bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Metformin Have an Effect on Stent Patency Rates
Authors: Kibrik Pavel , Alsheekh Ahmad , Izakovich Tereza , Chait Jesse , Goldstein Matthew A. , Monteleone Christina M. , Hingorani Anil , Ascher Enrico 
Published: June 2019

Background: Metformin is the most commonly used drug for type 2 diabetes. Research has shown that metformin also has a protective effect on endothelium by decreasing endothelial vascular reactivity. We hypothesize that metformin will decrease restenosis/reintervention rates in patients receiving lower extremity non–drug-eluting stents (nDESs) in the superficial femoral artery(SFA) and/or popliteal artery. Materials/Methods: Retrospective study was performed on 187 patients from October 2012 to December 2015 who received an nDES in the SFA and/or popliteal artery. Patients were divided into 3 groups (Table 1) and compared against for duplex based restenosis (>60%) rates, limb loss rates, and reintervention rates. Each patient’s Trans-Atlantic-Inter-Society-Consensus II (TASC-II) class was collected. Postoperative duplex was performed 1 week after the procedure, then every 3 months for the first year, then, every 6 months to check for patency. IBM-SPSS-22 was used for all analyses. Results: Average age of the patients was 64.65 ± 73.4 years. 101 patients had 101 procedures performed on the left lower extremity; 86 patients had 86 procedures performed on the right lower extremity; 123 patients were male and 64 were female. Average length of follow-up was 13.1±9.7 months. Most common indication for intervention was claudication, followed by critical limb threatening ischemia. Restenosis and reintervention by groups can be seen in Table 1. No patients experienced limb loss. There were no statistically significant differences between any of the 3 groups and their limb loss, restenosis, or reintervention rates. Conclusions: Despite having multiple proven effects in improving certain clinical outcomes and a proven protective effect on endothelium by decreasing endothelial vascular reactivity, metformin does not appear to reduce restenosis or reintervention rates in patients receiving lower extremity nDESs in the SFA and/or popliteal artery.
Echo intensity reliability between two rectus femoris probe sites
Authors: Rabello Rodrigo , Fröhlich Matias , Bueno Aline Felicio , Marcolino Miriam Allein Zago , De Bona Bernardi Thainá , Sbruzzi Graciele , Aurélio Vaz Marco 
Published: June 2019

Introduction The ultrasound technique has been extensively used to measure echo intensity, with the goal of measuring muscle quality, muscle damage, or to detect neuromuscular disorders. However, it is not clear how reliable the technique is when comparing different days, raters, and analysts, or if the reliability is affected by the muscle site where the image is obtained from. The goal of this study was to compare the intra-rater, inter-rater, and inter-analyst reliability of ultrasound measurements obtained from two different sites at the rectus femoris muscle. Methods Muscle echo intensity was quantified from ultrasound images acquired at 50% [RF50] and at 70% [RF70] of the thigh length in 32 healthy subjects. Results Echo intensity values were higher ( p = 0.0001) at RF50 (61.08 ± 12.04) compared to RF70 (57.32 ± 12.58). Reliability was high in both RF50 and RF70 for all comparisons: intra-rater (ICC = 0.89 and 0.94), inter-rater (ICC = 0.89 and 0.89), and inter-analyst (ICC = 0.98 and 0.99), respectively. However, there were differences ( p < 0.05) between raters and analysts when obtaining/analyzing echo intensity values in both rectus femoris sites. Conclusions The differences in echo intensity values between positions suggest that rectus femoris's structure is not homogeneous, and therefore measurements from different muscle regions should not be used interchangeably. Both sites showed a high reliability, meaning that the measure is accurate if performed by the same experienced rater in different days, if performed by different experienced raters in the same day, and if analyzed by different well-trained analysts, regardless of the evaluated muscle site.
Consumer Prices for Surgical Management of End-Stage Hallux Rigidus
Authors: Smyth Niall A. , Krishnan Vaishnavi , McCormick Johnathon R. , Kaplan Jonathan R. , Aiyer Amiethab A. 
Published: June 2019

