bluuebunny/crossref_metadata_2025_split huggingface dataset:
Periodontitis‐induced neuroinflammation impacts dendritic spine immaturity and cognitive impairment
Authors: Xie Changfu , Zhang Qiuyang , Ye Xinyi , Wu Weiliang , Cheng Xiaojuan , Ye Xiaoan , Ruan Jianyong , Pan Xiaodong 
Published: July 2023

AbstractObjectiveThis study investigated the spinal changes in ligature‐induced periodontitis and the role of periodontitis in cognitive impairment.MethodsTwenty mice were randomized into the control and chronic periodontitis (CP) groups, with the latter receiving ligature‐induced periodontitis. Cognitive performance was assessed by fear conditioning test. Periodontal inflammation and alveolar bone resorption were evaluated by micro‐computed tomography and histopathology. The hippocampal microglial activation was evaluated by immunohistochemistry (IHC). The expressions of hippocampal cytokines (TNF‐α, iNOS, IL‐1β, IL‐4, IL‐10, and TREM2) were measured by reverse transcription–polymerase chain reaction. The morphology and density of the dendritic spines were determined by Golgi–Cox staining.ResultsThe CP mice reported significant inflammatory cell infiltration and alveolar bone resorption, with marked increases in cytokine levels (TNF‐α, iNOS, IL‐1β, and TREM2) in the brain. Moreover, the CP mice showed significantly reduced freezing to the conditioned stimulus in the cued and contextual tests, indicating impaired memory. Further analyses revealed, in the hippocampus of the CP mice, enhanced microglial activation, decreased dendritic spine density, and increased proportion of thin dendritic spines.ConclusionsPeriodontitis‐induced neuroinflammation may impair the cognitive function by activating hippocampal microglia and inducing dendritic spine immaturity.
Efficacy of epidural analgesia for intractable cancer pain: A systematic review
Authors: Hsieh Yu‐Lien , Chen Hui‐Yu , Lin Chung‐Ren , Wang Chi‐Fei 
Published: July 2023

AbstractBackgroundEpidural analgesia is a common technique for managing perioperative and obstetric pain. Patients with cancer who cannot tolerate opioids or not responding to conventional treatment may benefit from epidural analgesia. Therefore, this systematic review aimed to analyze the efficacy and safety of epidural analgesia in patients with intractable cancer pain.MethodsWe searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials to identify studies on patients with cancer who received epidural analgesia. We assessed the quality of all included studies using the risk‐of‐bias tool or Newcastle‐Ottawa scale. The primary outcome was pain relief after epidural analgesia, and the secondary outcome was quality of life, analgesic consumption, and adverse events. The studies were grouped based on the medications used for epidural analgesia. A descriptive synthesis was performed following the Synthesis Without Meta‐analysis reporting guideline.ResultsOur systematic review included nine randomized controlled trials (n = 340) and 15 observational studies (n = 926). Two randomized controlled trials suggested that epidural opioids were not superior to systemic opioids in relieving pain. Epidural opioids combined with local anesthetics or adjuvants, including calcitonin, clonidine, ketamine, neostigmine, methadone, and dexamethasone, offered better analgesic effects. No significant difference in pain relief between an intermittent bolus and a continuous infusion of epidural morphine was observed. Epidural opioids had more analgesic effects on nociceptive pain than neuropathic pain. The methods used to evaluate the quality of life and the corresponding results were heterogeneous among studies. Six observational studies demonstrated that some patients could have decreased opioid consumption after epidural analgesia. Adverse events, including complications and drug‐related side effects, were reported in 23 studies. Five serious complications, such as epidural abscess and hematoma, required surgical management. The heterogeneity and methodological limitations of the studies hindered meta‐analysis and evidence‐level determination.ConclusionCoadministration of epidural opioids, local anesthetics, and adjuvants may provide better pain relief for intractable cancer pain. However, we must assess the patients to ensure that the benefits outweigh the risks before epidural analgesia. Therefore, further high‐quality studies are required.
Mapping children by ALT 4–5 years after liver transplant: Potential individual and population applications
Authors: Dixon Wesley , Perito Emily R. , Bucuvalas John , Feng Sandy 
Published: July 2023

