bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robotics Reduces Radiation Exposure in Minimally Invasive Lumbar Fusion Compared With Navigation
Authors: Shahi Pratyush , Vaishnav Avani , Araghi Kasra , Shinn Daniel , Song Junho , Dalal Sidhant , Melissaridou Dimitra , Mai Eric , Dupont Marcel , Sheha Evan , Dowdell James , Iyer Sravisht , Qureshi Sheeraz A. 
Published: July 2022

Study Design.
Retrospective cohort.

Objective.
To compare robotics and navigation for minimally invasive elective lumbar fusion in terms of radiation exposure and time demand.

Summary of Background Data.
Although various studies have been conducted to demonstrate the benefits of both navigation and robotics over fluoroscopy in terms of radiation exposure, literature is lacking in studies comparing robotics versus navigation.

Materials and Methods.
Patients who underwent elective one-level or two-level minimally invasive transforaminal lumbar interbody fusion (TLIF) by a single surgeon using navigation (Stryker SpineMask) or robotics (ExcelsiusGPS) were included (navigation 2017–2019, robotics 2019–2021, resulting in prospective cohorts of consecutive patients for each modality). All surgeries had the intraoperative computed tomography workflow. The two cohorts were compared for radiation exposure [fluoroscopy time and radiation dose: image capture, surgical procedure, and overall) and time demand (time for setup and image capture, operative time, and total operating room (OR) time].

Results.
A total of 244 patients (robotics 111, navigation 133) were included. The two cohorts were similar in terms of baseline demographics, primary/revision surgeries, and fusion levels. For one-level TLIF, total fluoroscopy time, total radiation dose, and % of radiation for surgical procedure were significantly less with robotics compared with navigation (20 vs. 25 s, P<0.001; 38 vs. 42 mGy, P=0.05; 58% vs. 65%, P=0.021). Although time for setup and image capture was significantly less with robotics (22 vs. 25 min, P<0.001) and operative time was significantly greater with robotics (103 vs. 93 min, P<0.001), there was no significant difference in the total OR time (145 vs. 141 min, P=0.25). Similar findings were seen for two-level TLIF as well.

Conclusion.
Robotics for minimally invasive TLIF, compared with navigation, leads to a significant reduction in radiation exposure both to the surgeon and patient, with no significant difference in the total OR time.
Functional mutations of SARS-CoV-2: implications to viral transmission, pathogenicity and immune escape
Authors: Dang Shengyuan , Ren Lili , Wang Jianwei 
Published: July 2022

Abstract
The pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to major public health challenges globally. The increasing viral lineages identified indicate that the SARS-CoV-2 genome is evolving at a rapid rate. Viral genomic mutations may cause antigenic drift or shift, which are important ways by which SARS-CoV-2 escapes the human immune system and changes its transmissibility and virulence. Herein, we summarize the functional mutations in SARS-CoV-2 genomes to characterize its adaptive evolution to inform the development of vaccination, treatment as well as control and intervention measures.
Improving Care for Families and Children with Neurodevelopmental Disorders and Co-occurring Chronic Health Conditions Using a Care Coordination Intervention
Authors: Gall V. Nadine , Buchhalter Jeffrey , Antonelli Richard C. , Richard Cathy , Yohemas Meridith , Lachuk Gina , Gibbard W. Ben 
Published: July 2022

ABSTRACT

Objective:
This clinical intervention study aimed to improve care integration and health service delivery for children with concurrent neurodevelopmental disorders and chronic health conditions. This population has significant unmet needs and disproportionate deficits in service delivery. A lack of coordination across child service sectors is a common barrier to successful treatment and support of children with neurodevelopmental disorders with complex medical needs.

Methods:
This project implemented an innovative care coordination model, involving one-on-one supports from a trained care coordinator who liaised with the broader intersectoral care team to improve joint care planning, integration of services, and the experience of both families and care providers. To evaluate the impact of care coordination activities, a single-group interventional study was conducted using a repeated-measures framework (at 0, 6, and 12 months) using previously established outcome measures.

Results:
Over 2 years, this project provided care coordination to 84 children and their families, with an age range from 2 to 17 years. The care coordination intervention demonstrated positive impacts for children, families, and care teams and contributed to clinical efficiencies. Children had fewer visits to the emergency department and less frequent acute care use. Improvement in access to services, joint care planning and communication across providers, and better linkage with school supports were demonstrated. Families reported that the program decreased their stress around coordinating care for their child.

