bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic obstructive pulmonary disease and advance care planning: A synthesis of qualitative literature on patients’ experiences
Authors: Ora Linda , Mannix Judy , Morgan Lucy , Gregory Linda , Luck Lauretta , Wilkes Lesley 
Published: February 2021

Objective Advance Care Planning supports patients to share their personal values, goals, and preferences for future medical care with their family members and healthcare professionals. The aim of this review was to uncover what is known about patients with Chronic Obstructive Pulmonary Disease and their experiences with Advance Care Planning. Methods A systematic review and thematic synthesis of qualitative studies was undertaken. Five databases were searched for qualitative articles published between 2009–2019. The review was guided by the PRISMA framework and seven studies met the eligibility criteria. Thematic synthesis of descriptive themes in each article was undertaken to develop overarching analytical themes, related to the experience of patients with Chronic Obstructive Pulmonary Disease and Advance Care Planning. Results Four analytical themes emerged from the review of the articles that met the inclusion criteria: patient readiness and willingness for Advance Care Planning discussions; considering the future; trusted relationships with healthcare professionals; and shared decision making. Discussion Patients with Chronic Obstructive Pulmonary Disease are generally open to Advance Care Planning discussions with healthcare professionals who are well-informed, and trusted by the patient. Models of care that integrate Advance Care Planning are beneficial in other non-malignant settings, and may be a way forward to support Advance Care Planning as part of routine care for patients with Chronic Obstructive Pulmonary Disease.
Intravenous thrombolysis in stroke with admission NIHSS score 0 or 1
Authors: Sykora Marek , Krebs Stefan , Simader Florentina , Gattringer Thomas , Greisenegger Stefan , Ferrari Julia , Bernegger Alexandra , Posekany Alexandra , Lang Wilfried ,   on behalf of the Austrian Stroke Unit Registry Collaborators
Published: February 2021

Background Up to 30% of stroke patients initially presenting with non-disabling or mild deficits may experience poor functional outcome. Despite, intravenous thrombolysis remains controversial in this subgroup of stroke patients due to its uncertain risk benefit ratio. Aim We aimed to analyze the real-world experience with intravenous thrombolysis in stroke patients presenting with very low NIHSS. Methods Data of stroke patients presenting with mild initial stroke severity (NIHSS 0–5) including vascular risk factors, stroke syndrome and etiology, early neurological deterioration, symptomatic intracerebral haemorrhage (sICH), and functional outcome by modified Rankin Scale were extracted from a large nationwide stroke registry and analysed. Patients were categorized and compared according to admission severity NIHSS 0–1 versus NIHSS 2–5 and intravenous thrombolysis use. Results Seven hundred and three (2%) of 35,113 patients presenting with NIHSS 0–1 and 6316 (13.9%) of 45,521 of patients presenting with NIHSS 2–5 underwent intravenous thrombolysis. In the NIHSS 0–1 group, intravenous thrombolysis was associated with early neurological deterioration (adjusted OR 8.84, CI 6.61–11.83), sICH (adjusted OR 9.32, CI 4.53–19.15) and lower rate of excellent outcome (mRS 0–1) at three months (adjusted OR 0.67, CI 0.5–0.9). In stroke patients with NIHSS 2–5, intravenous thrombolysis was associated with early neurological deterioration (adjusted OR 1.7, 1.47–1.98), sICH (adjusted OR 5.75, CI 4.45–7.45), and higher rate of excellent outcome (mRS 0–1) at three months (adjusted OR 1.21, CI 1.08–1.34). Conclusions Among patients with NIHSS 0–1, intravenous thrombolysis did not increase the likelihood of excellent outcome. Moreover, potential signals of harm were observed. Further research seems to be warranted.
Home-based, tailored intervention for reducing falls after stroke (FAST): Protocol for a randomized trial
Authors: Dean Catherine , Clemson Lindy , Ada Louise , Scrivener Katherine , Lannin Natasha , Mikolaizak Stefanie , Day Sally , Cusick Anne , Gardner Benjamin , Heller Gillian , Isbel Stephen , Jones Taryn , Mumford Virginia , Preston Elisabeth 
Published: February 2021

