bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective audit of joint mother–baby admissions to the Werribee Mercy mother and baby unit (MBU) and of the severity of maternal depression over the course of admission
Authors: Wang Imogen , Breadon Carolyn 
Published: October 2019

Objectives: This study examined (i) the demographic and illness profiles of mothers admitted to Werribee Mercy MBU in Victoria, Australia and (ii) the severity of maternal depressive symptoms over the course of admission. Method: A retrospective audit was conducted on consecutively admitted mother–baby dyads between January 2011 and June 2015. Routinely collected maternal Beck Depression Inventory, second edition (BDI-II) scores were analysed for severity and change. Results: A total of 307 mother–baby dyads were admitted during the study period. The majority of mothers was partnered and educated young adults. The average length of stay was 4.4 weeks. The mean age of babies was 3.3 months. One-third of mothers met International Classification of Diseases, 10th edition criteria for two or more psychiatric diagnoses. Unipolar major depression was the commonest diagnosis. Of the 307 mothers, 125 mothers completed BDI-II on admission and on discharge, which showed a mean reduction of 16 points ( p < 0.001) on discharge. Conclusions: This study notes the similarities between the clinical profiles of the study population with mother–baby admissions to MBUs worldwide. Maternal depressive symptoms improved by 16 points on the BDI-II over the course of MBU admission, which shows the utility of MBU admission on maternal depressive symptoms.
Early detection of developmental dysplasia of hip by ultrasound
Authors: Gyurkovits Zita , Sohár Gellért , Baricsa Anna , Németh Gábor , Orvos Hajnalka , Dubs Beat 
Published: October 2019

Objective: To assess the effectiveness of early universal ultrasound (US) screening of developmental dysplasia of the hip (DDH). Study design: A prospective study of universal hip screening of all mature neonates was conducted from 2012 to 2013, at the Department of Obstetrics and Gynaecology, University of Szeged; 1636 newborns (3272 hips) had clinical examinations and hip ultrasound by the Graf method within the1st 3 days of life. Prevalence of DDH, risk factors, sensitivity and specificity of clinical examinations were evaluated. Results: At the 1st US, 70 of the examined 3272 hips (2.14%) were found to be positive. According to Graf categories, the following distribution was observed: type II C, 21 hips (30.0%); D, 24 hips (34.28%); III, 24 hips (34.28%); IV, 1 hip (1.44%). Regarding the risk factors, female gender, breech presentation and positive family history proved to be significant. Interestingly, 28 (50.90%) of the 55 newborns with DDH had neither positive physical signs nor any risk factors, except being female. The physical examination was calculated for sensitivity (20.0%) and specificity (98.34%). Conclusions: In our 1-year period study, 50.9% of the newborns with DDH had neither any positive physical signs nor any risk factors, except being a female. In contrast, early universal US screening of the hip facilitated to diagnose all cases with hip dysplasia. Hip sonography is an effective mode of prevention in orthopaedics, however further studies are needed to compare the rates of operative procedures in selective versus universal screening models.
Treatment of multiple sclerosis with rituximab: A multicentric Italian–Swiss experience
Authors: Zecca Chiara , Bovis Francesca , Novi Giovanni , Capobianco Marco , Lanzillo Roberta , Frau Jessica , Repice Anna Maria , Hakiki Bahia , Realmuto Sabrina , Bonavita Simona , Curti Erica , Brambilla Laura , Mataluni Giorgia , Cavalla Paola , Di Sapio Alessia , Signoriello Elisabetta , Barone Stefania , Maniscalco Giorgia T , Maietta Ilaria , Maraffi Isabella , Boffa Giacomo , Malucchi Simona , Nozzolillo Agostino , Coghe Giancarlo , Mechi Claudia , Salemi Giuseppe , Gallo Antonio , Sacco Rosaria , Cellerino Maria , Malentacchi Maria , De Angelis Marcello , Lorefice Lorena , Magnani Eliana , Prestipino Elio , Sperli Francesca , Brescia Morra Vincenzo , Fenu Giuseppe , Barilaro Alessandro , Abbadessa Gianmarco , Signori Alessio , Granella Franco , Amato Maria Pia , Uccelli Antonio , Gobbi Claudio , Sormani Maria Pia 
Published: October 2019

