bluuebunny/crossref_metadata_2025_split huggingface dataset:
ДОСЛІДЖЕННЯ ЗМІН РЕПАРАТИВНОЇ ЗДАТНОСТІ ШКІРИ ПІСЛЯОПЕРАЦІЙНИХ РАН ЩУРІВ ІЗ СТРЕПТОЗОТОЦИНОВИМ ЦУКРОВИМ ДІАБЕТОМ
Authors: Лоза Є. О. , Гомелюк Т. М. , Криницька І. Я. , Марущак М. І. 
Published: September 2021

Резюме. Цукровий діабет (ЦД) у всьому світі визнаний одним із найбільш важливих неінфекційних захворювань. ЦД та його ускладнення є одними з найважливіших причин смертності, при цьому одним з важливих наслідків ЦД є порушення здатності до репарації.
Мета дослідження – виявити зміни репаративної здатності шкіри при різних способах закриття післяопераційних ран щурів за умов стрептозотоцинового цукрового діабету.
Матеріали і методи. Експериментальні дослідження проведено на 130 білих безпородних статевозрілих щурах-самцях, яких поділили на 4 групи: перша (30 тварин) – здорові, яким накладено вузлові шви на операційну рану; друга група (30 щурів) – здорові, яким для фіксації країв рани застосували шкірний клей; третя (30 тварин) – з цукровим діабетом, яким накладено вузлові шви на операційну рану; четверта група (30 щурів) – з цукровим діабетом, яким для фіксації країв рани застосували шкірний клей. Для контролю всі отримані результати порівнювали із показниками інтактних тварин (10 щурів).
Результати. Результати наших досліджень показують, що рановий процес призводить до зниження репаративної здатності шкіри на ранньому терміні спостереження. У віддаленому терміні спостереження у здорових групах щурів відбувається відновлення репаративної здатності дерми на відміну від груп щурів із стрептозотоциновим цукровим діабетом.
Висновки. Отримані результати свідчать про зниження репаративної здатності шкіри, зумовленої рановим процесом у щурів з експериментальним цукровим діабетом стосовно здорових щурів при застосуванні шкірного клею. При цьому застосування його є ефективнішим для формування нормотрофічного рубця за умов цукрового діабету, порівняно із накладанням вузлових швів для фіксації країв ран.
INCIDENCE OF COVID-19 AMONG INTERNATIONAL STUDENTS OF TERNOPIL NATIONAL MEDICAL UNIVERSITY: A QUESTIONNAIRE STUDY
Authors: Pereviznyk B. O. , Dzhavadova N. A. , Pokryshko O. V. 
Published: September 2021

Summary. SARS-CoV-2 became a global pandemic challenge for billions of people by reaching people of diffe­rent nationalities and age groups. Ukraine lists 80470 foreign students who are enrolled into university studies. Ternopil National Medical University (TNMU) includes 2414 foreign students who are enrolled in university studies with the biggest majority of Indian students.
The aim of the study – to assess the incidence of COVID-19 in students and identify the possible predisposing factors for disease appearance among the foreign students of TNMU.
Materials and Methods. The study included 641 medical students of TNMU from different countries. The questionnaire included 8 questions to evaluate the presence of risk factors among TNMU foreign students and identify the percentage of students who were already exposed to COVID-19.
Results. The amount of students that proved PCR-confirmed COVID-19 infection since the start of the pandemic equaled 7.17% (n=46). An evident contact with COVID-19 case prior to the personal disease appearance was proved by only 11.85 % of students (n=76). PCR-confirmed ca­ses in families of TNMU foreign medical students equaled 14.35% (n=92).
Conclusions. General incidence of COVID-19 among foreign students of TNMU is low. It is influenced by multiple factors including healthy lifestyle, small amount of smokers, and absence of chronic respiratory problems, current lockdown measures, good physical and mental health status.
Interleukin-1RA Mitigates SARS-CoV-2–Induced Inflammatory Lung Vascular Leakage and Mortality in Humanized K18-hACE-2 Mice
Authors: Xiong Shiqin , Zhang Lianghui , Qadir Abdul S. , Richner Justin M. , Class Jake , Rehman Jalees , Malik Asrar B. 
Published: September 2021

Objective:
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is a major cause of morbidity and mortality, often as a result of acute respiratory distress syndrome. Respiratory failure is characterized by a hyperinflammatory immune response, lung vascular injury, and edema formation. The potential for immunomodulatory therapy to prevent lung vascular injury and edema formation is not well understood.

