bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of autistic traits on response to and side-effects of pharmacological ADHD treatment in children with ADHD: results from a prospective clinical cohort
Authors: Lilja Maria M. , Sandblom Emil , Lichtenstein Paul , Serlachius Eva , Hellner Clara , Bhagia Jyoti , Halldner Linda 
Published: March 2022

Abstract
Background
Attention deficit hyperactivity disorder (ADHD) is a common childhood behavioral condition that globally affects an average of around 5% of children and is associated with several adverse life outcomes. Comorbidity with autism spectrum disorder (ASD) is highly prevalent. Pharmacological treatment for ADHD symptoms has been shown to be effective. However, the prevailing perception is that children with ADHD and concomitant ASD symptoms report poorer efficacy and more side effects. This has been supported by studies on this population, but prospective studies directly comparing children with ADHD and different levels of ASD symptoms are lacking. We aimed to assess if children with ADHD and concomitant ASD symptoms differ regarding effects and side-effects of pharmacological ADHD treatment compared to children with ADHD without ASD traits. This is to our knowledge the second study to directly compare the effect of ADHD medication between ADHD patients with different levels of ASD symptoms.

Methods
In a non-randomized, observational, prospective cohort study, 323 patients aged 6 to 17 years who were diagnosed with ADHD and starting pharmacological treatment were divided into two groups: one with high level of ASD symptoms (ASD group, N=71) and one with low level of ASD symptoms (non-ASD group, N = 252). Treatment outcome was measured as ADHD symptoms, and evaluated using the Swanson, Nolan and Pelham Teacher and Parent ADHD rating scale-version IV (SNAP-IV). Side-effects were evaluated using the Pediatric Side Effects Checklist (P-SEC), at 3 months follow-up.

Results
From baseline to 3 months, there was no significant difference in neither treatment effect nor number of clinically significant adverse events experienced between the ASD group and the non-ASD group.

Conclusions
Our results did not implicate that ADHD patients with concomitant ASD symptoms have decreased treatment effect of ADHD medication than patients with ADHD without concomitant ASD symptoms. Neither did the results support that ADHD patients with ASD symptoms experienced significantly more side-effects than ADHD patients without ASD symptoms. Although, we did not analyze different medications separately, this is in line with the only previous study directly comparing methylphenidate treatment in children with or without ASD.

Trial registration
NCT02136147, May 12, 2014.
Hyaluronan self-agglomerating nanoparticles for non-small cell lung cancer targeting
Authors: Kim Joo-Eun , Park Young-Joon 
Published: March 2022

Abstract
Background
Owing to the limited amount of research, there are no nanoparticle-based anticancer agents that use hydrophilic drugs. Therefore, we developed irinotecan-loaded self-agglomerating hyaluronan nanoparticles (ISHNs). While irinotecan has high hydrophilicity, the resulting nanoparticle should possess high anticancer drug-loading capacity and allow selective targeting of the cluster of differentiation 44 (CD44) protein, which is overexpressed on the surface of tumor cells.

Results
The ISHNs were successfully made with hyaluronan (HA) as a targeting moiety, FeCl3 as a binder, and D-glutamic acid (GA) as a stabilizer. The ISHNs self-agglomerated via chelating bonding and were lyophilized using a freeze dryer. The particle diameter and zeta potential of the ISHNs were 93.8 ± 4.48 nm and − 36.3 ± 0.28 mV, respectively; a relatively narrow size distribution was observed. The drug fixation yield and drug-loading concentration were 58.3% and 1.75 mg/mL, respectively. Affinity studies revealed a tenfold stronger targeting to H23 (CD44+) non-small-cell lung cancer (NSCLC) cells, than of A549 (CD44−) cells.