AbstractIntroductionAlthough clinicians repeatedly measure ALT to assess allograft health in children with liver transplants, they generally make decisions based on single values or qualitative trends without quantitative aggregation or synthesis. We therefore aimed to derive and test a holistic ALT metric for the 5th post‐transplant year (Yr 4–5) that may better guide clinical decision‐making and/or population comparisons.MethodsWe derived the “adjusted mean Yr 4–5 ALT” for children transplanted in 2005–2016 by averaging the median ALT from each month. Patients in quartiles (Q1–4) defined by the adjusted mean Yr 4–5 ALT were compared by clinical variables, Yr 5–8 outcomes, and tacrolimus standard deviation (MLVI).ResultsFor 97 children [49 male; 77 deceased donors; median (IQR) age at LT 2.5 (0.8–11.7) years], the 25th, 50th, and 75th percentile thresholds for adjusted mean Yr 4–5 ALT were 19, 28, and 47 U/L, respectively. Age, donor type, LT indication, rejection history, and mean tacrolimus levels did not differ between quartiles (Q). Children in Q4 had more Yr 4–5 acute rejection episodes (p < .01), higher Yr 4–5 MLVI (p < .01), and more Yr 5–8 for‐cause liver biopsies (p < .01) than those in Q1 + Q2. Children in Q3 also had higher Yr 4–5 MLVI than Q1 + Q2 (p = .047). Rates of chronic rejection and therapeutic liver‐related procedures were higher in Q4 but the difference did not reach significance.ConclusionAn integrated ALT metric calculated utilizing all available ALT values correlates with MLVI and future for‐cause biopsies. Further study of this novel ALT metric as a predictor of clinical outcomes and descriptor of populations is warranted.
Intestinal ultrasound may be a useful tool in monitoring acute rejection following intestinal transplantation
Authors: Couper Michael R. , Valamparampil Joseph , Thyagarajan Manigan , Hartley Jane , Gupte Girish 
Published: July 2023

AbstractBackgroundAcute rejection is the leading cause of mortality and morbidity for children following intestinal transplantation. Rapid detection and prompt treatment are critical; however, the only reliable method of diagnosis and monitoring is endoscopic graft biopsies. The required regular anesthetics are particularly problematic in children, and non‐invasive strategies are needed.MethodsWe describe the intestinal ultrasound findings of three children before and after treatment for rejection. Ultrasounds were performed within 24 h of endoscopically obtained biopsies which were used to establish a diagnosis of rejection and to define severity. A single sonographer performed the ultrasounds and was blinded to biopsy results at the time of the scanning. These findings are provided in the context of the ultrasound appearance of seven children who had no features of rejection on surveillance biopsies.ResultsIntestinal ultrasound demonstrated increased bowel wall thickness, vascularity, and mesenteric inflammation during moderate to severe rejection episodes. The submucosal layer was particularly thickened, which may represent a finding more specific for rejection. All patients demonstrated improvement in all quantitative ultrasound features correlating with the resolution of acute cellular rejection on histology. Patients with no evidence of rejection on biopsy had a bowel wall thickness range of 0.9–2.8 mm, suggesting a normal upper limit of 3 mm.ConclusionModerate and severe acute rejection may be detected and response to treatment can be monitored by intestinal ultrasound and, correlating with clinical improvement, can aid in follow‐up.
Effects of free textbooks on academic performance: Evidence from China's compulsory education
Authors: Liu Xinran 
Published: July 2023

AbstractSince little is known about the effects of free textbooks on compulsory school students in China, this paper examines the effects of free textbooks on the academic performance of Chinese middle school students. It combines propensity score matching and difference‐in‐difference estimation to control for both observable and unobservable factors that affect the probability of obtaining free textbooks as well as students' academic performance. Results indicate that free textbooks significantly improve the midterm scores of girls and rural students, and the effects vary across different subjects. Moreover, the impact mechanisms of free textbooks are different for different groups and different subjects.
A transfusion risk stratification score to facilitate quality management in cardiopulmonary bypass
Authors: Zhang Qiaoni , Gao Yuchen , Tian Yu , Gao Sizhe , Diao Xiaolin , Ji Hongwen , Wang Yuefu , Ji Bingyang 
Published: July 2023

