bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity-hyperlipidemia, Hypertension, and Left Atrial Enlargement During Stroke in Young Adults
Authors: Zhang Shouye , Zuo Peng 
Published: August 2023

Background:
This study investigated the association between left atrial enlargement and stroke severity in young adults. We also studied the differences between the normal and left atrial enlargement groups in clinical data.

Methods:
A total of 135 young stroke patients admitted to the Department of Neurology of the Taizhou People’s Hospital were recruited from January 2018 to December 2021. The patients were divided into normal and enlarged groups by left atrial size. The relationship between the left atrial diameter and the National Institutes of Health Stroke Scale score was analyzed apart from the differences in clinical variables.

Results:
No relationship was observed between the left atrial diameter and the National Institutes of Health Stroke Scale score (r=−0.045 P=0.603). The univariate analysis of both groups revealed that hypertension (P=0.004), hyperlipidemia (P=0.001), body mass index (P=0.000), obesity (P=0.015), and not stroke etiologic subtypes were associated with left atrial enlargement. In binary logistic regression analysis models, hyperlipidemia 3.384 (95% CI, 1.536 to 7.452), hypertension 2.661 (95% CI, 1.066 to 6.639), and obesity 2.858 (95% CI, 1.158 to 7.052) were significantly associated with the young stroke of left atrial enlargement.

Conclusions:
In young adults, obesity-hyperlipidemia and hypertension were significantly associated with left atrial enlargement in stroke.
Early Rehabilitation and Nursing Intervention (ERNI) Accelerates the Recovery of Patients With Ischemic Stroke
Authors: Huang Jianghua , Zuo Juan , Tang Xuan , Zou Jieqiong , Zeng Yahua , Chen Shuangqin , He Gufen 
Published: August 2023

Background:
Ischemic stroke, a severe disease with high disability and mortality, causes an overburden in society and demands more effective treatments. Early rehabilitation and nursing intervention (ERNI) helps the postoperative recovery of patients with hypertensive intracerebral hemorrhage. However, the effect of ERNI on the recovery of people after ischemic stroke remains unclear.

Methods:
Patients were treated with the ERNI program; subsequently, Mini-Mental State Examination, National Institute of Health stroke scale, Fugl-Meyer Assessment Scale, Daily living activity assessment, and Quality of life test were performed after the treatment of ERNI to evaluate the influence of ERNI on the cognitive function, motor function, and life quality of patients after ischemic stroke.

Results:
We observed that following the treatment of ERNI, cognitive, neurological, and motor functions, daily life qualities, and life quality in the ERNI-treated group were significantly better than that in the control group.

Conclusion:
ERNI promoted the recovery of neurological function and improved the life qualities of patients after ischemic stroke.
Case Report: Multimode Imaging of Chronic Syphilitic Chorioretinitis
Authors: Jiang Zhijian , Ji Huiying , Zhang Nan , Huang Liang , Dong Jianhong 
Published: August 2023

ABSTRACT

Significance
The clinical manifestations of ocular syphilis may mimic those of other diseases, which may result in a missed diagnosis and delayed treatment.

Purpose
We describe multimodal imaging findings and treatment outcomes of a patient with chronic syphilitic chorioretinitis.

Case Report
A 40-year-old male patient complained of progressive decreased visual acuity of his left eye for over one year. The best-corrected visual acuity (BCVA) was 20/20 in the right eye and 3/50 in the left eye. Relative afferent pupillary defect and 1+ vitreous cells were detected in the left eye. The authors performed fundus examination, fluorescence angiography, ultra-widefield fundus autofluorescence, structure optical coherence tomography, widefield montage optical coherence tomography angiography and visual field. Laboratory tests including a toluidine red unheated serum test (TRUST; 1:32) and the Treponema pallidum antibody (9.01S/CO) were positive. The diagnosis of chronic syphilitic chorioretinitis was diagnosed in both eyes. The patient was admitted for administration of intravenous penicillin G for 14 days, followed by intramuscular benzathine penicillin G weekly for three doses. Six months after treatment, the TRUST ratio had decreased to 1:2 (positive). BCVA was 20/20 in the right eye and 6/20 in the left eye. The re-examination results showed the ocular structure and capillaris flow partially recovered.