Conclusion
We developed irinotecan-loaded ISHNs, which comprised irinotecan hydrochloride as a water-soluble anticancer agent, HA as a targeting moiety, FeCl3 as a binder for self-agglomeration, and GA as a stabilizer; HA is a binding material for CD44 in NSCLC cells. Owing to their ease of manufacture, excellent stability, non-cell toxicity and CD44-targeting ability, ISHNs are potential nanocarriers for passive and active tumor targeting.
Ethylene-induced potassium transporter AcKUP2 gene is involved in kiwifruit postharvest ripening
Authors: Shan Nan , Zhang Yupei , Xu Yunhe , Yuan Xin , Wan Chunpeng , Chen Chuying , Chen Jinyin , Gan Zengyu 
Published: March 2022

Abstract
Background
Potassium (K) is important in the regulation of plant growth and development. It is the most abundant mineral element in kiwifruit, and its content increases during fruit ripening. However, how K+ transporter works in kiwifruit postharvest maturation is not yet clear.

Results
Here, 12 K+ transporter KT/HAK/KUP genes, AcKUP1 ~ AcKUP12, were isolated from kiwifruit, and their phylogeny, genomic structure, chromosomal location, protein properties, conserved motifs and cis-acting elements were analysed. Transcription analysis revealed that AcKUP2 expression increased rapidly and was maintained at a high level during postharvest maturation, consistent with the trend of K content; AcKUP2 expression was induced by ethylene, suggesting that AcKUP2 might play a role in ripening. Fluorescence microscopy showed that AcKUP2 is localised in the plasma membrane. Cis-elements, including DER or ethylene response element (ERE) responsive to ethylene, were found in the AcKUP2 promoter sequence, and ethylene significantly enhanced the AcKUP2 promoter activity. Furthermore, we verified that AcERF15, an ethylene response factor, directly binds to the AcKUP2 promoter to promote its expression. Thus, AcKUP2 may be an important potassium transporter gene which involved in ethylene-regulated kiwifruit postharvest ripening.

Conclusions
Therefore, our study establishes the first genome-wide analysis of the kiwifruit KT/HAK/KUP gene family and provides valuable information for understanding the function of the KT/HAK/KUP genes in kiwifruit postharvest ripening.
Decreased triiodothyronine (T3) as a predictor for prolonged mechanical ventilation in critically ill patients with cardiac surgery
Authors: Shen Xiao , Sun Jiakui , Hong Liang , Song Xiaochun , Zhang Cui , Liu Ying , Liu Han , Li Guojian , Mu Xinwei 
Published: March 2022

AbstractBackgroundThis study aimed to examine the correlation between thyroid hormone and prolonged mechanical ventilation (MV) in adult critically ill patients having undergone cardiac surgery.MethodsThe present study refers to a retrospective, cohort study conducted at Nanjing First Hospital from March 2019 to December 2020. Patients receiving cardiac surgery and admitting to the Cardiovascular Intensive Care Unit (CVICU) in the study period were screened for potential inclusion. Demographic information, thyroid hormone and other laboratory measurements and outcome variables were recorded for analysis. Prolonged MV was defined as the duration of MV after cardiac surgery longer than 5 days. Thyroid hormones were assessed for the prognostic significance for prolonged MV.ResultsOne thousand eight hundred ninety-six patients who underwent cardiac surgery were screened for potential enrollment. Overall, 118 patients were included and analyzed in this study. Patients fell to the control (n = 64) and the prolonged MV group (n = 54) by complying with the duration of MV after cardiac surgery. The median value of total triiodothyronine (TT3) and free triiodothyronine (FT3) were 1.03 nmol/L and 3.52 pmol/L in the prolonged MV group before cardiac surgery, significantly lower than 1.23 nmol/L (P = 0.005) and 3.87 pmol/L, respectively in control (P = 0.038). Multivariate logistic regression analysis indicated that TT3 before surgery (pre-op TT3) had an excellent prognostic significance for prolonged MV (OR: 0.049,P = 0.012).ConclusionsThis study concluded that decreased triiodothyronine (T3) could be common in cardiac patients with prolonged MV, and it would be further reduced after patients undergo cardiac surgery. Besides, decreased T3 before surgery could act as an effective predictor for prolonged MV after cardiac surgery.
Effects of transcutaneous electrical nerve stimulation on myocardial protection in patients undergoing aortic valve replacement: a randomized clinical trial
Authors: Cho Youn Joung , Jung Dhong-Eun , Nam Karam , Bae Jinyoung , Lee Seohee , Jeon Yunseok 
Published: March 2022

