bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep in children and adolescents with juvenile idiopathic arthritis: a systematic review and meta-analysis of case-control studies
Authors: Saidi Oussama , Rochette Emmanuelle , Bourdier Pierre , Ratel Sébastien , Merlin Etienne , Pereira Bruno , Duché Pascale 
Published: September 2021

AbstractStudy ObjectivesJuvenile idiopathic arthritis (JIA) is one of the most common pediatric rheumatic disease. However, sleep alteration associated with this autoimmune disease remain unclear. We aimed in this systematic review and meta-analysis to compare sleep duration, quality, and architecture in JIA subjects with those in their healthy peers.MethodsSystematic search performed in PubMed, EMBase, Cochrane, and PsycINFO databases included 19 studies in the qualitative synthesis of which 10 met the inclusion criteria for the meta-analysis.ResultsPooled results from subjective methods indicated pronounced sleep disturbances and complaints in youth with JIA compared with their healthy counterparts. This was further confirmed by increased difficulty maintaining sleep (wake after sleep onset [WASO]; standardized mean differences [SMD]: −0.69; CI: −1.29 to −0.09, p = .02) and a tendency to increased difficulty initiating sleep (sleep onset latency [SOL]; SMD: −0.29; CI: −0.60 to 0.03, p = .07). There were no remarkable differences in sleep duration or sleep architecture between JIA patients and healthy controls. High heterogeneity was found for several outcomes. This could be explained by the different methods used as well as associated sleep disorders, medication, and comorbidities.ConclusionsAlthough included studies were methodologically diverse, the summarized results of our review and meta-analysis bring evidence that children with JIA present more fragmented sleep compared to healthy peers. Thereby, the implementation of strategies to manage and improve sleep in this population are needed and might have a beneficial effect on the symptoms and functions of JIA.Statement of SignificanceWe observed that youth with Juvenile idiopathic arthritis (JIA) present pronounced sleep disturbances compared to their healthy counterparts: Meta-analysis found more difficulty maintaining sleep and a tendency to increased sleep latency in youth with JIA. However, results show discrepancies due to the different materials and methods used. Larger sample and further disentanglement of sample composition, considering associated sleep disorders, medication and comorbidities should be addressed in future studies.
Mobile forms of carbon in trees: metabolism and transport
Authors: Dominguez Pia Guadalupe , Niittylä Totte 
Published: September 2021

AbstractPlants constitute 80% of the biomass on earth, and almost two-thirds of this biomass is found in wood. Wood formation is a carbon (C)-demanding process and relies on C transport from photosynthetic tissues. Thus, understanding the transport process is of major interest for understanding terrestrial biomass formation. Here, we review the molecules and mechanisms used to transport and allocate C in trees. Sucrose is the major form in which C is transported in plants, and it is found in the phloem sap of all tree species investigated so far. However, in several tree species, sucrose is accompanied by other molecules, notably polyols and the raffinose family of oligosaccharides. We describe the molecules that constitute each of these transport groups, and their distribution across different tree species. Furthermore, we detail the metabolic reactions for their synthesis, the mechanisms by which trees load and unload these compounds in and out of the vascular system, and how they are radially transported in the trunk and finally catabolized during wood formation. We also address a particular C recirculation process between phloem and xylem that occurs in trees during the annual cycle of growth and dormancy. A search of possible evolutionary drivers behind the diversity of C-carrying molecules in trees reveals no consistent differences in C transport mechanisms between angiosperm and gymnosperm trees. Furthermore, the distribution of C forms across species suggests that climate-related environmental factors will not explain the diversity of C transport forms. However, the consideration of C-transport mechanisms in relation to tree–rhizosphere coevolution deserves further attention. To conclude the review, we identify possible future lines of research in this field.
Air, Air, Air: a champion midwife programme in Tanzania using HOT neonatal resuscitation—lessons learned
Authors: Becker Jan , Wu Chiung-Jung (Jo) , Becker Chase , Moir James , Gray Marion , Shimwela Meshak , Oprescu Florin 
Published: September 2021

Abstract

Background
Tanzania has approximately 40 000 newborn deaths per year, with &gt;25% of these linked to intrapartum-related hypoxia. The Helping Babies Breathe© and Golden minute© (HBB©) programme was developed to teach skilled intervention for non-breathing neonates at birth. While Helping Babies Breathe© and Golden minute©, providing training in simulated bag and mask ventilation, is theoretically successful in the classroom, it often fails to transfer to clinical practice without further support. Furthermore, the proclivity of midwives to suction excessively as a first-line intervention is an ingrained behaviour that delays ventilation, contributing to very early neonatal deaths.

