bluuebunny/crossref_metadata_2025_split huggingface dataset:
Major Reservoir for Heparin-Releasable TFPIα (Tissue Factor Pathway Inhibitor α) Is Extracellular Matrix
Authors: Peterson Julie A. , Maroney Susan A. , Martinez Nicholas D. , Mast Alan E. 
Published: April 2021

Objective:
Human endothelial cells produce 2 alternatively spliced TFPI (tissue factor pathway inhibitor) isoforms that maintain anticoagulant properties of the vasculature. TFPIβ is glycosylphosphatidylinositol anchored on the cell surface. TFPIα has a basic C terminus sharing homology with VEGF (vascular endothelial growth factor) and is a heparin-releasable protein, suggesting it binds glycosaminoglycans on the endothelium surface. However, this is unclear because TFPIα is not on the surface of cultured endothelial cells. This study identifies the source of heparin-releasable TFPIα.

Approach and Results:
ELISA assays localized heparin-releasable TFPIα to the extracellular matrix (ECM) of Ea.hy926 cells and human umbilical vein endothelial cells. Immunofluorescence microscopy for TFPIα showed punctate intracytoplasmic staining and ECM staining beneath individual cells. Flow cytometry identified TFPIβ but not TFPIα on the cell surface. TFPIα localization to ECM was confirmed with ELISA and immunohistochemistry studies of umbilical cord veins. The TFPIα C terminus interacted with Ea.hy926 ECM glycosaminoglycans, and a homologous VEGF peptide competed for this binding, suggesting these interactions modulate VEGF responses. Immobilized TFPIα C-terminal peptide bound to several ECM proteoglycans in Ea.hy926 conditioned media. Immunofluorescence studies of human kidney colocalized TFPIα with 4 of these proteoglycans surrounding the microvasculature: glypican-1, syndecan-4, thrombospondin, and laminin-5. The absence of TFPIα on the surface of endothelial cells and its co-localization with specific ECM proteins suggests TFPIα binds to unique proteoglycan structures.

Conclusions:
ECM contained the primary vascular pool of heparin-releasable TFPIα. By localizing to ECM, TFPIα is positioned to inhibit the procoagulant activity of tissue factor surrounding the vasculature.
Social Cognitive Dysfunction Following Pediatric Arterial Ischemic Stroke
Authors: Ryan Nicholas P. , Greenham Mardee , Gordon Anne L. , Ditchfield Michael , Coleman Lee , Cooper Anna , Crowe Louise , Hunt Rod W. , Monagle Paul , Mackay Mark T. , Anderson Vicki 
Published: April 2021

Background and Purpose:
Childhood and adolescence coincide with rapid maturation of distributed brain networks supporting social cognition; however, little is known about the impact of early ischemic brain insult on the acquisition of these skills. This study aimed to examine the influence of arterial ischemic stroke (AIS) on facial emotion recognition and theory of mind (ToM) abilities of children and adolescents initially recruited to a single-center, prospective longitudinal study of recovery following AIS.

Methods:
The study involved 67 participants, including 30 children with AIS (mean time since stroke=5 years) and 37 age-matched typically developing controls who were assessed on measures of cognitive ToM, facial emotion recognition, and affective ToM. Acute clinical magnetic resonance imaging, including diffusion-weighted imaging sequences, were used to evaluate prospective structure-function relationships between acute lesion characteristics (size, location, and arterial territories affected) and long-term social cognitive abilities.

Results:
Relative to age-matched typically developing controls, children with AIS showed significantly worse performance on measures of basic facial emotion processing, cognitive ToM, and affective ToM. In univariate models, poorer ToM was associated with larger infarcts, combined cortical-subcortical pathology, and involvement of multiple arterial territories. In multivariate analyses, larger lesions and multiterritory infants were predictive of ToM processing but not facial emotion recognition. Poorer cognitive ToM predicted less frequent prosocial behavior and increased peer problems.

