bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Tolerability of Direct Ischemic Postconditioning Following Thrombectomy for Acute Ischemic Stroke
Authors: Wu Longfei , Wei Ming , Zhang Bohao , Zhang Bowei , Chen Jian , Wang Sifei , Luo Leilei , Liu Shuling , Li Sijie , Ren Changhong , Hess David C. , Song Haiqing , Zhao Wenbo , Ji Xunming 
Published: July 2023

BACKGROUND:
Experimental studies have demonstrated the neuroprotection of ischemic postconditioning (IPostC) in acute ischemic stroke by attenuating ischemia-reperfusion injury. This study aimed to investigate the safety and tolerability of direct IPostC in both a dog model and patients with acute ischemic stroke treated with thrombectomy.

METHODS:
The study involved 2 parts. First, IPostC was induced by repeated balloon inflation and deflation in dogs, where a low-pressure balloon was navigated to the anterior spinal artery, and 4 cycles of 5-minute ischemia followed by 5-minute reperfusion were performed. Vascular injuries were assessed using angiography and vascular tissue specimens. Then, a 3+3 dose-escalation trial was conducted in patients with acute ischemic stroke following successful thrombectomy recanalization. Patients received direct IPostC with ischemia and reperfusion durations in progressive increments of 0, 1, 2, 3, 4, and 5 minutes ×4 cycles. Major adverse responses were defined as vessel perforation, rupture, dissection, reocclusion, severe vasospasm, thrombotic events, and rupture of the balloon.

RESULTS:
IPostC was investigated in 4 dogs. No vessel perforation or rupture, dissection, or vasospasm was observed under the angiography. Only 1 vessel experienced mild injury between the intima and the internal elastic membrane detected on a histopathologic slide. Then, 18 patients were recruited. The duration of IPostC was progressively escalated with no major response happened. No patient experienced agitation, discomfort, or other tolerability issues. Five patients (27.8%) experienced any intracranial hemorrhage after thrombectomy, and 1 (5.6%) was symptomatic. At 3-month follow-up, no patient died, and 9 patients (50%) achieved functional independence.

CONCLUSIONS:
Direct IPostC inducing by 4 cycles of 5-minute ischemia followed by 5-minute reperfusion is safe, feasible, and tolerable in patients with acute ischemic stroke treated with thrombectomy. Further investigations are needed to determine the safety and preliminary efficacy of direct IPostC.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05153655.
Assessing Vulnerability and Population Exposed to Drought in Various Climatic Regions of Northeastern Iran
Authors: Zarei Mahdi , Hosseini Seyyed Hadi , Naemitabar Mahnaz 
Published: July 2023

Abstract
The motivations of this research are the continuation and intensification of drought effects on various socioeconomic sectors and the observation of few studies and no coordinated efforts to provide a compatible framework for drought risk management in different economic sectors and population groups of the study region. Present research was carried out to assess the vulnerability and population exposed to drought in Khorasan Razavi Province. Meteorological datasets for the years 1950–2020; drought indices including self-calibrating Palmer (scPDSI), standardized precipitation (SPI), and standardized precipitation evapotranspiration (SPEI); population and livestock density indicators; agricultural lands; water stress; and socioeconomic and infrastructural factors have been used. Results indicate that dry and wet periods were estimated to be more intense by SPEI in all studied stations; also, a significant difference was observed between the results of the SPI and SPEI indices in determining the long dry and wet periods. The highest variation between the occurrence of dry and wet periods was estimated using SPEI, which could be related to seasonal fluctuations of temperature and computational evapotranspiration. Although no significant correlation was observed between used indices to identify the number of wet months, a significant positive correlation exists between the numbers of dry months estimated by those. Drought risk analysis demonstrated that the central and southern parts of the province are exposed to very severe drought while the northern and northeastern parts of the area are more inclined to severe drought. The highest class of drought exposure is observed in the southern, central, and eastern regions of the province, so they represent the high-risk category of drought.
Combination of the Ratio Between Negative and Harvested Lymph Nodes and Metastatic Lymph Node Count as a Prognostic Indicator in Stage III Colon Cancer: A Retrospective Cohort Study
Authors: Benli Sami , Tazeoğlu Deniz , Çolak Tahsin 
Published: July 2023