Background: Rituximab, an anti-CD20 monoclonal antibody leading to B lymphocyte depletion, is increasingly used as an off-label treatment option for multiple sclerosis (MS). Objective: To investigate the effectiveness and safety of rituximab in relapsing–remitting (RR) and progressive MS. Methods: This is a multicenter, retrospective study on consecutive MS patients treated off-label with rituximab in 22 Italian and 1 Swiss MS centers. Relapse rate, time to first relapse, Expanded Disability Status Scale (EDSS) progression, incidence of adverse events, and radiological outcomes from 2009 to 2019 were analyzed. Results: A total of 355/451 enrolled subjects had at least one follow-up visit and were included in the outcome analysis. Annualized relapse rate significantly decreases after rituximab initiation versus the pre-rituximab start year in RRMS (from 0.86 to 0.09, p < .0001) and in secondary-progressive (SP) MS (from 0.34 to 0.06, p < .0001) and had a slight decrease in primary-progressive (PP) MS patients (from 0.12 to 0.07, p = 0.45). After 3 years from rituximab start, the proportion of patients with a confirmed EDSS progression was 14.6% in the RRMS group, 24.7% in the SPMS group, and 41.5% in the PPMS group. No major safety concerns arose. Conclusion: Consistently with other observational studies, our data show effectiveness of rituximab in reducing disease activity in patients with MS.
No association between cortical lesions and leptomeningeal enhancement on 7-Tesla MRI in multiple sclerosis
Authors: Ighani Mehrnaz , Jonas Samuel , Izbudak Izlem , Choi Seongjin , Lema-Dopico Alfonso , Hua Jun , O’Connor Erin E , Harrison Daniel M 
Published: October 2019

Background: Autopsy data suggest a causative link between meningeal inflammation and cortical lesions (CLs) in multiple sclerosis (MS). Objective: To use leptomeningeal enhancement (LME) and CLs on 7-Tesla (7T) magnetic resonance imaging (MRI) to investigate associations between meningeal inflammation and cortical pathology. Methods: Forty-one participants with MS underwent 7T MRI of the brain. CLs and foci of LME were quantified. Results: All MS participants had CLs; 27 (65.8%) had >1 focus of LME. Except for hippocampal CL count (ρ = 0.32 with spread/fill-sulcal pattern LME, p = 0.042), no significant correlations were seen between LME and CLs. Mean cortical thickness correlated with the number of LME foci (ρ = –0.43, p = 0.005). Participants with relapsing–remitting multiple sclerosis (RRMS) showed no correlation with neocortical CLs, but significant correlations were seen between LME and hippocampal lesion count (ρ = 0.39, p = 0.030), normalized cortical gray matter (GM) volume (ρ = –0.49, p = 0.005), and mean cortical thickness (ρ = –0.59, p < 0.001). Conclusion: This study supports a relationship between LME and cortical GM atrophy but does not support an association of LME and neocortical CLs. This may indicate that meningeal inflammation is involved with neurodegenerative inflammatory processes, rather than focal lesion development.
The influence of human leukocyte antigen-DRB1*15:01 and its interaction with smoking in MS development is dependent on DQA1*01:01 status
Authors: Hedström Anna Karin , Hössjer Ola , Hillert Jan , Stridh Pernilla , Kockum Ingrid , Olsson Tomas , Alfredsson Lars 
Published: October 2019

Background: HLA-DRB1*15:01, absence of HLA-A*02:01, and smoking interact to increase multiple sclerosis (MS) risk. Objective: To analyze whether MS-associated human leukocyte antigen (HLA) alleles, apart from DRB1*15:01 and absence of A*02:01, interact with smoking in MS development, and to explore whether the established HLA-smoking interaction is affected by the DQA1*01:01 allele, which confers a protective effect only in the presence of DRB1*15:01. Methods: In two Swedish population-based case–control studies (5838 cases, 5412 controls), subjects with different genotypes and smoking habits were compared regarding MS risk, by calculating odds ratios with 95% confidence intervals employing logistic regression. Interaction on the additive scale between different genotypes and smoking was evaluated. Results: The DRB1*08:01 allele interacted with smoking to increase MS risk. The interaction between DRB1*15:01 and both the absence of A*02:01 and smoking was confined to DQA1*01:01 negative subjects, whereas no interactions occurred among DQA1*01:01 positive subjects. Conclusion: Multifaceted interactions take place between different class II alleles and smoking in MS development. The influence of DRB1*15:01 and its interaction with the absence of A*02:01 and smoking is dependent on DQA1*01:01 status which may be due to differences in the responding T-cell repertoires.
Evaluation of telemonitoring of continuous positive airway pressure therapy in obstructive sleep apnoea syndrome: TELEPAP pilot study
Authors: Fernandes Manuel , Antunes Catarina , Martinho Cristina , Carvalho João , Abreu Tiago , Oliveira Ana , Pinto Paula , Bárbara Cristina 
Published: October 2019

