bluuebunny/crossref_metadata_2025_split huggingface dataset:
Celsior® crystalloid cardioplegia versus standard hyperkalemic normothermic blood cardioplegia: Analysis of myocardial protection in elective mitral valve repair
Authors: Pontailler Margaux , David Charles-Henri , Lacoste Philippe , Guimbretière Guillaume , Marie Basile , Perigaud Christian , Mugniot Antoine , Fellah Imen , Roussel Jean-Christian , Senage Thomas 
Published: February 2021

Introduction: With the increase and refinement of video assisted mitral valve surgery, cristalloïd cardioplegia started regaining popularity. The aim of our study was to evaluate the effectiveness of Celsior®, a crystalloid cardioplegic solution, on myocardial protection in elective surgical mitral valve repair in comparison to blood based hyperkalemic cardioplegia. Methods: In this observational retrospective study, all consecutive elective isolated surgical mitral valve repair where Celsior® or normothermic hyperkalemic blood cardioplegia were used were included. Primary endpoint was any sign of myocardial protection failure (troponin levels, need for inotropic or mechanical support, rhythm disturbances, mortality). Secondary endpoint was Celsior® safety (allergic reactions, bleeding, organ toxicities). Results: From January 2009 to August 2016, 382 patients underwent elective isolated mitral valve repair in whom normothermic hyperkalemic blood cardioplegia ( n = 181) or Celsior® ( n = 201) were used. There were no statistically significant differences in baseline characteristics including Euroscore 2. Peak troponin (pg/ml) release and 30-days mortality were not statistically different. Need for cardioversion was significantly more frequent in the Celsior® group (47% vs 13%, p < 0.001). There was no statistical difference in post-operative atrial fibrillation, permanent pacemaker implantation, reoperation for bleeding, transfusion, acute kidney injury, haemoglobin at discharge or length of stay. No allergic reaction to Celsior® occurred. Conclusion: Effective myocardial protection was achieved with the Celsior® cardioplegic solution with no unexpected toxicity. Celsior® may be an efficacious and safe cardioprotective strategy in mitral valve repair.
1,25-(OH)2D3 ameliorates renal interstitial fibrosis in UUO rats through the AMPKα/mTOR pathway
Authors: Tian Shasha , Yang Xiaopeng , Wang Jianwu , Luo Jing , Guo Hui 
Published: February 2021

Objective To investigate the effects of 1,25(OH)2D3 on renal fibrosis associated with the AMP-activated protein kinase (AMPK)α/mechanistic target of rapamycin (mTOR) signalling pathway in a rat model of unilateral ureteral obstruction (UUO). Methods A total of 54 male Sprague Dawley rats were randomly divided into three groups: sham-operation group, UUO group, and UUO plus calcitriol (3 ng/100 g) group. Renal tissue was excised for histological examination by immunohistochemistry and Western blot, and for gene expression analysis using real-time polymerase chain reaction. Results 1,25(OH)2D3 enhanced AMPKα levels, inhibited mTOR levels and slowed the development of interstitial fibrosis in kidney tissue. Compared with the UUO plus calcitriol group, UUO rats demonstrated more severe renal damage characterized by marked tubular atrophy, interstitial fibrosis and significant induction of fibrogenic transforming growth factor-β1 and increased extra-cellular matrix proteins (α-smooth muscle actin and collagen type III), and decreased E-cadherin. Conclusion Treatment with 1,25(OH)2D3 altered the AMPKα/mTOR signalling pathway to suppress excessive fibroblast activation observed in UUO rats. This may serve as a novel mechanism to ameliorate renal dysfunction and fibrotic lesions.
A population-based study of the three major variants of papillary thyroid carcinoma
Authors: Xu Junming , Zhang Yingying , Liu Jun , Qiu Shenglong , Wang Min 
Published: February 2021