Background This study aimed to investigate the relationship between the ratio of negative lymph nodes (NLN) number to the number of metastatic lymph nodes (MLN) and the harvested lymph nodes (HLN) number ratio survival rate and compare its prognostic value. Methods This retrospective cohort study included 207 stage III colon cancer patients between 2010 and 2018 at a single center. NLN/MLN and NLN/HLN cut-off values were determined with the receiver operating characteristic (ROC) curve according to 5-year survival. The patients were divided into high-risk and low-risk groups according to the cut-off value. These 2 groups were evaluated according to the clinicopathological data of the patients. Result The time-dependent ROC curve showed the optimal cut-off values of NLN as 3.86 and .79, respectively. These values show 83 patients in the high-risk group and 124 in the low-risk group. There was no difference between the groups in tumor localization and T stage. According to Kaplan-Meier survival analysis, mean survival was 35.88 months in the high-risk group and 50.18 months in the low-risk group. The risk of death in the high-risk group was 305% compared to the low-risk group (Hazard Ratio: 3.05, 95% 1.91 – 4.88) ( P < .001). Conclusion NLNs are among the critical prognostic factors in colon cancer. Although NLNs have a positive correlation with the survival rate of the patients, there is no statistical difference in tumor T stage and localization.
Acute Effects of Systemic Glucocorticoids on the Vocal Folds in a Pre-Clinical Model
Authors: Gartling Gary , Nakamura Ryosuke , Sayce Lea , Kimball Emily E. , Wilson Azure , Schneeberger Steven , Zimmerman Zachary , Garabedian Michael J. , Branski Ryan C. , Rousseau Bernard 
Published: July 2023

Objectives/Hypothesis: Systemic glucocorticoids (GC)s are employed to treat various voice disorders. However, GCs have varying pharmacodynamic properties with adverse effects ranging from changes in epithelial integrity, skeletal muscle catabolism, and altered body weight. We sought to characterize the acute temporal effects of systemic dexamethasone and methylprednisolone on vocal fold (VF) epithelial glucocorticoid receptor (GR) nuclear translocation, epithelial tight junction (ZO-1) expression, thyroarytenoid (TA) muscle fiber morphology, and body weight using an established pre-clinical model. We hypothesized dexamethasone and methylprednisolone will elicit changes in VF epithelial GR nuclear translocation, epithelial ZO-1 expression, TA muscle morphology, and body weight compared to placebo-treated controls. Methods: Forty-five New Zealand white rabbits received intramuscular injections of methylprednisolone (4.5 mg; n = 15), dexamethasone (450 µg; n = 15), or volume matched saline ( n = 15) into the iliocostalis/longissimus muscle for 6 consecutive days. Vocal folds from 5 rabbits from each treatment group were harvested at 1-, 3-, or 7 days following the final injection and subjected to immunohistochemistry for ZO-1 and GR as well as TA muscle fiber cross-sectional area (CSA) measures. Results: Dexamethasone increased epithelial GR nuclear translocation and ZO-1 expression 1-day following injections compared to methylprednisolone ( P = .024; P = .012). Dexamethasone and methylprednisolone increased TA CSA 1-day following injections ( P = .011). Methylprednisolone decreased body weight 7 days following injections compared to controls ( P = .004). Conclusions: Systemic dexamethasone may more efficiently activate GR in the VF epithelium with a lower risk of body weight loss, suggesting a role for more refined approaches to GC selection for laryngeal pathology.
Biofortification in Ethiopia: Opportunities and Challenges
Authors: Bachewe Fantu , Genye Tirsit , Girma Meron , Samuel Aregash , Warner James , van Zyl Cornelia 
Published: July 2023