Conclusion:
This work demonstrated that intersectoral care coordination is attainable through innovative and collaborative practice for children with complex neurodevelopmental and medical needs.
Evaluating the Utility of Colchicine in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis
Authors: Bao Yu-Lin , Gu Ling-Feng , Du Chong , Wang Ya-Xin , Wang Lian-Sheng 
Published: July 2022

Abstract:
Colchicine has demonstrated promising effects in inhibiting local and systemic inflammation during acute coronary syndrome (ACS). However, the efficacy of colchicine in ACS is controversial. We performed a meta-analysis to assess the utility of colchicine in ACS by systematically searching randomized controlled trials. Recurrent myocardial infarction, coronary revascularization, and stroke were included as efficacy endpoint parameters whereas safety endpoints chosen were all-cause mortality, cardiovascular mortality, infectious events, and gastrointestinal (GI) adverse events. Nine identified studies were included (n = 7207 participants). Colchicine may reduce the risk of coronary revascularization by 54% [relative risk (RR) 0.46, 95% confidence interval (CI) 0.29–0.73; P < 0.01] and stroke by 61% (RR 0.39, 95%CI 0.18–0.81; P = 0.01). We observed no significant difference in all-cause mortality (RR 1.25, 95%CI 0.70–2.24; P = 0.46), cardiovascular mortality (RR 0.99, 95%CI 0.58–1.69; P = 0.98), recurrent myocardial infarction (RR 0.75, 95%CI 0.49–1.14; P = 0.18), and infectious events (RR 0.67, 95%CI 0.08–5.52; P = 0.71). Colchicine increased the risk of GI adverse reactions (RR 1.89, 95%CI 1.25–2.84; P < 0.01). Subgroup analysis of loading doses did not reveal significant differences in all endpoints (all P > 0.05), whereas subgroup analysis of follow-up periods showed a lower risk of GI adverse reactions with longer follow-up (P < 0.01), which may be related to establishing tolerability. Trial sequential analysis suggested that further data are needed before definitive conclusions can be drawn. Colchicine may decrease the occurrence of stroke and revascularization in ACS, whereas slightly increasing the risk of GI reactions. The loading doses probably did not significantly improve the prognosis of patients.
Melatonin Attenuates Vascular Smooth Muscle Contraction Through the γ-Secretase/Notch Intracellular Domain/Myocardin Pathway
Authors: Zheng Gui-qiong , Tong Wen-juan , Yuan Bi-chen , Luo Shi-yu , Zhang Ya-ling , Sun Shao-wei 
Published: July 2022

Abstract:
Inositol 1, 4, 5-trisphosphate (IP3) signaling-mediated calcium release drives the contraction of vascular smooth muscles and hence regulates blood vessel volume and blood pressure. Melatonin supplementation has been suggested to be beneficial for hypertension. To determine whether the blood pressure–lowering effect of melatonin was accounted for by IP3 signaling, we evaluated the vasoconstriction response and IP3 signaling in isolated mouse thoracic aortic rings during melatonin incubation. C57BL/6 mice were given intraperitoneal injections daily with melatonin, and the systolic blood pressure and contractility of aortic rings from melatonin-treated mice were decreased, and the contraction suppression effect of melatonin was attributed to the impaired expression of contractile proteins in vascular smooth muscle cells rather than IP3 signaling. Our results further showed that melatonin increased the expression of γ-secretase, which could cleave and release the notch intracellular domain, and the notch intracellular domain prevented the transcription of contractile genes by interfering with the interaction between serum response factor and myocardin, the master regulator of contractile protein. In this article, we report a novel mechanism by which melatonin regulates smooth muscle contractility that does not depend on IP3 signaling.
Renal Safety and Renin–Angiotensin–Aldosterone System Inhibitors in Patients With Contrast Media Exposure: A Multicenter Randomized Controlled Study
Authors: Lin Yaowang , Dong Shaohong , Liu Yuanhui , Wang Yongshun , Sun Xin , Yuan Jie , Yu Danqing , Liu Huadong 
Published: July 2022