Rationale People with stroke experience falls at more than twice the rate of the general older population resulting in high fall-related injuries. However, there are currently no effective interventions that prevent falls after stroke. Aims To determine the effect and cost-benefit of an innovative, home-based, tailored intervention to reduce falls after stroke. Sample size estimate A total of 370 participants will be recruited in order to be able to detect a clinically important between-group difference of a 30% lower rate of falls with 80% power at a two-tailed significance level of 0.05. Methods and design Falls after stroke trial (FAST) is a multistate, Phase III randomized trial with concealed allocation, blinded assessment, and intention-to-treat analysis. Ambulatory stroke survivors within five years of stroke who have been discharged from formal rehabilitation to the community and who have no significant language impairment will be randomly allocated to receive habit-forming exercise, home safety, and community mobility training or usual care. Study outcomes The primary outcome is the rate of falls over the previous 12 months. Secondary outcomes are the risk of falling (proportion of fallers), community participation, self-efficacy, balance, mobility, physical activity, depression, and health-related quality of life. Health care utilization will be collected retrospectively at baseline and prospectively to 6 and 12 months. Discussion The results of FAST are anticipated to directly influence intervention for stroke survivors in the community. Trial Registration: ANZCTR 12619001114134
Telemedicine in clinical gastroenterology practice: what do patients prefer?
Authors: Lahat Adi , Shatz Zina 
Published: February 2021

Background: The Coronavirus Disease 2019 pandemic has forced major changes on healthcare systems. Maintaining regular patients’ surveillance became a major challenge. Telemedicine has been promoted as an economic and effective way for long distance patient care. Our aim was to study patients’ acceptance and perspectives on telemedicine. Methods: Patients scheduled for clinic appointments were offered telemedicine. Those who agreed were asked to fill in a questionnaire assessing their satisfaction with the medical consultation. Patients’ demographic characteristics and answers were collected and reviewed. Results: Out of 358 patients approached 71 agreed to use telemedicine. Of them, 59 completed the questionnaire and were included in the study. All patients’ basic demographic data were collected. Patients’ included in the study mean age was: 43 ± 16.3 years, 35 (59.3%) women. Patients who chose not to use telemedicine were significantly older, mean age: 61 ± 15.2 years ( p = 0.036), 134 (46.7%) women. Most patients included (38; 64.4%) had inflammatory bowel disease (IBD). Most patients who chose not to use telemedicine were non-IBD patients (206, 72%). Fifty-one patients (86.4%) assessed their experience as ‘good’ or ‘excellent’. Satisfied patients had significantly less time under medical follow-up (3.7 versus 6.1 years, p = 0.028) and tended to be younger ( p = non-significant). Women were statistically significantly more satisfied than men (33 versus 18, p = 0.05). Advantages reported were ‘time saving’ (31.3%), accessibility (26.1%), availability (25%). The main disadvantage was absence of physical examination (70%). Conclusions: Telemedicine gained a high satisfaction rate among patients under regular medical surveillance. Most patients stated this that method is convenient, time saving and increases their compliance. Patients who agreed to telecare were younger, and tended to be of female gender and experiencing IBD. Further studies are needed to characterize specific barriers to telecare usage.
The value of anti-CarP and anti-PAD4 as markers of rheumatoid arthritis in ACPA/RF negative rheumatoid arthritis patients
Authors: Kolarz Bogdan , Ciesla Marek , Rosenthal Ann K. , Dryglewska Magdalena , Majdan Maria 
Published: February 2021

Background: Anti-citrullinated protein antibodies (ACPAs) and rheumatoid factor (RF) are key factors in the American College of Rheumatology/European League Against Rheumatism rheumatoid arthritis (RA) classification criteria markers. However, about 30% of patients diagnosed with RA are seronegative, rationalizing the need for new serologic markers for RA. Antibodies against carbamylated proteins (anti-CarP) and against peptidyl-arginine deiminase type 4 (anti-PAD4) have been postulated to be useful RA markers. The purpose of this study is to evaluate the value of anti-CarP and anti-PAD4 in a well-characterized population of RA patients and healthy controls (HCs). Methods: A total of 122 RA patients and 30 HCs were enrolled in the study. Serum levels of ACPA, anti-PAD4, anti-CarP and RF were determined by enzyme-linked immunosorbent immunoassays (ELISAs). Synthetic carbamylated peptides were used in the ELISA assay to determine the protein targets of the anti-CarP antibodies. Results: Rates of ACPA, RF, anti-PAD4 and anti-CarP positivity were 85.2%, 67.2%, 55.7% and 46.7% in RA, and 0%, 0%, 6.7% and 6.7% in HC respectively. In the RA population, 25.4% of patients had all four types of antibodies positive, while 6.6% had no antibodies. There was a significant correlation between anti-PAD4 and ACPAs ( rs = 0.39), RF and ACPAs, ( rs = 0.3) and RF and anti-CarP, ( rs = 0.3). There was no correlation between ACPAs and anti-CarP. Anti-CarP positivity was noted in 49 (47.1%) and 45 (54.9%) of ACPAs and RF positive patients respectively. In addition, five anti-CarP+ patients did not have ACPA nor RF. Conclusion: Anti-CarP but not anti-PAD4 may be a useful biomarker in identifying ACPA/RF negative RA patients. This antibody may identify an additional RA population who may benefit from early implementation of aggressive therapy.
Vertical and Horizontal Hop Performance: Contributions of the Hip, Knee, and Ankle
Authors: Kotsifaki Argyro , Korakakis Vasileios , Graham-Smith Philip , Sideris Vasileios , Whiteley Rod 
Published: February 2021

