bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vasopressin Response and Clinical Trajectory in Septic Shock Patients
Authors: Bauer Seth R. , Sacha Gretchen L. , Siuba Matthew T. , Wang Lu , Wang Xiaofeng , Scheraga Rachel G. , Vachharajani Vidula 
Published: September 2022

Background In septic shock, vasopressors aim to improve tissue perfusion and prevent persistent organ dysfunction, a characteristic of chronic critical illness (CCI). Adjunctive vasopressin is often used to decrease catecholamine dosage, but the association of vasopressin response with subsequent patient outcomes is unclear. We hypothesized vasopressin response is associated with favorable clinical trajectory. Methods We included patients with septic shock receiving vasopressin as a catecholamine adjunct in this retrospective cohort study. We defined vasopressin response as a lowering of the catecholamine dose required to maintain mean arterial pressure ≥65 mm Hg, 6 h after vasopressin initiation. Clinical trajectories were adjudicated as early death (ED; death before day 14), CCI (ICU stay ≥14 days with persistent organ dysfunction), or rapid recovery (RR; not meeting ED or CCI criteria). Trajectories were placed on an ordinal scale with ED the worst outcome, CCI next, and RR the best outcome. The association of vasopressin response with clinical trajectory was assessed with multivariable ordinal logistic regression. Results In total 938 patients were included; 426 (45.4%) were vasopressin responders. The most frequent trajectory was ED (49.8%), 29.7% developed CCI, and 20.5% had rapid recovery. In survivors to ICU day 14 (those without ED), 59.2% had CCI and 40.8% experienced RR. Compared with vasopressin non-responders, vasopressin responders less frequently experienced ED (42.5% vs. 55.9%) and more frequently experienced RR (24.6% vs. 17.0%; P < 0.01). After controlling for confounders, vasopressin response was independently associated with higher odds of developing a better clinical trajectory (OR 1.63; 95% CI 1.26−2.10). Medical patients most frequently developed ED and survivors more commonly developed CCI than RR; surgical patients developed the three trajectories with similar frequency ( P < 0.01). Conclusions Vasopressin responsive status was associated with improved clinical trajectory in septic shock patients. Early vasopressin response is a potential novel prognostic marker for short-term clinical trajectory.
In vitro and in vivo assessment of a novel ultra-flexible ventriculoamniotic shunt for treating fetal hydrocephalus
Authors: Emery Stephen P , Greene Stephanie , Elsisy Moataz , Chung Kaitlin , Ye Sang-Ho , Kim Seungil , Wagner William R , Hazen Nika , Chun Youngjae 
Published: September 2022

Fetal aqueductal stenosis (AS) is one of the most common causes of congenital hydrocephalus, which increases intracranial pressure due to partial or complete obstruction of cerebrospinal fluid (CSF) flow within the ventricular system. Approximately 2–4 infants per 10,000 births develop AS, which leads to progressive hydrocephalus, which enlarges the head often necessitating delivery by cesarean section. Most babies born with AS are severely neurologically impaired and experience a lifetime of disability. Therefore, a new device technology for venticuloamniotic shunting is urgently needed and has been studied to ameliorate or prevent fetal hydrocephalus development, which can provide a significant impact on patients and their family’s quality of life and on the decrease of the healthcare dollars spent for the treatment. This study has successfully validated the design of shunt devices and demonstrated the mechanical performance and valve functions. A functional prototype shunt has been fabricated and subsequently used in multiple in vitro tests to demonstrate the performance of this newly developed ventriculoamniotic shunt. The shunt contains a main silicone-nitinol composite tube, a superelastic 90° angled dual dumbbell anchor, and an ePTFE valve encased by a stainless-steel cage. The anchor will change its diameter from 1.15 mm (collapsed state) to 2.75 mm (deployed state) showing up to 1.4-fold diameter change in human body temperature. Flow rates in shunts were quantified to demonstrate the valve function in low flow rates mimicking the fetal hydrocephalus condition showing “no backflow” for the valved shunt while there is up to 15 mL/h flow through the shunt with pressure difference of 20 Pa. In vivo ovine study results show the initial successful device delivery and flow drainage with sheep model.
Assessing Combined Longitudinal Mentorship and Skills Training on Select Maternal and Neonatal Outcomes in Rural and Urban Health Facilities in Malawi
Authors: Blair Alden Hooper , Openshaw Maria , Mphande Isaac , Jana Oveka , Malirakwenda Richard , Muller Anna , Rankin Sally , Baltzell Kimberly 
Published: September 2022