Background: Children younger than 5 years and women of reproductive age often suffer from micronutrient deficiencies. Biofortification, which involves enriching staple crops with micronutrients, is a nutritional intervention focused on addressing micronutrient deficiencies. It is equitable, sustainable, and costs less than other nutritional interventions. Objective: This study investigates biofortification in Ethiopia, considering 6 globally biofortified crops, 5 of which are currently being biofortified in Ethiopia. However, only 2 of these crops are important in the consumption baskets of most Ethiopians. Therefore, efforts to mainstream biofortification should begin with studies to identify crops that have larger impacts in reducing local micronutrient deficiencies and their cost-effectiveness. Methods: Literature was searched between July and December 2021 using Google Scholar to provide insights into the state of biofortification in Ethiopia. Key-informant interviews were conducted to gain insights into the state of biofortification in Ethiopia and to identify bottlenecks for scaling up the production and consumption of biofortified foods. Furthermore, Annual Agriculture Sample Survey and 2015/16 Ethiopian Household Consumption and Expenditure Survey data were used to describe the area under production of biofortifiable crops and their importance in total consumption, respectively. Results: Mainstreaming biofortification in Ethiopia faces several challenges. Policy documents appear to be inconsistent, regressive, and vague regarding biofortification. Critically, there is no specific institution to oversee and/or coordinate biofortification-related activities. Conclusion: Overall, the success of biofortification depends upon a strong coordination body with clear mandates from detailed policies; adequate funding for research and development; and robust monitoring and evaluation of the identified production, adoption, and consumption issues.
Trends of Single, Dual, and Polytobacco Use Among School-Based Students in the United States: An Analysis of the National Youth Tobacco Survey
Authors: Cook Steven , Ortiz Chavez Stephany , Zavala-Arciniega Luis , Hirschtick Jana L. , Fleischer Nancy L. 
Published: July 2023

Purpose To examine trends in single, dual, and polytobacco use between 2014-2020 for US youth and to identify disparities in these trends by grade level, sex, and race/ethnicity. Design A secondary analysis of the National Youth Tobacco Survey (NYTS). Subjects A total of 122 566 students. Measures Past 30-day exclusive use of cigarettes, e-cigarettes, other combustibles (cigars, little cigars, cigarillos, hookah, pipe tobacco, bidis) and smokeless tobacco (snus, smokeless, dissolvable); dual use of each product with e-cigarettes; polyuse with e-cigarettes; dual/polyuse without e-cigarettes. Analysis Multivariable modified Poisson regression. Results Compared to 2014, exclusive e-cigarette use (APR = 2.51, 95% CI: 1.96, 3.21) trended upward while exclusive cigarette (APR = .34, 95% CI: .23, .50), ‘other’ combustibles (APR = .47, 95% CI: .37, .58), and smokeless tobacco (APR = .40, 95% CI: .25, .65) use trended downward in 2020. Polytobacco use with and without e-cigarettes trended downward in 2020 compared to 2014. We also saw differences in trends across sociodemographic groups. Comparing 2020 to 2014, exclusive e-cigarette use was higher for females than males, ‘other’ combustible tobacco use remained stable for Non-Hispanic Black students but decreased for other racial/ethnic groups, and dual e-cigarette/cigarette use trended upward more for middle school students than high school students. Conclusions Despite decreased trends in tobacco product use without e-cigarettes between 2014-2020, differences in tobacco product use trends by grade level, sex, and race/ethnicity were identified. Prevention efforts targeting disparities in tobacco product use are needed.
Voting Power of Citizens in a Democracy
Authors: Gupta Aakash 
Published: July 2023

Shapley and Shubik in 1954 proposed an index to measure the relative voting power of members of a decision-making body, given their weights in the said body. In this article, we have tried to investigate whether one can ensure equal voting power for all the citizens in a democracy through their respective representatives in the state legislature. The article shows that if the citizens realise their voting power through legislators and the number of constituencies in a democracy are at most four, then there does not exist any weighted voting rule such that the citizens enjoy equal voting power. JEL: C71, D71, D72
Case report: Drug-induced vitiligo during treatment with BRAF/MEK inhibitors in a patient with metastatic conjunctival melanoma
Authors: Saray Seray , Hızlı Pelin 
Published: July 2023

Introduction Autoimmune side effects can be detected during the use of BRAF/MEK inhibitor. Although its frequency, mechanism and importance are not known exactly, there are cases reported in the literature. Case Report We report a case of drug-induced vitiligo in a patient with metastatic conjunctival malignant melanoma who was treated with BRAF/MEK inhibition therapy. Management and Outcome In the case, vitiligo was controlled with topical treatments. Follow-up process of the patient has been continuing with no progression on month 12 of the current treatment. Discussion Although ICI-related autoimmune side effects and vitiligo have been described more frequently, vitiligo may also occur secondary to BRAK/MEK inhibition. This case also points out that cutaneous toxicity is manageable with no delay in treatment thanks to collaboration of dermatologists and oncologists.
Trends in Stimulant and Sedative/Hypnotic Dispensing: An Exploratory Study
Authors: Liou Harris , Gentry Melanie T. , Leung Jonathan G. , Mara Kristin C. , Staab Jeffrey P. , Rummans Teresa A. 
Published: July 2023