Objective To explore the clinicopathological features and relative prognostic risks of the three major variants of papillary thyroid carcinoma (PTC). Methods We retrospectively analyzed the clinicopathological characteristics and prognoses of patients with the three major PTC variants, conventional papillary thyroid carcinoma (CPTC), follicular-variant papillary carcinoma (FVPTC), and tall-cell papillary thyroid carcinoma (TCPTC), based on data from the Surveillance, Epidemiology, and End Results database from 2005 to 2009. Results A total of 29,555 patients were enrolled. In terms of their demographic and clinicopathological characteristics, TCPTC had the highest prevalence of older patients, men, patients with locally advanced stage (T stage and N stage), and mortality, while FVPTC had the lowest prevalence in relation to these factors. The three variants differed significantly in terms of 5-year overall survival and 5-year disease-specific survival. Cox regression analysis identified male sex, age ≥45 years, and higher American Joint Committee on Cancer and TNM stage as independent factors predicting a poor prognosis in relation to both overall and disease-specific survival. Conclusions CPTC, FVPTC, and TCPTC have different clinicopathological characteristics and prognoses, indicating the need for different treatment strategies for these three variants of PTC.
Combination of antibiotics, gastric lavage and nasojejunal feeding—an effective alternative for the management of acute phlegmonous gastritis: a case report
Authors: Wang Jiwei , Zhang Tao , Zhou Xin , Huang Handong , Wang Maijian , Xie Ming 
Published: February 2021

Background Phlegmonous gastritis is a rare bacterial infection of the gastric wall, characterised by purulent inflammation of the gastric mucosa, submucosa and muscularis layers. Phlegmonous gastritis has a high mortality rate, even with correct diagnosis and antimicrobial therapy. Case presentation A 22-year-old man presented for acute epigastric pain associated with aqueous diarrhoea, vomiting and sustained fever. Abdominal computed tomography showed diffuse oedema and thickened gastric wall, increased number and size of abdominal lymph nodes and the absence of pneumoperitoneum. Fibregastroscopy revealed oedematous, ridged and thickened gastric mucosa with abundant purulent secretion, especially in the antrum, consistent with phlegmonous gastritis, which was confirmed by histological evaluation of gastric biopsies. Cultures of the tissue biopsies and purulent secretion were positive for Enterococcus cecorum. He was treated with sensitive antibiotics according to the antibiogram, and importantly, with continuous gastric lavage and individualised nutritional support therapy. He eventually recovered well and was discharged with no abdominal symptoms. Conclusions Our case indicates that early diagnosis and immediate treatment are crucial to achieve positive outcomes. The combination of sensitive antibiotics, gastric lavage and early enteral nutrition via nasojejunal feeding might be an effective alternative for the comprehensive treatment of acute phlegmonous gastritis.
College Students’ Reasons for Using JUULs
Authors: Newcombe Kyra V. , Dobbs Page D. , Oehlers Julia S. , Dunlap Chris M. , Cheney Marshall K. 
Published: February 2021

Purpose: To identify reasons that college students use JUUL and explore associations between reasons for using JUUL and social and behavioral (tobacco use) factors. Design: On-line, cross-sectional survey. Setting: Large southwestern university in the US. Subjects: Undergraduate students (n = 605) who owned JUUL and used it weekly. Measures: The study measured age of JUUL initiation, JUUL dependence, and use of other e-cigarettes and other tobacco products. Participants described reasons for JUUL use as brief open-ended responses. Analysis: Responses were categorized by 2 researchers using an inductive procedure. Logistic regressions examined associations between demographics and use frequency and categorized reasons for using JUUL. Results: Four reasons for using JUUL emerged: self-help (48.4%), social (30.4%), experience (42.8%), and substance use/addiction (42.3%). Daily JUUL users were 1.66 (95% CI: 1.05-2.63) times as likely to use JUUL for self-help than those who used JUUL 1-3 days/week. Those who had never tried a cigarette were twice (OR = 2.08; 95% CI: 1.22-3.54) as likely as cigarette-first users to use JUUL for social reasons. Males (OR = 1.87; 95% CI: 1.32-2.65) had higher odds of using JUUL for the experience than females, and JUUL and other e-cigarettes users were 4.37 (95% CI: 1.83-10.45) times as likely as JUUL-only users to use JUUL due to substance use/addiction. Conclusion: JUUL users report unique reasons for use (e.g., addiction) not previously reported for older models of e-cigarette devices.
Identifying ethical and legal issues in elder care
Authors: Podgorica Nertila , Pjetri Emiljano , Müller Andreas W , Deufert Daniela 
Published: February 2021