Conclusions
Chronic syphilitic chorioretinitis profoundly affects the structure of the retina and choroid; however, eyes may partially recover after effective treatment. Ultra-widefield imaging technology has several advantages, such as broader imaging field and more details provided, in determining syphilis induced ocular disorders.
Localized Heat Treatment for Meibomian Gland Dysfunction: A Single-Center Retrospective Analysis of Efficacy over Time
Authors: Chester Thomas , Ferguson Tanner , Chester Emma 
Published: August 2023

SIGNIFICANCE
Meibomian gland dysfunction (MGD) can produce a myriad of symptoms. The effective treatment of MGD can reduce the burden of this condition. Although several studies have indicated that TearCare (Sight Sciences, Menlo Park, CA) is an effective treatment for MGD, no studies currently provide information regarding the duration of efficacy.

PURPOSE
The purpose of this analysis was to determine the duration of efficacy of symptom relief and improvement of signs (as measured by gland function) for a treatment consisting of controlled heating of the meibomian glands using SmartLids (Sight Sciences) combined with manual expression of the liquefied meibum by a physician.

METHODS
This study involved retrospective analysis of data gathered from a single-center ophthalmology/optometry practice. Symptoms were assessed using the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, and the signs were assessed using the meibomian gland expression (MGE) scores before and at several time points (8 weeks, 6 months, 12 months, and 18 months). Further analysis evaluating the efficacy in subgroups based on age, race, and sex was performed.

RESULTS
There were 78 patients included in this study. The mean baseline SPEED score decreased from 14 to 7.9 at 8 weeks. The mean SPEED scores at 6 and 12 months were maintained at 7.7 and 7.9, respectively, and at 18 months went to 8.9. At baseline, the mean MGE was 4.9 in the right eye and 4.8 in the left eye. In both eyes, the mean MGE increased to 9.0 in both eyes at 8 weeks. At 6 months, the mean MGE score was maintained at 8.6 in the right and 8.2 in the left and remained consistent at 12 months with 7.8 in the right and 7.8 in the left. At 18 months, the MGE score went to 6.8 in the right eye and 7.0 in the left eye.

CONCLUSIONS
A single TearCare treatment effectively reduced both the symptoms and signs of MGD and maintained its effects for 12 months.
Utility for Uncorrected Refractive Errors in Adolescent Schoolchildren in Kakamega County, Kenya
Authors: Okenwa-Vincent Emmanuel E. , Naidoo Jyoti , Clarke-Farr Peter C. 
Published: August 2023

ABSTRACT

Significance
Uncorrected refractive errors (UREs) present an enormous lifetime burden in children. Despite this, there is a dearth of knowledge on URE-related preference-based quality-of-life (QoL) in East Africa. This study demonstrates the positive impact of interventions on UREs; hence, it provides an empirical justification for advocacy to improve the QoL of children with URE.

Purpose
This study investigated the preference-based QoL (utility) for URE in school-going adolescents of Kakamega County, in Kenya.

Methods
An observational cross-sectional study with multi-stage sampling was conducted on randomly selected secondary school adolescents. School-going adolescents in Forms 1–4 were clinically examined for the presence of URE and classified according to their URE types. Prescreened students who met the selection criteria were classified into two groups: URE and normal sight. Participants in the normal-sight group were randomly selected from among screened students without URE. Selected participants were administered a previously validated adolescent-specific utility weighting instrument – Assessment of Quality of Life Six Dimensions (AQOL6D).

Results
A total of 330 participants aged 17.32 ± 1.60 years (URE:17.50 ± 1.58; normal-sight:17.15 ± 1.61) were included in the study. The mean utility score, as elicited by the AQOL6D scoring algorithm, was better in the normal-sight group (URE:0.496 ± 0.22; normal sight:0.567 ± 0.25) at baseline, whereas the converse was true at follow-up (URE:0.655 ± 0.20; normal sight:0.603 ± 0.25). In all cases, the differences were significant (P < .05); however, there was no significantly better (P > .05) utility elicited by any URE subtype at any given time point. Nonetheless, the URE group showed significantly better utility (P < .05) after spectacle correction.

