bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trough Concentration Deficiency of Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation Leading to Thromboembolism Events
Authors: Gao Hongjin , Li Yumei , Sun Hong , Huang Xiufang , Chen Hui , Lin Wei , Chen Min 
Published: August 2022

Abstract:
This retrospective study investigated factors influencing the steady-state trough concentrations (Ctrough) of rivaroxaban in patients with nonvalvular atrial fibrillation (NVAF). We retrieved data from patients with NAVF who first started rivaroxaban anticoagulation at the Fujian Provincial Hospital from October 2017 to October 2020 through the electronic medical record system. Patients were followed for 1 year after the first dose of rivaroxaban, and the primary efficacy and safety end points were recorded. All follow-up visits were completed by October 2021. A Ctrough of <12 ng/mL was defined as Ctrough deficiency. Factors that influenced rivaroxaban Ctrough deficiency were investigated using multivariate binary logistic regression analysis. Kaplan–Meier survival curve analysis was used to determine differences between Ctrough deficiency and event-free survival. A total of 167 patients with NVAF were enrolled in the study, including 113 men and 54 women, with an average (± SD) age of 70.40 ± 12.46 years. High albumin levels were an independent protective factor against Ctrough deficiency (odds ratio, 0.932; P = 0.031). Ctrough deficiency was associated with the probability of freedom from thrombotic events (P = 0.004); however, there were no significant differences in the probability of freedom from bleeding events (P > 0.05). In conclusion, among the variables studied, a low albumin level was the main contributor to Ctrough deficiency. Rivaroxaban Ctrough deficiency also increased thrombotic events, but this was not associated with hemorrhagic events in Chinese patients with NVAF.
Salidroside Regulates Mitochondrial Homeostasis After Polarization of RAW264.7 Macrophages
Authors: Wang Xiu-Long , Sun Rui-Xiang , Li Dong-Xu , Chen Zhi-Gang , Li Xue-Fang , Sun Si-Yu , Lin Fei , Zhao Guo-An 
Published: August 2022

Abstract:
Salidroside has anti-inflammatory and antiatherosclerotic effects, and mitochondrial homeostasis imbalance is closely related to cardiovascular disease. The aim of this study was to investigate the effect of salidroside on mitochondrial homeostasis after macrophage polarization and elucidate its possible mechanism against atherosclerosis. RAW264.7 cells were stimulated with 1 μg·mL−1 Lipopolysaccharide and 50 ng·mL−1 IFN-γ establish M1 polarization and were also pretreated with 400 μM salidroside. The relative expression of proinflammatory genes was detected by RT-PCR whereas that of mitochondrial homeostasis–related proteins and nuclear factor kappa-B (NF-κB) was detected by WB. Levels of intracellular reactive oxygen species (ROS), mitochondrial membrane potential, and mass were measured by chemifluorescence whereas that of NF-κB nuclear translocation was detected by immunofluorescence. Compared with the Mφ group, the M1 group demonstrated increased mRNA expression of interleukin-1β , inductible nitric oxide synthase (iNOS), and tumor necrosis factor-α ; increased protein expression of iNOS, NOD-like receptor protein 3, putative kinase 1 , and NF-κB p65 but decreased protein expression of MFN2, Tom20, and PGC-1α; decreased mitochondrial membrane potential and mass; and increased ROS levels and NF-κB p65 nuclear translocation. Salidroside intervention decreased mRNA expression of interleukin-1β and tumor necrosis factor-α compared with the M1 group but did not affect that of iNOS. Furthermore, salidroside intervention prevented the changes in protein expression, mitochondrial membrane potential and mass, ROS levels, and NF-κB p65 nuclear translocation observed in the M1 group. In summary, salidroside ultimately inhibits M1 macrophage polarization and maintains mitochondrial homeostasis after macrophage polarization by increasing mitochondrial membrane potential, decreasing ROS levels, inhibiting NF-κB activation, and in turn regulating the expression of proinflammatory factors and mitochondrial homeostasis–associated proteins.
The Practices and Attitudes of Saudi Plastic Surgeons in Managing Contaminated Autologous Grafts
Authors: Aljindan Fahad , Alhumaid Fahad , Allababidi Noor H. , Mortada Hatan , Alzaidi Salman 
Published: August 2022

