bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early mobilization in intensive care unit in Latin America: A survey based on clinical practice
Authors: Barros-Poblete Marisol , Bernardes Neto Saint-Clair , Benavides-Cordoba Vicente , Vieira Rodolfo P. , Baz Manuel , Martí Joan-Daniel , Spruit Martijn A. , Torres-Castro Rodrigo 
Published: November 2022

BackgroundThe application of early mobilization (EM) in intensive care units (ICUs) has shown to improve the physical and ventilatory status of critically ill patients, even after ICU stay. This study aimed to describe the practices regarding EM in ICUs in Latin America.MethodsWe conducted an observational, cross-sectional study of professionals from all countries in Latin America. Over 3 months, professionals working in ICU units in Latin America were invited to answer the survey, which was designed by an expert committee and incorporated preliminary questions based on studies about EM recommendations.ResultsAs many as 174 health professionals from 17 countries completed the survey. The interventions carried out within each ICU were active mobilization (90.5%), passive mobilization (85.0%), manual and instrumental techniques for drainage of mucus secretion (81.8%), and positioning techniques (81%). The professionals who most participated in the rehabilitation process in ICUs were physiotherapists (98.7%), intensive care physicians (61.6%), nurses (56.1%), and respiratory therapists (43.8%). In only 36.1% of the ICUs, protocols were established to determine when a patient should begin EM. In 38.1% of the cases, the onset of EM was established by individual evaluation, and in 25.0% of the cases, it was the medical indication to start rehabilitation and EM.ConclusionThis report shows us that EM of critically ill patients is an established practice in our ICUs like in other developed countries.
Assessment of dynamic cerebral autoregulation in near-infrared spectroscopy using short channels: A feasibility study in acute ischemic stroke patients
Authors: Becker Sabeth , Klein Franziska , König Katja , Mathys Christian , Liman Thomas , Witt Karsten 
Published: November 2022

IntroductionIn acute ischemic stroke, progressive impairment of cerebral autoregulation (CA) is frequent and associated with unfavorable outcomes. Easy assessment of cerebral blood flow and CA in stroke units bedside tools like near-infrared spectroscopy (NIRS) might improve early detection of CA deterioration. This study aimed to assess dynamic CA with multichannel CW-NIRS in acute ischemic stroke (AIS) patients compared to agematched healthy controls.MethodsCA reaction was amplified by changes in head of bed position. Long- and short channels were used to monitor systemic artery pressure- and intracranial oscillations simultaneously. Gain and phase shift in spontaneous low- and very low-frequency oscillations (LFO, VLFO) of blood pressure were assessed.ResultsA total of 54 participants, 27 with AIS and 27 age-matched controls were included. Gain was significantly lower in the AIS group in the LFO range (i) when the upper body was steadily elevated to 30. and (ii) after its abrupt elevation to 30°. No other differences were found between groups.DiscussionThis study demonstrates the feasibility of NIRS short channels to measure CA in AIS patients in one single instrument. A lower gain in AIS might indicate decreased CA activity in this pilot study, but further studies investigating the role of NIRS short channels in AIS are needed.
Disrupted topological organization of the motor execution network in Wilson's disease
Authors: Zhu Long , Yin Hongxi , Wang Yanxin , Yang Wenming , Dong Ting , Xu Lei , Hou Zhifeng , Shi Qiao , Shen Qi , Lin Zicheng , Zhao Haixia , Xu Yaqin , Chen Yanyan , Wu Jingjing , Yu Zheng , Wen Man , Huang Jiaying 
Published: November 2022

ObjectiveThere are a number of symptoms associated with Wilson's disease (WD), including motor function damage. The neuropathological mechanisms underlying motor impairments in WD are, however, little understood. In this study, we explored changes in the motor execution network topology in WD.MethodsWe conducted resting-state functional magnetic resonance imaging (fMRI) on 38 right-handed individuals, including 23 WD patients and 15 healthy controls of the same age. Based on graph theory, a motor execution network was constructed and analyzed. In this study, global, nodal, and edge topological properties of motor execution networks were compared.ResultsThe global topological organization of the motor execution network in the two groups did not differ significantly across groups. In the cerebellum, WD patients had a higher nodal degree. At the edge level, a cerebello-thalamo-striato-cortical circuit with altered functional connectivity strength in WD patients was observed. Specifically, the strength of the functional connections between the cerebellum and thalamus increased, whereas the cortical-thalamic, cortical-striatum and cortical-cerebellar connections exhibited a decrease in the strength of the functional connection.ConclusionThere is a disruption of the topology of the motor execution network in WD patients, which may be the potential basis for WD motor dysfunction and may provide important insights into neurobiological research related to WD motor dysfunction.
Case report: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) as a risk factor for central serous chorioretinopathy
Authors: Pazzaglia Alberto , Valsecchi Nicola , Belletti Matteo , Guaraldi Fabio , Fresina Michela , Fontana Luigi 
Published: November 2022