Conclusions
UREs are associated with reduced utility in school-going adolescents, regardless of URE subtype. Spectacle correction resulted in a significantly improved utility for those with URE. Thus, this study recommends early public health strategies and spectacle interventions in schools for adolescents with URE.
Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study
Authors: Rodriguez Neisha M. , Acevedo Ariette , Torres Vionette Pereira , Romero Angel F. 
Published: August 2023

SIGNIFICANCE
The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied.

PURPOSE
This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown.

METHODS
A retrospective record review of children aged 7 to 18 years who underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico was performed. The spherical equivalent pre- and post-lockdown was compared. The study excluded the best-corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia.

RESULTS
In total, 801 records were included in this study. The mean age was 12.7 ± 3.2 years, with 50.3% male and 49.7% female children. The mean spherical equivalent for the right and left eyes was similar (r = 0.93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre- and post- lockdown (0.22 ± 0.59 D, t
800 = 10.44, P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the 7- (0.13 ± 0.79 D, t
28 = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t
40 = 1.22, P = .23), respectively. No significant change was found between sexes before (0.16 ± 0.12 D; t
799 = 1.38, P = .16) and after (0.15 ± 0.13 D; t
799 = 1.19, P = .23) confinement.

CONCLUSIONS
The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement.
Atrial Fibrillation Screening in High-Risk Patients Using a Single Lead ECG Device: A Tertiary Hospital Experience
Authors: Aklilu Tesfamariam Betemariam , Kebede Meskerem Aleka , Mekonnen Duffera , Asrat Yidnekachew Birhan , Petros Adane Sikamo , Mekonnen Desalew 
Published: August 2023

AbstractBackgroundAtrial Fibrillation (AF) is a major public health problem and one of the commonest supraventricular arrhythmias. At least 20% of all strokes are directly attributable to AF. However, its burden is not clear in sub-Saharan Africa, possibly due in part to undervaluation and non-recognition. In recent decades several new devices have been developed for the betterment of the accuracy and rates of AF detection, which also offers flexibility and feasibility.ObjectiveThe objective of the study is to identify the prevalence of known and Unknown AF in a high-risk patient population using a validated single-lead ECG.Methods and materialsAn institution-based cross-sectional study was conducted in 410 adults (≥55 years) recruited from Tikur Anbessa hospital sub-specialty outpatient clinics from July to October 2021. ECG tracing was conducted using (AliveCor) SL ECG device. A standardized questionnaire was designed to collect socio-demographic and clinical information using ODK Collect v2021. 3.0. we used logistic regression to determine the potential associated factors.ResultsThe overall prevalence of AF in our study was 4.8%. It was strongly associated with age, diagnosis of heart failure, Substance use and high monthly income according to World Bank (WB) category. All the newly diagnosed patients were not on anticoagulation for stroke prevention.Conclusion and RecommendationsSingle timepoint screening in high-risk patients identified previously unknown AF in 2.1 %, out of which the majority were eligible for anticoagulation therapy. Identification of AF through targeted screening with up incoming novel technologies could reduce the stroke burden associated with undiagnosed AF.
Antimicrobial resistance patterns of bacterial isolates from bloodstream infections at Jinja regional referral hospital: A cross-sectional study
Authors: Lwigale Fahad 
Published: August 2023