Methods
The ‘champion’ programme provided guided instruction during a real-life resuscitation. The site was Amana Hospital, Tanzania. The labour ward conducts 13 500 deliveries annually, most of which are managed by midwives. Brief mannikin simulation practice was held two to three times a week followed by bedside hands-on training (HOT) of bag and mask skills and problem solving while reinforcing the mantra of ‘air, air, air’ as the first-line intervention during a real-life emergency.

Results
Champion midwives (trainers) guided instructions given during a real emergency at the bedside caused learners beliefs to change. Trainees observed changes in baby skin colour and the onset of spontaneous breathing after effective ventilation.

Conclusions
Visible success during an actual real-life emergency created confidence, mastery and collective self-efficacy.
Diagnosis and treatment of polycystic ovary syndrome in adolescents
Authors: Conlon J. Leocadia , Malcolm Sharyn , Monaghan Maureen 
Published: September 2021

ABSTRACT
Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction and hyperandrogenism, is one of the most common endocrine disorders in women of reproductive age. Early diagnosis can help clinicians address associated long-term metabolic and reproductive health complications and mitigate the negative effects of PCOS on a patient's mental health and quality of life. Clinicians often are challenged by the diagnosis and management of PCOS because of controversies around diagnostic criteria, especially for adolescents. The International Consortium of Paediatric Endocrinology 2017 Consensus Statement provides practical guidance for clinicians to implement best practices for the identification, diagnosis, and management of PCOS in adolescents.
Vestibular mapping assessment in idiopathic sudden sensorineural hearing loss
Authors: Seo Hee Won , Chung Jae Ho , Byun Hayoung , Lee Seung Hwan 
Published: September 2021

Objective:
The aim of this study was to investigate patterns of semicircular canal (SCC) and otolith organ dysfunction by vestibular mapping, and to determine the clinical implications of treatment outcomes in idiopathic sudden sensorineural hearing loss (ISSNHL).

Methods:
We retrospectively reviewed 135 consecutive patients diagnosed with ISSNHL from January 2016 to December 2020. Patients underwent video-head impulse tests (vHIT) for each SCC, cervical vestibular-evoked myogenic potential test for the saccules, ocular vestibular-evoked myogenic potential test for the utricles, and hearing tests. Hearing outcomes were evaluated according to the American Academy of Otolaryngology-Head and Neck Surgery criteria and factors associated with prognosis were assessed. We also conducted vestibular mapping assessments and hierarchical cluster analysis.

Results:
Overall, utricular impairment (76, 56.3%) was the most frequent diagnosis in the 135 ISSNHL patients, followed by saccular impairment (59, 43.7%) and posterior SCC impairment (30, 22.2%). The mean number of affected end organs was 1.37 ± 1.24, with higher numbers in the complete recovery group than in the partial/no recovery groups. In a multivariate analysis, higher initial hearing level and abnormal vHIT results in the posterior SCC were associated with poor prognosis in ISSNHL. In hierarchical cluster analysis, horizontal SCC and anterior SCC showed the highest similarity but were in different clusters than posterior SCC, and the saccule and utricle were in separate clusters from the three SCCs.

Conclusions:
The vestibular end organ showed various patterns of dysfunction in patients with ISSNHL. Of the five vestibular end organs, only abnormal posterior SCC was associated with poor prognosis for hearing recovery.
Comparative Effectiveness and Functional Outcome of C2 Dome-like Expansive Versus C2 Expansive Open-door Laminoplasty for Upper Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Yu Chengcheng , Wu Yinan , Zhang Zengjie , Zhang Ning , Yu Xinning , Li Fangcai , Chen Weishan , Chen Qixin , Li Wanli 
Published: September 2021

Study Design.
Retrospective Cohort Study.

Objectives.
This study compared the function and radiographical outcomes of the patients who underwent C2 dome-like expansive laminoplasty to those C2 expansive open-door laminoplasty for the treatment of OPLL with C2 involved.

