bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prognostic Utility of Electroencephalography in Stroke Recovery: A Systematic Review and Meta-Analysis
Authors: Vatinno Amanda A , Simpson Annie , Ramakrishnan Viswanathan , Bonilha Heather S. , Bonilha Leonardo , Seo Na Jin 
Published: March 2022

Background Improved ability to predict patient recovery would guide post-stroke care by helping clinicians personalize treatment and maximize outcomes. Electroencephalography (EEG) provides a direct measure of the functional neuroelectric activity in the brain that forms the basis for neuroplasticity and recovery, and thus may increase prognostic ability. Objective To examine evidence for the prognostic utility of EEG in stroke recovery via systematic review/meta-analysis. Methods Peer-reviewed journal articles that examined the relationship between EEG and subsequent clinical outcome(s) in stroke were searched using electronic databases. Two independent researchers extracted data for synthesis. Linear meta-regressions were performed across subsets of papers with common outcome measures to quantify the association between EEG and outcome. Results 75 papers were included. Association between EEG and clinical outcomes was seen not only early post-stroke, but more than 6 months post-stroke. The most studied prognostic potential of EEG was in predicting independence and stroke severity in the standard acute stroke care setting. The meta-analysis showed that EEG was associated with subsequent clinical outcomes measured by the Modified Rankin Scale, National Institutes of Health Stroke Scale, and Fugl-Meyer Upper Extremity Assessment (r = .72, .70, and .53 from 8, 13, and 12 papers, respectively). EEG improved prognostic abilities beyond prediction afforded by standard clinical assessments. However, the EEG variables examined were highly variable across studies and did not converge. Conclusions EEG shows potential to predict post-stroke recovery outcomes. However, evidence is largely explorative, primarily due to the lack of a definitive set of EEG measures to be used for prognosis.
Reconstructive Timing of Nail Preserved Fingertip Injury With Reverse Digital Artery Island Flap
Authors: Usami Satoshi , Kawahara Sanshiro , Inami Kohei , Hirase Yuichi 
Published: March 2022

Background: This study aimed to compare the outcomes of reverse digital artery island flap (RDAIF) in primary and secondary reconstruction after failed replantation or composite graft method. Methods: This study retrospectively analyzed 42 patients that underwent RDAIF (18 primary and 24 secondary). Preoperative details (demographics, injury details, and waiting days) and postoperative outcomes (active arc of proximal interphalangeal [PIP] and distal interphalangeal (DIP) joints, extension loss of PIP, flexion arc of metacarpophalangeal joint, total active motion, flap sensation, the presence of numbness, Tinel’s sign and cold intolerance) were evaluated. Quick Disabilities of the Arm, Shoulder, and Hand score (Quick-DASH) and patient satisfaction were also statistically compared between the 2 groups. Results: There was no significant difference in patient demographics between the 2 groups in sex, age, smoking and diabetic history, affected hand and finger, injury type and level, and flap area. The only difference was in waiting days. Similar sensory recovery and patient satisfaction were found in both groups. Range of motion in the DIP and PIP joints, extension loss of PIP, total active motion, and Quick-DASH were superior in the primary coverage group. Increasing age, subzone III injury, and secondary reconstruction were found to be the factors that adversely affected the postoperative range of motion. Conclusions: Secondary reconstruction was more likely to result in joint contracture. In the event of a damaged fingertip amputation in older patients, primary flap reconstruction should be considered as the initial treatment of choice, with regard to the ultimate range of motion.
Revascularization prevents amputation among patients with diabetic foot during the COVID-19 era
Authors: Lozano-Corona Rodrigo , Reyes-Monroy José A , Lara-González Viridiana , Anaya-Ayala Javier E , Dardik Alan , Hinojosa Carlos A 
Published: March 2022