Background: Single-leg vertical and horizontal hop tests are commonly used to assess performance of healthy athletes and as a measure of progress during rehabilitation from knee injury. It is unclear if they measure similar aspects of leg function, as the relative joint contributions of the hip, knee, and ankle joints during propulsion and landing are unknown. Hypothesis: The proportion of work done by the hip, knee, and ankle will not be the same for these 2 jump types and will vary for propulsive and landing phases. Study Design: Cross-sectional cohort study. Level of Evidence: Level 3. Methods: Twenty physically active participants completed instrumented single-leg hop analysis in both vertical and horizontal directions. Joint peak power, work generated or absorbed, and percentage contribution of each joint during propulsive and landing phases were compared between tasks using paired t tests. Results: Vertical hop was performed with roughly similar contributions of the hip, knee, and ankle for both propulsion (31%, 34%, 35%, respectively) and landing (29%, 34%, 37%, respectively). Horizontal hop distance was mostly (87%) determined by the hip and ankle (44% and 43%), but landing was mostly (65%) performed by the knee with lesser contribution from the hip and ankle (24% and 11%). Propulsive phase showed a proximal-to-distal temporal sequence for both hop types, but landing was more complex. Conclusion: Performance during vertical and horizontal hops (jump height and jump distance, respectively) measures different aspects of hip, knee, and ankle function during the propulsive and landing phases. Clinical Relevance: Assessment of knee joint function during rehabilitation should not be done using a horizontal hop. The knee contributes about a third to vertical hop height, but only about an eighth to horizontal hop distance. Practitioners carrying out performance testing using either vertical or horizontal hops should be mindful of the relative contributions for meaningful training inferences to be derived.
Return to Play After Symptomatic Lumbar Disc Herniation in Elite Athletes: A Systematic Review and Meta-analysis of Operative Versus Nonoperative Treatment
Authors: Sedrak Phelopater , Shahbaz Mustafa , Gohal Chetan , Madden Kim , Aleem Ilyas , Khan Moin 
Published: February 2021

Context: The prevalence of symptomatic lumbar disc herniation (LDH) in athletes can be as high as 75%. For elite athletes diagnosed with LDH, return to play (RTP) is a major concern, and thus comparing surgical with nonoperative care is essential to guide practitioners and athletes, not just in terms of recovery rates but also speed of recovery. Objective: The purpose of this systematic review is to provide an update on RTP outcomes for elite athletes after lumbar discectomy versus nonoperative treatment of LDHs. Data Sources: A search of the literature was conducted using 3 online databases (MEDLINE, EMBASE, and PubMed) to identify pertinent studies. Study Selection: Yielded studies were screened according to the inclusion criteria. Study Design: Systematic review with meta-analysis. Level of Evidence: Level 4. Data Extraction: Relevant data were extracted. A meta-analysis was performed comparing RTP rate for all comparative studies. Results: Twenty studies met the inclusion criteria and were included in this review. Overall, 663 out of 799 patients (83.0%) returned to play in the surgical group and 251 out of 308 patients (81.5%) returned to play in the nonoperative group. No statistically significant difference for RTP rate was found (odds ratio, 1.39; 95% CI, 0.58-3.34; P = 0.46; I2, 71%). The mean time to RTP for patients undergoing lumbar discectomy was 5.19 months (range 1.00-8.70 months), and 4.11 months (range 3.60-5.70 months) for those treated conservatively. Conclusion: There was no significant difference in RTP rate between athletes treated with operative or nonoperative management of LDHs, nor did operative management have a faster time to RTP. Athletes should consider the lack of difference in RTP rate in addition to the potential risks associated with spinal surgery when choosing a treatment option. Future randomized controlled trials are needed on this topic to allow for high-powered conclusions.
Association of Air Pollutant Exposure and Sinonasal Histopathology Findings in Chronic Rhinosinusitis
Authors: Patel Tirth R. , Tajudeen Bobby A. , Brown Hannah , Gattuso Paolo , LoSavio Phillip , Papagiannopoulos Peter , Batra Pete S. , Mahdavinia Mahboobeh 
Published: February 2021

