bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attenuation of Hypocretin/Orexin Signaling Is Associated With Increased Mortality After Myocardial Infarction
Authors: Wohlfahrt Peter , Jenča Dominik , Melenovský Vojtěch , Jarolím Petr , Dlouhá Dana , Šramko Marek , Kotrč Martin , Želízko Michael , Mrázková Jolana , Piťha Jan , Adámková Věra , Kautzner Josef 
Published: April 2023

Background
The hypocretin/orexin system has been shown to play a role in heart failure. Whether it also influences myocardial infarction (MI) outcomes is unknown. We evaluated the effect of the rs7767652 minor allele T associated with decreased transcription of the hypocretin/orexin receptor‐2 and circulating orexin A concentrations on mortality risk after MI.

Methods and Results

Data from a single‐center, prospectively designed registry of consecutive patients hospitalized for MI at a large tertiary cardiology center were analyzed. Patients without previous history of MI or heart failure were included. A random population sample was used to compare allele frequencies in the general population. Out of 1009 patients (aged 64±12 years, 74.6% men) after MI, 6.1% were homozygotes (TT) and 39.4% heterozygotes (CT) for minor allele. Allele frequencies in the MI group did not differ from 1953 subjects from general population (χ
2
P
=0.62). At index hospitalization, MI size was the same, but ventricular fibrillation and the need for cardiopulmonary resuscitation were more prevalent in the TT allele variant. Among patients with ejection fraction ≤40% at discharge, the TT variant was associated with a lower increase in left ventricular ejection fraction during follow‐up (
P
=0.03). During the 27‐month follow‐up, there was a statistically significant association of the TT variant with increased mortality risk (hazard ratio [HR], 2.83;
P
=0.001). Higher circulating orexin A was associated with a lower mortality risk (HR, 0.41;
P
<0.05).

Conclusions
Attenuation of hypocretin/orexin signaling is associated with increased mortality risk after MI. This effect may be partially explained by the increased arrhythmic risk and the effect on the left ventricular systolic function recovery.
Frequency and Risk Factors of Permanent Hypoparathyroidism After Total Thyroidectomy: An Experience at a Tertiary Care Hospital in Pakistan
Authors: Naushad Anum , Sattar Sadia , Salik Muhammad , Wajid Maria , Khalid Farah , Hussain Ali , Siddiqui Moghira I. U. , Masood Muhammad Q. 
Published: April 2023

Objectives Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia following total thyroidectomy (TT) is a common complication that is sometimes difficult to correct. This study aims to determine the frequency of hypocalcemia and permanent hypoparathyroidism (PtHPT) following TT. Methods A total of 363 patient records were reviewed who underwent TT for any reason. Thirty-eight patients did not have a follow-up in the clinic in the postoperative period and were excluded from the final analysis with the final sample as 325. For patients who developed hypocalcemia during the postoperative hospital stay, their lowest calcium levels were recorded and medical records were reviewed for the period of one year for the requirement of oral calcium and active form of vitamin D (calcitriol or alpha calcidiol) in the outpatient setting. Patients who required calcium and vitamin D supplementation for up to 1 year were labeled as having PtHPT. Risk factors were analyzed among those who developed PtHPT. Results From a total of 325 patients postoperative hypocalcemia developed in 163 (50.2%) patients, and 162 (49.8%) patients remained normocalcemic. Permanent hypoparathyroidism was found in 42(12.9%) patients and transient HPT in 121 (37.2%). Age, severe postoperative hypocalcemia (PoHC), and readmission for hypocalcemia were independent risk factors for PtHPT. Conclusions Transient hypoparathyroidism (THPT) is common in our setup. Patients who develop severe hypocalcemia postoperatively and need readmission should be closely followed for the development of PtHPT.
Suppression of inner ear signal intensity on fluid-attenuated inversion recovery magnetic resonance imaging in cats with vestibular disease
Authors: Everest Stephen , Monteith Gabrielle , Gaitero Luis , Samarani Francesca 
Published: April 2023

