bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the Potential of Spirulina (Arthrospira platensis) Aqueous Extract in Preventing Glycation of Hemoglobin and pBR322 Plasmid
Authors: Paramanya Additiya , Farah Mohammad Abul , Al-Anazi Khalid Mashay , Devkota Hari Prasad , Ali Ahmad 
Published: June 2023

Background Spirulina ( Arthrospira platensis), a cyanobacterium, is being consumed worldwide owing to its high nutritional value and therapeutic potential. Objectives This study aims to determine the phytochemical content, antioxidant capacity, and antiglycation property of A. platensis PCC 7345 aqueous extract against glucose, fructose, and ribose-mediated glycation of hemoglobin. Materials and Methods The antioxidant property of the extract was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and a nitric oxide scavenging assay. Protein glycation and its subsequent prevention were interpreted by observing a reduction in browning, fructosamine, glycated hemoglobin (HbA1c) level, protein carbonyl content, advanced glycation end products (AGEs) formation, and protein aggregation using spectrophotometry and spectrofluorometry. The prevention of strand nicking/breaks in the pBR322 plasmid was analyzed using electrophoresis, and the change in integrated density was calculated using ImageJ software. Results The extract showed very good antioxidant potential, which is evident and could be estimated from the inhibition concentration (IC50) values that were 45.97, 31.09, and 52.29 µg/mL in the DPPH, ABTS, and nitric oxide scavenging assays, respectively. A. platensis aqueous extract was found to be the most effective in preventing glucose-mediated glycation and protein aggregation, wherein 100 µg/mL of the extract could effectively cause ~50% inhibition in the formation of early and AGEs and prevented the formation of protein aggregates. The highest antiglycating potential of the extract was observed in glucose-mediated glycation, followed by fructose and ribose. The formation of four fluorescent AGEs, such as argpyrimidine, vesper lysine A, pentosidine, and crossline, was reduced. The extract could prevent 97% of DNA nicking in pBR322. Conclusion The aqueous extract of A. platensis has a potent ability to prevent glycation and its secondary complications.
Prenatal Diagnosis of Costello Syndrome Using Noninvasive Prenatal Single Gene Testing With Maternal Blood
Authors: M. Suner , A. Pitchika , G. Szuhay , P. Ankola 
Published: June 2023

Introduction Costello syndrome (CS) is a rare disorder that affects multiple organ systems, which is usually diagnosed postnatally, except for 2 cases diagnosed prenatally from chromosome analysis by amniocentesis. We present the first case of prenatally diagnosed CS via maternal blood testing. Case Description A 38-year-old woman was referred for genetic screening at 28 weeks of gestational age (GA) due to polyhydramnios and shortened limbs seen on prenatal ultrasound. Cell-free DNA, noninvasive prenatal single gene screening was positive for G12S HRAS mutation, which is indicative of CS. The infant was delivered via elective repeat cesarean section at 36 weeks and 6 days GA, was admitted to the neonatal intensive care unit for respiratory distress. Physical examination was significant for macrocephaly, wide depressed nasal bridge, short neck, rhizomelic limb shortening, micropenis, and bilateral equinovarus deformity of the feet. Echocardiography on the first day showed severe pulmonary hypertension. Brain MRI showed a possible cavernous mass lesion and small arachnoid cyst over the left cerebellar hemisphere. Postnatal gene-targeted testing confirmed CS diagnosis with pathogenic variants. The infant was managed for respiratory distress, hypoglycemia, jaundice, and feet deformities. He was subsequently transferred to another hospital at 45 weeks of age for gastrostomy tube placement due to persistent difficulty with oral feeding. Discussion CS affects multiple organ systems. Clinical presentations includes short stature; macrocephaly; coarse facial features, loose and soft skin; hypotonia and joint laxity; cardiac involvement with congenital heart defect, feeding difficulty, and developmental delay. The phenotypic spectrum is wide and can range from mild features to early lethal complications mostly as a result of severe progressive Hypertrophic Cardiomyopathy (HCM) and respiratory compromise. CS is an autosomal dominant genetic disorder caused by mutations in the HRAS gene, but almost all cases have new mutations with no family history. Disease course depends on cardiac and predisposition to benign and malignant tumor complications. Treatment requires a multidisciplinary team directed toward the specific clinical findings. Conclusion To our knowledge, this is the first reported case of prenatally diagnosed CS via maternal blood testing. Molecular diagnosis in the prenatal period allows neonatal care providers to prepare for potential complications in the postnatal period.
Self-Reported Level of Cultural Competence of Midwives in the North-West Province of South Africa
Authors: Shopo Khumoetsile Daphney , Du Preez Antoinette , Rabie Tinda , Bester Petra 
Published: June 2023