Introduction Continuous positive airway pressure is an effective treatment for obstructive sleep apnoea syndrome. However, positive airway pressure compliance rates are disappointingly low, so effective interventions are needed to improve compliance in sleep apnoea. Telemonitoring has been used to improve compliance, but results have been inconsistent. This study aimed to determine outcomes of telemonitoring positive airway pressure compliance and efficacy data compared to usual care and phone-call care. Methods Randomized controlled study in which 51 patients (82.4% male; between 25 and 78 years), diagnosed with moderate to severe obstructive sleep apnoea were consecutively randomized to usual care, weekly phone-call care or telemonitored care with the use of Restraxx™. All patients were submitted to a comprehensive educational programme during positive airway pressure adaptation. Patients were followed for the first four weeks of treatment with automatic positive airway pressure (AutoSet Spirit S8®; ResMed), and compliance and efficacy data were analyzed. Results Telemonitored care group used automatic positive airway pressure an average of 5.0 ± 1.8 hours/night, usual care patients 5.1 ± 2.5 hours and phone-call care patients 3.9 ± 2.6 hours. The residual Apnoea--Hypopnoea Index was 5.3 ± 3.0 in telemonitored care, 5.0 ± 2.5 in usual care and 5.6 ± 3.8 in phone-call care. No statistically significant differences were found between groups regarding positive airway pressure compliance or efficacy ( p = 0.296 and p = 0.825, respectively). Discussion In the presence of a comprehensive educational programme during positive airway pressure adaptation, telemonitoring patients did not show benefits concerning compliance and efficacy. A larger follow-up period is needed to evaluate the long-term results of a telemonitoring programme.
Exploring healthcare professionals’ understanding and experiences of artificial intelligence technology use in the delivery of healthcare: An integrative review
Authors: Shinners Lucy , Aggar Christina , Grace Sandra , Smith Stuart 
Published: October 2019

Background: The integration of artificial intelligence (AI) into our digital healthcare system is seen as a significant strategy to contain Australia’s rising healthcare costs, support clinical decision making, manage chronic disease burden and support our ageing population. With the increasing roll-out of ‘digital hospitals’, electronic medical records, new data capture and analysis technologies, as well as a digitally enabled health consumer, the Australian healthcare workforce is required to become digitally literate to manage the significant changes in the healthcare landscape. To ensure that new innovations such as AI are inclusive of clinicians, an understanding of how the technology will impact the healthcare professions is imperative. Method: In order to explore the complex phenomenon of healthcare professionals’ understanding and experiences of AI use in the delivery of healthcare, an integrative review inclusive of quantitative and qualitative studies was undertaken in June 2018. Results: One study met all inclusion criteria. This study was an observational study which used a questionnaire to measure healthcare professional’s intrinsic motivation in adoption behaviour when using an artificially intelligent medical diagnosis support system (AIMDSS). Discussion: The study found that healthcare professionals were less likely to use AI in the delivery of healthcare if they did not trust the technology or understand how it was used to improve patient outcomes or the delivery of care which is specific to the healthcare setting. The perception that AI would replace them in the healthcare setting was not evident. This may be due to the fact that AI is not yet at the forefront of technology use in healthcare setting. More research is needed to examine the experiences and perceptions of healthcare professionals using AI in the delivery of healthcare.
MiR-26a-5p Inhibits Cell Proliferation and Enhances Doxorubicin Sensitivity in HCC Cells via Targeting AURKA
Authors: Yuan Yan Li , Yu HaiBo , Mu Sen-Mao , Dong Ya Dong , Li De Yu 
Published: October 2019