Objective The COVID‐19 pandemic has led to significant changes in healthcare systems that impact the management of chronic diseases such as diabetic foot (DF). We hypothesized that lack of access to healthcare would increase the severity of disease and lead to worse outcomes. Methods The medical records of patients with DF were reviewed to determine demographic data and outcomes including wound healing, major amputation (MA), and death. Groups were divided into the pre–COVID-19 era (15 March 2019–15 March 2020) and the COVID-19 era (16 March 2020–16 March 2021); multivariable logistic analysis was performed to identify risk factors for MA. Results 261 patients with DF were included, 163 in the pre–COVID-19 era and 98 during the COVID-19 era. Patients in the COVID-19 presented with increased cardiovascular disease (19 vs 7%, p = 0.01), increased mean HbA1C (9.1 ± 2.1 vs 8.2 ± 2.1, p = 0.008) and higher WIFI-IV stage (78 vs 53%, p ≤ 0.0001). Patients with DF in the COVID-19 era were more likely to require MA (41 vs 21%, p ≤ 0.0001). Revascularization (OR = 0.12; 95% CI, 0.038–0.38) was a protective factor to reduce MA. Conclusions MA among DF patients increased two-fold during the COVID-19 era. Revascularization avoids MA in diabetic patients even during the COVID-19 pandemic, suggesting that revascularization should be performed when possible.
Top cited articles in concussion: A bibliometric analysis of the state of the science
Authors: Sharma Bhanu , Lawrence David Wyndham 
Published: March 2022

Objective Citation analyses identify the most-cited publications in a given field, which aids in understanding areas of the literature that are well-developed and those where additional research is required. Our objective was to perform a citation analysis in concussion to understand the state of the science from a bibliometric perspective. Design We performed a keyword search for articles related to concussion in Harzing's Publish or Perish, which scrapes Google Scholar for citation metrics. This approach was used to identify the 50 articles with the most lifetime citations as well as the 50 articles with the highest citation rate. Main outcome measures Citations and citation rates. Results Per our citation analysis, we found that concussion guidelines are among the most cited publications (comprising ≥20% of each citation cohort), yet there is a dearth of widely cited clinical trials to inform them; only one randomized trial (studying the effects of rest following concussion) was included in our citation analysis. The majority of study designs (≥40% of each citation cohort) were cross-sectional. Concussion recovery and secondary complications of concussion were common study topics, with ≥20% of publications in each citation cohort focused on these issues. The publications included in our analysis were authored by 596 authors from only 12 countries, suggesting a lack of global representation in concussion research. Conclusions Existing reviews and consensus statements have called for additional, high-quality research in concussion; our citation analysis quantifies this need. Further, although concussion is a global problem with its incidence and burden increasing in the developing world, our citation analysis demonstrates that the most-cited and discussed articles in concussion are published by authors from only 12 countries. Going forward, to address the global problem that is concussion, a more global research perspective is called for.
“Still on the Fence”: A Mixed Methods Investigation of COVID-19 Vaccine Confidence Among Health Care Providers
Authors: Choi Kristen , Chang John , Luo Yi X. , Lewin Bruno , Munoz-Plaza Corrine , Bronstein David , Rondinelli June , Bruxvoort Katia 
Published: March 2022

Background: There is evidence of disparities in COVID-19 vaccine acceptance among health care providers. The purpose of this study was to examine confidence receiving and recommending COVID-19 vaccines by health care provider type and race/ethnicity. Methods: This mixed methods study involved a cross-sectional survey and qualitative, semi-structured interviews from March to May 2021 among a sample of physicians, advanced practice providers, nurses, and pharmacists. These workers were recruited through voluntary response sampling from an integrated health system in Southern California. The primary dependent variables were (a) confidence in vaccine safety, (b) confidence in vaccine effectiveness, and (c) intent to recommend the vaccine to others. The primary independent variables were health care provider type and race/ethnicity. Findings: A total of 2,948 providers completed the survey. Nurses relative to physicians were 15% less likely to perceive the COVID-19 vaccine to be safe (risk ratio [RR] = 0.85; 95% confidence interval [CI] = 0.83–0.87); 27% less likely to perceive the vaccine to prevent COVID-19 (RR = 0.73; 95% CI = 0.69–0.76); and 11% less likely to recommend the vaccine to others (RR = 0.89; 95% CI = 0.87–0.91). Hispanic/Latinx providers were 10% less likely to perceive the vaccine to prevent COVID-19 (RR = 0.90; 95% CI = 0.83–0.98) relative to White providers. Qualitative themes included: No need for vaccine; distrusting vaccine research and roll-out; caretaking barriers; uncertainty and potential to change one’s mind; framing vaccine decisions around personal beliefs. Conclusions & Application to Practice: Health care workplaces should consider interventions to increase COVID-19 vaccination among their workers, including education and mandatory vaccination policies.
High BMP4 expression in low/intermediate risk BCP-ALL identifies children with poor outcomes
Authors: Fernández-Sevilla Lidia M. , Valencia Jaris , Ortiz-Sánchez Paula , Fraile-Ramos Alberto , Zuluaga Pilar , Jiménez Eva , Sacedón Rosa , Martínez-Sánchez María V. , Jazbec Janez , Debeljak Marusa , Fedders Birthe , Stanulla Martin , Schewe Denis , Cario Gunnar , Minguela Alfredo , Ramírez Manuel , Varas Alberto , Vicente Ángeles 
Published: March 2022

Abstract
Pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL) outcome has improved in the last decades, but leukemic relapses are still one of the main problems of this disease. Bone morphogenetic protein 4 (BMP4) was investigated as a new candidate biomarker with potential prognostic relevance, and its pathogenic role was assessed in the development of disease. A retrospective study was performed with 115 pediatric patients with BCP-ALL, and BMP4 expression was analyzed by quantitative reverse transcription polymerase chain reaction in leukemic blasts at the time of diagnosis. BMP4 mRNA expression levels in the third (upper) quartile were associated with a higher cumulative incidence of relapse as well as a worse 5-year event-free survival and central nervous system (CNS) involvement. Importantly, this association was also evident among children classified as having a nonhigh risk of relapse. A validation cohort of 236 patients with BCP-ALL supported these data. Furthermore, high BMP4 expression promoted engraftment and rapid disease progression in an NSG mouse xenograft model with CNS involvement. Pharmacological blockade of the canonical BMP signaling pathway significantly decreased CNS infiltration and consistently resulted in amelioration of clinical parameters, including neurological score. Mechanistically, BMP4 favored chemoresistance, enhanced adhesion and migration through brain vascular endothelial cells, and promoted a proinflammatory microenvironment and CNS angiogenesis. These data provide evidence that BMP4 expression levels in leukemic cells could be a useful biomarker to identify children with poor outcomes in the low-/intermediate-risk groups of BCP-ALL and that BMP4 could be a new therapeutic target to blockade leukemic CNS disease.
Divergent selection for natural antibodies in poultry in the presence of a major gene
Authors: Bovenhuis Henk , Berghof Tom V. L. , Visker Marleen H. P. W. , Arts Joop A. J. , Visscher Jeroen , van der Poel Jan J. , Parmentier Henk K. 
Published: March 2022

Abstract
Background
Natural antibodies (NAb) are antibodies that are present in a healthy individual without requiring previous exposure to an exogenous antigen. Selection for high NAb levels might contribute to improved general disease resistance. Our aim was to analyse the genetic background of NAb based on a divergent selection experiment in poultry, and in particular the effect of a polymorphism in the TLR1A gene.

Methods
The study population consisted of a base population from a commercial pure-bred elite white leghorn layer line and seven generations of birds from a High and Low selection line. Birds were selected for total KLH-binding NAb titer (IgTotal). An enzyme-linked immunosorbent assay was performed to determine NAb titers in blood plasma for IgTotal and the antibody isotypes IgM and IgG. NAb titers were available for 10,878 birds. Genotypes for a polymorphism in TLR1A were determined for chickens in generations 5, 6 and 7. The data were analysed using mixed linear animal models.

Results
The heritability estimate for IgM was 0.30 and higher than that for IgG and IgTotal (0.12). Maternal environmental effects explained 2 to 3% of the phenotypic variation in NAb. Selection for IgTotal resulted in a genetic difference between the High and Low line of 2.4 titer points (5.1 genetic standard deviation) in generation 7. For IgM, the selection response was asymmetrical and higher in the Low than the High line. The frequency of the TLR1A C allele was 0.45 in the base population and 0.66 and 0.04 in generation 7 of the High and Low line, respectively. The TLR1A polymorphism had large and significant effects on IgTotal and IgM. Estimated genotypic effects suggest full dominance of the TLR1A C allele. Significant TLR1A by generation interactions were detected for IgM and IgTotal.

Conclusions
The effect of a polymorphism in the TLR1A gene on IgTotal and IgM NAb was confirmed. Furthermore, we provide experimental verification of changes in allele frequencies at a major gene with dominant gene action on a quantitative trait that is subjected to mass selection. TLR1A by generation interactions indicate sensitivity to environmental factors.
Variation in terpenoids in leaves of Artemisia annua grown under different LED spectra resulting in diverse antimalarial activities against Plasmodium falciparum
Authors: Sankhuan Darunmas , Niramolyanun Gamolthip , Kangwanrangsan Niwat , Nakano Masaru , Supaibulwatana Kanyaratt 
Published: March 2022

Abstract
Background
Productivities of bioactive compounds in high-value herbs and medicinal plants are often compromised by uncontrollable environmental parameters. Recent advances in the development of plant factories with artificial lighting (PFAL) have led to improved qualitative and/or quantitative production of bioactive compounds in several medicinal plants. However, information concerning the effect of light qualities on plant pharmaceutical properties is limited. The influence of three different light-emitting diode (LED) spectra on leaf fresh weight (FW), bioactive compound production and bioactivity of Artemisia annua L. against the malarial parasite Plasmodium falciparum NF54 was investigated. Correlation between the A. annua metabolites and antimalarial activity of light-treated plant extracts were also determined.

Results
Artemisia annua plants grown under white and blue spectra that intersected at 445 nm exhibited higher leaf FW and increased amounts of artemisinin and artemisinic acid, with enhanced production of several terpenoids displaying a variety of pharmacological activities. Conversely, the red spectrum led to diminished production of bioactive compounds and a distinct metabolite profile compared with other wavelengths. Crude extracts obtained from white and blue spectral treatments exhibited 2 times higher anti-Plasmodium falciparum activity than those subjected to the red treatment. Highest bioactivity was 4 times greater than those obtained from greenhouse-grown plants. Hierarchical cluster analysis (HCA) revealed a strong correlation between levels of several terpenoids and antimalarial activity, suggesting that these compounds might be involved in increasing antimalarial activity.

Conclusions
Results demonstrated a strategy to overcome the limitation of A. annua cultivation in Bangkok, Thailand. A specific LED spectrum that operated in a PFAL system promoted the accumulation of some useful phytochemicals in A. annua, leading to increased antimalarial activity. Therefore, the application of PFAL with appropriate light spectra showed promise as an alternative method for industrial production of A. annua or other useful medicinal plants with minimal environmental influence.
The impact of iron store on red blood cell transfusion: a multicentre prospective cohort study in cardiac surgery
Authors: Gaudriot Baptiste , Oilleau Jean-Ferreol , Kerforne Thomas , Ecoffey Claude , Huet Olivier , Mansour Alexandre , Verhoye Jean-Philippe , Massart Nicolas , Nesseler Nicolas ,   for the AtlanRea Study Group, Gaudriot Baptiste , Oilleau Jean-Ferreol , Kerforne Thomas , Ecoffey Claude , Huet Olivier , Mansour Alexandre , Massart Nicolas , Nesseler Nicolas 
Published: March 2022

Abstract
Background
Anaemia is common prior to cardiac surgery and contributes to perioperative morbidity. Iron deficiency is the main cause of anaemia but its impact remains controversial in the surgical setting. We aimed to estimate the impact of iron deficiency on in-hospital perioperative red blood cell transfusion for patients undergoing elective and urgent cardiac surgery. Secondary objectives were to identify risk factors associated with in-hospital red blood cell transfusion.

Methods
We conducted a prospective multicentre observational study in three university hospitals performing cardiac surgery. We determined iron status prior to surgery and collected all transfusion data to compare iron-deficient and iron-replete patients during hospital stay. We performed a multivariable logistic regression to compare transfusion among groups.

Results
Five hundred and two patients were included. A trend of low haemoglobin levels associated with iron deficiency persisted until discharge. Red blood cell transfusion was significantly higher in the group of iron deficient patients during surgery (22% vs 13%, p = 0.017), however the incidence during the whole hospital stay was 31% in the iron-deficient group, not significantly different with the non-deficient group (26%, p = 0.28). Iron deficiency was not independently associated with in-hospital red blood cell transfusion (adjusted OR = 0.85 [0.53–1.36], p = 0.49).

Conclusions
In-hospital red blood cell transfusion was not significantly higher in iron-deficient patients and iron deficiency was not associated with in-hospital red blood cell transfusion in patients undergoing elective and urgent cardiac surgery. Iron deficiency was the main cause of anaemia and anaemia was a strong driver of red blood cell transfusion. Further studies should identify sub-population of iron-deficient patients which may benefit from preoperative iron deficiency management and explore the long-term impact of lower haemoglobin levels at discharge in the iron deficient population.
Clinical relevance of circulating angiogenic cells in patients with ischemic stroke
Authors: Rodríguez-Esparragón Francisco , Torres-Mata Laura B. , López-Fernández Juan Carlos , Cappiello Laura , González-Martín Jesús M. , Clavo Bernardino , Serna-Gómez Jaime A. , Estupiñán-Quintana Lidia , Torres-Ascensión Cristina , Villar Jesús 
Published: March 2022

Abstract
Background
Endothelial progenitor cells (EPCs) are circulating angiogenic cells with endothelial features associated with risk for stroke. We aimed to delve into their functional characteristics. EPCs were isolated and cultured from Ischemic Stroke (IS) patients and predictors of their variance evaluated.

Methods
This is a single-center observational study evaluating 187 consecutively hospitalized patients with IS. EPCs were isolated from blood samples. The number of circulating angiogenic cells (CACs), colony-forming units (CFU-ECs) and the emergence of late outgrowths endothelial cells (LOECs) were counted. We collected clinical variables and measured the stromal cell-derived factor 1 alpha (SDF1α) serum levels. We also examined the relative telomere length and the expression of osteogenic gene markers in CACs.

Results
CACs counts and CFU-ECs colony numbers were positively correlated (rho = 0.41, p < 0.001, n = 187). We found significant differences according to whether thrombolytic treatment was performed in the distribution of CFU-ECs (odds ratio (OR) = 2.5; 95% confidence interval (CI) 1.01–6.35; p = 0.042) and CACs (OR = 4.45; 95% IC 1.2–15.5; p = 0.012). The main determinants of CACs variation were the number of risks factors, thrombolysis treatment, arterial hypertension, LOECs occurrence, and the vascular endothelial growth factor expression, whereas CFU-ECs variations depended on hemoglobin content and the relative reduction in the National Institutes of Health Stroke Scale (NIHSS) criteria. The main predictors of LOECs appearance were thrombolysis and length of hospital stay.

Conclusions
Our study supports the relevance of patient risk factors and treatments in the analysis of the functional properties of EPCs.
Partial upper sternotomy for extensive arch repair in older acute type A aortic dissection patients
Authors: Qiu Zhihuang , Xiao Jun , Wu Qingsong , Chai Tianci , Zhang Li , Li Yumei , Chen Liangwan 
Published: March 2022

Abstract
Objectives
The partial upper sternotomy (PUS) approach is acceptable for aortic valve replacement, and even aortic root operation. However, the efficiency of PUS for extensive arch repair of acute type A aortic dissection (AAAD) in older adult patients has not been well investigated.

Methods
Between January 2014 and December 2019, 222 older adult patients (≥ 65 years) diagnosed with AAAD went through extensive arch repair, among which 127 received PUS, and 95 underwent full sternotomy (FS). Logistic regression analysis was used to identify risk factors for early death, and negative binomial regression analysis was applied to explore risk factors related to post-operative ventilator-supporting time and intensive care unit stay time.

Results
Total early mortality was 8.1% (18/222 patients). The PUS group had shorter Cardiopulmonary bypass time (133.0 vs.155.0 min, P < 0.001), cross-clamp time (44.0 vs. 61.0 min, P < 0.001) and shorter selective cerebral perfusion time (11.0 vs. 21.0 min, P < 0.001) than the FS group. Left ventricle ejection fraction  < 50% (odds ratio [OR] 17.05; 95% confidence interval [CI] 1.87–155.63; P = 0.012) and malperfusion syndromes (OR 65.83; 95% CI 11.53–375.86; P < 0.001) were related to early death. In the multivariate model, the PUS approach contributed to shorter ventilator-supporting time (incidence rate ratio [IRR] 0.76; 95% CI 0.64–0.91; P = 0.003), when compared with the FS group.

Conclusions
The early results of emergency extensive arch repair of AAAD via PUS in older adult patients were satisfactory. However, the long-term results remain to be investigated.