Objectives Otitis media/interna (OMI) is the most common cause of peripheral vestibular disease in cats. The inner ear contains endolymph and perilymph, with perilymph being very similar in composition to cerebrospinal fluid (CSF). As a very-low-protein fluid, it would be expected that normal perilymph should suppress on fluid-attenuated inversion recovery (FLAIR) MRI sequences. Based on this, we hypothesized that MRI FLAIR sequences should provide a non-invasive way of diagnosing inflammatory/infectious diseases such as OMI in cats, something that has previously been demonstrated in humans and, more recently, in dogs. Methods This was a retrospective cohort study in which 41 cats met the inclusion criteria. They were placed into one of four groups, based on presenting complaint: clinical OMI (group A); inflammatory central nervous system (CNS) disease (group B); non-inflammatory structural disease (group C); and normal brain MRI (control group; group D). Transverse T2-weighted and FLAIR MRI sequences at the level of the inner ears bilaterally were compared in each group. The inner ear was selected as a region of interest using Horos, with a FLAIR suppression ratio calculated to account for variability in signal intensity between MRIs. This FLAIR suppression ratio was then compared between groups. Statistical analyses were performed by an experienced statistician, with a general linear model used to compare mean FLAIR suppression ratio, CSF nucleated cell count and CSF protein concentration between groups. Results The OMI group (group A) had significantly lower FLAIR suppression scores compared with all other groups. The CSF cell count was also significantly increased in the OMI (group A) and inflammatory CNS disease (group B) groups compared with the control group (group D). Conclusions and relevance This study demonstrates the utility of MRI FLAIR sequences in diagnosing presumptive OMI in cats, similarly to in humans and dogs. This study is relevant to practicing veterinary neurologists and radiologists in interpreting MRI findings in cats with suspected OMI.
Comparison of outcomes between cross-linking plus topoguided excimer laser ablation and intrastromal corneal ring segments for keratoconus
Authors: Pinheiro Rosa L. , Rosa Andreia M. , Monteiro Tiago , Gil João Q. , Costa Ana Esmeralda , Tavares Cristina , Quadrado Maria João , Murta Joaquim N. 
Published: April 2023

Objective To compare cross-linking (CXL) plus topography-guided photorefractive keratectomy (t-PRK) and intrastromal corneal ring segments (ICRS) in keratoconus patients, at 12 months of follow-up. Methods This was a longitudinal, retrospective multi-center study. We included a referred sample of 154 eyes from 149 patients with grade I-III Amsler-Krümeich keratoconus with insufficient corrected-distance visual acuity (CDVA). In group 1 (CXL plus t-PRK, 87 eyes), another possible indication for surgery was evidence of progression. Group 2 (ICRS, 67 eyes) included only eyes with paracentral keratoconus (thinnest point at the inferotemporal quadrant) with coincident axes, and evidence of stabilization was required. A subgroup analysis was performed regarding the disease topographic phenotype. At 12 months postoperatively, visual, refractive, and topographic outcomes were evaluated. Results Comparison of the outcomes between CXL plus t-PRK (group 1) and ICRS (group 2) showed similar improvements in CDVA (in group 1, CDVA improved 0.18 logMAR, and in group 2 0.12 logMAR, P = .18) and K2 (−2,45 [6.46] D in group 1 and −2.13 [1.67] D in group 2, P = .34) The improvement in cylinder power was greater in group 2 (−2.37 [2.07] D in group 2 versus −1.18 [2.63] D in group 1, P = .003); group 1 had a higher decrease in Kmax (- 3.26 [3.64] versus—1.74 [2.67], P = .001). Conclusions Both CXL plus t-PRK and ICRS were equally effective in improving CDVA and topographic parameters in a similar group of keratoconus patients at 12 months.
Estimated mortality rates of individuals with sickle cell disease in Brazil: real-world evidence
Authors: Cançado Rodolfo Delfini , Costa Fernando Ferreira , Lobo Clarisse , Migliavaca Celina Borges , Falavigna Maicon , Souza Filho Homero C. R. , Bueno Carolina Tosin , Silva-Pinto Ana Cristina 
Published: April 2023