Abstract:
There is no clear consensus on the safety of renin–angiotensin–aldosterone system inhibitors in patients with contrast media exposure. We aimed to assess the safety of renin–angiotensin–aldosterone system inhibitors in patients exposed to contrast media at 1-year follow-up. Patients treated with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) were recruited and randomly divided into 2 groups (1:1 ratio): with ACEI/ARB group (ACEI/ARB continued throughout the study period) and without ACEI/ARB group (ACEI/ARB stopped 24 hours before and continued 48 hours after the procedure). The primary endpoint was contrast-induced acute kidney injury (CI-AKI) and secondary endpoints were major adverse cardiovascular events (MACEs), and the need for renal replacement therapy during hospitalization and at 1-year follow-up. The occurrence rates of CI-AKI were not comparable in the ACEI/ARB group and the without ACEI/ARB group (2.92% and 2.62%, respectively; P = 0.866). No significant between-group differences were found with respect to the frequency of MACEs or renal replacement therapy during hospitalization and at 1-year follow-up. On subgroup analysis, among patients with estimated glomerular filtration rate (eGFR) < 45 mL/min, the incidence of CI-AKI was significantly higher in the ACEI/ARB group [17.95% (14/78) vs. 6.02% (5/83), P = 0.029]. Among patients with eGFR ≥ 45 mL/min, the incidence of CI-AKI was comparable in the 2 groups [0.87% (5/572) vs. 2.12% (12/567), P = 0.094]. The incidence of MACEs and renal replacement therapy was not comparable in the 2 groups, during hospitalization and at 1-year follow-up. ACEI or ARB treatment can safely be continued after exposure to contrast media, but not in patients with eGFR < 45 mL/min.
Sympathetic activation and heart rate thresholds for cardiovascular risk in chronic kidney disease
Authors: Grassi Guido , Fowler Bianca , Scali Beatrice , Rossi Federica , Motto Elena , Pieruzzi Federico , Mancia Giuseppe 
Published: July 2022

Aim:
The current study was designed at assessing whether the sympathetic cardiovascular drive (SNS) is differently activated in chronic kidney disease (CKD) patients displaying less or more elevated resting heart rate (HR) values. It was also designed at determining at which HR cutoff value the SNS displays a greater activation.

Methods:
In 95 CKD middle-age patients we evaluated muscle sympathetic nerve activity (MSNA, microneurography) and venous plasma norepinephrine (HPLC assay), subdividing the patients in different groups according to their resting clinic and 24-h HR.

Results:
In CKD progressively greater values of clinic or 24-h HR were associated with a progressive increase in both MSNA and norepinephrine. HR cutoff values indicated by large-scale clinical trials for determining cardiorenal risk, that is more than 80 bpm, were associated with MSNA values significantly greater than the ones detected in patients with lower HR, this being the case also for norepinephrine. Both MSNA and norepinephrine were significantly related to clinic (r = 0.47, P < 0.0001 and r = 0.26, P < 0.0001, respectively) and 24-h (r = 0.42, P < 0.0001 and r = 0.27, P < 0.0001, respectively) HR. MSNA, norepinephrine, but not HR, were significantly and inversely related to estimated glomerular filtration rate (eGFR) values (r = −0.47, r = −0.23, P < 0.0001 and P < 0.02, respectively).

Conclusion:
In CKD both clinic and 24-h HR values greater than 80 bpm are associated with an enhanced sympathetic activation, which parallelles for magnitude the HR elevations. The sensitivity of HR as sympathetic marker is limited; however, no significant relationship being detected between HR and eGFR or left ventricular mass index.
Renal Farnesoid X Receptor improves high fructose-induced salt-sensitive hypertension in mice by inhibiting DNM3 to promote nitro oxide production
Authors: Zhu Yeyan , Tao Yufeng , Wu Chunying , Zeng Yuting , Du Huiting , Xiang Qunkun , Chen Yang , Zhu Qing , Wang Lei 
Published: July 2022

Objective:
Farnesoid X Receptor (FXR) is highly expressed in renal tubules, activation of which attenuates renal injury by suppressing inflammation and fibrosis. However, whether renal FXR contributes to the regulation of blood pressure (BP) is poorly understood. This study aimed to investigate the anti-hypertensive effect of renal FXR on high-fructose-induced salt-sensitive hypertension and underlying mechanism.