Abstract
Background
Cardiopulmonary bypass-related myocardial ischemia-reperfusion injury is a major contributor to postoperative morbidity. Although transcutaneous electrical nerve stimulation (TENS) has been found to have cardioprotective effects in animal studies and healthy volunteers, its effects on cardiac surgery under cardiopulmonary bypass patients have not been evaluated. We investigated the effects of TENS on myocardial protection in patients undergoing aortic valve replacement surgery using cardiopulmonary bypass.

Methods
Thirty patients were randomized to receive TENS or sham in three different anesthetic states – pre-anesthesia, sevoflurane, or propofol (each n = 5). TENS was applied with a pulse width of 385 μs and a frequency of 10 Hz using two surface electrodes at the upper arm for 30 min. Sham treatment was provided without stimulation. The primary outcome was the difference in myocardial infarct size following ischemia-reperfusion injury in rat hearts perfused with pre- and post-TENS plasma dialysate obtained from the patients using Langendorff perfusion system. The cardioprotective effects of TENS were determined by assessing reduction in infarct size following treatment.

Results
There were no differences in myocardial infarct size between pre- and post-treatment in any group (41.4 ± 4.3% vs. 36.7 ± 5.3%, 39.8 ± 7.3% vs. 27.8 ± 12.0%, and 41.6 ± 2.2% vs. 37.8 ± 7.6%; p = 0.080, 0.152, and 0.353 in the pre-anesthesia, sevoflurane, and propofol groups, respectively).

Conclusions
In our study, TENS did not show a cardioprotective effect in patients undergoing aortic valve replacement surgery.

Trial registration
This study was registered at clinicaltrials.gov (NCT03859115, on March 1, 2019).
Primary tumor resection with or without metastasectomy for left- and right-sided stage IV colorectal cancer: an instrumental variable analysis
Authors: Yao Yi-Chen , Chen Jun-Quan , Yin Ling , Lin Wu-Hao , Peng Jian-Hong , Fan Wen-Hua 
Published: March 2022

Abstract
Background
Whether primary tumor location (PTL) is predictive of survival benefits following primary tumor resection plus metastasectomy (PMTR) and primary tumor resection (PTR) alone in stage IV colorectal cancer patients is not known. We sought to address this issue by employing instrumental variable analysis to evaluate the efficacy of PMTR and PTR with stratification for primary tumor location in stage IV colorectal cancer patients.

Patients and methods
Stage IV colorectal cancer patients diagnosed between January 1, 2005 and December 31, 2015 were identified from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. To account for both measured and unmeasured confounders, the efficacy of PMTR and PTR in the left- and right-sided subgroups was evaluated using instrumental variable analysis, with the health service area as the instrument variable. Overall survival (OS) was the primary outcome of interest.

Results
A total of 50,333 eligible patients were analyzed (left-sided, n = 29,402 and right-sided, n = 20,931). OS was significantly better with PMTR than with other treatments (PTR, metastasectomy only, or no surgery) in patients with left-sided tumors (hazard ratio [HR] = 0.37 [95% CI 0.24–0.58], P < 0.001), but not in patients with right-sided tumors (HR = 0.98 [95% CI 0.65–1.47], P = 0.910; interaction test P < 0.001). OS was comparable in patients treated with PTR and those treated with no surgery in both the left-sided (HR = 1.11 [95% CI 0.68–1.81], P = 0.690) and right-sided (HR = 0.85 [95% CI 0.50–1.43], P = 0.530; interaction test P = 0.466) subgroups.