AbstractBackgroundOur previous showed that a blood management program in the cardiopulmonary bypass (CPB) department, reduced red blood cell (RBC) transfusion and complications, but assessing transfusion practice solely based on transfusion rates was insufficient. This study aimed to design a risk stratification score to predict perioperative RBC transfusion to guide targeted measures for on‐pump cardiac surgery patients.Study Design and MethodsWe analyzed data from 42,435 adult cardiac patients. Eight predictors were entered into the final model including age, sex, anemia, New York Heart Association classification, body surface area, cardiac surgery history, emergency surgery, and surgery type. We then simplified the score to an integer‐based system. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow goodness‐of‐fit test, and a calibration curve were used for its performance test. The score was compared to existing scores.ResultsThe final score included eight predictors. The AUC for the model was 0.77 (95% CI, 0.76–0.77) and 0.77 (95% CI, 0.76–0.78) in the training and test set, respectively. The calibration curves showed a good fit. The risk score was finally grouped into low‐risk (score of 0–13 points), medium‐risk (14–19 points), and high‐risk (more than 19 points). The score had better predictive power compared to the other two existing risk scores.DiscussionWe developed an effective risk stratification score with eight variables to predict perioperative RBC transfusion for on‐pump cardiac surgery. It assists perfusionists in proactively preparing blood conservation measures for high‐risk patients before surgery.
A role for vitamin D and the vitamin D receptor in keloid disorder
Authors: Hahn Jennifer M. , Combs Kelly A. , Powell Heather M. , Supp Dorothy M. 
Published: July 2023

AbstractKeloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti‐inflammatory, anti‐proliferative and pro‐differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.
Demographic patterns in Lyme borreliosis seasonality over 25 years
Authors: Goren Asena , Mysterud Atle , Jore Solveig , Viljugrein Hildegunn , Bakka Haakon , Vindenes Yngvild 
Published: July 2023

AbstractLyme borreliosis, the most common vector‐borne disease in Europe and North America, is attracting growing concern due to its expanding geographic range. The growth in incidence and geographic spread is largely attributed to climate and land‐use changes that support the tick vector and thereby increase disease risk. Despite a wide range of symptoms displayed by Lyme borreliosis patients, the demographic patterns in clinical manifestations and seasonal case timing have not been thoroughly investigated and may result from differences in exposure, immunity and pathogenesis. We analysed 25 years of surveillance data from Norway, supplemented by population demography data, using a Bayesian modelling framework. The analyses aimed to detect differences in case seasonality and clinical manifestations of Lyme borreliosis across age and sex differentiated patient groups. The results showed a bimodal pattern of incidence over age, where children (0–9 years) had the highest incidence, young adults (20–29 years) had low incidence and older adults had a second incidence peak in the ages 70–79 years. Youth (0–19 years) presented with a higher proportion of neuroborreliosis cases and a lower proportion of arthritic manifestations compared to adults (20+ years). Adult males had a higher overall incidence than adult females and a higher proportion of arthritis cases. The seasonal timing of Lyme borreliosis consistently occurred around 4.4 weeks earlier in youth compared to adults, regardless of clinical manifestation. All demographic groups exhibited a shift towards an earlier seasonal timing over the 25‐year study period, which appeared unrelated to changes in population demographics. However, the disproportionate incidence of Lyme borreliosis in seniors requires increased public awareness and knowledge about this high‐risk group as the population continues to age concurrently with disease emergence. Our findings highlight the importance of considering patient demographics when analysing the emergence and seasonal patterns of vector‐borne diseases using long‐term surveillance data.
Discharge criteria for inpatient paediatric asthma: a narrative systematic review
Authors: Sudarmana Aryanto , Lawrence Joanna , So Neda , Chen Katherine 
Published: July 2023