Background Ambient air pollution is well known to cause inflammatory change in respiratory epithelium and is associated with exacerbations of inflammatory conditions such as asthma and chronic obstructive pulmonary disease. However, limited work has been done on the impact of air pollution on pathogenesis of chronic rhinosinusitis and there are no reports in the literature of how pollutant exposure may impact sinonasal histopathology in patients with chronic rhinosinusitis. Objective This study aims to identify associations between certain histopathologic characteristics seen in sinus tissue of patients with chronic rhinosinusitis (CRS) and levels of particulate air pollution (PM2.5) and ground-level ozone in their place of residence. Methods A structured histopathology report was created to characterize the tissues of CRS patients undergoing sinus surgery. An estimate for each patient’s exposure to air pollutants including small particulate matter (PM2.5) and ground-level ozone was obtained using the Environmental Protection Agency’s (EPA) Environmental Justice Screening and Mapping Tool (EJSCREEN). Mean pollutant exposures for patients whose tissues exhibited varying histopathologic features were compared using logistic regression models. Results Data from 291 CRS patients were analyzed. Higher degree of inflammation was significantly associated with increased ozone exposure (p = 0.031). Amongst the patients with CRSwNP (n=131), presence of eosinophilic aggregates (p = 0.018) and Charcot-Leyden crystals (p = 0.036) was associated with increased ozone exposure. Conclusion Exposure to ambient air pollutants may contribute to pathogenesis of CRS. Increasing ozone exposure was linked to both higher tissue inflammation and presence of eosinophilic aggregates and Charcot-Leyden crystals in CRSwNP patients.
Sirt5 Deficiency Causes Posttranslational Protein Malonylation and Dysregulated Cellular Metabolism in Chondrocytes Under Obesity Conditions
Authors: Zhu Shouan , Batushansky Albert , Jopkiewicz Anita , Makosa Dawid , Humphries Kenneth M. , Van Remmen Holly , Griffin Timothy M. 
Published: February 2021

Objective Obesity accelerates the development of osteoarthritis (OA) during aging and is associated with altered chondrocyte cellular metabolism. Protein lysine malonylation (MaK) is a posttranslational modification (PTM) that has been shown to play an important role during aging and obesity. The objective of this study was to investigate the role of sirtuin 5 (Sirt5) in regulating MaK and cellular metabolism in chondrocytes under obesity-related conditions. Methods MaK and SIRT5 were immunostained in knee articular cartilage of obese db/db mice and different aged C57BL6 mice with or without destabilization of the medial meniscus surgery to induce OA. Primary chondrocytes were isolated from 7-day-old WT and Sirt5−/− mice and treated with varying concentrations of glucose and insulin to mimic obesity. Sirt5-dependent effects on MaK and metabolism were evaluated by western blot, Seahorse Respirometry, and gas/chromatography-mass/spectrometry (GC-MS) metabolic profiling. Results MaK was significantly increased in cartilage of db/db mice and in chondrocytes treated with high concentrations of glucose and insulin (GluhiInshi). Sirt5 was increased in an age-dependent manner following joint injury, and Sirt5 deficient primary chondrocytes had increased MaK, decreased glycolysis rate, and reduced basal mitochondrial respiration. GC-MS identified 41 metabolites. Sirt5 deficiency altered 13 distinct metabolites under basal conditions and 18 metabolites under GluhiInshi treatment. Pathway analysis identified a wide range of Sirt5-dependent altered metabolic pathways that include amino acid metabolism, TCA cycle, and glycolysis. Conclusion This study provides the first evidence that Sirt5 broadly regulates chondrocyte metabolism. We observed changes in SIRT5 and MaK levels in cartilage with obesity and joint injury, suggesting that the Sirt5-MaK pathway may contribute to altered chondrocyte metabolism that occurs during OA development.
T2 mapping of the peritumoral infiltration zone of glioblastoma and anaplastic astrocytoma
Authors: Auer Timo Alexander , Kern Maike , Fehrenbach Uli , Tanyldizi Yasemin , Misch Martin , Wiener Edzard 
Published: February 2021