Objective: To investigate the role of miR-26a-5p in cell proliferation and doxorubicin sensitivity in hepatocellular carcinoma. Methods: We evaluated miR-26a-5p expression in hepatocellular carcinoma tissues and cell lines by reverse transcription polymerase chain reaction. Cell Counting Kit-8 was used to examine cell proliferation. Relationship between miR-26a-5p and aurora kinase A was evaluated by luciferase report system. Western blot was used to detect expression of aurora kinase A. Results: In this study, we observed miR-26a-5p was downregulated in hepatocellular carcinoma tissues and cell lines. Gain-of-function experiments showed that proliferation rate of hepatocellular carcinoma cells decreased under condition of miR-26a-5p mimics. We found miR-26a-5p mimics could enhance doxorubicin sensitivity of hepatocellular carcinoma cells. Further study showed that aurora kinase A was target gene of miR-26a-5p. Suppression of aurora kinase A could lead to lower cell proliferation and higher doxorubicin sensitivity of hepatocellular carcinoma cells. Conclusion: Our study found that miR-26a-5p could inhibit cell proliferation and enhance doxorubicin sensitivity in hepatocellular carcinoma cells by targeting aurora kinase A.
Determining the optimal dose of tenecteplase before endovascular therapy for ischemic stroke (EXTEND-IA TNK Part 2): A multicenter, randomized, controlled study
Authors: Campbell Bruce CV , Mitchell Peter J , Churilov Leonid , Yassi Nawaf , Kleinig Timothy J , Yan Bernard , Thijs Vincent , Desmond Patricia M , Parsons Mark W , Donnan Geoffrey A , Davis Stephen M 
Published: October 2019

Background and hypothesis Intravenous thrombolysis with tenecteplase is more effective than alteplase in achieving substantial reperfusion at initial angiographic assessment and improves functional outcome. However, the optimal dose of tenecteplase remains uncertain. We hypothesized that 0.40 mg/kg tenecteplase is superior to 0.25 mg/kg tenecteplase in achieving reperfusion at initial angiogram, when administered within 4.5 h of ischemic stroke onset, in patients planned to undergo endovascular therapy. Study design EXTEND-IA TNK part 2 is an investigator-initiated, phase II, multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) study. Eligibility requires a diagnosis of ischemic stroke within 4.5 h of stroke onset, pre-stroke modified Rankin Scale (mRS)≤3 (no upper age limit), absence of contraindications to intravenous thrombolysis, and large vessel occlusion (internal carotid, basilar, or middle cerebral artery) on multimodal CT. Patients are randomized to IV tenecteplase at either 0.40 mg/kg (max 40 mg) or 0.25 mg/kg (max 25 mg) prior to thrombectomy. Study outcomes The primary outcome measure is reperfusion on the initial catheter angiogram, assessed as modified Treatment In Cerebral Infarction (mTICI) 2b/3, or the absence of retrievable intracranial thrombus. Secondary outcomes include mRS at day 90 and early neurological improvement (reduction in National Institutes of Health Stroke Scale (NIHSS) by ≥8 points or reaching 0–1) at day 3. Safety outcomes are death and symptomatic intracerebral hemorrhage. Trial registration: ClinicalTrials.gov NCT03340493
Should we change reference range for serum albumin in major gastrointestinal surgery? Preoperative serum albumin as an important prognostic factor
Authors: Czempik Piotr F , Czepczor Kinga , Czok Marcelina Z 
Published: October 2019

Introduction The aim of the study was to analyse prognostic value of laboratory markers of nutritional status in gastrointestinal surgery. Methods We performed a retrospective analysis of clinical and laboratory data of 102 patients admitted to an Intensive Care Unit following elective gastrointestinal surgery. The outcome measures included hospital mortality, infectious complications, surgical complications and length of stay. Results Forty-eight patients had all three laboratory markers of nutritional status determined before surgery and these patients constituted our study group. We found correlations between preoperative serum albumin and hospital mortality, risk of reoperation and urinary tract infection. Preoperative total serum protein correlated with urinary tract infection. Total lymphocyte count was predictive of bacteraemia. No statistically significant correlations were found between markers of nutritional status and length of stay. Conclusions Serum albumin concentration at the lower limit is associated with increased mortality, reoperation, urinary tract infection. Total serum protein predicts urinary tract infection, whereas total lymphocyte count predicts bacteraemia.
Diastolic dysfunction in men with severe obstructive sleep apnea syndrome but without cardiovascular or oxidative stress-related comorbidities
Authors: Papanikolaou John , Ntalapascha Melpomeni , Makris Demosthenes , Koukoubani Triantafyllia , Tsolaki Vasiliki , Zakynthinos George , Gourgoulianis Konstantinos , Zakynthinos Epaminondas 
Published: October 2019