Abstract
Sickle cell disease (SCD) is a group of hereditary chronic diseases with a substantial impact on quality of life and morbimortality. In Brazil, it is 1 of the most common hereditary diseases; however, there are sparse epidemiological data for the country. Using data from death certificates, we aimed to estimate the median age at death, years of life lost because of SCD, and the median survival. From 2015 to 2019, we identified 3320 records of deaths of individuals with SCD, from a total of 6 553 132 death records. Among individuals with SCD, the median age at death was 37 years less than that of the general population (SCD: aged 32.0 years at death, interquartile range [IQR], 19.0-46.0; general population: aged 69.0 years at death; IQR, 53.0-81.0). Results were consistent when stratified by sex or race. Over the 5 years evaluated, crude death rates varied from 0.30 to 0.34 per 100 000 inhabitants (mean 0.32 per 100 000 inhabitants). We estimated a prevalence of 60 017 individuals living with SCD (29.02 cases per 100 000) and an average incidence of 1362 cases yearly. The median estimated survival was 40 years for individuals with SCD and 80 years for the general population. SCD was associated with an increased risk of mortality in most age ranges. Among individuals with SCD aged between 1 and 9 years and between 10 and 39 years, the risk of death was 32 and 13 times higher, respectively. The most common causes of death were sepsis and respiratory failure. These results highlight the burden of SCD in Brazil and the necessity of improved care for this population.
Assessment of the scope, completeness, and consistency of various drug information resources related to COVID-19 medications in pregnancy and lactation
Authors: Shareef Javedh , Sridhar Sathvik Belagodu , Bhupathyraaj Mullaicharam , Shariff Atiqulla , Thomas Sabin , Salim Karattuthodi Mohammed 
Published: April 2023

Abstract
Background
Drug use in pregnancy and lactation is challenging. It becomes more challenging in pregnant and lactating women with certain critical clinical conditions such as COVID-19, because of inconsistent drug safety data. Therefore, we aimed to evaluate the various drug information resources for the scope, completeness, and consistency of the information related to COVID-19 medications in pregnancy and lactation.

Methods
Data related to COVID-19 medications from various drug information resources such as text references, subscription databases, and free online tools were used for the comparison. The congregated data were analyzed for scope, completeness, and consistency.

Results
Scope scores were highest for Portable Electronic Physician Information Database (PEPID), Up-to-date, and drugs.com compared to other resources. The overall completeness scores were higher for Micromedex and drugs.com (p < 0.05 compared to all other resources). The inter-reliability analysis for overall components by Fleiss kappa among all the resources was found to be 'slight' (k < 0.20, p < 0.0001). The information related to the older drugs in most of the resources, provides in-depth details on various components such as pregnancy safety, clinical data related to lactation, the effect of the drug distribution into breast milk, reproductive potential/infertility risk and the pregnancy category/recommendations. However, the information related to these components for newer drugs was superficial and incomplete, with insufficient data and inconclusive evidence, which is a statistically significant observation. The strength of observer agreement for the various COVID-19 medications ranged from poor to fair and moderate for the various recommendation categories studied.

Conclusion
This study reports discrepancies in the information related to pregnancy, lactation, drug level, reproductive risk, and pregnancy recommendations among the resources directing to refer to more than one resource for information about the safe and quality use of medications in this special population.The present study also emphasizes the need for development of comprehensive, evidence-based, and precise information guide that can promote safe and effective drug use in this special population.
Overexpression of DDX49 in prostate cancer is associated with poor prognosis
Authors: Tao Junyue , Ge Qintao , Meng Jialing , Liang Chaozhao , Hao Zongyao , Zhou Jun 
Published: April 2023

Abstract
Background
There is increasing evidence that DEAD-box helicases (DDX) can act either as promoters or suppressors in various cancer types. Nevertheless, the function of DDX49 in prostate cancer (PCa) is unknown. This study reveals the prognostic and predictive value of DDX49 in PCa.

Methods
First, we evaluated the expression of DDX49 between PCa and normal tissues based on TCGA and GEO databases. Univariate and multivariate regression analyses were conducted to reveal the risk factors for PCa recurrence. A K–M curve was employed to assess the relationship between DDX49 and recurrence-free survival. In vitro, DDX49 expression was evaluated in PCa and normal prostate cell lines. Furthermore, we constructed a shDDX49 lentivirus to knock down the expression of DDX49. Celigo® Image Cytometer and MTT assay were performed to analyse cell proliferation in PC-3 cells. Cell cycle distribution was detected with flow cytometry analysis. Apoptosis affected by the lack of DDX49 was metred with the PathScan® Stress and Apoptosis Signalling Antibody Array Kit.