Introduction: Limited research on cultural competence in nursing, midwifery, and education exists within low- and middle-income countries such as South Africa (SA). This study aimed to describe midwives’ self-reported levels of cultural competence toward women receiving maternal care. Methodology: A descriptive, cross-sectional survey design and an all-inclusive sample of ( N = 104; n = 82) midwives yielded a 79% response rate. Data were collected using the Transcultural Self-Efficacy Tool (TSET) questionnaire. Participants included midwives recruited from maternity units of five hospitals in South Africa: different hospitals that included one large district, two regional, and two tertiary hospitals in the North-West Province of SA. An all-inclusive sample of ( N = 104; n = 82) midwives participated, representing a 79% response rate. Results: Midwives reported an overall moderate level of competence regarding their knowledge and understanding of cultural factors; it was concerning that their confidence in interviewing patients from different cultural backgrounds on factors such as acculturation and worldview were the lowest. Discussion: To the best of the authors’ knowledge, this was the first study to assess the cultural competence of midwives in SA using TSET. The study highlighted the need for midwives’ training to improve their cultural competence.
The PACT Project: Feasibility of a Multidisciplinary, Multi-Faceted Intervention to Promote Goals of Care Conversations
Authors: Szmuilowicz Eytan , Clepp Rebecca K. , Neagle Jayson , Ogunseitan Adeboye , Twaddle Martha , Wood Gordon J. 
Published: June 2023

Background Patients living with serious illness generally want their physicians to facilitate Goals of Care conversations (GoCc), yet physicians may lack time and skills to engage in these conversations in the outpatient setting. The problem may be addressed by supporting multiple members of the clinical team to facilitate GoCc with the patient while admitted to the hospital. Methods A multi-modal training and mentored implementation program was developed. A group of 10 hospitals were recruited to participate. Each hospital selected a primary inpatient unit on which to start the intervention, then expanded to a secondary unit later in the project. The number of trained facilitators (champions) and the number of documented GoCc were tracked over time. Results Nine of 10 hospitals completed the 3-year project. Most of the units were general medical-surgical units. Forty-eight champions were trained at the kick-off conference, attended primarily by nurses, physicians, and social workers. By the end of the project, 153 champions had been trained. A total of 51 087 patients were admitted to PACT units with 85.4% being screened for eligibility. Of the patients who were eligible, over 68% had documented GoCc. Conclusion A multifaceted quality improvement intervention focused on serious illness communication skills can support a diverse clinical workforce to facilitate inpatient GoCc over time.
Two-Year Clinical and Radiologic Outcomes Following Surgical Treatment of Insertional Achilles Tendinopathy Using a Central Tendon-Splitting Approach
Authors: Tay Adriel You Wei , Goh Graham S. , Li Zongxian , Yeo Nicholas Eng Meng , Tay Kae Sian 
Published: June 2023

Background: If conservative treatment of insertional Achilles tendinopathy (IAT) fails, surgery is often considered. Various surgical approaches have been used including the central Achilles tendon splitting approach. This study aimed to report the 2-year clinical and radiologic outcomes after surgical treatment of IAT with a central tendon-splitting approach. Methods: Seventy-five cases of IAT treated surgically via the open central tendon-splitting approach were analyzed. Clinical outcomes included the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36) physical (PCS) and mental (MCS) component summary scores, all measured at baseline and 6 and 24 months postoperatively. Radiologic parameters measured included the Fowler-Philip angle (FPA) and parallel pitch lines (PPL). Results: Three patients had clinically significant wound issues but healed completely by 3 weeks. Mean AOFAS score improved from 45.63 preoperatively to 94.71 at 24 months. Mean VAS score improved from 6.73 preoperatively to 0.55, mean SF-36 PCS from 35.98 to 48.74, and mean SF-36 MCS from 53.04 to 55.43 at 24 months. Satisfaction at 2 years was 94.3%. Mean FPA decreased from 62.0 degrees preoperatively to 34.0 degrees postoperatively. PPL was positive in 82.7% (62 of 75) of cases preoperatively, decreasing to 1.3% (1 of 75) postoperatively. Increasing age and higher preoperative VAS and SF-36 MCS scores were significantly associated with improvements in postoperative AOFAS, SF-36 PCS, and MCS scores. Conclusion: Surgical treatment of IAT via the central tendon-splitting approach achieved substantial improvements in all patient-reported outcome measures measured. These excellent clinical outcomes continued to show improvement 2 years postoperatively. Level of Evidence: Level III, retrospective cohort study.
Risk for recurrence of symptomatic upper-extremity deep vein thrombosis in patients without cancer: Analysis of three RIETE cohorts
Authors: Núñez Fernández Manuel J , Padín Paz Emilio M , Vázquez Temprano Nuria , Nieto Rodríguez José A , Marchena Yglesias Pablo J , Imbalzano Egidio , Montenegro Ana Cristina , Fernández Jiménez Begoña , Rivera Alberto , Espitia Olivier , Monreal Manuel 
Published: June 2023