Background: We aimed to evaluate whether the severity of obstructive sleep apnea syndrome (OSAS) per se affects the prevalence of left ventricular (LV) diastolic dysfunction in patients without comorbidities. Methods: A total of 42 patients with first-diagnosed severe OSAS [apnea–hypopnea index (AHI) > 30] and 25 controls (AHI < 5), having been referred for snoring to the Sleep Laboratory Department of our tertiary Hospital, were enrolled in the study. Inclusion criteria were absence of any cardiovascular or oxidative stress-related comorbidities, and age between 20 and 70 years. Clinical, laboratory, echocardiographic, and polysomnographic data were recorded prospectively. Diastolic dysfunction diagnosis and grading was based on 2016 ASE/EACVI recommendations. Results: Severe OSAS was associated with significantly increased prevalence and degree of diastolic dysfunction (26/42; 61.9%) compared with controls (7/25; 28%) ( p = 0.007). AHI ⩾ 55 (dichotomous value of severe OSAS subset) was also characterized by greater prevalence and degree of diastolic dysfunction compared with 30 < AHI < 55 patients ( p = 0.015). In the severe OSAS subset, age >45 years-old, height <1.745 m, body-mass index (BMI) >27.76 kg m−2, OSAS severity (AHI > 57.35), oxidative stress (overnight reduction of reduced to oxidized glutathione ratio < 18.44%), and BMI/height ratio > 16.155 kg m−3 (an index describing ‘dense’, short-heavy patients) presented significant diagnostic utility in identifying diastolic dysfunction in ROC-curve analysis (0.697 ⩾ AUC ⩾ 0.855, 0.001 ⩽  p ⩽ 0.018). In binary logistic regression model, advanced age (OR 1.23, 95% CI 1.025–1.477; p = 0.026) and AHI (OR 1.123, 95% CI 1.007–1.253; p = 0.036) showed independent association with diastolic dysfunction in severe OSAS. Conclusions: The present prospective study may suggest that severe OSAS is significantly associated with LV diastolic dysfunction; OSAS clinical severity exerts a positive influence on (and possibly constitutes an independent risk factor of) LV diastolic dysfunction. The reviews of this paper are available via the supplementary material section.
Early Alterations of Subchondral Bone in the Rat Anterior Cruciate Ligament Transection Model of Osteoarthritis
Authors: Aizah Nik , Chong Pan Pan , Kamarul Tunku 
Published: October 2019

Objective Advances in research have shown that the subchondral bone plays an important role in the propagation of cartilage loss and progression of osteoarthritis (OA), but whether the subchondral bone changes precede or lead to articular cartilage loss remains debatable. In order to elucidate the subchondral bone and cartilage changes that occur in early OA, an experiment using anterior cruciate ligament transection (ACLT) induced posttraumatic OA model of the rat knee was conducted. Design Forty-two Sprague Dawley rats were divided into 2 groups: the ACLT group and the nonoperated control group. Surgery was conducted on the ACLT group, and subsequently rats from both groups were sacrificed at 1, 2, and 3 weeks postsurgery. Subchondral bone was evaluated using a high-resolution peripheral quantitative computed tomography scanner, while cartilage was histologically evaluated and scored. Results A significant reduction in the subchondral trabecular bone thickness and spacing was found as early as 1 week postsurgery in ACLT rats compared with the nonoperated control. This was subsequently followed by a reduction in bone mineral density and bone fractional volume at week 2, and finally a decrease in the trabecular number at week 3. These changes occurred together with cartilage degeneration as reflected by an increasing Mankin score over all 3 weeks. Conclusions Significant changes in subchondral bone occur very early in OA concurrent with surface articular cartilage degenerative change suggest that factors affecting bone remodeling and resorption together with cartilage matrix degradation occur very early in the disease.