Results
This study shows a high increase in DDX49 in PCa tissues in comparison with normal tissues and that increased DDX49 indicates a poor prognosis among PCa patients. Meanwhile, DDX49 knockdown suppressed the proliferation and migration of PC-3 cells, causing cell cycle arrest in the G1 phase. Stress and apoptosis pathway analysis revealed that the phosphorylation of HSP27, p53, and SAPK/JNK was reduced in the DDX49 knockdown group compared with the control group.

Conclusions
In summary, these results suggest that high expression of DDX49 predicts a poor prognosis among PCa patients. Downregulation of DDX49 can suppress cell proliferation, block the cell cycle, and facilitate cell apoptosis. Therefore, knockdown of DDX49 is a promising novel therapy for treating patients with PCa.
Two clinicians for one patient, is it worth it? Patients’ perspective on receiving treatment from a pair of clinicians, in a psychiatric emergency and crisis unit
Authors: Dedeystère Pobelov Caroline , Weber Orest , Krenz Sonia , Dorogi Yves , Michaud Laurent 
Published: April 2023

Abstract
Background
In the field of psychiatric crisis interventions, treatment is commonly provided by multidisciplinary teams in Western countries. However, empirical data on the processes involved in this type of intervention are lacking, in particular from a patient perspective. Our study aims to gain a better understanding of the patients’ experience of a treatment setting provided by a pair of clinicians in a psychiatric emergency and crisis intervention unit. Patients’ perspective could provide a broader understanding of its advantages (or disadvantages), as well as bring new insight on elements influencing patients’ treatment adherence.

Methods
We conducted 12 interviews with former patients treated by a pair of clinicians. The participants’ experience, explored with semi-structured questions on their views of the treatment setting, was analyzed by means of thematic analysis using an inductive approach.

Results
The majority of participants experienced this setting as advantageous. A broader comprehension of their issues is the benefit most often expressed. A minority experienced seeing two clinicians as disadvantageous (having to talk to several clinicians at a time, change interlocutors, repeat one’s story). Participants attributed joint sessions (with both clinicians) mainly to clinical reasons and separate sessions (with one clinician at a time) mainly to logistical ones.

Conclusions
This qualitative study provides first insights into patients’ experience of a setting including two clinicians providing emergency and crisis psychiatric care. The results show a perceived clinical gain of such a treatment setting for highly in crisis patients. However, further research is needed to evaluate the benefit of this setting, including the indication for joint or separate sessions as the patient’s clinical course evolves.
Evaluation of safety and efficacy of rapamycin-eluting balloon in patients with intracranial atherosclerotic stenosis: a cohort study
Authors: Xu Guodong , Dong Xiaoli , Tian Yingying , Ma Liang , Han Ning , Yao Wentao , Yin Kuochang , Yin Nan 
Published: April 2023

Abstract
Objective
The safety and efficacy of drug-eluting balloon on the treatment of intracranial atherosclerotic stenosis (ICAS) remain unclear. Here, we present our observation in a cohort study on the safety and efficacy of rapamycin-eluting balloon for patients with ICAS.

Methods
A total of 80 ICAS patients with stenosis degree of 70–99% were included. All patients were treated with rapamycin-eluting balloon and were followed up for 12 months after operation.

Results
All patients were successfully treated, where the mean stenosis severity reduced from 85.1 ± 7.6 to 6 ± 4.9%. 8 patients experienced immediate post-operational complications. Two patients passed away during the first month of the follow-up period. Recurrent ischemic syndrome and angiographic restenosis only appeared 7 days after operation. During later follow-up period, none of the patients had clinical angiographic restenosis or needed target vessel revascularization.