Background: The natural history of patients with a pacemaker-related upper-extremity deep vein thrombosis (UEDVT) has not been consistently studied. Methods: We used the RIETE registry data to compare the outcomes during anticoagulation and after its discontinuation in noncancer patients with symptomatic UEDVT associated with a pacemaker, other catheters, or no catheter. The major outcome was the composite of symptomatic pulmonary embolism or recurrent DVT. Results: As of February 2022, 2578 patients with UEDVT were included: 156 had a pacemaker-related UEDVT, 557 had other catheters, and 1865 had no catheter. During anticoagulation, 61 patients (2.3%) developed recurrent VTE, 38 had major bleeding (1.4%), and 90 died (3.4%). After its discontinuation, 52 patients (4.4%) had recurrent acute venous thromboembolism (VTE) and six had major bleeding (0.5%). On multivariable analysis, there were no differences among subgroups in the rates of VTE recurrences or major bleeding during anticoagulation. After its discontinuation, patients with a pacemaker-related UEDVT had a higher risk for VTE recurrences than those with no catheter (adjusted OR: 4.59; 95% CI: 1.98–10.6). Conclusions: Patients with pacemaker-related UEDVT are at increased risk for VTE recurrences after discontinuing anticoagulation. If our findings are validated in adequately designed trials, this may justify changes in the current recommendations on the duration of anticoagulation.
Understanding the Neuroplastic Effects of Auricular Vagus Nerve Stimulation in Animal Models of Stroke: A Systematic Review and Meta-Analysis
Authors: de Melo Paulo S. , Parente João , Rebello-Sanchez Ingrid , Marduy Anna , Gianlorenco Anna Carolyna , Kyung Kim Chi , Choi Hyuk , Song Jae-Jun , Fregni Felipe 
Published: June 2023

Background Transauricular vagus nerve stimulation (taVNS) is being studied as a feasible intervention for stroke, but the mechanisms by which this non-invasive technique acts in the cortex are still broadly unknown. Objectives This study aimed to systematically review the current pre-clinical evidence in the auricular vagus nerve stimulation (aVNS) neuroplastic effects in stroke. Methods We searched, in December of 2022, in Medline, Cochrane, Embase, and Lilacs databases. The authors executed the extraction of the data on Excel. The risk of bias was evaluated by adapted Cochrane Collaboration’s tool for animal studies (SYRCLES’s RoB tool). Results A total of 8 studies published between 2015 and 2022 were included in this review, including 391 animal models. In general, aVNS demonstrated a reduction in neurological deficits (SMD = −1.97, 95% CI −2.57 to −1.36, I2 = 44%), in time to perform the adhesive removal test (SMD = −2.26, 95% CI −4.45 to −0.08, I2 = 81%), and infarct size (SMD = −1.51, 95% CI −2.42 to −0.60, I2 = 58%). Regarding the neuroplasticity markers, aVNS showed to increase microcapillary density, CD31 proliferation, and BDNF protein levels and RNA expression. Conclusions The studies analyzed show a trend of results that demonstrate a significant effect of the auricular vagal nerve stimulation in stroke animal models. Although the aggregated results show high heterogeneity and high risk of bias. More studies are needed to create solid conclusions.
Grasp Analysis in the Home Environment as a Measure of Hand Function After Cervical Spinal Cord Injury
Authors: Dousty Mehdy , Bandini Andrea , Eftekhar Parvin , Fleet David J. , Zariffa José 
Published: June 2023