Methods:
Hypertension was induced in male C57BL/6 mice by 20% fructose in drinking water with 4% sodium chloride in diet (HFS) for 8 weeks. The effects of FXR on NO production were estimated in vitro and in vivo.

Results:
Compared with control, HFS intake elevated BP, enhanced renal injury and reduced renal NO levels as well as FXR expression in the kidney of mice. In the mouse renal collecting duct cells mIMCD-K2, FXR agonists promoted NO production by enhancing the expression of neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS), whereas this effect was diminished by fxr knockdown. We further found that Dynamin 3 (DNM3), a binding protein with nNOS in the renal medulla, was inhibited by FXR and its deficiency elevated NO production in mIMCD-K2 cells. In HFS-fed mice, renal fxr overexpression significantly attenuated hypertension and renal fibrosis, regulated the expression of DNM3/nNOS/iNOS, and increased renal NO levels.

Conclusion:
Our results demonstrated that renal FXR prevents HFS-induced hypertension by inhibiting DNM3 to promote NO production. These findings provide insights into the role and potential mechanism of renal FXR for the treatment of hypertension.
Corneal Cross-Linking: Epi-On
Authors: Hafezi Farhad 
Published: July 2022

Abstract:
When treating corneal ectasias, successful corneal cross-linking (CXL) requires three factors: riboflavin saturation of the corneal stroma, ultraviolet (UV) light, and oxygen. Riboflavin is too large to pass through epithelial tight junctions, so traditionally epithelial debridement is performed before riboflavin is applied making this approach an epithelium-off (epi-off) technique. However, this can result in pain as the epithelium regrows, corneal haze, and an increased infection risk postoperatively, which needs careful management with pharmacotherapy. Epithelium-on (epi-on) CXL should reduce the extent of these issues. Riboflavin can be passed through the epithelium into the stroma either by iontophoresis or with penetration enhancers, however this alone results in suboptimal cross-linking effects, as the epithelium not only absorbs around 20% of incoming UV energy, it also acts as a barrier to oxygen diffusion into the stroma. While it is simple to adjust the UV fluence delivered to the stroma to compensate for the energy lost in the epithelium, compensating for the lack of stromal oxygen is less simple. Several approaches (including oxygen goggles) have been taken to achieve this. However, adding iontophoresis and supplemental oxygen through goggles in the operating theater adds complexities that could be engineered out. Accordingly, the technique has advanced in the laboratory to a point where penetration enhancers, optimized UV irradiation profiles, and atmospheric oxygen can now provide epi-on CXL with the same corneal strengthening efficacy as epi-off CXL, suggesting simple, effective epi-on CXL could soon be in clinical use.
Tear Cytokines Associated With Therapeutic Effects in Chronic Ocular Graft-Versus-Host Disease
Authors: Ma Jiao , Shen Zhan , Peng Rongmei , Li Chendi , Zhao Yinghan , Hu Bohao , Hong Jing 
Published: July 2022

Purpose:
The local application of antiinflammatory and immunosuppressive agents is an effective method for the treatment of ocular graft-versus-host disease (oGVHD); however, we noticed that some patients with oGVHD did not respond to topical therapy as well as many others. This study aimed to determine whether tear cytokines were associated with therapeutic effects in oGVHD.

Methods:
Forty patients with chronic oGVHD were enrolled and grouped as responders (n = 24) and nonresponders (n = 16) based on the clinical response to 1 month of topical treatment. Tear samples were collected from each participant before and after treatment, and the tear concentrations of 7 cytokines (IL-2, IL-6, IL-8, IL-10, IL-17A, TNF-α, and ICAM-1) were measured using microsphere-based immunoassay analysis. Differences between pretreatment and posttreatment tear samples were analyzed using the Wilcoxon test.

Results:
No significant differences in ophthalmic symptoms or cytokine levels were observed between responders and nonresponders at baseline. After 1 month of topical treatment, ocular surface parameters (including Ocular Surface Disease Index, National Institutes of Health eye score, best-corrected visual acuity, corneal fluorescein staining score, and fluorescein tear film break-up time) were significantly ameliorated in responders, but not in nonresponders. Moreover, none of the cytokines exhibited significant alteration in nonresponders, whereas the tear levels of IL-6 (P = 0.031) and IL-8 (P = 0.037) exhibited significant decreases in responding patients.