Conclusion
Our data suggest that intracranial stenting with rapamycin-eluting balloon seems to be safe and effective, although more clinical data are needed to support this notion.
Effect of structural repairs on the load rating and reliability of a prestressed concrete bridge
Authors: Debees Marwan , Luleci Furkan , Catbas F. Necati 
Published: April 2023

AbstractPrestressed girders often deteriorate over time due to environmental and man-made stressors, lowering the strength and serviceability of bridge structures. Although structural repairs are implemented to improve the load carrying capacity of the structure, the presence of numerous unknowns leads to high uncertainty in estimating the adequacy of repairs. For instance, the cross-section of the remaining strands, material properties, applied external loads, and workmanship assumptions made throughout the repair process introduce ambiguities when estimating the adequacy of the repairs. This study evaluates the efficiency of re-tensioning repairs of prestressed concrete bridge span girders. The repairs include field splicing, re-tensioning, of deteriorated or damaged strands by torquing a splicing coupler. The evaluation in this study considers component, system reliability, and load ratings while accounting for several uncertainties, such as structural repair, material properties, and external loads. This paper introduces an approach to account for prestressing strands damage and repair uncertainties while also accounting for other uncertainties. In this regard, five cases are studied: as-built, repaired, and three varying degrees of damage cases. First, the distribution for structural demand and capacity accounting for uncertainty in loads, material properties, and repair process is defined for each girder in the prestressed concrete bridge span. In doing so, Monte-Carlo simulation is employed to determine the distributions. Accordingly, the limit state function of the girders is defined from the obtained distributions. Then, the component reliability of each AASHTO (American Association of State Highway and Transportation Officials) Type II girder is calculated from the obtained reliability indices based on the determined limit state functions. Finally, a system reliability model of the span is developed from the component reliability of each girder. Some advantages and disadvantages of using component and system reliability index versus load rating in damaged and repaired prestressed concrete bridge girders are also discussed. Several critical conclusions are made regarding the uncertainties in structural repair, material properties and external loads, and their impact on the load rating and the component and system reliability of the prestressed concrete bridge structure girders.
Pre– and Post–Sexual Maturity Liver-specific ERα Knockout Does Not Impact Hepatic Mitochondrial Function
Authors: Fuller Kelly N Z , Allen Julie , Kumari Roshan , Akakpo Jephte Y , Ruebel Meghan , Shankar Kartik , Thyfault John P 
Published: April 2023

Abstract
Compared with males, premenopausal women and female rodents are protected against hepatic steatosis and present with higher functioning mitochondria (greater hepatic mitochondrial respiration and reduced H2O2 emission). Despite evidence that estrogen action mediates female protection against steatosis, mechanisms remain unknown. Here we validated a mouse model with inducible reduction of liver estrogen receptor alpha (ERα) (LERKO) via adeno-associated virus (AAV) Cre. We phenotyped the liver health and mitochondrial function of LERKO mice (n = 10-12 per group) on a short-term high-fat diet (HFD), and then tested whether timing of LERKO induction at 2 timepoints (sexually immature: 4 weeks old [n = 11 per group] vs sexually mature: 8-10 weeks old [n = 8 per group]) would impact HFD-induced outcomes. We opted for an inducible LERKO model due to known estrogen-mediated developmental programming, and we reported both receptor and tissue specificity with our model. Control mice were ERαfl/fl receiving AAV with green fluorescent protein (GFP) only. Results show that there were no differences in body weight/composition or hepatic steatosis in LERKO mice with either short-term (4-week) or chronic (8-week) high-fat feeding. Similarly, LERKO genotype nor timing of LERKO induction (pre vs post sexual maturity) did not alter hepatic mitochondrial O2 and H2O2 flux, coupling, or OXPHOS protein. Transcriptomic analysis showed that hepatic gene expression in LERKO was significantly influenced by developmental stage. Together, these studies suggest that hepatic ERα is not required in female protection against HFD-induced hepatic steatosis nor does it mediate sexual dimorphism in liver mitochondria function.
Cardiac hydatid disease with palpitations as the only presenting complaint: the egg in the nest
Authors: Azari Ali , Bigdelu Leila , Maadarani Ossama , Bitar Zouheir 
Published: April 2023

Hydatid disease, also known as cystic echinococcosis, is a parasitic infection caused by the larval stage of Echinococcus granulosus. It usually invades organs such as the liver and the lungs but can affect any organ. Isolated cardiac involvement is a rare manifestation. We present a case of isolated left ventricle hydatid cyst with negative serological tests, which was treated with surgical removal and confirmed by histopathological examination.