Conclusions
PMTR appears to only benefit patients with left-sided stage IV colorectal cancer but not those with right-sided tumors. PTR does not improve OS, regardless of primary tumor location. When selecting patients for PMTR, primary tumor location should be considered. Overuse of PTR should be avoided.
Effects and contextual factors of a diet and resistance exercise intervention vary across settings: an overview of three successive ProMuscle interventions
Authors: Dorhout Berber G. , de Groot Lisette C.P.G.M. , van Dongen Ellen J.I. , Doets Esmée L. , Haveman-Nies Annemien 
Published: March 2022

Abstract
Background
Although many effective interventions have been developed, limited interventions have successfully been implemented. An intervention that was translated across settings is ProMuscle: a diet and resistance exercise intervention for older adults. However, varying contexts often lead to varying effects due to contextual factors (characteristics of individuals, organizations, communities or society). The current study aimed to gain insights into effects and contextual factors of ProMuscle in the controlled setting (ProMuscle: PM), real-life setting (ProMuscle in Practice: PiP), and real-life setting of the implementation pilots (ProMuscle Implementation Pilots: IP).

Methods
Data from the intervention arms of PM (N = 31) and PiP (N = 82), and from IP (N = 35) were used. Physical functioning (chair-rise test) and leg strength (1-10 repetition maximum) were measured at baseline and after 12-weeks intervention. Paired t-tests and General Linear Models were used to study changes after 12 weeks and differences between interventions. To explore contextual factors, researchers of PM and physiotherapists and dietitians of PiP and IP were interviewed. Factors were categorized according to the five domains and its underlying constructs of the Consolidated Framework for Implementation Research (CFIR).

Results
Improvements on chair-rise performance were found in PM (-2.0 ± 7.0 s, p = 0.186), PiP (-0.8 ± 2.9 s, p = 0.019) and IP (-3.3 ± 4.2 s, p = 0.001). Similar results were found for leg strength in PM (32.6 ± 24.8 kg, p < 0.001), PiP (17.0 ± 23.2 kg, p < 0.001), and IP (47.8 ± 46.8 kg, p < 0.001). Contextual factors that contribute to explaining the relatively high effects in IP included room for adapting and tailoring the intervention, involvement of experienced professionals, availability of and access to facilities, and participants characteristics.

Conclusions
Effects of the intervention appeared to be strongest in the real-life setting of the implementation pilots. Specific contextual factors contributed to explaining the different findings across settings. Future studies should investigate crucial factors that determine successful implementation of interventions in the real-life setting, to ensure that effective interventions are put into action and reach a broad population.

Trial registration
The ProMuscle intervention was registered in the Trial Registration (clinicaltrials.gov identifier: NCT01110369) on February 12th, 2010. The ProMuscle in Practice intervention was registered in the Netherlands Trial Register (NTR6038) on August 30th, 2016. Trial registration was not needed for the ProMuscle Implementation Pilots as this research did not fall within the remit of the Dutch ‘Medical Research Involving Human Subjects Act’.
Disseminated talaromycosis complicated by recurrent gastrointestinal bleeding and hemorrhagic shock: a case report
Authors: Cui Xiaoya , Su Feifei , Ye Hui , Jiang Yi , Guo Xiuxiu 
Published: March 2022

Abstract
Background
Gastrointestinal involvement is not uncommon in patients with disseminated talaromycosis, but successful management of massive gastrointestinal bleeding and hemorrhagic shock secondary to talaromycosis is rarely reported. Clinical management strategies for these patients have not been well documented.

Case presentation
Here, we reported a case of disseminated talaromycosis with recurrent gastrointestinal bleeding and hemorrhagic shock who was successfully alleviated solely with medical treatment.