Approach and Results:
We show that SARS-CoV-2 infection in humanized K18-hACE-2 mice activated inflammatory NLRP3 (NLR family pyrin domain containing 3)–caspase-1 pyroptotic signaling in lungs, release of IL (interleukin)-1β, and downregulation of the lung endothelial adherens junction protein VE (vascular endothelial)-cadherin. Primary human lung microvascular endothelial cells were susceptible to SARS-CoV-2 infection and displayed pyroptosis-like injury. We observed profound lung vascular injury post–SARS-CoV-2 infection and resultant protein-rich lung edema formation. Selective blockade of IL-1 receptor signaling by IL-1RA (IL-1 receptor antagonist) anakinra prevented downregulation of VE-cadherin, as well as accompanying lung vascular hyperpermeability. IL-1RA also significantly increased survival.

Conclusions:
These results provide insights into the central role of NLRP3–caspase-1 pyroptotic innate immune signaling and loss of lung endothelial adherens junctions in the mechanism of acute respiratory distress syndrome induced by SARS-CoV-2. Our data show that treatment with IL-1RA during activation of inflammasome provides the ideal scenario for preventing lung vascular injury and respiratory failure in coronavirus disease 2019 (COVID-19).

Graphic Abstract:
A graphic abstract is available for this article.
Deep Learning–Based Automated Thrombolysis in Cerebral Infarction Scoring: A Timely Proof-of-Principle Study
Authors: Nielsen Maximilian , Waldmann Moritz , Frölich Andreas M. , Flottmann Fabian , Hristova Evelin , Bendszus Martin , Seker Fatih , Fiehler Jens , Sentker Thilo , Werner Rene 
Published: September 2021

Background and Purpose:
Mechanical thrombectomy is an established procedure for treatment of acute ischemic stroke. Mechanical thrombectomy success is commonly assessed by the Thrombolysis in Cerebral Infarction (TICI) score, assigned by visual inspection of X-ray digital subtraction angiography data. However, expert-based TICI scoring is highly observer-dependent. This represents a major obstacle for mechanical thrombectomy outcome comparison in, for instance, multicentric clinical studies. Focusing on occlusions of the M1 segment of the middle cerebral artery, the present study aimed to develop a deep learning (DL) solution to automated and, therefore, objective TICI scoring, to evaluate the agreement of DL- and expert-based scoring, and to compare corresponding numbers to published scoring variability of clinical experts.

Methods:
The study comprises 2 independent datasets. For DL system training and initial evaluation, an in-house dataset of 491 digital subtraction angiography series and modified TICI scores of 236 patients with M1 occlusions was collected. To test the model generalization capability, an independent external dataset with 95 digital subtraction angiography series was analyzed. Characteristics of the DL system were modeling TICI scoring as ordinal regression, explicit consideration of the temporal image information, integration of physiological knowledge, and modeling of inherent TICI scoring uncertainties.

Results:
For the in-house dataset, the DL system yields Cohen’s kappa, overall accuracy, and specific agreement values of 0.61, 71%, and 63% to 84%, respectively, compared with the gold standard: the expert rating. Values slightly drop to 0.52/64%/43% to 87% when the model is, without changes, applied to the external dataset. After model updating, they increase to 0.65/74%/60% to 90%. Literature Cohen’s kappa values for expert-based TICI scoring agreement are in the order of 0.6.

Conclusions:
The agreement of DL- and expert-based modified TICI scores in the range of published interobserver variability of clinical experts highlights the potential of the proposed DL solution to automated TICI scoring.
Treatment-Relevant Findings in Transesophageal Echocardiography After Stroke: A Prospective Multicenter Cohort Study
Authors: Thomalla Götz , Upneja Mira , Camen Stephan , Jensen Märit , Schröder Julian , Barow Ewgenia , Boskamp Stefan , Ostermeier Birgit , Kissling Sandra , Leinisch Elke , Tiburtius Claudia , Clausen Henning , Cheng Bastian , Blankenberg Stefan , Nedelmann Max , Steinbrecher Andreas , Andres Frank , Rosenkranz Michael , Sinning Christoph , Schnabel Renate B. , Gerloff Christian 
Published: September 2021

Background and Purpose:
Cardiac ultrasound to identify sources of cardioembolism is part of the diagnostic workup of acute ischemic stroke. Recommendations on whether transesophageal echocardiography (TEE) should be performed in addition to transthoracic echocardiography (TTE) are controversial. We aimed to determine the incremental diagnostic yield of TEE in addition to TTE in patients with acute ischemic stroke with undetermined cause.