Background:
The use of autologous grafts is a standard reconstructive option in plastic surgery. The absence of a well-established protocol for decontamination after accidental contamination increases the risk of postoperative infection. We aimed to explore the current practice and decontamination methods among Saudi plastic surgeons. This would help develop a well-established, unified method of decontamination intraoperatively.

Methods:
A validated self-administered questionnaire cross-sectional study was conducted in February 2022. The questionnaire was distributed through social media to all board-certified plastic surgeons in Saudi Arabia. The questionnaire was designed to obtain data on incidents, treatment preferences, and management of autograft contamination.

Results:
A total sample size of 61 participants was included, with an overall response rate of 64.58%. Out of the 61 respondents, 73.8% (n = 45) had previously experienced graft contamination. Regarding the methods of graft contamination, the most common way was accidentally dropping the graft on the floor (39.7%, n = 25). The majority of the surgeons answered that they decontaminated the graft using povidone-iodine (44.6%, n = 29) and then used it (45.9%, n = 28). The lower extremity area was the most common anatomical location having surgery at the time of the graft contamination, accounting for 32.5% of the cases (n = 25).

Conclusions:
Our study indicates that graft contamination is a common occurrence among our population, but we lack national guidelines on dealing with these situations. Although most responders used adequate decontamination methods, the lack of standardization could pose a risk to patients.
Public Confidence for Undergoing Elective Plastic Surgery Procedures during the COVID-19 Pandemic
Authors: Manstein Samuel M. , Elmer Nicholas , Comer Carly D. , Shiah Eric , Laikhter Elizabeth , Bustos Valeria P. , Hassell Natalie , Veeramani Anamika , Boustany Ashley N. , Lin Samuel J. 
Published: August 2022

Background:
The COVID-19 vaccine rollout has since been followed by a gradual resumption of elective surgery. Many individuals remain cautious about visiting a hospital or clinic to undergo surgery. As plastic surgeons are starting to resume elective surgery at this time, it is important to understand the perspectives of potential patients and the concerns they may have.

Methods:
A survey was distributed to participants in the United States through Amazon’s Mechanical Turk (mTurk) during March of 2021. Participants were surveyed regarding their views on the severity of COVID-19, vaccination status, and how much COVID-19 has affected their interest in undergoing surgery.

Results:
Thirty-nine percent of respondents were either no longer willing or less willing to undergo elective plastic surgery. Seventy-three percent of respondents felt comfortable going to an office for a consultation. With regards to feeling comfortable visiting a hospital, 43.4% reported they would feel safe, 36% felt they would feel safe only if they could be discharged on the same day, and 30.6% reported not feeling safe. Fifty-two percent of respondents reported feeling comfortable undergoing surgery now or within the next year. Respondents who do not think COVID-19 is still a major health issue were more likely to still want plastic surgery.

Conclusion:
The results of this study highlight that the majority of patients, regardless of vaccination status, currently feel comfortable undergoing elective plastic surgery, particularly in an office setting. Plastic surgeons may expect to see a return in demand for elective procedures in the coming months.
The impact of sodium–glucose cotransporter inhibitors on blood pressure: a meta-analysis and metaregression of 111 randomized-controlled trials
Authors: Teo Yao H. , Chia Alys Z.Q. , Teo Yao N. , Chong Elliot Y. , Syn Nicholas L. , Cheong Jia Y.A. , Ong How T. , Wee Caitlin F. , Ting Adriel Z.H. , Tan Joshua T.A. , Li Tony Y.W. , Kong William K.F. , Lee Chi-Hang , Chan Mark Y.-Y. , Wong Raymond C.C. , Yeo Tiong-Cheng , Chai Ping , Sia Ching-Hui 
Published: August 2022

Objective:
Multiple trials on sodium–glucose cotransporter (SGLT) inhibitors have been performed recently demonstrating blood pressure (BP) reduction benefits in both diabetic and nondiabetic patients. Hence, we conducted a systematic review and meta-analysis to determine the effect of different SGLT inhibitors on BP in both patients with and without diabetes mellitus.