PurposeTo describe an atypical case of central serous chorioretinopathy (CSC) in a patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL).MethodsA retrospective case report.ResultsA 43-year-old white man with a genetic diagnosis of CADASIL was referred to our hospital because of reduced visual acuity in his right eye (20/30). In the previous 2 months, he developed CSC with subretinal fluid (SRF) and damage to the retinal pigmented epithelium without pachychoroid and pachyvessels or known risk factors for CSC. The patient was treated with transfoveal subthreshold micropulse yellow laser (577 nm) therapy. One month later, there were no signs of SRF, and visual acuity improved to 20/20.ConclusionsCerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is a genetic condition that primarily affects vascular smooth cells in small cerebral vessels and retinal arterioles. However, we hypothesize that CADASIL could also be responsible for an alteration of the vascular smooth cells in the choroidal arterioles, leading to choriocapillaris ischemia and CSC, even in the absence of a pachychoroid spectrum.
Prevalence of post-concussion syndrome and associated factors among patients with traumatic brain injury at Debre Tabor Comprehensive Hospital, North Central Ethiopia
Authors: Teshome Assefa Agegnehu , Ayehu Gashaw Walle , Yitbark Getachew Yideg , Abebe Endeshaw Chekol , Mengstie Misganaw Asmamaw , Seid Mohammed Abdu , Molla Yalew Melkamu , Baye Nega Dagnaw , Amare Tadeg Jemere , Abate Agmas Wassie , Yazie Taklo Semineh , Setargew Kidist Hunegn 
Published: November 2022

IntroductionThe occurrence of three or more of the following signs and symptoms, such as headache, dizziness, exhaustion, irritability, sleeplessness, difficulties in concentrating, or memory problems, following a head injury is referred to as post-concussion syndrome (PCS). Even though post-concussion syndrome has not been studied in Ethiopia, the productive age group is frequently affected by health issues related to head trauma, which either directly or indirectly affect the growth of the nation.ObjectiveTo assess the prevalence and associated factors of post-concussion syndrome among patients with traumatic brain injury at Debre Tabor Comprehensive Hospital, Debre Tabor, North Central Ethiopia.MethodsA successive sampling technique was used to conduct a hospital-based cross-sectional study on 405 traumatic brain injury patients at Debre Tabor Comprehensive Hospital from January 1, 2022, to May 30, 2022. SPSS version 25 was used to analyze the data. The factors connected to post-concussion syndrome were found using bivariate and multivariable logistic regression analysis. Statistical significance was determined by a P-value of ≤ 0.05.ResultsDuring the data collection period, 405 cases in total were interviewed, with a 98% response rate. More than half (60.7%) of patients were married, with the majority of patients (39.8%) falling between the ages of 18 and 29. At least three post-concussion syndrome symptoms were present in 42.8% of subjects. A history of comorbidities, GCS levels of 8 or below, 9 to 12 at the time of presentation, brain neuroimaging findings, and having fair or poor social support were found to be substantially linked with PCS in multivariate logistic regression.ConclusionAbout 41.5% of study participants had at least three symptoms of PCS. The Glasgow coma scale level at the time of presentation, the reason for the injury, social support, and the site of the injury were all significantly associated with the occurrence of PCS.
Sustained ameliorating effects and autonomic mechanisms of transcutaneous electrical acustimulation at ST36 in patients with chronic constipation
Authors: Zhou Jie-Yi , Wang Jian , Ning Bei-Fang , Hu Ye-Dong , Zhao Qi , Tan Wei , Shi Pei-Mei , Yuan Zong-Li , Feng Xin-Wei , Chen Jiande D. Z. , Xie Wei-Fen 
Published: November 2022