Objective: To investigate patterns and trends of co-prescriptions of stimulants and sedatives within the last 6 years at a tertiary care center. Method: Patients 18 years of age and older who were dispensed at least one stimulant prescription from an institutional pharmacy between 1/1/2015 and 7/1/2021 were included. Prescription data for any co-prescribed sedative/hypnotic were collected. Results: Both the number of stimulant dispenses and the number of patients with stimulant dispenses increased significantly with yearly incidence rate ratios of 1.115 (95% CI [1.110, 1.119]) and 1.090 (95% CI [1.084, 1.096]), respectively. The number of patients with a stimulant dispensed who also had a benzodiazepine or “Z-drug” sedative-hypnotic dispensed at any point in the search timeframe increased significantly with incidence rate ratios of 1.077 and 1.092, respectively. The number of stimulant dispenses, number of patients with stimulant dispenses, and number of patients with a stimulant dispensed who also had both a benzodiazepine and Z-drug dispensed at any point in the search timeframe increased significantly more in Non-White than in White patients. Conclusions: The results confirm previous findings of increases in dispensing of stimulants over the past 6 years and report increased polypharmacy of stimulants and sedative-hypnotics.
Management of diabetic neuropathy with memantine: A randomized clinical trial
Authors: Jafarzadeh Elnaz , Beheshtirouy Samineh , Aghamohammadzadeh Nasser , Ghaffary Saba , Sarbakhsh Parvin , Shaseb Elnaz 
Published: July 2023

Background Diabetes patients frequently experience diabetic neuropathy (DN), a microvascular complication that significantly reduces patients’ quality of life. Memantine has demonstrated potential benefits for neuropathic pains in preclinical studies. This study aimed to assess the efficacy of memantine in the management of peripheral neuropathy in patients with type 2 diabetes mellitus (T2DM). Method This randomized clinical trial includes 143 diabetic patients (aged between 18 and 75 years) with a confirmed diagnosis of diabetic neuropathy. Patients were randomly assigned to receive memantine 5 mg twice daily for 1 week, followed by 10 mg twice daily plus gabapentin 300 mg daily ( n = 72) or just gabapentin 300 mg daily ( n = 71) for 8 weeks. The DN4 questionnaire, monofilament, tuning fork, and Tip-therm tests were used to measure neuropathy at baseline and after the 8-week intervention. Results The mean score of the DN4 questionnaire in the memantine group was significantly lower than the control group ( p. value: .001). The number of patients with diabetic neuropathy remarkably decreased in the memantine group at the end of the study based on the performed tests ( p. value: .001). Conclusion Memantine functions as a beneficial agent in the management of diabetic neuropathy, which would significantly improve the quality of life in diabetic patients.
Increased Piezo1 expression in myofibroblasts in patients with symptomatic carotid atherosclerotic plaques undergoing carotid endarterectomy: A pilot study
Authors: Konishi Takao , Kamiyama Kenji , Osato Toshiaki , Yoshimoto Tetsuyuki , Aoki Takeshi , Anzai Toshihisa , Tanaka Shinya 
Published: July 2023