Methods:
Four electronic databases (PubMed, Embase, Cochrane, and SCOPUS) were searched on 4 November 2021 for articles published from 1 January 2000 up to 21 November 2021, for studies evaluating the BP effects of SGLT inhibitors. Pair-wise meta-analysis and random effects metaregression models were utilized.

Results:
In total, 111 studies examining SBP (108 studies, 104 304 patients) and/or DBP (82 studies, 74 719 patients) were included. In patients with diabetes, the random effects model demonstrated SGLT inhibitor produced a mean reduction in SBPs of −3.46 mmHg (95% confidence interval: −3.83, −3.09) compared with placebo. There were no statistically significant changes in BP among patients without diabetes. Drug response relationship was not observed in SGLT inhibitors and BP, except for Canagliflozin and DBP.

Conclusion:
Sodium–glucose cotransporter 2 inhibitors and combined sodium–glucose cotransporter 1/2 inhibitors produced small reductions in BP in patients with diabetes.
Multimodal imaging of Unilateral Idiopathic Macular Telangiectasia Type 2 – A five-year study
Authors: Manayath George J , Verghese Shishir , Narendran Venkatapathy 
Published: August 2022

Abstract

Purpose:
To report a rare presentation of unilateral macular telangiectasia type 2 (Mac-Tel 2) followed up over 5 years

Methods:
Case report

Results:
A 58-year-old gentleman presented to us with complaints of painless progressive reduction of vision in the right eye for the past two years. He had no systemic illnesses. On examination his best corrected visual acuity was 20/40 in the right eye and 20/20 in the left eye. Fundus examination in the right eye revealed loss of foveal reflex along with mild temporal greying of the fovea and the left eye was within normal limits. Both eyes showed the presence of peripapillary myelinated nerve fibres. Multimodal imaging findings included spectral domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), fundus autofluorescence and fundus fluorescein angiogram which revealed findings suggestive of exudative preproliferative variant of macular telangiectasia type 2 (Mac-Tel 2) in the right eye whereas the left eye was within normal limits. After a follow up of five years SD-OCT and OCTA revealed no striking differences in both eyes, with no evidence of the disease in his left eye.

Conclusion:
This reports highlights a rare advanced unilateral presentation of Mac-Tel 2 with no evidence of even early signs of the disease in the fellow eye, over a long term follow-up.
Effect of simulated lenticular debris on corneal endothelial cells: experimental study in rabbit eyes
Authors: Wilkinson Samuel W. , Park Sally S.E. , Ungricht Emilie L. , Trapnell Michael , Nydegger Jacob , Cardenas Ivan A. , Brintz Ben J. , Mamalis Nick , Olson Randall J. , Werner Liliana 
Published: August 2022

Purpose:
To evaluate mechanical damage of simulated lenticular debris on corneal endothelial cells during phacoemulsification.

Setting:
University setting, Salt Lake City, Utah.

Design:
Experimental study.

Methods:
12 New Zealand rabbits underwent bilateral surgery. After incision, 10 1.0 mm beads were injected into the anterior chamber of test eyes to simulate lenticular debris. A balanced salt solution was injected into the contralateral eyes with the same injector. The Intrepid Balanced Tip of the Centurion Ozil handpiece was inserted into the anterior chamber, and 60% torsional ultrasound was applied for 20 seconds with 50 mL/min flow, 70 mm Hg intraocular pressure, and 600 mm Hg vacuum. Cumulative dissipated energy (CDE) was noted. After euthanasia and enucleation, the corneas were removed, stained with trypan blue/alizarin red, and photographed in a standardized manner (×400 photographs from 5 specific areas and 1 overview photograph from each corneal button). The ImageJ program was used to evaluate cell damage and loss in the photographs.