Background Following a spinal cord injury, regaining hand function is a top priority. Current hand assessments are conducted in clinics, which may not fully represent real-world hand function. Grasp strategies used in the home environment are an important consideration when examining the impact of rehabilitation interventions. Objective The main objective of this study is to investigate the relationship between grasp use at home and clinical scores. Method We used a previously collected dataset in which 21 individuals with spinal cord injuries (SCI) recorded egocentric video while performing activities of daily living in their homes. We manually annotated 4432 hand-object interactions into power, precision, intermediate, and non-prehensile grasps. We examined the distributions of grasp types used and their relationships with clinical assessments. Results Moderate to strong correlations were obtained between reliance on power grasp and the Spinal Cord Independence Measure III (SCIM; P < .05), the upper extremity motor score (UEMS; P < .01), and the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) Prehension ( P < .01) and Strength ( P < .01). Negative correlations were observed between the proportion of non-prehensile grasping and SCIM ( P < .05), UEMS ( P < .05), and GRASSP Prehension ( P < .01) and Strength ( P < .01). Conclusion The types of grasp types used in naturalistic activities at home are related to upper limb impairment after cervical SCI. This study provides the first direct demonstration of the importance of hand grasp analysis in the home environment.
The Cost Does Not Outweigh the Benefit: Pathologic Evaluation of Wrist Ganglion Cysts Should Not Be Routine
Authors: McLaughlin Caroline M. , LePere Darren , Candela Xavier , Ingraham John M. 
Published: June 2023

Background: As health care costs in the United States continue to rise, there is increasing attention on cost-saving measures. One area of investigation is the utility of pathologic examination of specimens from routine procedures with a suspected benign pathology. We assessed the utility and cost of routine pathologic analysis for wrist ganglion cyst excision. Methods: A retrospective cohort study of all wrist ganglion cyst excisions performed by seven hand surgeons was conducted from 2015 to 2019 at Penn State Hershey Medical Center. Preoperative and intraoperative diagnoses, pathologic diagnosis, and pathology cost were assessed. Results: A total of 407 patients underwent ganglion cyst excision, with 318 (78.1%) specimens sent for pathologic review. Of the 318, 317 (99.6%) specimens were concordant with the preoperative or intraoperative diagnosis of ganglion cyst. One specimen (0.3%) resulted as a benign cystic vascular malformation. The charge per specimen was $258, totaling $81,786 spent confirming benign pathology that was clinically correctly diagnosed by the operating surgeon in 99.6% of cases. Conclusions: Routine pathologic analysis is not indicated in cases in which surgeons have a high clinical suspicion for ganglion cyst based on preoperative and intraoperative findings. Pathologic review should be reserved for cases with atypical presentations or intraoperative findings.
The Tissue Lymphocyte-to-Eosinophil Ratio Predicted Long-Term Recurrence of Eosinophilic CRSwNP
Authors: Wang Jianwei , Yang Yujuan , Guo Jing , Yu Pengyi , Wang Guangkuo , Liu Xinyue , Zhang Zheng , Li Tong , Zhang Yu , Song Xicheng 
Published: June 2023

Background Eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP) remains a recalcitrant disease with a high recurrence rate. Objective This study aimed to identify a predictor of long-term recurrence in patients with Eos-CRSwNP. Methods A total of 39 Eos-CRSwNP patients who had their initial and recurrent nasal polyps surgically removed were retrospectively included in this study, with 49 Eos-CRSwNP patients without recurrence and 32 patients with non-Eos-CRSwNP matched by randomly chosen. Clinical characteristics were compared among or between groups. Spearman correlation analyses and a backward stepwise multivariate logistic regression analysis were performed to find factors associated with the recurrence and recurrence time of Eos-CRSwNP. Furthermore, a receiver operating characteristic (ROC) curve was used to determine the predictor of long-term Eos-CRSwNP recurrence. Results The number and ratio of tissue eosinophils were highest in Eos-CRSwNP with recurrence and lowest in non-Eos-CRSwNP. The ratio of tissue lymphocytes was highest in non-Eos-CRSwNP and lowest in Eos-CRSwNP with recurrence, with the number of tissue lymphocytes higher in Eos-CRSwNP without recurrence than the other two groups. The numbers of tissue lymphocytes in the initial nasal polyps were lower and the numbers of tissue eosinophils were higher in the group of recurrent nasal polyps that recurred at >5 years after surgery than in the nasal polyps that recurred at <5 years after surgery. The tissue lymphocyte-to-eosinophil ratio (LER) showed a significant negative correlation with the recurrence and the recurrence time of Eos-CRSwNP. A ROC curve revealed that a tissue LER value < 0.67 predicted long-term Eos-CRSwNP recurrence with 72.73% sensitivity and 82.35% specificity (area under the curve  =  0.789). Conclusion Tissue LER is strongly associated with Eos-CRSwNP recurrence and may play a key role in predicting long-term Eos-CRSwNP recurrence.
Afterload-related cardiac performance is a powerful hemodynamic predictor of mortality in patients with chronic heart failure
Authors: Wu Yihang , Tian Pengchao , Liang Lin , Chen Yuyi , Feng Jiayu , Huang Boping , Huang Liyan , Zhao Xuemei , Wang Jing , Guan Jingyuan , Li Xinqing , Zhang Yuhui , Zhang Jian 
Published: June 2023

