post-mortem brains from subjects with post-stroke dementia (PSD), vascular dementia (VaD), Alzheimer’s disease (AD) and AD-VaD (Mixed) and, post-stroke non-demented (PSND) stroke survivors as well as normal ageing controls. Collagen 4 (COL4)-positive nucleated pericyte soma were identified as protrusions on capillaries of the frontal cortex. The COL4-positive somata or nodule-like cell bodies were also verified by platelet derived growth factor receptor-β (PDGFR-β) immunohistochemistry. The mean (± SEM) pericyte somata in frontal cortical capillaries in normal young controls (46–65 years of age) was estimated as 5.2 ± 0.2 per mm capillary length. This number was reduced by 45% in older controls (> 78 years) to 2.9 ± 0.1 per mm capillary length (P < 0.001). We further found that the numbers of pericyte cell bodies per COL4 mm2 area or per mm capillary length were not decreased but rather preserved or increased in PSD, AD and Mixed dementia groups compared to similar age older controls (P < 0.01). Consistent with this, we noted that capillary length densities identified by the endothelial marker glucose transporter 1 or COL4 were not different across the dementias compared to older controls. There was a negative correlation with age (P < 0.001) suggesting fewer pericyte somata in older age, although the % COL4 immunoreactive capillary area was increased in older controls compared to young controls. Using a proven reliable method to quantify COL4-positive nucleated pericytes, our observations demonstrate ageing related loss but mostly preserved pericytes in the frontal cortex of vascular and AD dementias. We suggest there is differential regulation of capillary pericytes in the frontal lobe between the cortex and white matter in ageing-related dementias.
Robotic-assisted proximal gastrectomy using the double-flap technique for early gastric cancer with situs inversus totalis: a case report
Authors: Takeno Atsushi , Masuzawa Toru , Katsuyama Shinsuke , Murakami Kohei , Kawai Kenji , Katsura Yoshiteru , Ohmura Yoshiaki , Kagawa Yoshinori , Takeda Yutaka , Hata Taishi , Murata Kohei 
Published: August 2021

Abstract
Background
The robotic system has been applied in the treatment of gastric cancer (GC), and the procedure has been found to be safe and feasible. Situs inversus totalis (SIT) is a relatively rare autosomal recessive congenital anomaly. We successfully performed robot-assisted proximal gastrectomy (RAPG) and handsewn double-flap esophagogastrostomy for GC in a patient with SIT.

Case presentation
A 71-year-old woman was referred to us with an asymptomatic ulcerative lesion in the upper body of the stomach. Computed tomography revealed that she had SIT. She was diagnosed with cT1bN0M0, cStageIA gastric cancer. RAPG with lymph node dissection and handsewn double-flap esophagogastrostomy was performed. Robotic surgery enabled the surgeon to perform the surgery without changing his position and experiencing any confusion resulting from the patient’s reversed anatomy. It took 448 min, and no intraoperative complications occurred. Her postoperative course was uneventful; she was discharged on postoperative day 10. The final pathologic report showed pT1b1N0M0, pStage IA.

Conclusions
This is the first case describing RAPG with handsewn double-flap esophagogastrostomy for a SIT patient with early GC.
miR221 regulates cell migration by targeting annexin a1 expression in human mesothelial MeT-5A cells neoplastic-like transformed by multi-walled carbon nanotube
Authors: Ju Li , Zhu Lijin , Wu Hao , Yu Min , Yin Xianhong , Jia Zhenyu , Feng Lingfang , Ying Shibo , Xia Hailing , Zhang Shuzhi , Lou Jianlin , Yang Jun 
Published: August 2021

Abstract
Background
Multi-walled carbon nanotube (MWCNT) is one of the most widely used manufactured nanomaterials, however, its potential harmful effect on human health is of great concern. Previously we have shown the acute and chronic exposure to MWCNT induced different responses in human mesothelial MeT-5A cells. In the current study, MeT-5A cells were continuously subjected to MWCNT exposure at 10 μg/cm2 for 48 h per passage, up to a whole year, to further clarify the carcinogesis and its potential mechanisms of MWCNT.

Results
After one-year MWCNT treatment, MeT-5A cells exhibited neoplastic-like properties, including morphological changes, anchorage-independent growth, increased cell proliferation and cell migration. Further examination revealed the expression of microRNA 221 (miR221) was gradually decreased, while the annexin a1 expression was increased at both the mRNA and protein level during the exposure. Bioinformatic analysis indicated that annexin a1 is a target for miR221 regulation, and it was confirmed by transfecting cells with miR221 mimics, which resulted in the downregulation of annexin a1. Detailed analyses demonstrated miR221 was involved in the regulation of cell migration, e.g., downregulation of miR221 or overexpression of ANNEXIN A1, contributed to the increased cell migration. In contrast, overexpression of miR221 or downregulation of ANNEXIN A1 slowed cell migration.