Objectives We aimed to investigate Piezo1 expression in myofibroblasts in symptomatic and asymptomatic patients undergoing carotid endarterectomy and its relationship with atherosclerotic plaque formation. Methods This cross-sectional study analyzed carotid plaques of 17 randomly selected patients who underwent carotid endarterectomy from May 2015 to August 2017. In total, 51 sections (the most stenotic lesion, and the sections 5-mm proximal and distal) stained with hematoxylin-eosin and elastica-Masson were examined. Immunohistochemistry was performed using antibodies to Piezo1. The Piezo1 score of a section was calculated semiquantitatively, averaged across 30 randomly selected myofibroblasts in the fibrous cap of the plaque. Results Of 17 patients (mean age: 74.2 ± 7.1 years), 15 were men, 9 had diabetes mellitus, and 13 had hypertension. Symptomatic patients had higher mean Piezo1 score than asymptomatic patients (1.78 ± 0.23 vs 1.34 ± 0.17, p < .001). Univariate linear regression analyses suggested an association between plaque rupture, thin-cap fibroatheroma and microcalcifications and the Piezo1 score ( p = .001, .008, and 0.003, respectively). Conclusions Increased Piezo1 expression of myofibroblasts may be associated with atherosclerotic carotid plaque instability. Further study is warranted to support this finding.
Characterization of Ankle Injuries and Associated Risk Factors in the National Basketball Association: Minutes Per Game and Usage Rate Associated With Time Loss
Authors: Tummala Sailesh V. , Morikawa Landon , Brinkman Joseph C. , Crijns Tom J. , Vij Neeraj , Gill Vikram , Kile Todd A. , Patel Karan , Chhabra Anikar 
Published: July 2023

Background: Ankle injuries are more common in the National Basketball Association (NBA) compared with other professional sports. Purpose/Hypothesis: The purpose of this study was to report the incidence and associated risk factors of ankle injuries in NBA athletes. It was hypothesized that factors associated with an increased physiologic burden, such as minutes per game (MPG), usage rate, and associated lower extremity injury, would be associated with increased ankle injury risk and time loss. Study Design: Descriptive epidemiology study. Methods: Ankle injury data from the 2015-2016 through 2020-2021 NBA seasons were evaluated. The truncated 2019-2020 season due to the COVID-19 pandemic was omitted. The primary outcome was the incidence of ankle injuries, reported per 1000 game-exposures (GEs). Secondary analysis was performed to identify risk factors for ankle injuries through bivariate analysis and multivariable logistic regression of player demographic characteristics, performance statistics, injury characteristics, and previous lower extremity injuries. Factors influencing the time loss after injury were assessed via a negative binomial regression analysis. Results: A total of 554 ankle injuries (4.06 injuries per 1000 GEs) were sustained by NBA players over 5 NBA seasons, with sprain/strain the most common injury type (3.71 injuries per 1000 GEs). The majority of ankle injury events (55%) resulted in 2 to 10 game absences. The likelihood of sustaining an ankle injury was significantly associated with a greater number of games played ( P = .029) and previous injury to the hip, hamstring, or quadriceps ( P = .004). Increased length of absence due to ankle injury was associated with greater height ( P = .019), MPG ( P < .001), usage rate ( P = .025), points per game ( P = .011), and a prior history of foot ( P = .003), ankle ( P < .001), and knee injuries ( P < .001). Conclusion: The incidence of ankle injuries was 4.06 per 1000 GEs in professional basketball players. Games played and prior history of hip, hamstring, or quadriceps injuries were found to be risk factors for ankle injuries. Factors associated with physiologic burden such as MPG and usage rate were associated with an increased time loss after injury.
The impact of respiratory infections and probiotic use on the nasal microbiota of frail residents in long-term care homes
Authors: Bowdish Dawn M.E. , Rossi Laura , Loeb Mark , Johnstone Jennie , Schenck Louis P. , Fontes Michelle , Surette Michael G. , Whelan Fiona J. 
Published: July 2023

BackgroundResidents in long-term care homes, who tend to be of advanced age and frail, are at increased risk of respiratory infections. The respiratory microbiota is known to change with age, but whether these changes contribute to the risk of infection is not known. Our goal was to determine how the nasal microbiota of frail older adults changes during symptoms of influenza-like illness (ILI) and how this may be impacted by enrolment in a placebo-controlled trial testing the feasibility of administering aLactobacillus rhamnosusGG probiotic to prevent respiratory infection (2014–2017).MethodsThe microbiome of the nasal (mid-turbinate) of 150 residents of long-term care homes was interrogated using 16S rRNA gene sequencing.ResultsWe identified a diverse and individualised microbiota which could be separated into nine distinct clusters based on Bray–Curtis distances. Samples collected during symptoms of ILI differed statistically from those collected pre- and post-cold and influenza season, and we observed decreased temporal stability (as measured by movement between clusters) in individuals who experienced ILI compared to those who did not.ConclusionsThe use of probiotics decreased ILI-induced changes to the microbiota; however, it is not clear whether this decrease is sufficient to prevent respiratory illness.