Conclusions
Early diagnosis and treatment for Talaromyces marneffei, intravenous fluid resuscitation, hemostatic therapy and blood transfusion are all essential for talaromycosis complicated with gastrointestinal bleeding and hemorrhagic shock. It is also necessary to warn about the possibility of bleeding induced or aggravated by endoscopic biopsy trauma.
Spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia: spatial and multi-level analysis based on 2016 EDHS
Authors: Belay Daniel Gashaneh , Getnet Mihret , Akalu Yonas , Diress Mengistie , Gela Yibeltal Yismaw , Getahun Amare Belete , Bitew Desalegn Anmut , Terefe Bewuketu , Belsti Yitayeh 
Published: March 2022

Abstract
Background
Bottle feeding is associated with diarrheal disease morbidity and mortality and risk of pyloric stenosis, especially in developing countries. Even though, World Health Organization (WHO) recommended avoiding bottle feeding among children, still higher magnitude was reported in developing countries. This study aimed to assess the spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia.

Methods
This study was conducted based on Ethiopian Demographic and Health Surveys data (EDHS). The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then a total of 4,275 weighted samples of under two years children were used to investigate the study. The data were cleaned using MS excel and extracted and analyzed using STATA V.16 software. A multilevel binary logistic regression model was fitted. P-value < 0.05 was taken to declare statistical significance. A spatial analysis was done using ArcGIS and SaTScan software.

Results
The prevalence of bottle feeding practice among under two years children in Ethiopia were 13.5% (95%CI: 11.16, 15.29) and ranges from the lowest 5.16% (95% CI: 3.28, 78.73) Amhara region to the highest 55.98% (95% CI: 47.98, 61.46) Addis Ababa region. Women with secondary and above education status [AOR=2.49; 95%CI; 1.66, 3.74], women from richest household [AOR=1.33; 95%CI; 1.01, 1.78], child 12-23 months age [AOR= 1.59; 95%CI; 1.23, 2.05], multiple birth [AOR=4.30; 95%CI; 1.88, 9.84], rural residence [AOR=0.49; 95%CI; 0.16, 0.82] and large central region [AOR= 0.15; 95%CI; 0.08, 0.27] have significantly associated with bottle feeding. Addis Ababa, Central Oromia, Dire Dewa, Somali and Harari regions were the hot spot areas for bottle feeding practice among under two years children.

Conclusion and recommendations
The prevalence of bottle feeding practices in Ethiopia is relatively moderate. Maternal education, wealth index, child age, multiple births, residence and region were significant predictors of bottle feeding. These findings highlight that, the Ministry of Health Ethiopia (MOH), policymakers, and other stakeholders had better give prior attention to preventable factors such as empowering women, enhancing household wealth status to decreasing bottle feeding practice in Ethiopia.
Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach
Authors: Winkelmann Juliane , Gómez Rossi Jesús , Schwendicke Falk , Dimova Antoniya , Atanasova Elka , Habicht Triin , Kasekamp Kaija , Gandré Coralie , Or Zeynep , McAuliffe Úna , Murauskiene Liubove , Kroneman Madelon , de Jong Judith , Kowalska-Bobko Iwona , Badora-Musiał Katarzyna , Motyl Sylwia , Figueiredo Augusto Gonçalo , Pažitný Peter , Kandilaki Daniela , Löffler Lubica , Lundgren Carl , Janlöv Nils , van Ginneken Ewout , Panteli Dimitra 
Published: March 2022

Abstract
Background
Oral health, coupled with rising awareness on the impact that limited dental care coverage has on oral health and general health and well-being, has received increased attention over the past few years. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach.

Methods
We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists.

Results
Completed vignettes were received from 11 countries: Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different physical barriers to accessing dental care. The limited availability of contracted dentists (especially in rural areas) and the unequal distribution and lack of specialised dentists are major access barriers to public dental care.

Conclusions
According to the results, statutory coverage of dental care varies across European countries, while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries, leading to high out-of-pocket spending. Socioeconomic status is thus a main determinant for access to dental care, but other factors such as geography, age and comorbidities can also inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care.