Background and aimsThe treatment of chronic constipation is still a great challenge in clinical practice. This study aimed to determine the efficacy and sustained effects of transcutaneous electrical acustimulation (TEA) at acupoint ST36 on the treatment of chronic constipation and explore possible underlying mechanisms.MethodsForty-four patients with chronic constipation were recruited and randomly assigned to a TEA group or sham-TEA group. A bowel diary was recorded by the patients. The Patient Assessment of Constipation Symptom (PAC-SYM) and the Patient Assessment of Constipation Quality of Life (PAC-QoL) questionnaires were administered during each visit. Anal and rectal functions were evaluated with anorectal manometry. Autonomic functions were assessed by the special analysis of heart rate variability derived from the ECG recording.ResultsCompared with sham-TEA, 2-week TEA treatment significantly increased the number of spontaneous bowel movements (SBMs) (5.64 ± 0.54 vs. 2.82 ± 0.36, P &lt; 0.001) and lowered the total scores of PAC-SYM (0.90 ± 0.14 vs. 1.35 ± 0.13, P &lt; 0.001) and PAC-QoL (0.89 ± 0.13 vs. 1.32 ± 0.14, P &lt; 0.05). TEA improved symptoms, as reflected by a reduction in the straining (P &lt; 0.001), the incomplete defecation (P &lt; 0.05), the frequency of emergency drug use (P &lt; 0.05), the days of abdominal distension (P &lt; 0.01) and an increase in intestinal satisfaction (P &lt; 0.01). Interestingly, the effects of TEA on the improvement of weekly SBMs sustained four weeks after the cessation of treatment (P &lt; 0.001). Anorectal manometry indicated that 2-week treatment of TEA lowered the threshold of first sensation (P &lt; 0.05), desire of defecation (P &lt; 0.01) and maximum tolerable volume (P &lt; 0.001) compared with sham-TEA group. TEA also significantly enhanced vagal activity, reflected by high-frequency band of heart rate variability, compared with sham-TEA (57.86 ± 1.83 vs. 48.51 ± 2.04, P &lt; 0.01).ConclusionTEA ameliorates constipation with sustained effects, which may be mediated via improvement of rectal sensitivity and enhancement of vagal activity.Clinical trial registration[https://clinicaltrials.gov/], identifier [ChiCTR210004267].
Migraine severity, disability, and duration: Is a good diet quality, high intake of phytochemicals and polyphenols important?
Authors: Bakırhan Hande , Pehlivan Merve , Uyar Cankay Tuğba , Kocak Mehmet 
Published: November 2022

ObjectivesDietary pattern may be the determinant of migraine prognosis through various mechanisms such as systemic inflammation, vasodilation, cerebral glucose metabolism, and mitochondrial dysfunction.This study was conducted to examine the relationship of the symptoms and signs of migraine with dietary polyphenols and the phytochemical intake and the quality of the diet.Materials and methodsIndividuals (n = 90), who were admitted to the headache outpatient clinic due to the diagnosis of episodic migraine, underwent physical examination by a neurologist. Migraine characteristics were assessed using the Migraine Disability Assessment Questionnaire and the Visual Analogue Scale. The Healthy Eating Index-2015 (HEI-2015) was used to evaluate the diet quality of individuals, and the Phytochemical Index developed by McCarty was used to determine the dietary intake of phytochemicals. Phenol-Explorer version 3.6 and the USDA Database for the Flavonoid Content of Selected Foods-Release 3.3 were used to calculate the dietary polyphenol intake.ResultsMigraine severity was negatively correlated with the intake of phytochemicals and good diet quality (r = −0.37, p = 0.0003; r = −0.37, p = 0.0003, respectively), and with the intake of phenolic components flavanones (r = −0.27, p = 0.01) and lignans (r = −0.27, p = 0.01). With respect to the food groups; migraine severity was found to be inversely correlated with the total phenol intake from olive oil, oil, and fruits (r = −0.26, p = 0.01; r = −0.21, p = 0.04; r = −0.24, p = 0.02, respectively), and the flavonoid intake from olive oil, oil, fruits, and vegetables (r = −0.26, p = 0.01; r = −0.26, p = 0.01; r = −0.35, p = 0.0007; r = −0.22, p = 0.04, respectively). Strikingly, fruit flavanone intake was correlated with low migraine severity (r = −0.39, p = 0.0002), and fruit flavanol intake was correlated with low migraine disability (r = −0.21, p = 0.04).ConclusionA high-quality diet rich in phytochemicals and polyphenols (especially flavanones and lignans) is associated with low migraine severity. Lower intake of phenols and flavonoids from vegetable oil, olive oil, fruits, and vegetables were associated with more severe migraine attacks. Examination of migraine characteristics and dietary pattern together with phytochemical and polyphenol intake may guide the development of dietary strategies to be used in migraine patients.
Significance of monocyte infiltration in patients with gastric cancer: A combined study based on single cell sequencing and TCGA
Authors: Xu Wei , Zhao Dongxu , Huang Xiaowei , Zhang Man , Zhu Wenxin , Xu Chunfang 
Published: November 2022