Results:
CDE was 4.64 ± 0.19 for test eyes with beads and 4.66 ± 0.17 for control eyes without beads (P = .58). The percentage of intact cells was statistically higher in the control group (P = .0005), whereas the percentages of damaged and lost cells were statistically higher in the test group (P = .0010 and .0005, respectively). This was observed in the analysis of the ×400 photographs and overview photographs.

Conclusions:
This study suggests that lenticular debris swirling around the anterior chamber may cause significant damage to the corneal endothelium, providing further insight on mechanisms of damage during phacoemulsification.
Comparison of keratometry using SS-OCT and dual Scheimpflug-Placido imaging in postmyopic corneal refractive surgery eyes
Authors: Khimani Karima , Ordonez Adriana , Pandit Rahul T. 
Published: August 2022

Purpose:
To compare simulated (SimK) and total (True-K) keratometry and corneal astigmatism values between the IOLMaster 700 (IOLM) and Galilei G4 (G4) devices in postmyopic laser refractive surgery eyes.

Setting:
Methodist Eye Associates, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.

Design:
Retrospective cohort study.

Methods:
A chart review was conducted on patients with prior myopic laser–assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK), undergoing phacoemulsification at a single institution from May 2019 through January 2022, who underwent imaging with both the IOLM and G4. Exclusion criteria were prior radial keratotomy, keratoectatic diseases, and inability to obtain a reliable image. Mean, flat, and steep SimK and True-K (TK from the IOLM and TCPIOL from the G4) values and astigmatism magnitude were compared.

Results:
50 eyes of 50 patients were included. The mean difference in SimK and True-K between devices (IOLM − G4) was −0.04 (95% CI −0.13 to 0.06; P > .05) diopters (D) and 1.14 (95% CI 1.02 to 1.25; P < .05) D, respectively. The IOLM measured steeper True-K values than the G4. There were no statistically significant differences between devices for all other SimK values, whereas for True-K there were significant differences in flat K and steep K (P < .05), but not astigmatism magnitude.

Conclusions:
Despite an overall good correlation in postmyopic laser refractive surgery eyes in keratometry and astigmatism measurements, there is a significant difference in True-K, with the IOLM measuring steeper values by about 1.0 D compared with the G4, similar to prior studies on nonrefractive surgery eyes.
Effectiveness of Elastic Band Exercises on the Functional Fitness of Older Adults in Long-Term Care Facilities
Authors: SU Yi-Lin , CHEN Hsiao-Lien , HAN Shao-Li , LIN Yueh-Kuei , LIN Su-Yun , LIU Chieh-Hsing 
Published: August 2022

ABSTRACT

Background
Population aging has caused a rise in the institutionalization, disability, and mortality rates of older adults worldwide. Older adults are able to engage in muscle training. Elastic band exercises can safely and effectively improve the upper and lower muscle strength and balance of older adults.

Purpose
This study was developed to examine the effects of a 3-month elastic band exercise program on the activities of daily living (ADLs), hand muscle strength, balance, and lower limb muscle strength of older adults living in institutional settings.

Methods
This was a randomized controlled trial. Sixty-one participants were randomly sampled from two long-term care facilities (LTCFs) in northern Taiwan (31 participants in the experimental group and 30 participants in the control group). Both groups underwent pretesting concurrently. The experimental group participated in 3 months of elastic band exercises, whereas the control group participated in the routine exercise program in their LTCFs. All of the participants were tested 1 and 3 months after the intervention.

Results
The average ADL, hand muscle strength, balance, and lower limb muscle strength scores of participants in the experimental group had improved significantly more than those of the control group at posttest (all ps < .05).