Summary of Background Data.
There are few comparative studies of these two surgical methods. C2 dome-like and C2 expansive open-door laminoplasty are posterior approaches for posterior longitudinal ligament ossification with C2 level and above.

Methods.
This study performed a retrospective cohort analysis of 59 patients with OPLL up to C2 which cause compression symptoms. 31 patients underwent C2 dome-like expansive laminoplasty with C3-7 expansive open-door laminoplasty (Group Dom) and 28 underwent C2-7 expansive open-door laminoplasty (Group Exp). The preoperative and postoperative space available for cord (SAC) of C2 segment, cervical curvature index of C2-7, C2-7 range of motion, Japanese orthopedic association (JOA) score, visual analog scale (VAS) score, and neck disability index (NDI) were used to assess clinical out-comes and statistically analyzed.

Results.
The cervical curvature index, JOA score, and NDI significantly changed at the final follow-up in two groups with no significant intergroup differences. There were no significant differences in preoperative SAC and VAS between the two groups. At the final follow-up, the SAC of C2/3 in Group Exp was significantly larger than Group Dom, while the VAS and range of motion of Group Dom became significantly better than Group Exp.

Conclusion.
The C2 dome-like expansive laminoplasty can reduce postoperative neck pain more obviously and achieve better cervical curvature. C2 expansive open-door laminoplasty can get more adequate decompression in the spinal canal, which may be recommend to the patients with OPLL occupying more than 50% of the vertebral canal at C2/3, or with developmental spinal stenosis.

Level of Evidence.
3
Late Awakening Is Common in Settings Without Withdrawal of Life-Sustaining Therapy in Out-of-Hospital Cardiac Arrest Survivors Who Undergo Targeted Temperature Management*
Authors: Lee Dong Hun , Cho Yong Soo , Lee Byung Kook , Lee Hyoung Youn , Jeung Kyung Woon , Jung Yong Hun , Park Kyu Nam , Kim Youn-Jung , Chae Minjung Kathy , Seo Dong-Woo ,   on behalf of the Korean Hypothermia Network (KORHN) Investigators
Published: September 2021

OBJECTIVES:
We investigated awakening time and characteristics of awakening compared nonawakening and factors contributing to poor neurologic outcomes in out-of-hospital cardiac arrest survivors in no withdrawal of life-sustaining therapy settings.

DESIGN:
Retrospective analysis of the Korean Hypothermia Network Pro registry.

SETTING:
Multicenter ICU.

PATIENTS:
Adult (≥ 18 yr) comatose out-of-hospital cardiac arrest survivors who underwent targeted temperature management at 33–36°C between October 2015 and December 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We measured the time from the end of rewarming to awakening, defined as a total Glasgow Coma Scale score greater than or equal to 9 or Glasgow Coma Scale motor score equals to 6. The primary outcome was awakening time. The secondary outcome was 6-month neurologic outcomes (poor outcome: Cerebral Performance Category 3–5). Among 1,145 out-of-hospital cardiac arrest survivors, 477 patients (41.7%) regained consciousness 30 hours (6–71 hr) later, and 116 patients (24.3%) awakened late (72 hr after the end of rewarming). Young age, witnessed arrest, shockable rhythm, cardiac etiology, shorter time to return of spontaneous circulation, lower serum lactate level, absence of seizures, and multisedative requirement were associated with awakening. Of the 477 who woke up, 74 (15.5%) had poor neurologic outcomes. Older age, liver cirrhosis, nonshockable rhythm, noncardiac etiology, a higher Sequential Organ Failure Assessment score, and higher serum lactate levels were associated with poor neurologic outcomes. Late awakeners were more common in the poor than in the good neurologic outcome group (38/74 [51.4%] vs 78/403 [19.4%]; p < 0.001). The awakening time (odds ratio, 1.005; 95% CIs, 1.003–1.008) and late awakening (odds ratio, 3.194; 95% CIs, 1.776–5.746) were independently associated with poor neurologic outcomes.