Conclusions
Taken together, these results point to a neoplastic-transforming property of MWCNT, and the miR221-annexin a1 axis is involved in the regulation of cell migration in the transformed cells.
Phenotypic and phylogenetic characterization of Lactobacillus species isolated from traditional Lighvan cheese
Authors: Forouhandeh Haleh , Vahed Sepideh Zununi , Ahangari Hossein , Tarhriz Vahideh , Hejazi Mohammad Saeid 
Published: August 2021

AbstractLighvan cheese (Lighvan panir) is among the most famous traditional cheese in Iran for its desired aroma and flavor. Undoubtedly, the lactic acid bacteria especially the genusLactobacillusare the critical factors in developing the aroma, flavor, and texture in Lighvan cheese. In this study, the Lactobacillus population of the main Lighvan cheese was investigated. The Lactobacillus of the main Lighvan cheese was isolated using specific culture methods according to previously published Guidelines. Then, the phylogenetic features were investigated and the phenotypic characteristics were examined using specific culture methods. Twenty-eight Gram-positive bacterial species were identified belonged to the genus Lactobacillus. According to the same sequences as each other, three groups (A, B, and C) of isolates were categorized with a high degree of similarity toL. fermentum(100%) and L. casei group (L. casei,L. paracasei, andL. rhamnosus) (99.0 to 100%). Random amplified polymorphic DNA (RAPD) fingerprint analysis manifested the presence of three clusters that were dominant in traditional Lighvan cheese. Cluster І was divided into 4 sub-clusters. By the result of carbohydrate fermentation pattern and 16S rRNA sequencing, isolates were identified asL. rhamnosus. The isolates in clusters II and III representedL. paracaseiandL. fermentum, respectively as they were identified by 16S rRNA sequencing and fermented carbohydrate patterns. Our result indicated that the specific aroma and flavor of traditional Lighvan cheese can be related to itsLactobacilluspopulation includingL. fermentum,L. casei, L. paracasei, andL. rhamnosus.Graphical abstract
Magical Habits
Authors: Huerta Monica 
Published: August 2021

In Magical Habits Monica Huerta draws on her experiences growing up in her family's Mexican restaurants and her life as a scholar of literature and culture to meditate on how relationships among self, place, race, and storytelling contend with both the afterlives of history and racial capitalism. Whether dwelling on mundane aspects of everyday life, such as the smell of old kitchen grease, or grappling with the thorny, unsatisfying question of authenticity, Huerta stages a dynamic conversation among genres, voices, and archives: personal and critical essays exist alongside a fairy tale; photographs and restaurant menus complement fictional monologues based on her family's history. Developing a new mode of criticism through storytelling, Huerta takes readers through Cook County courtrooms, the Cristero Rebellion (in which her great-grandfather was martyred by the Mexican government), Japanese baths in San Francisco—and a little bit about Chaucer too. Ultimately, Huerta sketches out habits of living while thinking that allow us to consider what it means to live with and try to peer beyond history even as we are caught up in the middle of it.
Duke University Press Scholars of Color First Book Award recipient
Anesthesia modality does not affect clinical outcomes of intra-arterial vasodilator treatment in patients with symptomatic cerebral vasospasms
Authors: Fischer Corinne , Vulcu Sonja , Goldberg Johannes , Wagner Franca , Rodriguez Belén , Söll Nicole , Mordasini Pasquale , Haenggi Matthias , Schefold Joerg C. , Raabe Andreas , Z'Graggen Werner J. 
Published: August 2021

Background: Delayed cerebral ischemia and cerebral vasospasm remain the leading causes of poor outcome in survivors of aneurysmal subarachnoid hemorrhage. Refractory cerebral vasospasms can be treated with endovascular vasodilator therapy, which can either be performed in conscious sedation or general anesthesia. The aim of this study is to compare the effect of the anesthesia modality on long-term clinical outcomes in patients undergoing endovascular vasodilator therapy due to cerebral vasospasm and hypoperfusion. Methods: Modified Rankin Scale (mRS) scores were retrospectively analyzed at time of discharge from the hospital and six months after aneurysmal subarachnoid hemorrhage. Additionally, National Institutes of Health Stroke Scale (NIHSS) was assessed 24 hours before, immediately before, immediately after, and 24 hours after endovascular vasodilator therapy, and at discharge and six months. Interventional parameters such as duration of intervention, choice and dosage of vasodilator and number of arteries treated were also recorded. Results: A total of 98 patients were included in this analysis and separated into patients who had interventions in conscious sedation, general anesthesia and a mix of both. Neither mRS at discharge nor at six months showed a significant difference for functionally independent outcomes (mRS 0-2) between groups. NIHSS before endovascular vasodilator therapy was significantly higher in patients receiving interventions in general anesthesia but did not differ anymore between groups six months after the initial bleed. Conclusion: This study did not observe a difference in outcome whether patients underwent endovascular vasodilator therapy in general anesthesia or conscious sedation for refractory cerebral vasospasms. Hence, the choice should be made for each patient individually.