Background: Afterload-related cardiac performance (ACP), a diagnostic parameter for septic cardiomyopathy, integrates both cardiac performance and vascular effects and could predict prognosis in septic shock. Objectives: We hypothesized that ACP would also correlate with clinical outcomes in patients with chronic heart failure (HF). Design: A retrospective study. Methods: We retrospectively studied consecutive patients with chronic HF who underwent right heart catheterization and established an expected cardiac output-systemic vascular resistance (CO-SVR) curve model in chronic HF for the first time. ACP was calculated as COmeasured/COpredicted × 100%. ACP > 80%, 60% < ACP ⩽ 80%, and ACP ⩽ 60% represented less impaired, mildly impaired, and severely impaired cardiovascular function, respectively. The primary outcome was all-cause mortality, and the secondary outcome was event-free survival. Results: A total of 965 individual measurements from 290 eligible patients were used to establish the expected CO-SVR curve model (COpredicted = 53.468 × SVR −0.799). Patients with ACP ⩽ 60% had higher serum NT-proBNP levels ( P < 0.001), lower left ventricular ejection fraction ( P = 0.001), and required dopamine more frequently ( P < 0.001). Complete follow-up data were available in 263 of 290 patients (90.7%). After multivariate adjustment, ACP remained associated with both primary outcome (hazard ratio (HR) 0.956, 95% confidence interval (CI) 0.927–0.987) and secondary outcome (HR 0.977, 95% CI 0.963–0.992). Patients with ACP ⩽ 60% had the worst prognosis (all P < 0.001). ACP was significantly more discriminating (area under the curve of 0.770) than other conventional hemodynamic parameters in predicting mortality (Delong test, all P < 0.05). Conclusion: ACP is a powerful independent hemodynamic predictor of mortality in patients with chronic HF. ACP and the novel CO-SVR two-dimensional graph could be useful in assessing cardiovascular function and making clinical decisions. Clinical trial registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02664818.
Perceived benefits of digital health and social services among older adults: A population-based cross-sectional survey
Authors: Kainiemi Emma , Saukkonen Petra , Virtanen Lotta , Vehko Tuulikki , Kyytsönen Maiju , Aaltonen Mari , Heponiemi Tarja 
Published: June 2023

Objective The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d) Internet use, were examined. Methods The present sample included 8019 respondents aged between 75 and 99 years. The inverse probability weighting method was used to correct for bias. Linear regression analyses were used to examine the associations. Results The ease of use of the services regardless of the time and location was perceived as the most beneficial. Convenient distance to local health or social services (parameter estimate  =  0.15 [0.08–0.23]), good functional ability (PE  =  0.08 [0.01–0.14]), good vision (PE  =  0.15 [0.04–0.25]), ability to learn (PE  =  0.05 [0.01–0.10]) and living with someone (PE  =  0.08 [95% CI 0.04–0.13]) were associated with perceiving more benefits. In addition, access to the Internet (PE  =  0.12 [0.06–0.19]) and independent use of the Internet (PE  =  0.23 [0.17–0.29]) were associated with perceiving more benefits. Conclusions Older adults who are healthier, have a social relationship in their everyday life or have easier access to traditional services seem to perceive more benefits from digital health and social services. Digital services should be developed to correspond with special needs caused by disadvantages in health and the social environment. To facilitate the use of digital health and social services, more efforts should be made to enhance older adults’ perceptions of their benefits.