Methods:
In a prospective, observational, pragmatic multicenter cohort study, patients with acute ischemic stroke or transient ischemic attack with undetermined cause before cardiac ultrasound were studied by TTE and TEE. The primary outcome was the rate of treatment-relevant findings in TTE and TEE as defined by a panel of experts based on current evidence. Further outcomes included the rate of changes in the assessment of stroke cause after TEE.

Results:

Between July 1, 2017, and June 30, 2019, we enrolled 494 patients, of whom 492 (99.6%) received TTE and 454 (91.9%) received TEE. Mean age was 64.7 years, and 204 (41.3%) were women. TEE showed a higher rate of treatment-relevant findings than TTE (86 [18.9%] versus 64 [14.1%],
P
<0.001). TEE in addition to TTE resulted in 29 (6.4%) additional patients with treatment-relevant findings. Among 191 patients ≤60 years additional treatment-relevant findings by TEE were observed in 27 (14.1%) patients. Classification of stroke cause changed after TEE in 52 of 453 patients (11.5%), resulting in a significant difference in the distribution of stroke cause before and after TEE (
P
<0.001).

Conclusions:
In patients with undetermined cause of stroke, TEE yielded a higher number of treatment-relevant findings than TTE. TEE appears especially useful in younger patients with stroke, with treatment-relevant findings in one out of seven patients ≤60 years.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03411642.
The Efficiency of University Technology Transfer in China
Authors: Li Dongfu (Franco) , Fu Xiaoqing (Maggie) 
Published: September 2021

Abstract
There has been no significant improvement in China's comprehensive innovation capability over the past decade despite the country's tremendously large investment in research and development. This study uses a three-stage procedure (i.e., research innovation, experimental development, and value creation) to understand this disappointing outcome by estimating the efficiency of the technology transfer operating through major Chinese universities. We find a substantial decrease in the average level of efficiency across the three stages, with the value creation stage identified as the weakest link. An analysis of the determinants suggests that universities with better faculty quality, experienced technology transfer offices, more affiliated investment funds, and a comprehensive rather than specialized focus perform better in all three stages.
A Constraint Method for Supersaturation in a Variational Data Assimilation System
Authors: Sawada Ken , Honda Yuki 
Published: September 2021

Abstract
The reproducibility of precipitation in the early stages of forecasts, often called a spindown or spinup problem, has been a significant issue in numerical weather prediction. This problem is caused by moisture imbalance in the analysis data, and in the case of the Japan Meteorological Agency’s (JMA’s) mesoscale data assimilation system, JNoVA, we found that the imbalance stems from the existence of unrealistic supersaturated states in the minimal solution of the cost function in JNoVA. Based on the theory of constrained optimization problems, we implemented an exterior penalty function method for the mixing ratio within JNoVA to suppress unrealistic supersaturated states. The advantage of this method is the simplicity of its theory and implementation. The results of twin data assimilation cycle experiments conducted for the heavy rain event of July 2018 over Japan show that—with the new method—unrealistic supersaturated states are reduced successfully, negative temperature bias to the observations is alleviated, and a sharper distribution of the mixing ratio is obtained. These changes help to initiate the development of convection at the proper location and improve the fractions skill score (FSS) of precipitation in the early stages of the forecast. From these results, we conclude that the initial shock caused by moisture imbalance is mitigated by implementing the penalty function method, and the new moisture balance has a positive impact on the reproducibility of precipitation in the early stages of forecasts.
Liposomal Bupivacaine Versus Immediate-Release Bupivacaine for Postoperative Pain Control
Authors: Dilawri Atul , Wyman Marcia , Shah Sneha 
Published: September 2021