BackgroundGastric cancer is still one of the most lethal tumor diseases in the world. Despite some improvements, the prognosis of patients with gastric cancer is still not accurately predicted.MethodsBased on single cell sequencing data, we conducted a detailed analysis of gastric cancer patients and normal tissues to determine the role of monocytes in the progression of gastric cancer. WCGA facilitated our search for Grade-related genes in TCGA. Then, according to the marker genes and cell differentiation genes of monocytes, we determined the cancer-promoting genes of monocytes. Based on LASSO regression, we established a prognostic model using TCGA database. The accuracy of the model was verified by PCA, ROC curve, survival analysis and prognostic analysis. Finally, we evaluated the significance of the model in clinical diagnosis and treatment by observing drug sensitivity, immune microenvironment and immune checkpoint expression in patients with different risk groups.ResultsMonocytes were poorly differentiated in tumor microenvironment. It mainly played a role in promoting cancer in two ways. One was to promote tumor progression indirectly by interacting with other tumor stromal cells. The other was to directly connect with tumor cells through the MIF and TNF pathway to play a tumor-promoting role. The former was more important in these two ways. A total of 292 monocyte tumor-promoting genes were obtained, and 12 genes were finally included in the construction of the prognosis model. A variety of validation methods showed that our model had an accurate prediction ability. Drug sensitivity analysis could provide guidance for clinical medication of patients. The results of immune microenvironment and immune checkpoint also indicated the reasons for poor prognosis of high-risk patients.ConclusionIn conclusion, we provided a 12-gene risk score formula and nomogram for gastric cancer patients to assist clinical drug therapy and prognosis prediction. This model had good accuracy and clinical significance.
Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT
Authors: Deng Youjun , Cai Songhua , Huang Chujian , Liu Wenyi , Du Longde , Wang Chunguang , Jia Ran , Lin Shengcheng , Yu Xin , Yu Xiangyang , Yang Yikun , Yang Chenglin , Zhao Hongbo , Wang Zhe , Wang Lixu , Ma Kai , Yu Zhentao , Guo Xiaotong 
Published: November 2022

BackgroundWith its growing popularity and potential outcome, preoperative three-dimensional reconstruction of chest computed tomography (CT) has been widely used in video-assisted thoracic surgery (VATS) segmentectomy for treating non-small cell lung cancer (NSCLC). This study aimed to summarize the experience of anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on the three-dimensional reconstruction of chest CT.Materials and methodsA total of 103 patients with early-stage NSCLC were chosen to undergo VATS segmentectomy based on preoperative three-dimensional reconstruction of chest CT in our institute from September 2019 to July 2022. Data such as clinical characteristics and variations in blood vessels and bronchi were reviewed in this study.ResultsThe branches of the left lingular pulmonary artery may mutate into the LS1 + 2 + 3. A1 + 2 has four subtypes. The distribution of variation is relatively balanced, and the most common variation is type I (35/103, 33.9%). Most lingular arteries originate from the oblique cleft side of the lingular bronchus (79/103,76.7%). Most V(1 + 2)c* are small developments (70/103, 68.0%). The venous return of the proper segment mainly depends on V(1 + 2)b + c. The variation in the left upper lobe bronchus is complex. The most common variant is the bifurcation type (type A to G, 92/103, 89.3%) and bifurcation type A (62/103, 60.2%). The posterior apical segment artery of the left upper lobe is not accompanied by its bronchus.ConclusionsThe variation types of blood vessels and bronchus in the upper lobe of the left lung are complex. Preoperative CT-based three-dimensional reconstruction of pulmonary arteries, veins, and bronchi is of great significance. It can help understand the variations, accurately locate lesions before the surgery, and effectively plan surgeries.
Apnoeic oxygenation during paediatric intubation: A systematic review
Authors: George Shane , Wilson Megan , Humphreys Susan , Gibbons Kristen , Long Elliot , Schibler Andreas 
Published: November 2022

