bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does pre-existing cognitive impairment impact on amount of stroke rehabilitation received? An observational cohort study
Authors: Longley Verity , Peters Sarah , Swarbrick Caroline , Rhodes Sarah , Bowen Audrey 
Published: April 2019

Objective: To examine whether stroke survivors in inpatient rehabilitation with pre-existing cognitive impairment receive less therapy than those without. Design: Prospective observational cohort. Setting: Four UK inpatient stroke rehabilitation units. Participants: A total of 139 stroke patients receiving rehabilitation, able to give informed consent/had an individual available to act as personal consultee. In total, 33 participants were categorized with pre-existing cognitive impairment based on routine documentation by clinicians and 106 without. Measures: Number of inpatient therapy sessions received during the first eight weeks post-stroke, referral to early supported discharge, and length of stay. Results: On average, participants with pre-existing cognitive impairment received 40 total physiotherapy and occupational therapy sessions compared to 56 for those without (mean difference = 16.0, 95% confidence interval (CI) = 2.9, 29.2), which was not fully explained by adjusting for potential confounders (age, sex, National Institutes of Health Stroke Scale (NIHSS), and pre-stroke modified Rankin Scale (mRS)). While those with pre-existing cognitive impairment received nine fewer single-discipline physiotherapy sessions (95% CI = 3.7, 14.8), they received similar amounts of single-discipline occupational therapy, psychology, and speech and language therapy; two more non-patient-facing occupational therapy sessions (95% CI = –4.3, –0.6); and nine fewer patient-facing occupational therapy sessions (95% CI = 3.5, 14.9). There was no evidence to suggest they were discharged earlier, but of the 85 participants discharged within eight weeks, 8 (42%) with pre-existing cognitive impairment were referred to early supported discharge compared to 47 (75%) without. Conclusion: People in stroke rehabilitation with pre-existing cognitive impairments receive less therapy than those without, but it remains unknown whether this affects outcomes.
Combination of radiofrequency ablation and transcatheter arterial chemoembolization to treat hepatocellular carcinoma: measurement of distance from needle tip to nodule for assessment of local tumor progression
Authors: Haochen Wang , Jian Wang , Li Song , Tianshi Lv , Xiaoqiang Tong , Yinghua Zou 
Published: April 2019

Objective This study was performed to determine the relationship between the minimum distance from the radiofrequency ablation (RFA) needle tip to the tumor and local tumor progression (LTP) of hepatocellular carcinoma (HCC) nodules and identify prognostic factors for LTP. Methods We reviewed 197 patients (197 nodules) who underwent RFA after transcatheter arterial chemoembolization for HCC from January 2010 to January 2015. Three-dimensional registration of images was used to calculate the minimum distance from the tip to the tumor. We then divided the minimum distance into two groups: <2 and ≥2 mm. Contrast-enhanced computed tomography was performed after treatment. The LTP rate was calculated 1 and 3 years after RFA. We performed multivariate analysis to identify independent prognostic factors for LTP. Results The cumulative 1-year LTP rates in the <2- and ≥2-mm groups were 82.7% and 4.3%, respectively, and the cumulative 3-year LTP rates in the two groups were 94.8% and 10.8%, respectively. The minimum distance from the needle tip to the tumor was an independent prognostic factor for LTP. Conclusions A minimum distance of 2 mm from the needle tip to the tumor should be completely ablated along with the tumor.
Correlation Between Joint-Position Sense, Peroneal Strength, Postural Control, and Functional Performance Ability in Patients With Chronic Lateral Ankle Instability
Authors: Cho Byung-Ki , Park Ji-Kang 
Published: April 2019