Background Liposomal bupivacaine (LB) is increasingly being used for postoperative pain control, but there are conflicting efficacy data when compared with immediate-release bupivacaine (IRB). Objective To evaluate the comparative efficacies of LB and IRB for postoperative pain control in order to assess the formulary status of LB at our institution. Methods A single-center, retrospective, institutional review board–approved, noninferiority matched cohort study at a tertiary care academic medical center. Adult surgical patients admitted for >24 hours who received LB or IRB were included. The primary outcome was total opioid consumption within 24 hours postoperatively. Secondary outcomes included total opioid consumption within 72 hours postoperatively, nonopioid analgesic use within 24 and 72 hours postoperatively, time to rescue analgesic use, and postoperative length of stay (LOS). Results A total of 326 patients were included in the matched cohort. Median 24-hour opioid consumption was significantly lower in the IRB group compared with the LB group (81 mg [30, 153] vs 103 mg [46, 241]; P = 0.01). Patients receiving IRB compared with LB also had a decrease in total opioid consumption 72 hours postoperatively (110 mg [45, 258] vs 165 mg [68, 402]; P = 0.005) and shorter postoperative LOS (2.8 days [1.7, 4] vs 3.3 days [2, 5.1]; P < 0.001). There was no difference in time to rescue analgesic use. Conclusion and Relevance Across a variety of surgical procedures, administration of IRB compared with LB was associated with a reduction in total opioid consumption within 24 and 72 hours postoperatively and shorter LOS in adult surgical patients.
A Critical Analysis of the Specific Pharmacist Interventions and Risk Assessments During the 12-Month TRANSAFE Rx Randomized Controlled Trial
Authors: Gonzales Haley M. , Fleming James N. , Gebregziabher Mulugeta , Posadas Salas Maria Aurora , McGillicuddy John W. , Taber David J. 
Published: September 2021

Background Medication safety issues have detrimental implications on long-term outcomes in the high-risk kidney transplant (KTX) population. Medication errors, adverse drug events, and medication nonadherence are important and modifiable mechanisms of graft loss. Objective To describe the frequency and types of interventions made during a pharmacist-led, mobile health–based intervention in KTX recipients and the impact on patient risk levels. Methods This was a secondary analysis of data collected during a 12-month, parallel-arm, 1:1 randomized clinical controlled trial including 136 KTX recipients. Participants were randomized to receive either usual care or supplemental, pharmacist-driven medication therapy monitoring and management using a smartphone-enabled app integrated with telemonitoring of blood pressure and glucose (when applicable) and risk-based televisits. The primary outcome was pharmacist intervention type. Secondary outcomes included frequency of interventions and changes in risk levels. Results A total of 68 patients were randomized to the intervention and included in this analysis. The mean age at baseline was 50.2 years; 51.5% of participants were male, and 58.8% were black. Primary pharmacist intervention types were medication reconciliation and patient education, followed by medication changes. Medication reconciliation remained high throughout the study period, whereas education and medication changes trended downward. From baseline to month 12, we observed an approximately 15% decrease in high-risk patients and a corresponding 15% increase in medium- or low-risk patients. Conclusion and Relevance A pharmacist-led mHealth intervention may enhance opportunities for pharmacological and nonpharmacological interventions and mitigate risk levels in KTX recipients.
Risk factors for peripartum depression in women with multiple sclerosis
Authors: Krysko Kristen M , Anderson Annika , Singh Jessica , McPolin Kira , Rutatangwa Alice , Rowles William , Sadovnick A Dessa , Houtchens Maria K , Bove Riley 
Published: September 2021