IntroductionCriteria-led discharges (CLDs) and inpatient care pathways (ICPs) aim to standardise care and improve efficiency by allowing patients to be discharged on fulfilment of discharge criteria. This narrative systematic review aims to summarise the evidence for use of CLDs and discharge criteria in ICPs for paediatric inpatients with asthma, and summarise the evidence for each discharge criterion used.MethodsDatabase search using keywords was performed using Medline, Embase and PubMed for studies published until 9 June 2022. Inclusion criteria included: paediatric patients <18 years old, admitted to hospital with asthma or wheeze and use of CLD, nurse-led discharge or ICP. Reviewers screened studies, extracted data and assessed study quality using the Quality Assessment with Diverse Studies tool. Results were tabulated. Meta-analysis was not performed due to heterogeneity of study designs and outcomes.ResultsDatabase search identified 2478 studies. 17 studies met the inclusion criteria. Common discharge criteria include bronchodilator frequency, oxygen saturation and respiratory assessment. Discharge criteria definitions varied between studies. Most definitions were associated with improvements in length of stay (LOS) without increasing re-presentation or readmission.ConclusionCLDs and ICPs in the care of paediatric inpatients with asthma are associated with improvements in LOS without increasing re-presentations or readmissions. Discharge criteria lack consensus and evidence base. Common criteria include bronchodilator frequency, oxygen saturations and respiratory assessment. This study was limited by a paucity of high-quality studies and exclusion of studies not published in English. Further research is necessary to identify optimal definitions for each discharge criterion.
Intravitreal panitumumab and myopic macular degeneration
Authors: Bikbov Mukharram M , Kazakbaeva Gyulli M , Holz Frank G , Panda-Jonas Songhomitra , Gilemzianova Leisan I , Khakimov Dinar A , Jonas Jost B 
Published: July 2023

BackgroundIn experimental studies, intravitreally applied antibodies against epidermal growth factor (EGF), EGF family members (amphiregulin, neuregulin-1, betacellulin, epigen, epiregulin) and against the EGF receptor (EGFR) were associated with a reduction in lens-induced axial elongation and decrease in physiological eye elongation in guinea pigs and in non-human primates. Here, we investigated the intraocular tolerability and safety of a fully human monoclonal IgG2-antibody against EGFR, already in clinical use in oncology, as a potential future therapeutic approach for axial elongation in adult eyes with pathological myopia.MethodsThe clinical, monocentre, open-label, multiple-dose, phase-1 study included patients with myopic macular degeneration of stage 4, who received intravitreal injections of panitumumab in various doses and in intervals ranging between 2.1 months and 6.3 months.ResultsThe study included 11 patients (age:66.8±6.3 years), receiving panitumumab injections in doses of 0.6 mg (4 eyes; 1×1 injection, 3×2 injections), 1.2 mg (4 eyes; 1×1 injection, 2×2 injections, 1×3 injections) and 1.8 mg (3 eyes; 1×1 injection, 2×2 injections), respectively. None of the participants showed treatment-emergent systemic adverse events or intraocular inflammatory reactions. Best-corrected visual acuity (1.62±0.47 logarithm of the minimal angle of resolution (logMAR) vs 1.28±0.59 logMAR; p=0.08) and intraocular pressure (13.8±2.4 mm Hg vs 14.3±2.6 mm Hg; p=0.20) remained unchanged. In nine patients with a follow-up of >3 months (mean:6.7±2.7 months), axial length did not change significantly (30.73±1.03 mm vs 30.77±1.19 mm; p=0.56).ConclusionsIn this open-labelled, phase-1 study with a mean follow-up of 6.7 months, panitumumab repeatedly administered intravitreally up to a dose of 1.8 mg was not associated with intraocular or systemic adverse effects. During the study period, axial length remained unchanged.Trial registration numberDRKS00027302.
Associations of dietary patterns, ultra-processed food and nutrient intake with incident atrial fibrillation
Authors: Tu Samuel J , Gallagher Celine , Elliott Adrian D , Bradbury Kathryn E , Marcus Gregory M , Linz Dominik , Pitman Bradley M , Middeldorp Melissa E , Hendriks Jeroen M , Lau Dennis H , Sanders Prashanthan , Wong Christopher X 
Published: July 2023