Introduction: Despite successful efforts to improve clinical access and skilled birth attendance in Malawi, it still faces high rates of maternal and neonatal mortality. In 2017, the UCSF-GAIN partnership began a nurse-midwifery clinical education and longitudinal mentorship program. While it has received positive reviews, it is unclear whether routinely collected indicators can assess such a program’s impact. Method: A longitudinal review of the Malawian DHIS2 database explored variables associated with maternal and newborn care and outcomes before and after the intervention. Data were analyzed using generalized estimating equations (GEE) to account for facility-level correlations over time. Results: Quality issues with DHIS2 data were identified. Significant changes potentially associated with the GAIN intervention were noted. Discussion: The GAIN approach appears to be associated with positive trends in maternal and neonatal care. National summary databases are problematic, however, for evaluating targeted interventions and the provision of care to specific outcomes.
The Impact of COVID-19 Pandemic on Health Inequities: A Photovoice Study With Nursing Students
Authors: Andina-Díaz Elena , Siles-González José , Solano-Ruiz MCarmen , Welch Lindsay , Delblanco-Ubiergo Gema , Serrano-Fuentes Nestor 
Published: September 2022

Introduction: The COVID-19 pandemic has an amplified impact on vulnerable populations. Also, aspects related to health inequalities are insufficiently taught in higher education. This study aims to promote reflection in nursing students on the impact of the COVID-19 pandemic on vulnerable populations affected by health inequities. Methodology: A photovoice method was used. Undergraduate nursing students (Spain and United Kingdom) took and explained photographs using SHOWED models. Results: 108 students participated. Two-domain summary themes were created: The COVID-19 pandemic has impacted ethnic minorities and socioeconomically vulnerable groups, and Proposals to respond to the negative impact on ethnic minorities and socioeconomically vulnerable groups. Discussion: The students identified negative health scenarios by linking COVID-19 with aspects of work, salary, and housing of these two specific populations. Holistic actions were also proposed to protect their health. As future health professionals, they must recognize these communities and work to eliminate inequalities.
Establishing Victim Services in an American Indian Tribal Community: A Needs Assessment
Authors: Koch Tracey A. , Anderson Michelle , Weaver Melody 
Published: September 2022

Introduction: American Indian/Alaska Native (AIAN) communities experience a disproportionate number of violent crimes compared with other populations. Tribal-based services for victims are lacking on smaller reservations. A needs assessment was conducted for a tribe in the Pacific Northwest addressing this issue. Method: Utilizing a framework of community-based participatory research (CBPR), a survey study was conducted with tribal members and local service providers. Survey A was composed of questions constructed by a tribal working group and Survey B questions were from an existing survey. Results: Tribal members ( n = 5) indicated violence was experienced by all and witnessed by 80% of participants. Service providers ( n = 17) perceived adequate but underutilization of resources. Discussion: The presence of violence in the community was confirmed. Services were not routinely accessed by members. Service providers indicated knowledge gaps in the community and cultural barriers for AIAN people. The study raised awareness of violence in AIAN communities and need for additional research.
Tackling Oppressive Beliefs and Sexual Violence on College Campuses: Evaluation of an Innovative Theater-Based Intervention
Authors: Fleckman Julia , Brown Komal , Lederer Alyssa , Stoltman Sarah , Craft Timothy 
Published: September 2022

Background Sexual violence (SV) prevalence remains high among U.S. college campuses; prevention strategies may benefit from addressing socially oppressive beliefs, including racism, sexism, and heterosexism that all directly link to attitudes and beliefs related to SV. Aims The objective of this study is to evaluate the potential efficacy of a novel student-driven, theater-based intervention in shifting beliefs regarding racism, heterosexism, and SV. Method Data were utilized from paired pre- and posttest surveys ( n = 272) from undergraduate students, at a university in the Southeastern United States, who attended a student-driven theater production covering topics of SV, heterosexism, and racism. The survey included questions on rape myth acceptance, heteronormative attitudes and beliefs, perceived racism on campus, and relevant respondent demographic information. Results After viewing the theater production, participants demonstrated significant decreases pretest-posttest in rape myth acceptance, (Δ M = 0.04, SD = 0.25), t(261) = 2.57, p = .01, heteronormative attitudes and beliefs, (Δ M = 0.09, SD = 0.36), t(267) = 3.32, p = .0001, and an increased pretest-posttest in perceived racism on campus, (Δ M = −0.15, SD = 0.47), t(266) = −5.15, p < .0001. For rape myth acceptance and heteronormative attitudes and beliefs, no apparent differences were present by race, gender identity, sexual orientation, or year in school. Only White and mixed-race students’ levels of perceived prevalence racism increased when examined by race. Implications Findings from this study suggest that theater interventions may not only be an effective tool for addressing SV on campus, but also targeting other forms of discrimination, including sexism, homophobia, and racism among students.
Melatonin receptor agonist ramelteon alleviates experimental acute ocular inflammation via HIF-1Α/VEGF/E-NOS signaling
Authors: Usta Sofu Gulsah , Erzurumlu Yalcın , Karaca Umut , Candan Ibrahim Aydın , Savran Mehtap , Asci Halil , Hasseyid Nursel 
Published: September 2022

Purpose Ramelteon (RML) is a potent, selective agonist of the high-affinity melatonin receptor 1 and 2 receptors. In addition, RML is known to have antioxidant and anti-inflammatory effects. In this study, we aimed to investigate the effects of RML on HIF-1α, VEGF and e-NOS signaling pathway in a rat model of endotoxin-induced uveitis (EIU). Methods Twenty-eight Wistar albino rats were divided into 4 groups as controls, lypopolysaccharide (LPS) group (5 mg/kg i.p.), LPS  +  RML group (5 mg/kg i.p and 8 mg/kg orally, respectively) and RML group (8 mg/kg orally). EIU was induced by a single intraperitoneal LPS injection. Histopathological and genetical analyses were performed. Results In histopathological analysis, LPS caused mild anterior uveitis characterized by increased surface area of iris leaflets and ciliary body due to edema, mild to moderate congestion, and inflammatory infiltrate 6 h following the injection. The pathological findings were reduced by RML. Higher inflammation levels seen in LPS group were significantly reduced in LPS  +  RML group. Also, HIF-1 α, eNOS and VEGF expressions increased in LPS and decreased in LPS  +  RML group. Conclusion RML treatment reversed the changes in the HIF-1α /eNOS/ VEGF signaling pathway in LPS-induced uveitis in rats, preventing the progression of the damage and showed positive effects.
Intravitreal fluocinolone acetonide implant for chronic postoperative cystoid macular edema – two years results
Authors: Chronopoulos Argyrios , Chronopoulos Panagiotis , Hattenbach L.O. , Ashurov Agharza , Schutz James S. , Pfeiffer Norbert , Korb Christina 
Published: September 2022

Purpose We report visual and anatomical outcomes of chronic postoperative macular edema treated with a fluocinolone acetonide intravitreal implant. Method Retrospective study of chronic, post-surgical CME treated with a fluocinolone acetonide intravitreal implant. Best registered visual acuity (BRVA), central retinal thickness (CRT), and Goldmann tonometry intraocular pressure (IOP) were assessed over 24 months. The need for IOP lowering treatment, top-up therapy during follow-up, and complications were also assessed. Results We analyzed 16 consecutive eyes of 16 patients with chronic, post-surgical CME treated with fluocinolone acetonide intravitreal implant. Surgical indications included cataract surgery, vitrectomy plus membrane peeling and combined phaco-vitrectomy. Baseline mean BRVA of 0.8 ± 0.65 logMAR improved to 0.60 ± 0.4 logMAR ( p = 0.02) at 12 months and to 0.7 ± 0.5 logMAR ( p = 0.32) at 24 months. At month 12, BRVA improved in 11 eyes, stabilized in 4 eyes, and decreased in 1 eye. At month 24, VA remained improved in 5 eyes, remained stabilized in 5 eyes, and decreased in 1 eye. Mean CRT decreased from 524 ± 132 μm at baseline to 389 μm at month 3, 347 μm at month 6, 355 ± 106 μm ( p = 0.0003) at month 12, and 313 ± 83 μm ( p = 0.0001) at month 24. At 12 months, CRT improved in 13 eyes and remained unchanged in 2 eyes. At 24 months, CRT improved further in 8 eyes, and stabilized in 3 eyes. Increased IOP (≥21 mmHg) was observed only in 4 eyes, all successfully managed with topical medication. No further side effects were observed in any patient. Conclusion Visual and anatomic improvements were achieved by a single fluocinolone acetonide implant with few side effects up to 24 months in CME eyes with a long and heavy prior treatment history.
Effect of telehealth interventions on anxiety and depression in cancer patients: A systematic review and meta-analysis of randomized controlled trials
Authors: Yang Yufan , Huang Yingying , Dong Ning , Zhang Liping , Zhang Shuanghong 
Published: September 2022

Introduction Cancer patients not only experience a variety of problems associated with the treatment of their disease but also a range of psychological problems such as anxiety and depression, which may lead to reduced adherence to treatment and a lower quality of life for cancer patients. Telehealth interventions are widely used for cancer patients, and their effectiveness in improving anxiety and depression in cancer patients is variable and still contradictory. Methods Embase, Pubmed, Web of Science, PsycINFO, CINAHL Complete, and the Cochrane Central Register of Controlled Trials were searched from inception to 19 April 2022. Data synthesis was conducted using STATA 15.0, and scores for anxiety and depression were calculated using standardized mean differences and 95% confidence intervals. Results A total of 13125 cancer patients from 68 randomized controlled trials were included in the systematic evaluation. The meta-analysis showed that the telehealth intervention had a significant effect on anxiety (standardized mean differences = −0.40, 95% confidence intervals: −0.6 to 0.2, p < 0.001) and depression (standardized mean differences = −0.48, 95% confidence intervals: −0.67 to 0.28, p < 0.001) in patients with cancer. Discussion Telehealth interventions significantly improved anxiety and depression levels in cancer patients compared to traditional care interventions. Breast cancer patients most often received telehealth interventions; electronic device-based and application-based telehealth interventions were more effective than online interventions; short-term interventions were more effective than medium-term and long-term interventions, and different outcome measurement tools led to different intervention outcomes. More high-quality research is needed to explore the effects of telehealth interventions.
The association between baseline circulating progenitor cells and vascular function: The role of aging and risk factors
Authors: Moazzami Kasra , Mehta Anurag , Young An , Dhindsa Devinder Singh , Martin Greg , Mokhtari Ali , Ghaini Hesaroieh Iraj , Shah Amit , Bremner J Douglas , Vaccarino Viola , Waller Edmund K , Quyyumi Arshed A 
Published: September 2022

Background: To investigate the cross-sectional and longitudinal relationships between vascular function and circulating progenitor cell (CPC) counts with respect to aging and exposure to risk factors. Methods: In 797 adult participants, CPCs were enumerated by flow cytometry as CD45med mononuclear cells expressing CD34 epitope and its subsets co-expressing CD133, and chemokine C-X-C motif receptor 4 (CXCR4+). Arterial stiffness was evaluated by tonometry-derived pulse wave velocity (PWV) and microvascular function was assessed as digital reactive hyperemia index (RHI). Results: In cross-sectional analyses, for every doubling in CD34+ cell counts, PWV was 15% higher and RHI was 9% lower, after adjusting for baseline characteristics and risk factors ( p for all < 0.01). There were significant CPC-by-age-by-risk factor interactions ( p <0.05) for both vascular measures. Among younger subjects (< 48 years), CPC counts were higher in those with risk factors and vascular function was better in those with higher compared to those with lower CPC counts ( p for all < 0.0l). In contrast, in older participants, CPCs were not higher in those with risk factors, and vascular function was worse compared to the younger age group. A lower CPC count at baseline was an independent predictor of worsening vascular function during 2-year follow-up. Conclusion: A higher CPC count in the presence of risk factors is associated with better vascular function among younger individuals. There is no increase in CPC count with risk factors in older individuals who have worse vascular function. Moreover, a higher CPC count is associated with less vascular dysfunction with aging.
Frequency and anatomic distribution of magnetic resonance imaging lesions in the sacroiliac joints of spondyloarthritis and non-spondyloarthritis patients
Authors: Hecquet Sophie , Lustig Jean-Philippe , Verhoeven Frank , Chouk Mickaël , Aubry Sébastien , Wendling Daniel , Prati Clément 
Published: September 2022