ObjectiveThis review assesses the effect of apnoeic oxygenation during paediatric intubation on rates of hypoxaemia, successful intubation on the first attempt and other adverse events.Data sourcesThe databases searched included PubMed, Medline, CINAHL, EMBASE and The Cochrane Library. An electronic search for unpublished studies was also performed.Study selectionWe screened studies that include children undergoing intubation, studies that evaluate the use of apnoeic oxygenation by any method or device with outcomes of hypoxaemia, intubation outcome and adverse events were eligible for inclusion.Data extractionScreening, risk of bias, quality of evidence and data extraction was performed by two independent reviewers, with conflicts resolved by a third reviewer where consensus could not be reached.Data synthesisFrom 362 screened studies, fourteen studies (N = 2442) met the eligibility criteria. Randomised controlled trials (N = 482) and studies performed in the operating theatre (N = 835) favoured the use of apnoeic oxygenation with a reduced incidence of hypoxaemia (RR: 0.34, 95% CI: 0.24 to 0.47, p &lt; 0.001, I2 = 0% and RR: 0.27, 95% CI: 0.11 to 0.68, p = 0.005, I2 = 68% respectively). Studies in the ED and PICU were of lower methodological quality, displaying heterogeneity in their results and were unsuitable for meta-analysis. Among the studies reporting first attempt intubation success, there were inconsistent effects reported and data were not suitable for meta-analysis.ConclusionThere is a growing body of evidence to support the use of apnoeic oxygenation during the intubation of children. Further research is required to determine optimal flow rates and delivery technique. The use of humidified high-flow oxygen shows promise as an effective technique based on data in the operating theatre, however its efficacy has not been shown to be superior to low flow oxygen in either the elective anesthetic or emergency intubation situations
Systematic Review Registration: This review was prospectively registered in the PROSPERO international register of systematic reviews (Reference: CRD42020170884, registered April 28, 2020).
Does intermittent hypoxic exposure enhance the cardioprotective effect of exercise in an inactive population?
Authors: Lizamore Catherine A. , Stoner Lee , Kathiravel Yaso , Elliott John , Hamlin Michael J. 
Published: November 2022

The aim of this study was to determine whether exercise supplemented with passive intermittent hypoxic exposure (IHE) improved overall cardiovascular disease risk and individual risk factors. Participants were randomized to exercise-only (Ex, n = 18, 5 males, 13 females; age: 56.4 ± 6.5 years; weight: 81.2 ± 15.9; height: 167.3 ± 8.42) or exercise + IHE (IHE + Ex, n = 16; 6 males, 10 females; age: 56.7 ± 6.4 years; weight: 78.6 ± 12.4 kg; height: 168.0 ± 8.8 cm). Both groups received the same strength and aerobic exercise training (1 h, 3 days/wk, 10 weeks). IHE + Ex also received IHE (5 min hypoxia: 5 min ambient air ×6) for 2–3 days/wk. Measurements were collected before (Baseline), after (Post), and 4- and 8-week following the intervention. There were small, beneficial reductions in overall 5- year cardiovascular risk in both groups. At Post, for IHE + Ex compared to IHE there were unclear to likely improvements in high density lipoprotein (8.0% ± 8.0%), systolic blood pressure (−3.4% ± 3.4%) and VO2peak (3.1% ± 7.7%). These improvements persisted at 8-week. There was an unclear improvement in arterial wave reflection (augmentation index) at Post (−6.1% ± 18.4%, unclear), but became very likely harmful at 8-week (8-week: 24.8% ± 19.7%). The conflicting findings indicate that in inactive adults, the addition of IHE to exercise may be beneficial to systemic markers of cardiovascular health but may also increase myocardial load due to increased arterial wave reflection.