ObjectiveTo examine the associations between specific dietary patterns and incident atrial fibrillation (AF).MethodsUsing data from the UK Biobank, dietary intakes were calculated from 24-hour diet recall questionnaires. Indices representing adherence to dietary patterns (Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH) and plant-based diets) were scored, and ultra-processed food consumption was studied as a percentage of total food mass consumed. Incident AF hospitalisations were assessed in Cox regression models.ResultsA total of 121 300 individuals were included, with 4 579 incident AF cases over a median follow-up of 8.8 years. Adherence to Mediterranean-style or DASH diets was associated with a lower incidence of AF in minimally adjusted analyses (HR for highest vs lowest quintile 0.87 (95% CI 0.80–0.96) and HR 0.78 (95% CI 0.71–0.86), respectively). However, associations were no longer significant after accounting for lifestyle factors (HR 0.95 (95% CI 0.87–1.04) and 0.94 (95% CI 0.86–1.04) respectively), with adjustment for body mass index responsible for approximately three-quarters of the effect size attenuation. Plant-based diets were not associated with AF risk in any models. Greatest ultra-processed food consumption was associated with a significant increase in AF risk even in fully adjusted models (HR 1.13 (95% CI 1.02–1.24)), and a 10% increase in absolute intake of ultra-processed food was associated with a 5% increase in AF risk (HR 1.05 (95% CI 1.01–1.08)).ConclusionWith the possible exception of reducing ultra-processed food consumption, these findings suggest that attention to other modifiable risk factors, particularly obesity, may be more important than specific dietary patterns for the primary prevention of AF.
Non-COVID-19 cardiovascular pathology from return-to-play screening in college athletes after COVID-19
Authors: Klein Christian F , Petek Bradley J , Moulson Nathaniel , Baggish Aaron L , Churchill Timothy W , Harmon Kimberly G , Kliethermes Stephanie A , Patel Manesh R , Drezner Jonathan A 
Published: July 2023

ObjectiveConcerns for cardiac involvement after SARS-CoV-2 infection led to widespread cardiac testing in athletes. We examined incidental non-COVID-19 cardiovascular pathology in college athletes undergoing postinfection return-to-play screening.MethodsThe Outcomes Registry for Cardiac Conditions in Athletes was a nationwide prospective multicentre observational cohort study that captured testing and outcomes data from 45 institutions (September 2020–June 2021). Athletes with an ECG and transthoracic echocardiogram (TTE) and no pre-existing conditions were included. Findings were defined as major (associated with sudden cardiac death or requiring intervention), minor (warrants surveillance), incidental (no follow-up needed) or uncertain significance (abnormal with subsequent normal testing).ResultsAthletes with both ECG and TTE (n=2900, mean age 20±1, 32% female, 27% black) were included. 35 (1.2%) had ECG abnormalities. Of these, 2 (5.7%) had TTE abnormalities indicating cardiomyopathy (hypertrophic-1, dilated-1), and 1 with normal TTE had atrial fibrillation. Of 2865 (98.8%) athletes with a normal ECG, 54 (1.9%) had TTE abnormalities: 3 (5.6%) with aortic root dilatation ≥40 mm, 15 (27.8%) with minor abnormalities, 25 (46.3%) with incidental findings and 11 (20.4%) with findings of uncertain significance. Overall, 6 (0.2%) athletes had major conditions; however, coronary anatomy and aortic dimensions were inconsistently reported and pathology may have been missed.ConclusionMajor non-COVID-19 cardiovascular pathology was identified in 1/500 college athletes undergoing return-to-play screening. In athletes without ECG abnormalities, TTE’s added value was limited to pathological aortic root dilatation in 1/1000 athletes and minor abnormalities warranting surveillance in 1/160 athletes. Two-thirds of findings were incidental or of uncertain significance.