Conclusions/Implications for Practice
Elastic band exercises positively affect ADLs, hand muscle strength, balance, and lower limb muscle strength in older adults living in LTCFs. Moreover, the high benefit-to-cost ratio of these exercises helps lower the threshold of health promotion. We recommend including elastic band exercises in routine activities and designing different elastic band exercises for older adults at different proficiency levels. Furthermore, an elastic band exercise network should be established to improve the policy and implementation aspects of elastic band activities, raise awareness among community-dwelling and institutionalized older adults, and promote elastic band exercises to LTCFs nationwide.
Factors Associated With Depression Among Family Caregivers of Patients With Stroke in Indonesia: A Cross-Sectional Study
Authors: FAUZIAH Wahyuni , KATO Mayumi , SHOGENJI Miho , TSUJIGUCHI Hiromasa , TANIGUCHI Yoshimi 
Published: August 2022

ABSTRACT

Background
Strokes may lead to increased dependency, which may impact the daily lives of patients with stroke and their family caregivers. Caring for a poststroke family member in Indonesia may differ from other countries in terms of extending beyond the provision of hands-on care. Contradictions and gaps in the factors affecting caregiver depression have been highlighted in a review of the relevant literature. Few studies have examined comprehensively the contradictory factors, uncovered factors, and cultural and spiritual values affecting this phenomenon.

Purpose
This study was designed to identify the factors associated with depression in family caregivers of patients with stroke in Indonesia. We examined the following factors related to caregiver depression: demographic characteristics of the caregiver and care recipient, functional ability of the patient, caregiver self-efficacy, knowledge regarding stroke care, and spiritual values.

Methods
In this cross-sectional study, 157 primary caregivers completed questionnaires involving depression factors during face-to-face interviews. The data were analyzed using multiple logistic regression.

Results
The prevalence of depression among the participants was 56.7%. The overall mean ages of the participants and their care recipients were 43.6 and 57.1 years, respectively. In this study, 65.6% of the participants were female, and 70.1% lacked knowledge regarding stroke care. In the early caregiving phase, caregiver depression was more likely to occur in female caregivers with back pain and long care hours. Self-efficacy in achieving respite time was found to be associated with a lower risk of depression.

Conclusions/Implications for Practice
Caregivers' gender, presence of back pain, sufficient respite time, and time since stroke occurrence should be considered when providing knowledge, skills, and coping strategies to caregivers to help them adapt to their caregiving role, maintain their quality of life, and prevent the onset of depression. Understanding the factors influencing caregiver depression may help nursing professionals identify individuals at a higher risk of depression early on and provide critical follow-up and early access to supportive counseling.
The value of the lymph node ratio and total number of lymph nodes examined for resected pancreatic signet ring cell carcinoma: a retrospective cohort study
Authors: Ren Chao , Xue Feng , Wu Yinying , Wang Zheng 
Published: August 2022

Background:
Pancreatic signet ring cell carcinoma (SRCC) is an exceedingly rare histological subtype of pancreatic cancer. Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC. Our objectives of the study were to analyze the prognostic value of the lymph node ratio (LNR) and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC.

Method:
We analyzed 120 patients diagnosed from January 1, 1990, to December 31, 2016, constituted the study cohort from the Surveillance, Epidemiology, and End Results (SEER) registry. We calculated the overall survival (OS) of these patients by using a Kaplan–Meier analysis. The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis. The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC. Receiver-operating characteristic curve (ROC) analysis to investigate the discriminatory ability of the total number of lymph nodes examined (TNLE) relative to whether lymph node metastasis was present.

Results:
The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14 (interquartile range: 6.25–20.0). According to the univariate analysis of OS, age, grade, chemotherapy, LNR, and TNLE were significantly different (P < .05). We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC, whereas radiotherapy was not associated with improved survival. The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS. TNLE ≥ 8 showed the highest discriminatory power for evaluating lymph node metastasis (Area under curve (AUC): 0.656, 95% confidence interval: 0.564–0.741, Youden index:0.2533, sensitivity: 78.67%, specificity: 46.67%, P = .003).

Conclusion:
Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC. Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients. An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC.