bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does hospital volume affect outcomes after abdominal cancer surgery: an analysis of Swiss health insurance claims data
Authors: Wirth Kevin , Näpflin Markus , Graber Sereina M. , Blozik Eva 
Published: February 2022

Abstract
Background
Medical treatment quality has been shown to be better in high volume than in low volume hospitals. However, this relationship has not yet been confirmed in abdominal cancer in Switzerland and is relevant for referral of patients and healthcare planning. Thus, the present study investigates the association between hospital volumes for surgical resections of colon, gastric, rectal, and pancreatic carcinomas and outcomes.

Methods
This retrospective analysis is based on anonymized claims data of patients with mandatory health insurance at Helsana Group, a leading health insurance in Switzerland. Outcome parameters were length of hospital stay, mortality and cost during the inpatient stay as well as at 1-year follow-up. Hospital volume information was derived from the Quality Indicators dataset provided by the Swiss Federal Office of Public Health. The impact of hospital volume on the different treatment outcomes was statistically tested using generalized estimating equations (GEE) models, taking into account the non-independence of observations from the same hospital.

Results
The studies included 2′859 resections in patients aged 18 years and older who were hospitalized for abdominal cancer surgery between 2014 and 2018. Colon resections were the most common procedures (n = 1′690), followed by rectal resections (n = 709). For rectal, colon and pancreatic resections, an increase in the mean number of interventions per hospital and a reduction of low volume hospitals could be observed. For the relationship between hospital volume and outcomes, we did not observe a clear dose-response relationship, as no significantly better outcomes were observed in the higher-volume category than in the lower-volume category. Even though a positive “routine effect” cannot be excluded, our results suggest that even hospitals with low volumes are able to achieve comparable treatment outcomes to larger hospitals.

Conclusion
In summary, this study increases transparency on the relationship between hospital volume and treatment success. It shows that simple measures such as defining a minimum number of procedures only might not lead to the intended effects if other factors such as infrastructure, the operating team or aggregation level of the available data are not taken into account.
A selective inhibitor of the NLRP3 inflammasome as a potential therapeutic approach for neuroprotection in a transgenic mouse model of Huntington’s disease
Authors: Chen Kai-Po , Hua Kuo-Feng , Tsai Fu-Ting , Lin Ting-Yu , Cheng Chih-Yuan , Yang Ding-I. , Hsu Hsien-Ta , Ju Tz-Chuen 
Published: February 2022

Abstract
Background
Huntington’s disease (HD) is a neurodegenerative disorder caused by the expansion of the CAG repeat in the huntingtin (HTT) gene. When the number of CAG repeats exceeds 36, the translated expanded polyglutamine-containing HTT protein (mutant HTT [mHTT]) interferes with the normal functions of many cellular proteins and subsequently jeopardizes important cellular machineries in major types of brain cells, including neurons, astrocytes, and microglia. The NACHT, LRR, and PYD domain-containing protein 3 (NLRP3) inflammasome, which comprises NLRP3, ASC, and caspase-1, is involved in the activation of IL-1β and IL-18 and has been implicated in various biological functions. Although the existence of the NLRP3 inflammasome in the brain has been documented, the roles of the NLRP3 inflammasome in HD remain largely uncharacterized. MCC950 is a highly selective and potent small-molecule inhibitor of NLRP3 that has been used for the treatment of several diseases such as Alzheimer’s disease. However, whether MCC950 is also beneficial in HD remains unknown. Therefore, we hypothesized that MCC950 exerts beneficial effects in a transgenic mouse model of HD.

Methods
To evaluate the effects of MCC950 in HD, we used the R6/2 (B6CBA-Tg[HDexon1]62Gpb/1J) transgenic mouse model of HD, which expresses exon 1 of the human HTT gene carrying 120 ± 5 CAG repeats. Male transgenic R6/2 mice were treated daily with MCC950 (10 mg/kg of body weight; oral administration) or water for 5 weeks from the age of 7 weeks. We examined neuronal density, neuroinflammation, and mHTT aggregation in the striatum of R6/2 mice vs. their wild-type littermates. We also evaluated the motor function, body weight, and lifespan of R6/2 mice.