Background: The first aim of this study was to evaluate the side-to-side difference of joint-position sense, peroneal strength, postural control, and functional performance ability in patients with chronic lateral ankle instability. The second aim was to identify the correlation between various components contributing to the functional ankle instability (FAI). Methods: Thirty-five patients to be scheduled for the modified Broström procedure for chronic ankle instability were analyzed. Joint-position sense and peroneal strength were measured with an isokinetic dynamometer. Postural control ability was evaluated using the modified Romberg test. The functional performance test consisted of the 1-leg hop test, 6-meter hop test, and cross 3-m hop test. Spearman’s correlation coefficient ( r) was calculated to determine the linear association between the individual components of the FAI. Results: Except for the 6-m and cross 3-m hop tests, most examination tools for the FAI demonstrated significant side-to-side differences compared with the unaffected ankle. Spearman’s correlation analysis revealed that individual components (joint-position sense, peroneal strength, postural control, and functional performance ability) of the FAI were significantly associated with one another, except between peroneal strength and postural control ability ( r = 0.21, P = .195). Conclusion: Joint-position sense, peroneal strength, postural control ability, and 1-leg hop test demonstrated significant side-to-side differences in patients with chronic lateral ankle instability. Individual components contributing to the FAI were significantly correlated with one another, except between peroneal strength and postural control ability. Postural control evaluation using the modified Romberg test could substitute for dynamometer testing, with convenience and economic advantage. Level of Evidence: Level IV, prospective case series.
Burkitt lymphoma masquerading as Tolosa–Hunt syndrome in an HIV-seropositive patient
Authors: Baig Iyza , Webb Ashley , Crowell Eric L , Supsupin Emilio P , Adesina Ore-ofe O 
Published: April 2019

Purpose: To describe a rare case of Burkitt lymphoma metastatic to the cavernous sinus that was initially diagnosed as Tolosa–Hunt syndrome. Case description: A 31-year-old confirmed and treatment-compliant HIV-positive Hispanic male acutely developed diplopia, ptosis, numbness in the V1 distribution, and complete external ophthalmoplegia in the right eye over 1 week. Imaging showed a mass-like lesion within the right cavernous sinus without other intracranial abnormalities. He was started on broad-spectrum antibiotics and antifungals without improvement. Inflammatory and infectious workup was negative. A presumed diagnosis of Tolosa–Hunt syndrome was made based on clinical and radiographic findings, as well as the absence of another etiology to explain the patient’s presentation. He was then started on high-dose oral steroids with improvement of orbital pain only. Shortly after being discharged on steroids, the patient returned to the hospital with severe abdominal pain. Computed tomography of the abdomen showed perforated ileitis with aneurysmal dilation of the ileum and marked wall thickening concerning for a mass lesion. Positron emission tomography–computed tomography showed an uptake in the terminal ileum and right cavernous sinus consistent with metastatic Burkitt lymphoma, matching with pathology. After several cycles of chemotherapy, symptoms improved, and he regained full ocular motility in the affected eye. However, the patient ultimately died due to peritonitis and pyelonephritis. Conclusion: Burkitt lymphoma metastatic to the cavernous sinus was diagnosed after an initial diagnosis of Tolosa–Hunt syndrome. Tolosa–Hunt syndrome is a diagnosis of exclusion and should only be made after ruling out other pathologies.
SIRT1 in Astrocytes Regulates Glucose Metabolism and Reproductive Function
Authors: Choi Irene , Rickert Emily , Fernandez Marina , Webster Nicholas J G 
Published: April 2019

AbstractSirtuin 1 (Sirt1) is an NAD-dependent class III deacetylase that functions as a cellular energy sensor. In addition to its well-characterized effects in peripheral tissues, evidence suggests that SIRT1 in neurons plays a role in the central regulation of energy balance and reproduction, but no studies have addressed the contribution of astrocytes. We show here that overexpression of SIRT1 in astrocytes causes markedly increased food intake, body weight gain, and glucose intolerance, but expression of a deacetylase-deficient SIRT1 mutant decreases food intake and body weight and improves glucose tolerance, particularly in female mice. Paradoxically, the effect of these SIRT1 mutants on insulin tolerance was reversed, with overexpression showing greater insulin sensitivity. The mice overexpressing SIRT1 were more active, generated more heat, and had elevated oxygen consumption, possibly in compensation for the increased food intake. The female overexpressing mice were also more sensitive to diet-induced obesity. Reproductively, the mice expressing the deacetylase-deficient SIRT1 mutant had impaired estrous cycles, decreased LH surges, and fewer corpora lutea, indicating decreased ovulation. The GnRH neurons were responsive to kisspeptin stimulation, but hypothalamic expression of Kiss1 was reduced in the mutant mice. Our results showed that SIRT1 signaling in astrocytes can contribute to metabolic and reproductive regulation independent of SIRT1 effects in neurons.
Inflammation in the Pathophysiology and Therapy of Cardiometabolic Disease
Authors: Donath Marc Y , Meier Daniel T , Böni-Schnetzler Marianne 
Published: April 2019

Abstract
The role of chronic inflammation in the pathogenesis of type 2 diabetes mellitus and associated complications is now well established. Therapeutic interventions counteracting metabolic inflammation improve insulin secretion and action and glucose control and may prevent long-term complications. Thus, a number of anti-inflammatory drugs approved for the treatment of other inflammatory conditions are evaluated in patients with metabolic syndrome. Most advanced are clinical studies with IL-1 antagonists showing improved β-cell function and glycemia and prevention of cardiovascular diseases and heart failure. However, alternative anti-inflammatory treatments, alone or in combinations, may turn out to be more effective, depending on genetic predispositions, duration, and manifestation of the disease. Thus, there is a great need for comprehensive and well-designed clinical studies to implement anti-inflammatory drugs in the treatment of patients with metabolic syndrome and its associated conditions.
Effect of Macronutrient Type and Gastrointestinal Release Site on PYY Response in Normal Healthy Subjects
Authors: Mangan Aisling M , Al Najim Werd , McNamara Niamh , Martin William P , Antanaitis Andrius , Bleiel Sinéad B , Kent Robert M , le Roux Carel W , Docherty Neil G 
Published: April 2019

Abstract

Background and Aims
Enteroendocrine L cells release satiety inducing hormones in response to stimulation by luminal macronutrients. We sought to profile the differential effect of macronutrient type and site of release on circulating concentrations of the L cell-derived enteroendocrine hormone peptide tyrosine tyrosine (amino acids 1 to 36) (PYY).

Materials and Methods
Eight healthy volunteers were recruited to a randomized, double-blinded, six-way crossover study. At each visit, the participants consumed a 500-kcal drink containing carbohydrate, protein, or fat in either gastric or small intestinal release formulations. Plasma PYY concentrations and hunger ratings were assessed for 3 hours after consumption of the test drink. The food intake was recorded thereafter at an ad libitum lunch.

Results
Microcapsular formulations targeting the distal small intestinal delivery of fat, but not carbohydrate or protein, markedly enhance PYY release relative to macronutrient delivery in gastric release formulations. Food intake at an ad libitum meal was lowest after consumption of the formulation releasing fat at the distal small intestine.

Conclusion
Targeting of fat to the distal small intestine in delayed release microcapsules enhanced PYY release and was associated with reductions in food intake.
Clinical but Not Histological Outcomes in Males With 45,X/46,XY Mosaicism Vary Depending on Reason for Diagnosis
Authors: Ljubicic Marie Lindhardt , Jørgensen Anne , Acerini Carlo , Andrade Juliana , Balsamo Antonio , Bertelloni Silvano , Cools Martine , Cuccaro Rieko Tadokoro , Darendeliler Feyza , Flück Christa E , Grinspon Romina P , Maciel-Guerra Andrea , Guran Tulay , Hannema Sabine E , Lucas-Herald Angela K , Hiort Olaf , Holterhus Paul Martin , Lichiardopol Corina , Looijenga Leendert H J , Ortolano Rita , Riedl Stefan , Ahmed S Faisal , Juul Anders 
Published: April 2019

Abstract

Context
Larger studies on outcomes in males with 45,X/46,XY mosaicism are rare.

Objective
To compare health outcomes in males with 45,X/46,XY diagnosed as a result of either genital abnormalities at birth or nongenital reasons later in life.

Design
A retrospective, multicenter study.

Setting
Sixteen tertiary centers.

Patients or Other Participants
Sixty-three males older than 13 years with 45,X/46,XY mosaicism.

Main Outcome Measures
Health outcomes, such as genital phenotype, gonadal function, growth, comorbidities, fertility, and gonadal histology, including risk of neoplasia.

Results
Thirty-five patients were in the genital group and 28 in the nongenital. Eighty percent of all patients experienced spontaneous pubertal onset, significantly more in the nongenital group (P = 0.023). Patients were significantly shorter in the genital group with median adult heights of 156.7 cm and 164.5 cm, respectively (P = 0.016). Twenty-seven percent of patients received recombinant human GH. Forty-four patients had gonadal histology evaluated. Germ cells were detected in 42%. Neoplasia in situ was found in five patients. Twenty-five percent had focal spermatogenesis, and another 25.0% had arrested spermatogenesis. Fourteen out of 17 (82%) with semen analyses were azoospermic; three had motile sperm.

Conclusion
Patients diagnosed as a result of genital abnormalities have poorer health outcomes than those diagnosed as a result of nongenital reasons. Most patients, however, have relatively good endocrine gonadal function, but most are also short statured. Patients have a risk of gonadal neoplasia, and most are azoospermic, but almost one-half of patients has germ cells present histologically and up to one-quarter has focal spermatogenesis, providing hope for fertility treatment options.
Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study
Authors: Shah Viral N , DuBose Stephanie N , Li Zoey , Beck Roy W , Peters Anne L , Weinstock Ruth S , Kruger Davida , Tansey Michael , Sparling David , Woerner Stephanie , Vendrame Francesco , Bergenstal Richard , Tamborlane William V , Watson Sara E , Sherr Jennifer 
Published: April 2019

Abstract

Context
Use of continuous glucose monitoring (CGM) is increasing for insulin-requiring patients with diabetes. Although data on glycemic profiles of healthy, nondiabetic individuals exist for older sensors, assessment of glycemic metrics with new-generation CGM devices is lacking.

Objective
To establish reference sensor glucose ranges in healthy, nondiabetic individuals across different age groups using a current generation CGM sensor.

Design
Multicenter, prospective study.

Setting
Twelve centers within the T1D Exchange Clinic Network.

Patients or Participants
Nonpregnant, healthy, nondiabetic children and adults (age ≥6 years) with nonobese body mass index.

Intervention
Each participant wore a blinded Dexcom G6 CGM, with once-daily calibration, for up to 10 days.

Main Outcome Measures
CGM metrics of mean glucose, hyperglycemia, hypoglycemia, and glycemic variability.

Results
A total of 153 participants (age 7 to 80 years) were included in the analyses. Mean average glucose was 98 to 99 mg/dL (5.4 to 5.5 mmol/L) for all age groups except those over 60 years, in whom mean average glucose was 104 mg/dL (5.8 mmol/L). The median time between 70 to 140 mg/dL (3.9 to 7.8 mmol/L) was 96% (interquartile range, 93 to 98). Mean within-individual coefficient of variation was 17 ± 3%. Median time spent with glucose levels &gt;140 mg/dL was 2.1% (30 min/d), and median time spent with glucose levels &lt;70 mg/dL (3.9 mmol/L) was 1.1% (15 min/d).

Conclusion
By assessing across age groups in a healthy, nondiabetic population, normative sensor glucose data have been derived and will be useful as a benchmark for future research studies.
Regional Cerebral Activation Accompanies Sympathoexcitation in Women With Polycystic Ovary Syndrome
Authors: Lansdown Andrew J , Warnert Esther A H , Sverrisdóttir Yrsa , Wise Richard G , Rees D Aled 
Published: April 2019

AbstractContextPolycystic ovary syndrome (PCOS) is associated with increased sympathetic nervous system activation, but the cerebral pathways involved are unclear.ObjectiveTo compare cerebral [blood oxygen level–dependent (BOLD) functional MRI], pressor [blood pressure (BP), heart rate (HR], and muscle sympathetic nerve activity (MSNA) responses to isometric forearm contraction (IFC) in women with PCOS and matched control subjects.DesignCase-control study.SettingReferral center.ParticipantsPatients with PCOS (n = 20; mean ± SD data: age, 29.8 ± 4.8 years; body mass index (BMI), 26.1 ± 4.9 kg/ m2) and 20 age- and BMI-matched control subjects (age, 29.7 ± 5.0 years; BMI, 26.1 ± 4.8 kg/ m2).Main outcome measuresBP, HR, catecholamine, and MSNA responses to 30% IFC. BOLD signal change was modeled for BP response to 30% IFC.ResultsAlthough HR and BP increased to a similar extent in both groups after IFC, MSNA burst frequency increased by 68% in the PCOS group compared with 11.9% in control subjects (n = 7 in both groups; P = 0.002). Brain activation indexed by the BOLD signal in response to IFC was significantly greater in the PCOS group (n = 15) compared with controls (n = 15) in the right orbitofrontal cortex (P < 0.0001). Adjustment for insulin sensitivity, but not hyperandrogenism, abolished these between-group differences.ConclusionOur study confirms enhanced sympathoexcitation in women with PCOS and demonstrates increased regional brain activation in response to IFC. The right orbitofrontal cortex BOLD signal change in women with PCOS is associated with insulin sensitivity. Additional studies are warranted to clarify whether this may offer a novel target for cardiovascular risk reduction.
Myocardial differentiation is dependent upon endocardial signaling during early cardiogenesis in vitro
Authors: Saint-Jean Leshana , Barkas Nikolaos , Harmelink Cristina , Tompkins Kevin L. , Oakey Rebecca J. , Baldwin H. Scott 
Published: April 2019