Background: Peripartum depression (PPD) is underexplored in multiple sclerosis (MS). Objective: To evaluate prevalence of and risk factors for PPD in women with MS. Methods: Retrospective single-center analysis of women with MS with a live birth. Prevalence of PPD was estimated with logistic regression with generalized estimating equations (GEE). GEE evaluated predictors of PPD (e.g. age, marital status, parity, pre-pregnancy depression/anxiety, antidepressant discontinuation, sleep disturbance, breastfeeding, relapses, gadolinium-enhancing lesions, and disability). Factors significant in univariable analyses were included in multivariable analysis. Results: We identified 143 live births in 111 women (mean age 33.1 ± 4.7 years). PPD was found in 18/143 pregnancies (12.6%, 95% CI = 7.3–17.8). Factors associated with PPD included older age (OR 1.16, 95% CI = 1.03–1.32 for 1-year increase), primiparity (OR 4.02, CI = 1.14–14.23), pre-pregnancy depression (OR 3.70, CI = 1.27–10.01), sleep disturbance (OR 3.23, CI = 1.17–8.91), and breastfeeding difficulty (OR 3.58, CI = 1.27–10.08). Maternal age (OR 1.17, CI = 1.02–1.34), primiparity (OR 8.10, CI = 1.38–47.40), and pre-pregnancy depression (OR 3.89, CI = 1.04–14.60) remained significant in multivariable analyses. Relapses, MRI activity, and disability were not associated with PPD. Conclusion: The prevalence of PPD in MS appeared similar to the general population, but was likely underestimated due to lack of screening. PPD can affect MS self-management and offspring development, and prospective studies are needed.
Benchmarks of meaningful improvement on neurocognitive tests in multiple sclerosis
Authors: Wojcik Curtis , Jaworski Michael , Dwyer Michael G , Youngs Margaret , Unverdi Mahmut , Weinstock-Guttman Bianca , Benedict Ralph HB 
Published: September 2021

Background: Previous studies have established benchmarks of clinically meaningful decline on neuropsychological tests. However, little is known about meaningful testing benchmarks based on gains in function. Objective: Investigate neuropsychological changes in multiple sclerosis (MS) patients with work gains and calculate benchmarks of meaningful improvement on neuropsychological tests. Methods: A total of 323 people with MS were monitored longitudinally with neuropsychological testing and the Buffalo Vocational Monitoring Survey. Results/Conclusions: Those with work gains showed significant improvement (~3 points) on the Symbol Digit Modalities Test (SDMT) over time, p = 0.01. Benchmarks for clinically meaningful improvement on the SDMT are similar to those previously established for clinically meaningful decline.
How to deliver an effective primary survey report for the trauma CT: A radiological and surgical perspective
Authors: Davies Joseph , Johnson Rowena , Kashef Elika , Khan Mansoor , Dick Elizabeth 
Published: September 2021

Whole body contrast-enhanced multidetector CT (WB-CE MDCT) is integral to the assessment of the severely injured patient with stable haemodynamic parameters or in those who respond to resuscitation with blood products. WB-CE MDCT is able to identify the number and severity of injuries sustained by the patient and enable time critical intervention. In this narrative review article we discuss how communication within the trauma team, including the radiologists and appropriate clinicians is crucial in optimizing the effectiveness of WB-CE MDCT. We review the time critical imaging findings and their clinical relevance, which should be included in a succinct CT primary survey report. We also discuss the process through which the effectiveness of the trauma report may be maximised and how non technical factors including teamwork may be optimised to facilitate decision making in this high pressure environment.
Players at home: Physical activity and quality of life in 12–17 years-old football (soccer) players during the Covid-19 lockdown
Authors: Zago Matteo , Lovecchio Nicola , Galli Manuela 
Published: September 2021

Background Aggressive preventive actions were required to face the Covid-19 outbreak. However, from March 2020 on, many healthy youth football players have seen their sporting activities disrupted by the restrictions on outdoor exercise. This study describes physical activity and quality of life during April 2020 lockdown of young people participating in organized football. Methods 1163 young football players aged 12–17 years (185 girls) completed a web-based questionnaire including the Youth Physical Activity and the Youth Quality of Life-Short Form Questionnaires; information on lifestyle and football-specific activity were also collected. Differences according to sex, urban/rural context and élite/non-élite club level were tested using a 2 [Formula: see text] 2 [Formula: see text] 2 MANOVA (age considered as a covariate). Results We found that: (i) on average, exposure to football accounted for 3.2 hours/week, was higher in élite clubs and changed in nature, being mainly performed individually; 19% of participants practiced football <1 hour/week; (ii) only 56% of the participants reported 7 or more hours/week of moderate-to-vigorous physical activity, which decreased with age and changed according to the geographical context; (iii) perceived quality of life was lower in youth playing for non-elite clubs and in older girls; (iv) coaches, rather that official initiatives, were the primary source of football exercises practiced at home. Conclusion A status of limited physical activity emerged; this might lead to deconditioning and susceptibility to injuries when football could restart. Governing bodies, football Associations and clubs could exploit these results to take informed decisions and support evidence-based interventions during and after the Covid-19 pandemic.