CONCLUSIONS:
Late awakening after out-of-hospital cardiac arrest was common in no withdrawal of life-sustaining therapy settings and the probability of awakening decreased over time.
CircRNA MFACR Is Upregulated in Myocardial Infarction and Downregulates miR-125b to Promote Cardiomyocyte Apoptosis Induced by Hypoxia
Authors: Wang Shujuan , Li Long , Deng Weijie , Jiang Minhua 
Published: September 2021

Abstract:
Circular RNA (circRNA) MFACR promotes cardiomyocyte death that leads to myocardial infarction (MI). This study aimed to explore the role of MFACR in MI. T-qPCRs were performed to measure the expression levels of MFACR and miR-125b in plasma samples from both MI patients (n = 61) and healthy controls (n = 61). MFACR or miR-125b was overexpressed in AC16 cells (cardiomyocytes) to explore the interaction between them. Methylation of miR-125b gene in cells with the overexpression of MFACR was detected by methylation-specific PCR. Cell apoptosis after transfections was detected by cell apoptosis assay. MI model was constructed to further demonstrate the effect of MFACR in vivo. We found that MFACR was upregulated in MI and inversely correlated with miR-125b. In AC16 cells, hypoxia treatment increased the expression levels of MFACR and decreased the expression levels of miR-125b. In AC16 cells, overexpression of MFACR decreased the expression levels of miR-125b and increased the methylation of miR-125b gene. Under hypoxia treatment, overexpression of MFACR increased AC16 cell apoptosis, and overexpression of miR-125b decreased cell apoptosis. In addition, overexpression of miR-125b reversed the effects of overexpression of MFACR on cell apoptosis both in vivo and in vitro.
Combined Usage of Trimetazidine With 3-Bromopyruvate May Lead to Cardiotoxicity by Activating Oxidative Stress and Apoptosis in Rats
Authors: Zheng Min , Zhan Chengchuang , Bai Nan , Bai Juncai , Nie Chaoqun , Chi Jing , Ding Xue , Liu Jiaren , Yang Wei 
Published: September 2021

Abstract:
The energy used by the heart is generated mainly by the metabolism of fatty acids and glucose. Trimetazidine (TMZ) inhibits fatty acid metabolism and is used for the treatment of heart diseases such as heart failure. 3-Bromopyruvate (3-BrPA) can suppress glucose metabolism, and it is considered a promising candidate agent for tumor therapy. Because TMZ and 3-BrPA can separately inhibit the 2 main cardiac energy sources, it is necessary to investigate the effects of 3-BrPA combined with TMZ on the heart. Forty male Wistar rats were randomly divided into 4 groups: a control group, a TMZ group, a 3-BrPA group, and a 3-BrPA + TMZ group. Weight was recorded every day, and echocardiography was performed 14 days later. Heart function, the levels of adenosine triphosphate, oxidative stress-related factors (ROS, glutathione, oxidized glutathione, malondialdehyde, superoxide dismutase and total antioxidant capacity), and apoptosis in heart tissues were assessed to evaluate the effects of 3-BrPA and TMZ on the heart. In our study, no obvious changes occurred in the 3-BrPA group or the TMZ group compared with the control group. The combination of 3-BrPA and TMZ worsened heart function, decreased adenosine triphosphate levels, and increased oxidative stress and myocardial apoptosis. In conclusion, 3-BrPA and TMZ are not recommended for concurrent use.
Can 3D artificial intelligence models outshine 2D ones in the detection of intracranial metastatic tumors on magnetic resonance images?
Authors: Sun Ying-Chou , Hsieh Ang-Ting , Fang Ssu-Ting , Wu Hsiu-Mei , Kao Liang-Wei , Chung Wen-Yuh , Chen Hung-Hsun , Liou Kang-Du , Lin Yu-Shiou , Guo Wan-Yuo , Lu Henry Horng-Shing 
Published: September 2021

Background:
This study aimed to compare the prediction performance of two-dimensional (2D) and three-dimensional (3D) semantic segmentation models for intracranial metastatic tumors with a volume ≥ 0.3 mL.

Methods:
We used postcontrast T1 whole-brain magnetic resonance (MR), which was collected from Taipei Veterans General Hospital (TVGH). Also, the study was approved by the institutional review board (IRB) of TVGH. The 2D image segmentation model does not fully use the spatial information between neighboring slices, whereas the 3D segmentation model does. We treated the U-Net as the basic model for 2D and 3D architectures.

Results:
For the prediction of intracranial metastatic tumors, the area under the curve (AUC) of the 3D model was 87.6% and that of the 2D model was 81.5%.