Conclusions:
Our results revealed that tear IL-6 and IL-8 levels were significantly altered in response to topical oGVHD treatment.
Delivery of Cells to the Cornea Using Synthetic Biomaterials
Authors: Ross Mitchell , Amaral Nicole , Taiyab Aftab , Sheardown Heather 
Published: July 2022

Abstract:The cornea is subject to a myriad of ocular conditions often attributed to cell loss or cell dysfunction. Owing to the superficial positioning of tissues composing the anterior segment of the eye, particularly the cornea, regenerative medicine in this region is aided by accessibility as compared with the invasive delivery methods required to reach deep ocular tissues. As such, cell therapies employing the use of carrier substrates have been widely explored. This review covers recent advances made in the delivery of stem cells, corneal epithelial cells, and corneal endothelial cells. Particular focus is placed on the most popular forms of synthetic scaffolds currently being examined: contact lenses, electrospun substrates, polymeric films, and hydrogels.
Chronic pain experience through COVID-19: a comparison of reports prior and during the early stages of the pandemic
Authors: Buckley Lisa , Sterling Michele , Elphinston Rachel A. 
Published: July 2022

Abstract
The impacts of COVID-19 and imposed restrictions on individuals with chronic noncancer pain continue to emerge, varying across countries. More recent research (including with longitudinal designs) suggests that the pandemic may not have such a disproportionate effect on chronic noncancer pain and its management as first thought. This longitudinal study, with assessments before the pandemic (2019) and early during the pandemic (May–July 2020), examined changes in validated measures of pain severity, pain interference, prescription opioid misuse, and mental health symptoms. Patients (N = 236) self-reported significant improvements in pain severity, pain interference, pain self-efficacy, pain catastrophizing, prescription opioid misuse, depression, and anxiety symptoms over time. Approximately 30% and 33% of patients achieved minimally important reductions (10% change) in pain severity and pain interference, respectively. In follow-up exploratory analyses, prepandemic sociodemographic and psychological factors predictive of 10% improved (vs 10% worse) pain severity and interference were investigated in logistic regressions. Reduction in pain interference was predicted by current employment, older age, and higher pain self-efficacy. There were no significant predictors of reduction in pain severity. The impact of COVID-19 on patients' pain experience and mental health was negligible in the early stages of the pandemic, and findings suggest improvements through the period. Targeted interventions that promote the protective factor of pain self-efficacy and build resilience may buffer patients' future response to the pandemic because it evolves as a part of our new normal. Targeted social determinants of health interventions that direct resources toward maintaining employment could also be important.
Cardiometabolic Risk Factors Among Insufficiently Active African American Women With Obesity
Authors: Joseph Rodney P. , Ainsworth Barbara E. , Vega-López Sonia , Adams Marc A. , Todd Michael , Gaesser Glenn A. , Keller Colleen 
Published: July 2022

Background
Low moderate-to-vigorous physical activity (MVPA) levels and obesity are associated with increased cardiometabolic disease risk.

Objective
The aim of this study was to describe MVPA and cardiometabolic risk characteristics of insufficiently active African American women with obesity (N = 60) enrolled in a culturally tailored MVPA intervention.

Methods
We assessed accelerometer-measured and self-reported MVPA, blood pressure, serum lipid profiles, cardiorespiratory fitness (VO2 peak), and aortic pulse wave velocity.

Results
Participants (mean age, 38.4; mean body mass index, 40.6 kg/m2) averaged 15 min/d of accelerometer-measured MVPA and 30 min/wk of self-reported MVPA. Systolic and diastolic blood pressure levels were elevated (135.4 and 84.0 mm Hg, respectively). With the exception of low-density lipoprotein cholesterol (121.4 mg/dL) and high-density lipoprotein cholesterol (47.6 mg/dL), lipid profiles were within reference ranges. Compared with normative reference values, average VO2 peak was low (18.7 mL/kg/min), and pulse wave velocity was high (7.4 m/s).

Conclusions
Our sample of insufficiently active African American women with obesity was at an elevated risk for cardiometabolic disease.