Background: As a non–European Union member state, Albania is increasingly orienting itself on Western models regarding human rights, patient rights, and legal regulations for healthcare. Due to its limited fiscal and legal power, enforcing legal and ethical regulations poses a major problem. Aim: The aim of this study is to investigate nurse’s knowledge and experiences regarding ethical and legal issues in Albanian elder care in state-funded and privately run institutions. Research design: The study was conducted using an inductive and qualitative design, utilizing a focused ethnographic approach, based on Roper and Shapira’s framework. Method: Data were collected between June 2017 and September 2018 using participant observation, field notes, and semi-structured interviews with 15 nurses in seven different elder care institutions. In total, 100 h of observation and 15 interviews were performed. Data analysis was based on Mayring’s qualitative content analysis. Ethical consideration: The approval for the study was obtained from UMIT—The Health and Life Sciences University, Austria. Findings: The findings of the study fell into the following main categories: “Everyday care issues,” “End-of-life issues,” “Legal issues,” and “Ethical-legal education and conflicts.” Discussion: The participants reported many ethical and legal issues when describing their everyday challenges and displayed a strong lack of ethical and legal education. Despite a wide spectrum in the quality of care between private and state-funded nursing homes, older people mostly do not know their own diagnosis. Conclusion: This study indicates that further ethical and legal education is needed. Furthermore, nurses need to be better prepared for ethical conflicts with families, as strengthening patient rights could come into conflict with traditional rights of the Albanian family.
Subannular Tubes in Children With Cleft Palate
Authors: Martins Sónia Pires , Alexandre Pedro Lopes , Santos Margarida , Moura Carla Pinto 
Published: February 2021

Objective: To investigate subannular tube (SAT) placement as an alternative treatment of chronic middle ear disease in children with cleft palate. Design: Retrospective cohort study. Participants: All children with cleft palate with intractable otitis media with effusion and/or with tympanic membrane retraction, operated for insertion of 1 or more sets of transtympanic tubes followed by SAT in a tertiary center. Main Outcome Measures: Audiological outcomes, average duration of tubes, and postoperative complications were analyzed. Results: This study included 21 children with cleft palate, aged 3 to 14 years. A total of 38 ears was evaluated. The median time of follow-up was 42 months. During follow-up, 69.2% of the patients had no complications. Observed complications were otorrhea (13.5%) and tube obstruction (7.7%). In 7.9% of the cases, otitis media with effusion relapsed after tube extrusion. By the end of the study, 76.3% of the tubes remained in situ and 68.4% of the tympanic membranes had the SAT in place and had no significant alterations. The mean duration of SATs was 16 months, which was significantly superior to transtympanic tube duration. A significant sustained improvement in the hearing of children with SATs was observed. Conclusion: Subannular tube insertion results in hearing improvement to normal range and tympanic retraction pockets reversion in children with cleft palate with persistent otitis media with effusion and tympanic retraction/atelectasis. This surgery appears to be safe and provides long-term efficient middle ear aeration. Strict postoperative follow-up is crucial for the success of the treatment.
Co-Occurrence of Symptoms and Gut Microbiota Composition Before Neoadjuvant Chemotherapy and Radiation Therapy for Rectal Cancer: A Proof of Concept
Authors: González-Mercado Velda J. , Lim Jean , Yu Gary , Penedo Frank , Pedro Elsa , Bernabe Raul , Tirado-Gómez Maribel , Aouizerat Bradley 
Published: February 2021

Purpose: To examine a) whether there are significant differences in gut microbial diversity and in the abundance of gut microbial taxa; and b) differences in predicted functional pathways of the gut microbiome between those participants with high co-occurring symptoms and those with low co-occurring symptoms, prior to neoadjuvant chemotherapy and radiation therapy (CRT) for rectal cancer. Methods: Rectal cancer patients (n = 41) provided stool samples for 16 S rRNA gene sequencing and symptom ratings for fatigue, sleep disturbance, and depressive symptoms prior to CRT. Descriptive statistics were computed for symptoms. Gut microbiome data were analyzed using QIIME2, LEfSe, and the R statistical package. Results: Participants with high co-occurring symptoms (n = 19) had significantly higher bacterial abundances of Ezakiella, Clostridium sensu stricto, Porphyromonas, Barnesiella, Coriobacteriales Incertae Sedis, Synergistiaceae, Echerichia-Shigella, and Turicibacter compared to those with low co-occurring symptoms before CRT (n = 22). Biosynthesis pathways for lipopolysaccharide, L-tryptophan, and colanic acid building blocks were enriched in participants with high co-occurring symptoms. Participants with low co-occurring symptoms showed enriched abundances of Enterococcus and Lachnospiraceae, as well as pathways for β-D-glucoronosides, hexuronide/hexuronate, and nicotinate degradation, methanogenesis, and L-lysine biosynthesis. Conclusion: A number of bacterial taxa and predicted functional pathways were differentially abundant in patients with high co-occurring symptoms compared to those with low co-occurring symptoms before CRT for rectal cancer. Detailed examination of bacterial taxa and pathways mediating co-occurring symptoms is warranted.
Superficial Granulomatous Pyoderma Gangrenosum Involving the Face: A Case Series of Five Patients and a Review of the Literature
Authors: Shavit Eran , Cecchini Michael , Limacher James J. , Walsh Scott , Wentworth Ashely , Davis Mark Denis P. , Alavi Afsaneh 
Published: February 2021