Purpose To characterise peritumoral zones in glioblastoma and anaplastic astrocytoma evaluating T2 values using T2 mapping sequences. Materials and methods In this study, 41 patients with histopathologically confirmed World Health Organization high grade gliomas and preoperative magnetic resonance imaging examinations were retrospectively identified and enrolled. High grade gliomas were differentiated: (a) by grade, glioblastoma versus anaplastic astrocytoma; and (b) by isocitrate dehydrogenase mutational state, mutated versus wildtype. T2 map relaxation times were assessed from the tumour centre to peritumoral zones by means of a region of interest and calculated pixelwise by using a fit model. Results Significant differences between T2 values evaluated from the tumour centre to the peritumoral zone were found between glioblastoma and anaplastic astrocytoma, showing a higher decrease in signal intensity (T2 value) from tumour centre to periphery for glioblastoma ( P = 0.0049 – fit-model: glioblastoma –25.02± 19.89 (–54–10); anaplastic astrocytoma –5.57±22.94 (–51–47)). Similar results were found when the cohort was subdivided by their isocitrate dehydrogenase profile, showing an increased drawdown from tumour centre to periphery for wildtype in comparison to mutated isocitrate dehydrogenase ( P = 0.0430 – fit model: isocitrate dehydrogenase wildtype –10.35±16.20 (–51) – 0; isocitrate dehydrogenase mutated 12.14±21.24 (–15–47)). A strong statistical proof for both subgroup analyses ( P = 0.9987 – glioblastoma R2 0.93±0.08; anaplastic astrocytoma R2 0.94±0.15) was found. Conclusion Peritumoral T2 mapping relaxation time tissue behaviour of glioblastoma differs from anaplastic astrocytoma. Significant differences in T2 values, using T2 mapping relaxation time, were found between glioblastoma and anaplastic astrocytoma, capturing the tumour centre to the peritumoral zone. A similar curve progression from tumour centre to peritumoral zone was found for isocitrate dehydrogenase wildtype high grade gliomas in comparison to isocitrate dehydrogenase mutated high grade gliomas. This finding is in accordance with the biologically more aggressive behaviour of isocitrate dehydrogenase wildtype in comparison to isocitrate dehydrogenase mutated high grade gliomas. These results emphasize the potential of mapping techniques to reflect the tissue composition of high grade gliomas.
Chinese traditional medicine (GuiZhi-ShaoYao-ZhiMu decoction) as an add-on medication to methotrexate for rheumatoid arthritis: a meta-analysis of randomized clinical trials
Authors: Feng Chenxi , Chen Rongrong , Wang Keer , Wen Chengping , Xu Zhenghao 
Published: February 2021

Background: GuiZhi-ShaoYao-ZhiMu decoction (GSZD), a traditional Chinese herbal medication, has been frequently used as an add-on medication to methotrexate (MTX) for rheumatoid arthritis (RA) treatment in China. This meta-analysis evaluated the efficacy and safety of adding GSZD to MTX for RA treatment. Methods: We performed a systematic search of PubMed, Web of Science, EMBASE, and the Cochrane Library (all databases) for English-language studies and WanFang, VIP, and CNKI for Chinese-language studies up to 28 July 2020. Data from selected studies, mainly the response rates and rate of adverse events (AEs), were extracted independently by two authors, and a random-effects model (Mantel–Haenszel method) was used for the meta-analysis. Results: A total of 14 randomized controlled trials and 1224 patients were included (623 patients in the GSZD + MTX group and 601 patients in the MTX group). For efficacy, the meta-analysis found that combining GSZD with MTX increased the effective rate [relative risk (RR) = 1.24, 95% confidence interval (CI): 1.18–1.30, based on 1069 patients], defined as >30% efficacy, American College of Rheumatology 20, or a decrease of disease activity score 28 >0.6. Adding GSZD reduced the swollen and tender joint counts, the duration of morning stiffness, the levels of C-reactive protein and rheumatoid factor, and erythrocyte sedimentation rate. The adjuvant therapeutic effect of GSZD was independent of the dose of MTX or the combined utilization of other drugs in both groups. For safety, adding GSZD was associated with a lower rate of total AEs (RR = 0.46, 95% CI: 0.26–0.83, based on 615 patients) and gastrointestinal tract AEs (RR = 0.46, 95% CI: 0.24–0.88, based on 537 patients). Conclusion: Combining GSZD with MTX may be a more efficacious and safer strategy for treating RA compared with MTX alone. Further large studies are warranted to investigate the long-term efficacy and safety of adding GSZD to MTX for RA treatment.