Conclusions:
Social cognitive skills appear vulnerable to disruption from early ischemic brain insult. In the first study to examine social cognition in a prospective cohort of children with AIS, our findings suggest that acute magnetic resonance imaging-based lesion characteristics may have predictive value for long-term social cognitive outcomes and may assist to identify children at elevated risk for social cognitive dysfunction.
A composite risk model predicts disease progression in early stages of COVID-19: A propensity score-matched cohort study
Authors: Xu Jianjun , Gao Yang , Hu Shaobo , Li Suzhen , Wang Weimin , Wu Yuzhe , Su Zhe , Zhou Xing , Cheng Xiang , Zheng Qichang 
Published: April 2021

Background Recently, studies on COVID-19 have focused on the epidemiology of the disease and clinical characteristics of patients, as well as on the risk factors associated with mortality during hospitalization in critical COVID-19 cases. However, few research has been performed on the prediction of disease progression in particular group of patients in the early stages of COVID-19. Methods The study included 338 patients with COVID-19 treated at two hospitals in Wuhan, China, from December 2019 to March 2020. Predictors of the progression of COVID-19 from mild to severe stages were selected by the logistic regression analysis. Results COVID-19 progression to severe and critical stages was confirmed in 78 (23.1%) patients. The average value of the neutrophil-to-lymphocyte ratio (NLR) was higher in patients in the disease progression group than in the improvement group. Multivariable logistic regression analysis revealed that elevated NLR, LDH and IL-10 were independent predictors of disease progression. The optimal cut-off value of NLR was 3.75. The values of the area under the curve, reflecting the accuracy of predicting COVID-19 progression by NLR was 0.739 (95%CI: 0.605–0.804). The risk model based on NLR, LDH and IL-10 had the highest area under the ROC curve. Conclusions The performed analysis demonstrates that high concentrations of NLR, LDH and IL-10 were independent risk factors for predicting disease progression in patients at the early stage of COVID-19. The risk model combined with NLR, LDH and IL-10 improved the accuracy of the prediction of disease progression in patients in the early stages of COVID-19.
Canadian and American Religion Redux: Revisiting America’s Religious Exceptionalism and Persistence Compared to Canada
Authors: Hay Alastair 
Published: April 2021

Two core lines of argument presently define our understanding of why Christianity’s historical influence continues to persist in the lives of Americans to a degree not observed in Canada (despite the recent loss of religious affiliation in both countries). These are: 1) changes in the functional dominance of social systems (i.e. shifts to the welfare state in Canada) and 2) important foundational, cultural differences between Canada and America. Using a historiographic approach (coupled with quantitative research conducted in Canada and the US), this article argues that one less well-recognized factor also deserves our attention: Charles Taylor’s observation that American religious culture was primed for the Age of Authenticity. In this article I argue that Taylor was probably right. Over and above the well-established individualistic character of the religious lives of Americans is a related, but important, additional effect—the sanctioning of the ‘this-worldly’ potential of the individual life from within its religious institutions. It is this aspect of America’s religious exceptionalism, I argue, that has also helped to render the religious lives of Americans less vulnerable to – but not immune from – the watershed effects of the sixties compared to Christianity in Canada.
Intra-household Bargaining, Son Preference and the Status of Women in India
Authors: Alakshendra Abhinav , Li Dong 
Published: April 2021

Son preference prevails among Indian families. We test the hypothesis that women who bear sons experience an elevated status within the household, which translates into their increased role in decision-making. Using data from the Indian Human Development Survey, we find that women who have given birth to at least one son show greater participation in the household’s financial decisions as well as other decisions on a regular basis. After analysing 13 decision variables, we find that women who have given birth to at least one son enjoy higher overall bargaining power in the household. For example, in decisions concerning what to spend money on, having a son is equivalent to 6 years of formal education. We also show that the presence of a senior member in the household, however, often reduces the women’s household bargaining strength. JEL Classification Codes: J11, J12, J13, D190
Integration of mental health comorbidity in medical specialty programs in 20 countries
Authors: Heinze Gerhard , Sartorius Norman , Guizar Sanchez Diana Patricia , Bernard-Fuentes Napoleón , Cawthorpe David , Cimino Larry , Cohen Dan , Lecic-Tosevski Dusica , Filipcic Igor , Lloyd Cathy , Mohan Isaac , Ndetei David , Poyurovsky Michael , Rabbani Golam , Starostina Elena , Yifeng Wei , EstefaníaLimon Limón 
Published: April 2021