Background Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful and ulcerating lesions on the skin. It rarely involves the face and is often difficult to diagnose. There are few cases reported in the literature of PG involving the face. Aim To share our experience with 5 patients in whom the final diagnosis was PG involving the face, and to review the literature. Methods We report a series of 5 patients with a final diagnosis of PG involving the face and reviewed relevant literature. We searched through PubMed and EMBASE using keywords such as “face” and “pyoderma gangrenosum,” “blastomycosis-like pyoderma gangrenosum, vegetative pyoderma gangrenosum and granulomatous pyoderma gangrenosum.” Results We report 5 patients (4 females) with pyoderma gangrenosum involving the face. All 5 had a final diagnosis of superficial granulomatous PG. All cases presented with nonhealing facial ulcer most commonly on cheeks and a common histopathology of mixed inflammatory infiltrates, multinucleated giant cells, and plasma cells with some granulomatous inflammation. Conclusions PG can involve the face, and all 5 of our patients had the superficial granulomatous as the most common form.
Comparing patient-reported outcomes across countries: An assessment of methodological challenges
Authors: Sutherland Jason M , Rajapakshe Shanika , Crump Trafford , Chartrand Andrée , Liu Guiping , Karimuddin Ahmer 
Published: February 2021

Objectives There is little published literature on the comparison of patient-reported outcomes between countries. This study aimed to assess pre- and postoperative health among samples of patients undergoing elective groin hernia repair procedures in the National Health Service (NHS), England, and groin hernia patients in Vancouver, Canada. Methods We used datasets from two different sources. For the English NHS we used published anonymized patient-level data files which include the EQ-5D(3L) patient-reported outcome measure and a number of demographic and clinical characteristics. For Vancouver, we used data from a sample of Vancouver patients who completed the same instrument during a similar time frame. English patients were matched with Vancouver participant’s characteristics using propensity score methods. A linear regression model was used to measure differences in postoperative visual analogue scale values between countries, adjusting for patient characteristics. Results Our study revealed a range of methodological issues concerning the comparability of patient-reported outcomes following hernia repair surgery in the two health systems. These related to differences in approaches to collecting patient-reported outcome measures and the nature of explanatory variables (self-report vs. administrative data), among other challenges. As a consequence, there were differences between the matched samples and the NHS data, indicating a healthy participant bias. Unadjusted results found that Vancouver patients (N = 280) reported more problems in domains of mobility, self care, usual activities and anxiety/depression than the matched cohort of NHS patients (N = 840). Interpreting differences is challenging given different sampling designs. Conclusions There are significant hurdles facing comparisons of surgical patients’ outcomes between countries, including adjusting for patient differences, health system factors and approaches to survey administration. While between-country comparisons of surgical outcomes using patient-reported outcomes shows significant promise, much work on standardizing sampling design, variables and analytic methods is needed.
Effects of deviations in the nose and chin prominence on facial attractiveness
Authors: Rezaei Navid , Abbasi Hoshyar , Khaksar Ali , Golshah Amin 
Published: February 2021