ABSTRACT
The endocardium interacts with the myocardium to promote proliferation and morphogenesis during the later stages of heart development. However, the role of the endocardium in early cardiac ontogeny remains under-explored. Given the shared origin, subsequent juxtaposition, and essential cell-cell interactions of endocardial and myocardial cells throughout heart development, we hypothesized that paracrine signaling from the endocardium to the myocardium is crucial for initiating early differentiation of myocardial cells. To test this, we generated an in vitro, endocardial-specific ablation model using the diphtheria toxin receptor under the regulatory elements of the Nfatc1 genomic locus (NFATc1-DTR). Early treatment of NFATc1-DTR mouse embryoid bodies with diphtheria toxin efficiently ablated endocardial cells, which significantly attenuated the percentage of beating EBs in culture and expression of early and late myocardial differentiation markers. The addition of Bmp2 during endocardial ablation partially rescued myocyte differentiation, maturation and function. Therefore, we conclude that early stages of myocardial differentiation rely on endocardial paracrine signaling mediated in part by Bmp2. Our findings provide novel insight into early endocardial-myocardial interactions that can be explored to promote early myocardial development and growth.
Total knee arthroplasty using hinge joints: Indications and results
Authors: Rodríguez-Merchán E. Carlos 
Published: April 2019

Possible indications for a rotating hinge or pure hinge implant in primary total knee arthroplasty (TKA) include collateral ligament insufficiency, severe varus or valgus deformity (> 20°) with relevant soft-tissue release, relevant bone loss, including insertions of collateral ligaments, gross flexion-extension gap imbalance, ankylosis and hyperlaxity. The use of hinged implants in primary TKA should be limited to the aforementioned selected indications, especially for elderly patients. Potential indications for a rotating hinge or pure hinge implant in revision TKA include infection, aseptic loosening, instability and bone loss. Rotating hinge knee implants have a 10-year survivorship in the range of 51% to 92.5%. Complication rates of rotating hinge knee implants are in the range of 9.2% to 63%, with infection and aseptic loosening as the most common complications. Although the results reported in the literature are inconsistent, clinical results generally depend on the implant design, appropriate technical use and adequate indications. Considering that the revision of implants with long cemented stems can be challenging, in the future it would be better to use shorter stems in modular versions of hinged knee implants. Cite this article: EFORT Open Rev 2019;4:121-132. DOI: 10.1302/2058-5241.4.180056
The effect of thermal cycling on the mechanical properties of jute fiber reinforced by E-glass fiber composites
Authors: Sudhabindu B , P.V. Ramarao Dr , C. Uday Kiran Dr 
Published: April 2019

This work researches the mechanical, aging and opacity properties of jute fiber reinforced by E-glass fiber by hybrid composites. The detrimental impacts of climate conditions are reproduced and they are used to anticipate the longevity of materials utilized outside. Rain and humidity are additionally be reenacted with a buildup framework and additionally water splash. The harming impacts of daylight are reproduced by UV-fluorescent lights. UVB light ranges from 280-315 nm are conveyed to uncover in hybrid composite and varieties in tensile tests are resolved for 50, 75 and 100 hrs. The mechanical properties as an element of fortification substance are influenced which are reflected in the estimations of the ductile modulus and quality and also affect protection and hardness. Including mechanical properties, opacity test is conducted before and after exposure to ultraviolet radiation and surface morphology is studied