Methods A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs include: 1) name of the medical specialties that take into account mental health content in curriculum design, 2) name of the mental health issues addressed by these programs. After independent review and data extraction, paired investigators compared the findings and reached consensus on all discrepancies before the final presentation of the data. Descriptive statistics evaluated the frequency of the data presented. Results Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs. In four countries: Bangladesh, Serbia, the Netherlands and France, 50%of all graduate specialty training programs include mental health content. In ten countries: Germany, Sweden, the United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel and Spain, between 20% and 49% of all graduate specialty training programs include mental health content. In six countries - Brazil, Chile, Colombia, Croatia, Kenya, and the United States-less than 20% of all graduate specialty training programs include mental health content. Discussion The proposal that we have made in this article should be taken into account by decision-makers, in order to complement the different postgraduate training programs with mental health issues that are frequently present with other physical symptoms. It is not our intention that the different specialists know how to treat psychiatric comorbidities, but rather pay attention to their existence and implications in the diagnosis, evolution and prognosis of many other diseases. The current fragmentation of medicine into ever finer specialties makes the management of comorbidity ever more difficult: a reorientation of post- graduate training might improve the situation.
Food cue images and subjective appetitive responses in obese children
Authors: Lizia M Shiny , Hemamalini A J , Ravichandran Latha 
Published: April 2021

Background: Food decision-making is based on various intrinsic and extrinsic factors of an individual. Food preferences and food cue sensitivity influence energy intake, which in turn affects body weight. Aim: The present study assessed the subjective appetite of obese children in response to food cue images. Methods: A total of 70 obese children (37 boys and 33 girls) of the age group 7–10 years were recruited for the study; 34 images of food items grouped under ten food blocks were used as cues to study the self-reported hunger, appetite and satiety sensations among the participants. A visual analogue scale (VAS) was used to measure participant responses for each food block. Results: The mean (standard deviation (SD)) body mass index-for-age ‘Z’ scores (BAZ) of the participants was found to be 2.15 (0.36). The subjective appetitive responses assessed using VAS showed that the hunger ratings of participants were found to be higher in response to images of cereals and cereal products (92.86%), and sweets (97.14%); satiety ratings of the participants were observed to be higher for milk and milk products (87.14%); cereals and savoury foods (78.57%); and higher appetite ratings of participants were recorded for sweets (97.14%) and cereals (92.86%). Conclusion: Sophisticated neuroimaging techniques are well established in measuring appetite, but our study focused on the subjective analysis of appetite using cost-effective tools such as food cue images and visual analogue scales to further expand the research platform in appetite regulation and obesity.
Breathing-based leg exercises during hemodialysis improve quality of life: A randomized controlled trial
Authors: Huang Hsin-Yi , Hung Kuo-Sheng , Yeh Mei-Ling , Chou Hsiu-Ling , Yeh Albert Lou , Liao Tzu-Yi 
Published: April 2021

Objective: To evaluate the effect of a 12-week breathing-based leg exercises program on quality of life under stabilizing heart rate variability and reducing fatigue in regular hemodialysis patients. Design: Randomized controlled trial. Setting: A 94-bed hemodialysis department at a medical center in northern Taiwan. Participants: Eighty-six patients with end-stage renal disease undergoing hemodialysis were recruited and randomly assigned to the ExBr or control groups. Interventions: The breathing-based leg exercises program comprised abdominal breathing and low-intensity leg exercise, including leg lifts, quadriceps femoris contraction and knee flexion, and lasted for 15 minutes at one time, three times a week for 12 weeks. Main measure: Data was collected by using the World Health Organization quality of life assessment-brief, physiological signal recorder for heart rate variability and hemodialysis-related fatigue scale at baseline and on Week 4, Week 8, and Week 12. Results: Average (standard deviation) age was 53.70 (10.04) years in the ExBr group and 61.19 (10.19) years in the control group. The linear mixed model with adjusted age, creatinine, heart rate variability and fatigue revealed that the ExBr group had significantly higher quality of life than did the control group ( P = 0.01), especially on Week 12 ( P = 0.04). Fatigue was significantly correlated with quality of life ( P < 0.001). Conclusion: This study supported the benefits of the continued breathing-based leg exercises during hemodialysis for at least 12 weeks, which improved the quality of life of patients with end-stage renal disease and did not affect the stability of their vital signs.
Analysis of common causes of liver damage among children 12 years and younger in Weifang
Authors: Meng Qinghong , Li Na , Yuan Lianmei , Gao Xiaona 
Published: April 2021

Aims To explore the causes of liver damage among children 12 years and younger in Weifang and to provide a theoretical basis for early diagnosis of liver damage in children. Methods Retrospective study of clinical data from pediatric patients (age ≤12 years) with liver damage in diagnosed at Weifang People's Hospital from June 2010 to May 2020. Results A total of 2632 children (1572 boys, 1060 girls) aged ≤12 years were diagnosed with liver damage including infectious liver damage (2100 cases), non-infectious liver damage (446 cases) and liver damage of unknown etiology (86 cases). The most common causes of infectious liver damage were viral infection (1515 cases), Mycoplasma pneumoniae infection (343 cases), and bacterial infection (197 cases). The most common causes of viral liver damage were Epstein–Barr virus, cytomegalovirus, and enterovirus. The most common causes of non-infectious liver damage were drug-induced liver damage, Kawasaki disease, and genetic metabolic diseases. There were 31 cases of severe liver damage. Conclusion There were many causes of liver damage among children in Weifang. Infections, and especially viral infections such as Epstein–Barr virus, were the most common causes of liver damage. Severe liver damage was primarily caused by drugs or poisons.
Intrathecal dexmedetomidine improves epidural labor analgesia effects: a randomized controlled trial
Authors: Li Gehui , Wang Hao , Qi Xiaofei , Huang Xiaolei , Li Yuantao 
Published: April 2021

Objective α2‑agonists and opioids have been used as intrathecal adjuvants to local anesthetics for several years, but the effect of intrathecal dexmedetomidine (Dex) or sufentanil combined with epidural ropivacaine in labor analgesia is not fully understood. Methods A total of 108 parturient women receiving combined spinal-epidural labor analgesia were randomly divided into three groups. Group C received l mL saline (0.9%) intrathecally, Group D received 5 µg Dex intrathecally, and Group S received 5 µg sufentanil intrathecally. All parturient women then received 0.1% epidural ropivacaine and 0.2 µg/mL sufentanil for patient-controlled epidural analgesia with standard settings. The visual analog scale score, onset time, duration of intrathecal injection, local anesthetic requirements, and side effects were recorded. Results The labor analgesia effects in Groups D and S were better than those in Group C. Groups D and S displayed significantly shorter onset times, longer durations of intrathecal injection, and reduced local anesthetic requirements compared with Group C. The incidence of shivering and pruritus in Group D was lower than that in Group S. Conclusion Intrathecal administration of 5 µg Dex could improve epidural labor analgesia effects. This randomized controlled clinical trial was registered with the Chinese Clinical Registry Center (ChiCTR-1800014943, http://www.chictr.org.cn/ ).
Short-Term Bone Fusion With Arthroscopic Double-Button Latarjet Versus Open-Screw Latarjet
Authors: Bonnevialle Nicolas , Girard Mathieu , Dalmas Yoann , Martinel Vincent , Faruch Marie , Mansat Pierre 
Published: April 2021

Background: Recently, arthroscopic double-button Latarjet (AL) has provided an alternative to conventional open Latarjet (OL) in the treatment of anterior shoulder instability with glenoid bone loss. Therefore, theoretically, the faster fusion is obtained, the sooner return to sports under safe conditions can occur. The emerging flexible fixation of the bone block has clearly offered a new approach to achieve bone fusion. However, the period required to achieve this goal remains controversial. Purpose/Hypothesis: The purpose was to compare computed tomography (CT) scan results of AL and OL in the early postoperative period. It was hypothesized that the bone block fusion with AL would require a longer time than that with OL. Study Design: Cohort study; Level of evidence, 3. Methods: In a retrospective 1-year study, the authors compared 17 primary double-button AL to 22 primary 2-screw OL procedures indicated for anterior shoulder instability in patients with an Index Severity Instability Score >3 points. These patients were reviewed with a CT scan at 1 day, 3 months, and 6 months postoperatively. The characteristics for the 2 groups were comparable. CT scans aimed to analyze graft position, bone contact area with the scapula, and fusion at 3 and 6 months. Clinical assessment was based on the Walch-Duplay and Rowe scores. Results: The mean preoperative Index Severity Instability Score was 5.3 ± 1.9 points, with a mean anterior glenoid bone loss of 9.1% ± 4.6%. At 3 months, the rates of fusion were 41% and 100% for the AL and OL groups, respectively ( P < .001). This rate increased to 70% in the AL group at 6 months ( P = .006). In the axial and sagittal planes, there was no difference in graft position between the AL group and the OL group. The bone block was longer and there was a more extensive bone contact area in the OL group (AL, 131 mm2 vs OL, 223 mm2; P < .001). At 6 months of follow-up, no significant difference in clinical scores was noted between the groups: Walch-Duplay score, 93.0 ± 10.9 points versus 91.8 ± 12.5 points ( P = .867); and Rowe score, 99.0 ± 2.2 points versus 95.0 ± 8.4 points ( P = .307) for the AL and OL groups, respectively. Conclusion: AL required more time to achieve bone block fusion than OL. This finding should be taken into account when considering this procedure for patients in a hurry to return to sports involving the shoulder.
Effect of Anterior Cruciate Ligament Rupture on Physical Activity, Sports Participation, Patient-Reported Health Outcomes, and Physical Function in Young Female Athletes
Authors: Ezzat Allison M. , Brussoni Mariana , Mâsse Louise C. , Emery Carolyn A. 
Published: April 2021

Background: Return to sports (RTS) is frequently considered an indicator of successful recovery after anterior cruciate ligament reconstruction (ACLR). However, despite the well-recognized health benefits of physical activity (PA), little is known about objectively measured PA in the 1 to 2 years after ACLR. Given that young female athletes have a high prevalence of ACLR and lower RTS rates as compared with their male counterparts, an in-depth examination of PA in this subgroup is warranted. Hypothesis: We hypothesized that female youth and young adults who have had ACLR in the previous 1 to 2 years would have less moderate or vigorous PA (MVPA) compared with healthy matched controls. We also hypothesized that the ACLR group would report lower levels of sports participation, patient-reported health outcomes, and physical function. Study Design: Cohort study; Level of evidence, 3. Methods: Participants included 51 female athletes with primary unilateral ACLR for a sports-related injury in the previous 1 to 2 years and 51 age- and sports-matched controls. Outcomes included objectively measured PA (GT3X accelerometers), previous and current sports participation and RTS, body mass index, Knee injury and Osteoarthritis Outcome Score (KOOS), triple single-leg hop, and one-leg rise. Mean within-pair differences with 95% CIs were used to assess differences between groups across all outcomes. Multivariable linear regression (clustered by pair) was used to examine whether the ACLR group had less MVPA than did the age- and sports-matched control group, adjusting for total wear time, age, time since injury, and body mass index. Results: Median age was 17.8 years (range, 14.6-22.6 years). There was no significant difference between groups in MVPA. However, the injury group had fewer mean minutes per day of vigorous PA (–1.22; 95% CI, −2.40 to −0.04), poorer KOOS values on all subscales, and shorter triple single-leg hop distance. In the injury group, 28 (55%) returned to sports, including 14 (27.5%) who returned at preinjury performance level. Across both groups, over one-third changed their most important sport, shifting toward an individual-based sport. Conclusion: At 1 to 2 years after ACLR, female athletes demonstrated no differences in combined MVPA and only a very small reduction in vigorous PA, yet they had higher levels of self-reported knee pain and symptoms, reduced knee function in sports, lower quality of life, and poorer objective knee function compared with matched controls.