Conclusion:
Building a semantic segmentation model based on 3D deep convolutional neural networks might be crucial to achieve a high detection rate in clinical applications for intracranial metastatic tumors.
Latinx Sexual Minority Men's Access to HIV and Behavioral Health Services in South Florida During COVID-19: A Qualitative Study of Barriers, Facilitators, and Innovations
Authors: Harkness Audrey , Weinstein Elliott R. , Atuluru Pranusha , Mayo Daniel , Vidal Ronald , Rodríguez-Díaz Carlos E. , Safren Steven A. 
Published: September 2021

Abstract
Despite the availability of HIV prevention and treatment tools, HIV disparities continue to affect Latinx sexual minority men (LSMM). Behavioral health concerns further exacerbate HIV disparities among LSMM. This study used rapid qualitative analysis to understand factors influencing LSMM's access to HIV and behavioral health services during coronavirus disease 2019 (COVID-19). Participants included LSMM with (n = 10) and without HIV (n = 10). The analysis identified 15 themes. Themes revealed that LSMM's access was disrupted by new and worsening barriers resulting from COVID-19, such as anxiety about COVID-19 exposure, confusion and disruptions to services, and new structural challenges. Other themes highlight positive changes, such as telehealth and relaxed clinic protocols, which enhanced LSMM's access to services during COVID-19. The findings suggest the need for HIV and behavioral health clinics to innovate and ensure LSMM's continued access to services during and beyond COVID-19.
Is Ignorance Bliss? Examining the Effect of News Media Exposure on Anxiety and Depression During the COVID-19 Pandemic
Authors: Hoyt Danielle L. , Hiserodt Michele , Gold Alexandra K. , Milligan Megan A. , Otto Michael W. 
Published: September 2021

Abstract
There has been a widespread increase in affective disorders after the emergence of the COVID-19 pandemic. In the current study, we investigated the effects of exposure to and perceived accuracy of news media and demographic characteristics on anxiety and depressive symptoms. We conducted an online survey of US adults (N = 480) using hierarchical linear regression models to understand the predictive roles of duration and frequency of news media exposure, as well as the perceived accuracy of COVID-19 portrayal by the news media, on anxiety and depression. Increased exposure duration predicted greater anxiety, and decreased frequency of exposure and perceived overreaction in the news media coverage of COVID-19 were linked to greater anxiety and depression. Perceived accuracy moderated the relationship of exposure frequency to both affective outcomes. Accordingly, our data support the importance of adequate levels of accurate and trusted information to help mitigate the overall mental health burden of the pandemic.
Expanded use of tranexamic acid is safe and decreases transfusion rates in patients with geriatric hip fractures
Authors: Kahan Joseph B. , Morris Jensa , Li Don , Moran Jay , O’Connor Mary I. 
Published: September 2021

Abstract

Objectives:
To determine the effect of a standardized tranexamic acid (TXA) protocol on red blood cell transfusions and adverse events in fragility hip fracture patients.

Design:
Retrospective cohort study.

Setting:
Academic Tertiary Care Center.

Patients/Participants:
Series of 209 patients with fragility hip fractures treated operatively from April 1, 2019 to September 30, 2019.

Intervention:
Eligible patients received 4 intravenous doses of TXA. Some patients missed doses and only received between 1 and 3 doses of TXA: Ineligible patients received no TXA. Patients with medical conditions precluding the use of TXA were deemed ineligible: allergy to TXA; creatinine clearance <30 mL/min; active malignancy; vascular event in the past year; anticoagulant use; fracture > 48 hours prior to presentation.

Main Outcome Measures:
Red blood cell transfusion; major adverse vascular events; minor drug related adverse events.

Results:
Patients who received all 4 doses of TXA (n = 70) had a significantly lower transfusion rate compared to those who did not receive any TXA (7.1% vs 28.1%, P = .003). There were no significant differences in the number of major or minor adverse events between the 2 groups.

Conclusions:
The use of a standardized TXA protocol of 4 doses significantly decreases transfusion rates in eligible patients undergoing operative intervention for fragility hip fracture without an increase in major or minor adverse events. These findings are even more pronounced in patients with decreased preoperative hemoglobin.

Level of Evidence: Prognostic Level III