Objective: To assess the effects of deviations in the nose and chin prominence on facial attractiveness. Methods: In this study, a reference digital photograph was taken from the facial profile view of an adult female model. Some changes were made in the nose and chin prominence in Photoshop software using the Crumley’s analysis. Changes made in the nose prominence yielded a prominent nose (2:11 ratio), a normal nose (3:53 ratio) and a small nose (4:61 ratio). Changes made in the chin prominence were protrusion by +2 and 0 mm and retrusion by −2, −4 and −6 mm (distance from the pogonion to the vertical reference line). In total, 18 orthodontists, 18 oral and maxillofacial surgeons, 18 art students and 18 laypeople evaluated the photographs (n = 15) and expressed their opinion regarding the facial profile attractiveness using a visual analogue scale (0−100). Data were analysed using SPSS version 18. Results: A significant difference was noted in the ratings of photographs (Greenhouse-Geisser, P < 0.001). Orthodontists gave a significantly higher score than laypeople to photographs with a small nose and deviations of the chin prominence ( P = 0.015). Art students gave a significantly higher score than laypeople to photographs with a prominent chin and deviations in the nose prominence ( P = 0.012). Conclusions: Facial profile with a normal (3:53 ratio) or small (4:61 ratio) nose and chin protrusion/retrusion by 2 mm (pogonion-vertical line) is considered attractive.
Adherence to RCS recommendations for extraction of first permanent molars in a teaching hospital: To compensate or not to compensate?
Authors: Lee Jed , Johnson Joanna , Bister Dirk , Chaudhary Mohsin , Khoshkhounejad Golfam 
Published: February 2021

Objective: To observe whether paediatric dentists and orthodontists balance and compensate the extraction of first permanent molars (FPMs) in children aged 7–11 years. Design: Service evaluation. Setting: UK dental teaching hospital. Methods: Retrospective analysis of FPM extraction patterns in patients aged 7–11 years that attended for extraction of FPMs from 1 January 2019 to 31 January 2020 (13-month period). Results: A total of 194 patients were included and they collectively had 435 FPMs extracted. No balancing extractions to prevent dental centreline shifts and no lower FPM compensatory extractions were performed. Compensatory extraction of good prognosis upper FPMs were performed in 64% (94/146) of cases to avoid overeruption. Orthodontic input was sought for poor prognosis lower FPMs in 76% of cases compared to 51% for poor prognosis upper FPMs. Conclusion: Compensatory extraction of good prognosis upper FPMs to avoid overeruption appears to be a common practice at Guy’s and St Thomas’ Hospitals. There was also higher demand for orthodontic advice for cases presenting with poor prognosis lower FPMs compared to poor prognosis upper FPMs, which suggests that paediatric dentists may prefer for the final decision on upper FPM compensatory extractions to be made by an orthodontist, even with national guidelines available. More high-quality research on the topic is required to determine the necessity of this practice for achieving optimal long-term oral health in children.
DNA aptamer raised against receptor for advanced glycation end products suppresses renal tubular damage and improves insulin resistance in diabetic mice
Authors: Sotokawauchi Ami , Matsui Takanori , Higashimoto Yuichiro , Nishino Yuri , Koga Yoshinori , Yagi Minoru , Yamagishi Sho-ichi 
Published: February 2021

Objective: Interaction of advanced glycation end products (AGEs) with the receptor RAGE plays a role in diabetic nephropathy. However, effects of RAGE-aptamer on tubular damage remain unknown. We examined whether RAGE-aptamer inhibited tubular damage in KKAy/Ta mice, obese type 2 diabetic mice with insulin resistance. Materials and Methods: Male 8-week-old KKAy/Ta mice received continuous intraperitoneal infusion of either control-aptamer or RAGE-aptamer for 8 weeks. Blood biochemistry and blood pressure, and urinary N-acetyl-β-D-glucosaminidase (NAG) activity and albumin excretion levels were monitored. Kidney and adipose tissue samples were obtained for immunohistochemical analyses. Results: Although RAGE-aptamer did not affect blood glucose, blood pressure, body weight, or serum creatinine values, it significantly inhibited the increase in urinary NAG activity and HOMA-IR in diabetic mice at 12 and 16 and at 16 weeks old, respectively. Furthermore, compared with control-aptamer-treated mice, renal carboxymethyllysine, RAGE, and NADPH oxidase-driven superoxide generation were significantly decreased in RAGE-aptamer-treated mice at 12 weeks old with subsequent amelioration of histological alterations in glomerular and interstitial area, while adipose tissue adiponectin expression was increased. Conclusion: Our present results suggest that RAGE-aptamer could inhibit tubular injury in obese type 2 diabetic mice partly by suppressing the AGE-RAGE-oxidative stress axis and improving insulin resistance.