Results
Systematic administration of MCC950 to R6/2 mice suppressed the NLRP3 inflammasome, decreased IL-1β and reactive oxygen species production, and reduced neuronal toxicity, as assessed based on increased neuronal density and upregulation of the NeuN and PSD-95 proteins. Most importantly, oral administration of MCC950 increased neuronal survival, reduced neuroinflammation, extended lifespan, and improved motor dysfunction in R6/2 mice.

Conclusions
Collectively, our findings indicate that MCC950 exerts beneficial effects in a transgenic mouse model of HD and has therapeutic potential for treatment of this devastating neurodegenerative disease.
Orbital volume changes during growth and development in human children assessed using cone beam computed tomography
Authors: Smith Eric A. , Halbach Caroline S. , Robertson Adriana Z. , Peterson Aden M. , Harrison Andrew R. , Grünheid Thorsten , Larson Brent E. , Mokhtarzadeh Ali 
Published: February 2022

Abstract
Objectives
To measure growth-related changes in orbital volume from childhood to the late teenage years using cone-beam computed tomography (CBCT) scans.

Methods
This retrospective cohort study involved 65 (24 male, 41 female) healthy Caucasian children (ages 6–18 years) with existing serial craniofacial CBCT scans. CBCT scans were available for 292 orbits. Each orbit was transformed into a closed space with well-defined boundaries, and orbital volume was measured using manual segmentation. A novel statistical analysis was applied to extract the maximum amount of longitudinal information from the data. Intra- and inter-operator correlation coefficients were calculated from replications performed on a random subset of 10% of the sample.

Results
Orbital volume increased at a rate of 1–2% annually until the late teenage years. Intra- and inter-operator agreement between repeated measurements were >90%.

Conclusions
Orbital volume increases by 1–2% per year throughout childhood continuing until the late teenage years. This annual increase is large enough to be clinically relevant as it may lead to less-than-optimal long term surgical outcomes when reconstructive surgery for the pediatric anophthalmic socket is required.
Compound genetic etiology in a patient with a syndrome including diabetes, intellectual deficiency and distichiasis
Authors: Le Collen Lauriane , Delemer Brigitte , Spodenkiewicz Marta , Cornillet Lefebvre Pascale , Durand Emmanuelle , Vaillant Emmanuel , Badreddine Alaa , Derhourhi Mehdi , Mouhoub Tarik Ait , Jouret Guillaume , Juttet Pauline , Souchon Pierre François , Vaxillaire Martine , Froguel Philippe , Bonnefond Amélie , Doco Fenzy Martine 
Published: February 2022

Abstract
Background
We studied a young woman with atypical diabetes associated with mild intellectual disability, lymphedema distichiasis syndrome (LDS) and polymalformative syndrome including distichiasis. We used different genetic tools to identify causative pathogenic mutations and/or copy number variations.

Results
Although proband’s, diabetes mellitus occurred during childhood, type 1 diabetes was unlikely due to the absence of detectable autoimmunity. DNA microarray analysis first identified a de novo, heterozygous deletion at the chr16q24.2 locus. Previously, thirty-three pathogenic or likely pathogenic deletions encompassing this locus have been reported in patients presenting with intellectual deficiency, obesity and/or lymphedema but not with diabetes. Of note, the deletion encompassed two topological association domains, whose one included FOXC2 that is known to be linked with LDS. Via whole-exome sequencing, we found a heterozygous, likely pathogenic variant in WFS1 (encoding wolframin endoplasmic reticulum [ER] transmembrane glycoprotein) which was inherited from her father who also had diabetes. WFS1 is known to be involved in monogenic diabetes. We also found a likely pathogenic variant in USP9X (encoding ubiquitin specific peptidase 9 X-linked) that is involved in X-linked intellectual disability, which was inherited from her mother who had dyscalculia and dyspraxia.

Conclusions
Our comprehensive genetic analysis suggested that the peculiar phenotypes of our patient were possibly due to the combination of multiple genetic causes including chr16q24.2 deletion, and two likely pathogenic variants in WFS1 and USP9X.
Atheroprotective mechanism by which folic acid regulates monocyte subsets and function through DNA methylation
Authors: Xiang Yang , Liang Bin , Zhang Xiaokang , Qiu Xueping , Deng Qianyun , Yu Li , Yu Hong , Lu Zhibing , Zheng Fang 
Published: February 2022

Abstract
Background
Recent studies have suggested that folic acid can restore abnormal DNA methylation and monocyte subset shifts caused by hyperhomocysteinemia (HHcy) and hyperlipidemia (HL). However, the exact mechanism of action is still not fully understood. In this study, we further investigated the reversal effect and underlying mechanism of folic acid on the shift in monocyte subsets induced by aberrant lipids and Hcy metabolism via DNA methylation in vitro and in vivo.

Results
Our results showed that intermediate monocytes were significantly increased but had the lowest global 5-methylcytosine (5-mC) levels in coronary artery disease (CAD) patients, which might lead to a decrease in the global 5-mC levels of peripheral blood leukocytes (PBLs). We also discovered that ARID5B might mediate the increased proportion of intermediate monocytes, as this factor was related to the proportion of monocyte subsets and the expression of CCR2. The expression of ARID5B was inversely associated with the hypermethylated cg25953130 CpG site, which was induced by HL and HHcy. ARID5B could also regulate monocyte CCR2, MCP-1, and TNF-α expression, adhesion and migration, macrophage polarization, and monocyte/macrophage apoptosis, which might explain the regulatory effect of ARID5B on monocyte subset shifting. Folic acid reversed HL- and HHcy-mediated aberrant global and cg25953130 DNA methylation, reduced the proportion of intermediate monocytes, and inhibited the formation of atherosclerotic plaques.

Conclusion
Folic acid plays a protective role against atherosclerosis through the regulation of DNA methylation, ARID5B expression, and monocyte subsets.
Cell-type heterogeneity: Why we should adjust for it in epigenome and biomarker studies
Authors: Qi Luo , Teschendorff Andrew E. 
Published: February 2022

AbstractMost studies aiming to identify epigenetic biomarkers do so from complex tissues that are composed of many different cell-types. By definition, these cell-types vary substantially in terms of their epigenetic profiles. This cell-type specific variation among healthy cells is completely independent of the variation associated with disease, yet it dominates the epigenetic variability landscape. While cell-type composition of tissues can change in disease and this may provide accurate and reproducible biomarkers, not adjusting for the underlying cell-type heterogeneity may seriously limit the sensitivity and precision to detect disease-relevant biomarkers or hamper our understanding of such biomarkers. Given that computational and experimental tools for tackling cell-type heterogeneity are available, we here stress that future epigenetic biomarker studies should aim to provide estimates of underlying cell-type fractions for all samples in the study, and to identify biomarkers before and after adjustment for cell-type heterogeneity, in order to obtain a more complete and unbiased picture of the biomarker-landscape. This is critical, not only to improve reproducibility and for the eventual clinical application of such biomarkers, but importantly, to also improve our molecular understanding of disease itself.
Avascular necrosis of the talus causing meniscoid lesions in the ankle joint: a case report
Authors: Hamoudi Ceyran , Doljencu Andrei , Illes Tamás 
Published: February 2022

Abstract
Background
Meniscoid lesions have been reported in patients with chronic ankle injuries, especially in soccer athletes, and such lesions cause soft-tissue impingement and pain. To our knowledge, we are the first to report a meniscoid lesion in the ankle joint presenting as a long-term sequela of avascular necrosis of the talus that developed in childhood.

Case presentation
In this paper, we describe a 55-year-old Caucasian male patient who presented with a 1-year history of intermittent locking, “giving way,” weight-bearing pain, and swelling over the anterior aspect of the ankle joint. Imaging showed a rare case of avascular necrosis of the talus associated with an unstable plica-like lesion that was removed arthroscopically after unsuccessful conservative treatment.

Conclusion
We demonstrate that unstable meniscoid lesions of the ankle joint can be treated successfully with arthroscopic debridement. We obtained satisfactory short-term clinical results at the 2-year follow-up, even though advanced osteoarthritis was present.
Advances in electrical impedance tomography-based brain imaging
Authors: Ke Xi-Yang , Hou Wei , Huang Qi , Hou Xue , Bao Xue-Ying , Kong Wei-Xuan , Li Cheng-Xiang , Qiu Yu-Qi , Hu Si-Yi , Dong Li-Hua 
Published: February 2022

AbstractNovel advances in the field of brain imaging have enabled the unprecedented clinical application of various imaging modalities to facilitate disease diagnosis and treatment. Electrical impedance tomography (EIT) is a functional imaging technique that measures the transfer impedances between electrodes on the body surface to estimate the spatial distribution of electrical properties of tissues. EIT offers many advantages over other neuroimaging technologies, which has led to its potential clinical use. This qualitative review provides an overview of the basic principles, algorithms, and system composition of EIT. Recent advances in the field of EIT are discussed in the context of epilepsy, stroke, brain injuries and edema, and other brain diseases. Further, we summarize factors limiting the development of brain EIT and highlight prospects for the field. In epilepsy imaging, there have been advances in EIT imaging depth, from cortical to subcortical regions. In stroke research, a bedside EIT stroke monitoring system has been developed for clinical practice, and data support the role of EIT in multi-modal imaging for diagnosing stroke. Additionally, EIT has been applied to monitor the changes in brain water content associated with cerebral edema, enabling the early identification of brain edema and the evaluation of mannitol dehydration. However, anatomically realistic geometry, inhomogeneity, cranium completeness, anisotropy and skull type, etc., must be considered to improve the accuracy of EIT modeling. Thus, the further establishment of EIT as a mature and routine diagnostic technique will necessitate the accumulation of more supporting evidence.
Raising awareness of pre-conception care in community pharmacies: a feasibility study
Authors: Eastwood KA , Allen-Walker V. A. , Maxwell M. , McKinley M. C. 
Published: February 2022

Abstract
Background
There is growing evidence to support the introduction of pre-conception interventions to optimise the health of mothers and their future children. At present, there is poor awareness regarding the importance of pre-conception care (PCC) amongst healthcare professionals and couples planning a pregnancy. Community pharmacies are ideally placed to reach a range of prospective couples planning a pregnancy and could effectively provide information about PCC.

Methods
This study assessed feasibility of an intervention to raise awareness of PCC in community pharmacies in Northern Ireland over 3 months. Inclusion criteria: women of childbearing age (16–45 years) engaging with services at participating pharmacies. Study resources: campaign posters, information cards, crib sheets for pharmacy staff. A mixed methods approach was employed, including, brief information provision for women, record of staff interactions with customers, customer feedback cards and qualitative interviews with pharmacy staff. Descriptive statistics assessed distribution of study resources and staff interviews were analysed using a thematic analysis framework.

Results
There were eight participating pharmacies, three of which consented to post-study interviews. Three pharmacies chose not to deliver the planned intervention. Distribution of campaign cards (n = 456) varied (0–86%). Analysis of customer feedback cards (n = 9) demonstrated that the majority of respondents were happy to receive information on pre-conception health. Of the women who responded to this question (n = 8), all were ‘extremely likely’ or ‘likely’ to act on the information provided. Four main themes emerged from analysis of staff interviews: (1) training and experience in providing health advice, (2) intervention resources, (3) understanding the aims of the intervention, (4) perceived value of the intervention. Barriers to intervention delivery included non-engagement from pharmacies and need for additional training of staff.

Conclusions
An intervention to raise awareness of PCC within a community pharmacy setting was feasible and acceptable to both women and staff in participating pharmacies. This study indicates that a number of factors must be considered to enhance implementation and effectiveness of PCC interventions in this setting. In particular, better understanding of non-engagement, provision of adequate training and support for staff, and exploring incentives for pharmacies to prioritise PCC.
Dialysis access-associated steal syndrome with percutaneous endovascular arteriovenous fistula creation
Authors: Varma Rakesh , Betancourt-Torres Manuel , Bready Eric , Al-Balas Alian 
Published: February 2022

Abstract
Background
Dialysis access-associated steal syndrome (DASS) is an infrequent complication after hemodialysis access creation. Clinical symptoms depend on the degree of steal. Percutaneous arteriovenous fistula creation offers a minimally invasive alternative to surgical creation, though complications have been reported. The following presents the first described case of DASS after percutaneous endovascular arteriovenous fistula creation, and discusses risk factors and management.

Case Presentation
Our case is that of a 27-year-old male with end stage renal disease due to congenital renal dysplasia, who underwent left percutaneous arteriovenous fistula creation for initiation of dialysis. Two months after the procedure the patient complained of coldness, pain, tingling, and numbness in the left arm during dialysis, concerning for steal syndrome. The patient subsequently underwent brachial artery angiogram, which showed minimal antegrade flow through the ulnar and interosseous arteries towards the hand, and a focal, severe stenosis in the distal ulnar artery. Angioplasty of the stenosis was performed, though steal symptoms continued.

Conclusions
DASS, though rare, can be seen with percutaneous arteriovenous fistula creation. Identification of the risk factors prior to creation can help avoid this complication. Management is largely guided by clinical presentation. As long as there is adequate collateral supply to the extremity, single vessel occlusion is not a contraindication to percutaneous arteriovenous fistula creation with the use of WavelinQ technology. Careful patient selection with pre-creation angiogram may reduce the risk of symptomatic steal.
Perspectives of healthcare professionals in Nigeria about physiotherapists’ scope of practice and skills in ICU patients’ management: a cross-sectional study
Authors: Odunaiya Nse , Muonwe Chidile , Agbaje Samuel A. 
Published: February 2022

Abstract
Background
There is growing evidence for physiotherapy in the intensive care unit (ICU), but physiotherapy in the ICU and patients’ referral rate remains low in Nigeria. This study assessed the healthcare professionals’ perception of the physiotherapists’ scope of practice and skills in managing patients in the ICU of selected teaching hospitals in Southern Nigeria. The study was a cross-sectional survey that involved seventy healthcare professionals working in the ICU who completed an adapted and validated questionnaire. The data obtained from the cross-sectional study were presented using descriptive statistics of mean, standard deviation, frequency distribution, and percentage.

Results
The mean age of the participants was 39.74 ± 7.08 years. The majority of the participants had a bachelor’s degree and had worked for a minimum of 5 years in the ICU, with all the participants working in a mixed ICU and 46.7% work in ICUs with four to six beds. Physiotherapists (PTs) are not posted exclusively to the ICUs, and PTs were reported to be on call in most of the ICUs during the weekdays and weekends. Patients were referred for physiotherapy by the physicians. Healthcare professionals had negative perceptions about PTs’ scope in airway suctioning, nebulization, weaning, and adjustment of mechanical ventilators, intubation, extubation, and changing tracheostomy tubes for ICU patients. Participants had a positive perception about PTs’ assessment skills in the ICU except for hypoxemia calculation, readiness for weaning, and the need for humidification.

Conclusion
Healthcare professionals working in the ICU in the selected hospitals had both negative and positive perceptions regarding certain areas about the scope of practice and skills of PTs in managing patients in the ICU.
High Residual β-cell Function in Chinese Patients With Autoimmune Type 1 Diabetes
Authors: Wang Yueshu , Qin Yao , Gu Huilan , Zhang Linyu , Wang Jing , Huang Yiting , Shi Yuwen , Hu Qizhen , Chen Yang , Gu Yong , Shi Yun , Tao Yang , Zhang Mei 
Published: February 2022

Abstract

Objective
The destruction of pancreatic β cells causes type 1 diabetes mellitus (T1D), an autoimmune disease. Studies have demonstrated that there is heterogeneity in residual β-cell function in Caucasians; therefore, we aimed to evaluate β-cell function in Chinese autoimmune T1D patients.

Methods
β-cell function was determined using oral glucose tolerance testing or standardized steamed bread meal tolerance test in 446 participants with autoantibody-positive T1D. Clinical factors, such as age onset, sex, duration, body mass index, autoantibodies, other autoimmune diseases, diabetic ketoacidosis, hypoglycemia events, glycosylated hemoglobin, and insulin dose, were retrieved. We also analyzed single nucleotide polymorphism (SNP) data for C-peptides from 144 participants enrolled in the Chinese-T1D genome-wide association study.

Results
Of 446 T1D patients, 98.5%, 97.4%, 86.9%, and 42.6% of individuals had detectable C-peptide values (≥ 0.003 nmol/L) at durations of &lt; 1 year, 1 to 2 years, 3 to 6 years, and ≥ 7 years, respectively. A total of 60.7% of patients diagnosed at ≥ 18 years old and 15.8% of those diagnosed at &lt; 18 years had detectable C-peptide after ≥ 7 years from the diagnosis. Furthermore, the patients diagnosed at ≥ 18 years old had higher absolute values of stimulated C-peptide (≥ 0.2 nmol/L). Diabetic ketoacidosis, hypoglycemia events, and insulin doses were shown to be associated with β-cell function. SNPs rs1770 and rs55904 were associated with C-peptide levels.

Conclusion
Our results have indicated that there are high residuals of β-cell mass in Chinese patients with autoimmune T1D. These findings may aid in the consideration of therapeutic strategies seeking prevention and reversal of β-cell function among Chinese T1D patients.