Background. Hallux rigidus is the most prevalent arthritic condition of the foot. Treatment of end-stage disease traditionally consists of a first metatarsophalangeal joint (MTPJ) arthrodesis; however, the use of a synthetic cartilage implant is becoming more common. With the high prevalence of disease and implementation of new treatment modalities, health care consumers should be aware of the costs associated with management. The purpose of this study was to determine access to the cost and variability in price of first MTPJ arthrodesis and synthetic cartilage implantation. Methods. Forty academic centers were contacted using a standardized patient script. The patient was a 59-year-old female who had failed conservative treatment of hallux rigidus. Each institution was contacted up to 3 times in an attempt to obtain a full bundled operative quote for a first MTPJ arthrodesis and synthetic cartilage implantation. Results. Twenty centers (50%) provided a quote for first MTPJ arthrodesis and 15 centers (38%) provided a quote for synthetic cartilage implantation. Only 14 centers (35%) were able to provide a quote for both procedures. The mean bundled price for MTPJ arthrodesis was $21 767 (range $8417 to $39 265). The mean bundled price for synthetic cartilage implantation was $21 546 (range $4903 to $74 145). There was no statistically significant difference between the bundled price for first MTPJ arthrodesis and synthetic cartilage implantation. Conclusions. There was limited availability of consumer prices for first MTPJ arthrodesis and synthetic implantation, thus impeding health care consumers’ decision making. There was a wide range of quotes for both procedures, indicating potential cost savings. Levels of Evidence: IV, basic science
The Effect of Select Systemic Medications on Visual Outcomes in Diabetics With Branch Retinal Vein Occlusion
Authors: Birnbaum Faith A. , Thomas Akshay S. , Thomas Mridul K. , Yoon Stephen P. , Dmitriev Pauline , Kim Jane S. , Powers James H. , Khan Kirin , Gomez-Caraballo Maria , Fekrat Sharon 
Published: June 2019

Purpose: The purpose of this article is to evaluate the effect of systemic medications and glycemic control on the visual outcome and treatment burden in patients with diabetes and branch retinal vein occlusion (BRVO). Methods: A retrospective review was performed for patients with diabetes diagnosed with a BRVO at an academic eye center from 2009 to 2017. The use of select antihypertensives, antiplatelet agents, anticoagulants, and hypoglycemics was reviewed. Data on visual acuity (VA), central subfield thickness (CST), treatment course, and hemoglobin (Hb)A1c were obtained throughout follow-up. Results: A total of 121 eyes met criteria with a median follow-up duration of 19.4 months. The mean baseline logarithm of the minimum angle of resolution (logMAR) VA was 0.56 (Snellen equivalent, 20/72) and mean final logMAR VA was 0.5 (20/63). At final follow-up, aspirin 325 mg was associated with 4.8 fewer injections (n = 13, P = .04), insulin was associated with 3.6 more injections (n = 26, P = .04), warfarin was associated with a 79 µm increase in CST ( P = .02), and a 1% increase in HbA1c was associated with 0.86 more injections ( P < .01). Conclusions: The VA outcome of BRVO in diabetics may be worse than that of BRVO in nondiabetics. Worse diabetic control was associated with a higher treatment burden. High-dose aspirin was associated with fewer injections.
RETRACTED ARTICLE: Down-regulated lncRNA DLX6-AS1 inhibits tumorigenesis through STAT3 signaling pathway by suppressing CADM1 promoter methylation in liver cancer stem cells
Authors: Wu Dong-Mei , Zheng Zi-Hui , Zhang Ying-Bo , Fan Shao-Hua , Zhang Zi-Feng , Wang Yong-Jian , Zheng Yuan-Lin , Lu Jun 
Published: June 2019

Abstract
Background
Liver cancer stem cells (LCSCs) are a small subset of cells characterized by unlimited self-renewal, cell differentiation, and uncontrollable cellular growth. LCSCs are also resistant to conventional therapies and are thus believed to be held responsible for causing treatment failure of hepatocellular carcinoma (HCC). It has been recently found that long non-coding RNAs (lncRNAs) are important regulators in HCC. This present study aims to explore the underlying mechanism of how lncRNA DLX6-AS1 influences the development of LCSCs and HCC.

Methods
A microarray-based analysis was performed to initially screen differentially expressed lncRNAs associated with HCC. We then analyzed the lncRNA DLX6-AS1 levels as well as CADM1 promoter methylation. The mRNA and protein expression of CADM1, STAT3, CD133, CD13, OCT-4, SOX2, and Nanog were then detected. We quantified our results by evaluating the spheroid formation, proliferation, and tumor formation abilities, as well as the proportion of tumor stem cells, and the recruitment of DNA methyltransferase (DNMT) in LCSCs when lncRNA DLX6-AS1 was either overexpressed or silenced.

Results
LncRNA DLX6-AS1 was upregulated in HCC. The silencing of lncRNA DLX6-AS1 was shown to reduce and inhibit spheroid formation, colony formation, proliferation, and tumor formation abilities, as well as attenuate CD133, CD13, OCT-4, SOX2, and Nanog expression in LCSCs. Furthermore, downregulation of lncRNA DLX6-AS1 contributed to a reduction in CADM1 promoter methylation via suppression of DNMT1, DNMT3a, and DNMT3b in LCSCs and inactivating the STAT3 signaling pathway.

Conclusion
This study demonstrated that down-regulated lncRNA DLX6-AS1 may inhibit the stem cell properties of LCSCs through upregulation of CADM1 by suppressing the methylation of the CADM1 promoter and inactivation of the STAT3 signaling pathway.
Multidisciplinary work promotes preventive medicine and health education in primary care: a cross-sectional survey
Authors: Schor Ayelet , Bergovoy-Yellin Lucia , Landsberger Daniel , Kolobov Tania , Baron-Epel Orna 
Published: June 2019

Abstract

Background
Preventive medicine and health education are among the strategies used in coping with chronic diseases. However, it is yet to be determined what effect do personal and organizational aspects have on its’ implementation in primary care.

Methods
A cross-sectional survey was conducted in order to assess and compare preventive medicine and health education activities in three types of primary care models: solo working independent physicians, nurse-physician collaborations and teamwork (nurses, dietitians and social workers working alongside a physician). Questionnaires were emailed to 1203 health professionals between September and November 2015, working at Maccabi Healthcare Services, the second largest Israeli healthcare organization.
Self-reported rates of health education groups conducted, proactive appointments scheduling and self-empowerment techniques use during routine appointments, were compared among the three models. Independent variables included clinic size as well as health professionals’ occupation, health behaviors and training.
A series of multivariate linear regressions were performed in order to identify predictors of preventive medicine and health education implementation.
Computerized health records (CHR) validated our self-report data through data regarding patients’ health behaviours and outcomes, including health education group registration, adherence to occult blood tests and influenza vaccinations as well as blood lipid levels.

Results
Responders included physicians, nurses, dietitians and social workers working at 921 clinics (n = 516, response rate = 31%).
Higher rates of proactive appointments scheduling and health education groups were found in the Teamwork and Collaboration models, compared to the Independent Physician Model. Occupation (nurses and dietitians), group facilitation training and personal screening adherence were identified as preventive medicine and health education implementation predictors.
Group registration, occult blood tests, healthy population’s well-controlled blood lipids as well as influenza vaccinations among chronically ill patients were all significantly higher in the Teamwork and Collaboration models, compared to the Independent Physician Model.

Conclusions
The Teamwork and Collaboration models presented higher rates of preventive medicine and health education implementation as well as higher rates of patients’ positive health behaviours documented in these models.
This suggests multidisciplinary primary care models may contribute to population’s health by enhancing preventive medicine and health education implementation alongside health professionals’ characteristics.
Oncological and functional outcomes following transoral laser microsurgery in patients with T2a vs T2b glottic squamous cell carcinoma
Authors: Forner David , Rigby Matthew H. , Hart Robert D. , Trites Jonathan R. , Taylor S. Mark 
Published: June 2019

Background There is a paucity of evidence comparing oncological and voice outcomes between T2a and T2b glottic squamous cell carcinoma (SCC) patients treated with transoral laser microsurgery (TLM). This study identified functional and oncological outcomes in this cohort. Methods Retrospective review of prospectively collected data of patients treated with TLM for T2 glottic SCC from 2003 to 2017. Results In total, 75 patients were included. Five-year local control rates were significantly different between T2a and T2b patients (75.2% vs 57.0%, p = 0.022). There was no difference in five-year survival between patients with T2a disease and T2b disease (69.5% vs 73.4%, p = 0.627). There was no significant difference in mean VHI-10 scores in the pre-operative period (18.3 vs 21.4, p = 0.409). However, patients with T2b disease had significantly worse perceived voice outcomes post-operatively (6.6 vs 21.3 p = 0.001). Patients with T2a disease saw significant improvements in mean VHI-10 scores following surgery (18.3 vs 6.6, p = 0.000), while T2b patients did not (21.4 vs 21.3, p = 0.979). The overall laryngeal preservation rate was 94.7%, with 11.5% of T2b patients requiring salvage organ sacrifice. Conclusions This study highlights positive functional outcomes for T2a glottic SCC. Patients with T2b disease appear to have significantly worse oncological and functional outcomes, including worse voice quality following surgery and higher rates of salvage laryngectomy.
So you want to do biocodicology? A field guide to the biological analysis of parchment
Authors: Fiddyment Sarah , Teasdale Matthew D. , Vnouček Jiří , Lévêque Élodie , Binois Annelise , Collins Matthew J. 
Published: June 2019

Abstract
Biocodicology, the study of the biological information stored in manuscripts, offers the possibility of interrogating manuscripts in novel ways. Exploring the biological data associated to parchment documents will add a deeper level of understanding and interpretation to these invaluable objects, revealing information about book production, livestock economies, handling, conservation and the historic use of the object. As biotechnological methods continue to improve we hope that biocodicology will become a highly relevant discipline in manuscript studies, contributing an additional perspective to the current scholarship. We hope that this review will act as a catalyst enabling further interactions between the heritage science community, manuscript scholars, curators and conservators.
Anterior cleft palate due to Cbfb deficiency and its rescue by folic acid
Authors: Sarper Safiye E. , Inubushi Toshihiro , Kurosaka Hiroshi , Ono Minagi Hitomi , Murata Yuka , Kuremoto Koh-ichi , Sakai Takayoshi , Taniuchi Ichiro , Yamashiro Takashi 
Published: June 2019

ABSTRACT
Core binding factor β (Cbfb) is a cofactor of the Runx family of transcription factors. Among these transcription factors, Runx1 is a prerequisite for anterior-specific palatal fusion. It was previously unclear, however, whether Cbfb served as a modulator or as an obligatory factor in the Runx signaling process that regulates palatogenesis. Here, we report that Cbfb is essential and indispensable in mouse anterior palatogenesis. Palatal fusion in Cbfb mutants is disrupted owing to failed disintegration of the fusing epithelium specifically at the anterior portion, as observed in Runx1 mutants. In these mutants, expression of TGFB3 is disrupted in the area of failed palatal fusion, in which phosphorylation of Stat3 is also affected. TGFB3 protein has been shown to rescue palatal fusion in vitro. TGFB3 also activated Stat3 phosphorylation. Strikingly, the anterior cleft palate in Cbfb mutants is further rescued by pharmaceutical application of folic acid, which activates suppressed Stat3 phosphorylation and Tgfb3 expression in vitro. With these findings, we provide the first evidence that Cbfb is a prerequisite for anterior palatogenesis and acts as an obligatory cofactor in the Runx1/Cbfb-Stat3-Tgfb3 signaling axis. Furthermore, the rescue of the mutant cleft palate using folic acid might highlight potential therapeutic targets aimed at Stat3 modification for the prevention and pharmaceutical intervention of cleft palate.
Paediatric morbidity and mortality in Sierra Leone. Have things changed after the 2014/2015 Ebola outbreak?
Authors: Sesay Tom , Denisiuk Olga , Zachariah Rony 
Published: June 2019

Background: Sierra Leone was severely affected by the 2014/2015 Ebola outbreak and is likely to have had longer term repercussions on the health system including on paediatric morbidity and mortality. We thus assessed under-five morbidity and mortality for malaria, acute respiratory Infections (ARI)/pneumonia, watery diarrhoea and measles during the post-Ebola period in Sierra Leone and compared this with the pre- and intra-Ebola periods. Methods: This was a retrospective cross-sectional study using program data from the District Health Information system (DHIS2) and sourced from 14 districts in Sierra Leone. It included under-five children from 1,200 health facilities country-wide. Study periods included: before (June 1st, 2013-April 30th, 2014); during (June 1st, 2014-April 30th, 2015); and after Ebola (June 1st, 2016-April 30th, 2017). Results: Malaria, ARI/pneumonia and diarrhoea consultations declined during Ebola but recovered to pre-Ebola levels in the post-Ebola period. During the post-Ebola period, there was a highly significant reduction in case-fatality for the first three morbidities compared to the pre-Ebola period (P<0.0001). Average number of measles cases increased from 48/month in the pre-Ebola period to 568/month (12-fold increase) post-Ebola. Although there was no difference in measles case-fatality between the pre- and post-Ebola periods, case-fatality post-Ebola was significantly lower than during Ebola (Relative Risk: 0.05, 95% confidence interval 0.02-0.15, P<0.0001). Conclusions: Consultations for under-five children at health facilities in Sierra Leone recovered to pre-Ebola levels and case-fatality for common childhood illnesses declined significantly. This is a change for the better. However, the high level of reported measles cases in the post-Ebola period indicates gaps in immune status and needs focused attention.
Staffing in public health facilities after the Ebola outbreak in rural Sierra Leone: How much has changed?
Authors: Squire James Sylvester , Hann Katrina , Denisiuk Olga , Zachariah Rony 
Published: June 2019

Background: The 2014-2015 Ebola outbreak in Sierra Leone led the Ministry of Health and Sanitation to set minimum standards of staffing (medical/non-medical) at the district level for the provision of basic essential health services (BPEHS). In one of the worst Ebola affected districts in Sierra Leone, we assessed staffing levels measured against these stipulated standards before, during, and 16 months after the Ebola outbreak. Methods: The study population included all health workers in 83 health facilities. We assessed staffing levels at three points in time: pre-Ebola (April 2014); the end of the outbreak (November 2015); and 16 months post-Ebola (March 2017). April 2014 was immediately prior to the Ebola outbreak and thus representative of the human resource situation before the outbreak. November 2015 was the month when Sierra Leone was declared Ebola-free, and thus reflects the end-situation after Ebola. March 2017 was two years since the launch of the BPEHS, and some progress should be expected. Results: Against recommended medical staff numbers during pre-, intra- and post-Ebola periods, deficits were 67%, 65% and 60% respectively. Similarly, against recommended non-medical staff numbers during pre-, intra- and post-Ebola periods, the deficit remained at 92% throughout. In the post-Ebola period, there was a deficit of 73% against 1,389 recommended health worker positions. Conclusions: Nothing has really changed in the state of human resources for health, and urgent measures are needed to rectify the situation and prevent a déjà vu in the advent of a new Ebola outbreak.
Prevalence and risk factors for low back pain among university teaching staff in Nairobi, Kenya: a cross-sectional study
Authors: Diallo Saikou Yaya Kollet , Mweu Marshal Mutinda , Mbuya Simeon Ochanda , Mwanthi Mutuku Alexander 
Published: June 2019

Background: To date, there are few studies carried out on low back pain (LBP) among university teaching staff in developing countries despite academics being a high-risk group for LBP. In Kenya, to the best of our knowledge, there are no published studies that have investigated risk factors for LBP among teaching staff. The objectives of this study were to estimate the prevalence of LBP among teaching staff of the University of Nairobi (UoN), during the period June 2016 – May 2017, and to identify its socio-demographic and work-related risk factors. Methods: An analytical cross-sectional study design was used to estimate the prevalence and investigate the risk factors for LBP among 136 teaching staff of UoN. A semi-structured questionnaire was used to collect data on LBP history, work-related and socio-demographic characteristics of the study participants. The 12-month prevalence of LBP and its associated 95% exact binomial confidence interval were estimated. A mixed-effects logistic regression model was used to evaluate the relationship between the predictors and LBP. Results: The estimated 12-month prevalence of LBP was 64% (95% CI: 55.3%–72.0%). From the multivariable analysis, physical inactivity (aOR: 6.0; 95% CI: 1.2–29.6), office chairs without lumbar supports (aOR: 3.3; 95% CI: 0.1–0.9) and high workplace stress (aOR: 4.4; 95% CI: 1.1–17.5) were identified as significant risk factors for LBP among the respondents. Conclusions: This study has revealed a high burden of LBP among teaching staff of the UoN and undoubtedly mimics the situation in other higher learning institutions in Kenya. Physical inactivity, sitting on chairs without lumbar supports and workplace stress have been identified as modifiable risk factors for LBP among teaching staff. This suggests a need to strengthen advocacy for regular physical activity, team-building activities and investment in office infrastructure to mitigate the effects of LBP within learning institutions.