AbstractIntroductionBloodstream infections are a commonly encountered clinical syndrome of public health concern with variable epidemiology. The characteristic of resistance to multiple antibiotics by their etiologic agents has limited the options for empirical sepsis case management. This study determined the most frequent aetiologic agents responsible for bloodstream infections, their antimicrobial susceptibility patterns, and infection sources in Eastern-Central Uganda.Materials and methodsThis retrospective study involved analysis of all non-duplicate blood culture reports from 2019 to 2021. The frequency and percentage of significant pathogenic organisms and contaminants were calculated. Positivity distribution including infection sources was determined. World Health Organization Network (WHONET) 2022 desktop software was used for antimicrobial susceptibility data analysis.ResultsThe 1364 participants had a diagnostic yield of 114(6.8%) and a 1.5% contamination rate. Over 37% and 13% of infections were hospital and community-acquired respectively. Most etiologic agents were Gram-positive bacteria dominated byStaphylococcus aureus39(34.2%). Gram-negatives mainly included unspecifiedColiforms12(10.5%), andE. coli10(8.8%). Polymicrobial growth existed in 4(0.3%) cases.S. aureuswas mainly resistant to Penicillin G (100%), Cefoxitin (60%), and Erythromycin (52.2%). BothEscherichia coliand unspecifiedcoliformsshowed high resistance to Ampicillin (87.5%) and third-generation Cephalosporins (100%). The least resistance was to Chloramphenicol and Carbapenems.ConclusionBSIs are mainly due to Gram-positive bacteria. Suspected sepsis cases byS. aureusin this region can be empirically managed using Gentamicin. Microbiology services should be routinely utilized to guide antimicrobial use, monitor blood culture contamination rates and resistance trends to strengthen regional antimicrobial stewardship.
Metabolomics-assisted mechanism analysis of γ-PGA synthesis regulated by PhoP inB. licheniformis
Authors: Zhang Qing , He Shisi , Zhu Wanying , Yang Fan , Chen Yaozhong , Cai Dongbo , Chen Shouwen 
Published: August 2023

AbstractPoly γ-glutamic acid (γ-PGA) is a widely used biopolymer whose synthesis relies on external nitrogen sources. PhoP is a global transcription factor that has been reported to be involved in regulation of phosphorus and nitrogen metabolisms, whether PhoP regulates γ-PGA synthesis is worthy of further study. In this study, γ-PGA yield was decreased by 19.4% inphoPdeletion strain, while PhoP overexpression benefited γ-PGA synthesis inBacillus licheniformis, and the results of transcriptional level, electrophoretic mobility shift (EMSA) and GFP expression assays confirmed the direct positive regulation on γ-PGA synthetase genepgsBby PhoP. Furthermore, based on metabolomic and physiological analysis, we dissected three aspects that γ-PGA synthesis indirectly regulated by PhoP. (i) PhoP influences glutamate transport through positively regulating glutamate transporter GltT. (ii) PhoP influences nitrogen source utilization through negatively regulating nitrogen metabolic repressor TnrA and positively regulating GlnR. (iii) PhoP influences ammonia assimilation through GlnR and TnrA. Together, our study improved metabolic regulatory network of γ-PGA synthesis, and laid a foundation for PhoP regulation nitrogen metabolic network inBacillus.
RSV neutralizing antibodies in dried blood
Authors: Terstappen Jonne , Delemarre Eveline M. , Versnel Anouk , White Joleen T. , Derrien-Colemyn Alexandrine , Ruckwardt Tracy J , Bont Louis , Mazur Natalie I. 
Published: August 2023

AbstractThe key correlate of protection of respiratory syncytial virus (RSV) vaccines and monoclonal antibodies (mAb) is virus neutralization, measured using sera obtained through venipuncture. Dried blood obtained with a finger prick can simplify acquisition, processing, storage, and transport in trials, and thereby reduce costs. In this study we aim to validate a low-tech assay to measure RSV neutralization in dried capillary blood. Recovery of mAb from dried blood (volumetric absorptive microsampling) was used to validate the elution method using indirect ELISA. Functional antibodies measured by a neutralization assay were compared between matched serum and dried blood samples from a phase I trial with RSM01, a novel investigational anti-RSV Prefusion F mAb. Hep-2 cells were infected with a serial dilution of sample-virus mixture using RSV-A2-mKate to determine half-maximal inhibitory concentration. Stability of dried blood was evaluated over time and during temperature stress. Functional antibodies in dried blood were highly correlated with serum (R2= 0.98, p < 0.0001). The intra-assay, inter-assay, and inter-operator precision of the assay for dried blood was similar to serum. The function of mAb remained stable for 9 months at room temperature and frozen dried blood samples but lower concentrations showed instability after 6 months. Dried blood samples resisted 48 hours of temperature stress. We demonstrated the feasibility of measuring RSV neutralization using dried blood as an alternative to serum. Measuring antibody function using dried blood is a patient-centered solution that may replace serology testing in trials against RSV or other viruses, such as influenza and SARS-CoV-2.Summary pointsNeutralizing antibodies against RSV in serum and dried blood from clinical samples are highly correlated.Neutralizing antibodies are stable in dried blood for 6 months and can withstand temperature variation.Dried blood samples are a patient-centered and logistical solution for vaccine trials in remote areas and low- and lower-middle income countries.
Thigh muscle mass is associated with circulating valeric acid in healthy male volunteers
Authors: Hassler Eva M. , Reishofer Gernot , Köfeler Harald , Renner Wilfried , Hannes Deutschmann H , Mangge Harald , Herrmann Markus , Leber Stefan L. , Gunzer Felix , Almer Gunter 
Published: August 2023

AbstractShort-chain fatty acids (SCFAs) are circulating metabolites generated by gut microbiota. Recently, a link between age-related muscle loss and gut microbiota has been described, and SCFAs could play a mediating role in this relationship. Acetic, propionic, and butyric acid are the abundant forms and are considered to have health benefits, less is known about valeric and caproic acid.In a cross-sectional study including 155 healthy volunteers, we investigated the relationship between muscle area, as well as intramuscular adipose tissue measured by magnet resonance imaging and circulating SCFAs. SCFAs and additional parameters were measured from serum and sport activities recorded by means of a questionnaire.We found a significant positive association between valeric acid (VA) levels and the thigh cross-sectional muscle area in males. This relationship was independent of age, BMI and weekly training times and was not observed in females. No associations between other SCFAs and the thigh muscle cross-sectional area were observed.To our knowledge, this is the first human study demonstrating a significant relationship between thigh muscle mass and VA, supporting the thesis of the “gut–muscle axis” with VA as a possible interacting player, on the one hand, affected by sex differences, on the other.
Development of an electronic decision aid tool to facilitate mainstream genetic testing in ovarian cancer patients
Authors: Shannon Kristen M. , Patel Devanshi , Jonas Jessica , Blouch Erica L. , Hicks Stephanie , Wooters Mackenzie , Seidel Meredith , Grant Carly F. , Emmet Margaret , Chung Daniel C. , Sepucha Karen 
Published: August 2023

AbstractBackgroundMultigene panel testing is an important component of cancer treatment plans and risk assessment, but there are many different panel options and choosing the most appropriate panel can be challenging for healthcare providers and patients. Electronic tools have been proposed to help patients make informed decisions about which gene panel to choose by considering their preferences and priorities.Materials and MethodsAn electronic decision aid tool was developed in line with the International Patient Decision Aids Standards (IPDAS) collaboration. The multidisciplinary project team collaborated with an external healthcare communications agency and the MGH Cancer Center patient family advisory committee (PFAC) to develop the decision aid. Surveys of genetic counselors and patients were used to scope the content, and alpha testing was used to refine the design and content.ResultsSurveys of genetic counselors (n=12) and patients (n=228) identified common themes in discussing panel size and strategies for helping patients decide between panels and in identifying confusing terms for patients and distribution of patients’ choices. The decision aid, organized into two major sections, provides educational text, graphics and videos to guide patients through the decision-making process. Alpha testing feedback from the PFAC (n=4), genetic counselors (n=3) and a group of lay people (n=8) identified areas to improve navigation, simplify wording and improve layout.ConclusionThe decision aid developed in this study has the potential to facilitate informed decision-making by patients regarding cancer genetic testing. The distinctive feature of this decision aid is that it addresses the specific question of which multigene panel may be most suitable for the patient. Its acceptability and effectiveness will be evaluated in future studies.Implications for PracticeThe use of multigene panel testing in oncology has increased significantly, but selecting the most appropriate panel for each patient can be challenging for healthcare providers and patients. The complexity and heterogeneity of the data generated by these tests, coupled with the potential psychological, emotional, and financial impacts, make informed consent a critical component of the genetic testing process. With the expansion of germline genetic testing, the traditional model of pre-test informed consent by a genetic counselor may no longer be scalable. Electronic decision aids have shown promise in increasing patient knowledge and empowerment in the shared decision-making process. The development of a comprehensive electronic tool can facilitate patient education while maximizing patient autonomy, allowing for more personalized and informed decisions about which gene panel to choose.⍰