Background: Lesions detected by magnetic resonance imaging (MRI) of the sacroiliac joints are critical to the diagnosis of non-radiographic axial spondyloarthritis. However, inflammatory and structural lesions may be encountered in other conditions. Objectives: The objective of this study was to evaluate and compare the frequency and localization of inflammatory and structural lesions on MRIs of the sacroiliac joint of spondyloarthritis (SpA) and non-spondyloarthritis (non-SpA) patients. Design: This is a retrospective study including 200 patients, each having undergone an MRI of the sacroiliac joints. Methods: Two experienced readers evaluated the whole set of images to detect erosions, subchondral sclerosis, fatty lesions, bone marrow edema (BME) and ankylosis according to the definitions established by the ASAS MRI working group. We divided sacroiliac joints into five segments: upper, antero-middle, intermediate-middle, postero-middle and lower. Results: A total of 96 subjects with SpA (mean age 37.4 ± 11.8 years) and 104 without SpA (mean age 39.9 ± 11.6 years) were included. Of the 96 SpA patients, 65% had inflammatory buttock pain compared with 25% in the non-SpA group. BME was seen in 65% of SpA patients, mainly in the intermediate-middle segment, and in 20% of non-SpA patients, predominantly in the antero-middle segment. Subchondral sclerosis occurred in 44% of non-SpA patients, mostly in the antero-middle segment, and in 36% of SpA patients. Fatty lesions were present in 34% of SpA and in 21% of non-SpA patients. Erosions were seen in 25% of non-SpA and in 60% of SpA patients. BME and structural lesions were minimally observed in the postero-middle segment in non-SpA patients. Conclusion: Inflammatory and structural lesions were observed in all segments of the joint in SpA, mainly in the middle segments, while lesions predominantly affected the antero-middle segment in non-SpA, and were uncommon in the postero-middle segment.
Uveitis in peripheral spondyloarthritis patients: an ancillary analysis of the ASAS-PerSpA study
Authors: Llop Maria , Gratacós Jordi , Moreno Mireia , Arévalo Marta , Calvet Joan , Dougados Maxime , López-Medina Clementina 
Published: September 2022

Background: Acute anterior uveitis (AAU) is the most frequent extra-musculoskeletal manifestation in spondyloarhtritis (SpA). Previous data on AAU focused on axial disease; therefore, it is not well known whether the clinical characteristics of patients with AAU and recurrent AAU differ between patients with axial and peripheral SpA. Objective: Primary objective was to compare the clinical characteristics of patients with AAU from patients without AAU in axial and peripheral spondyloarthritis (SpA) patients. Secondary objectives were to describe the clinical features of patients with AAU in the subset of patients with peripheral SpA (pSpA) and the clinical characteristics of patients with recurrent AAU in SpA patients. Design: This is an ancillary analysis of the ASAS-PerSpA study which included 3152 patients, 2719 patients with axSpA and 433 with pSpA according to rheumatologist judgement. Methods: Recurrent AAU was defined as the presence of two or more episodes of AAU ever. Univariable and multivariable binary logistic regression analyses were conducted to identify factors associated with the presence of AAU ever and the presence of recurrent AAU. Results: Overall, 663 patients (21%) presented AAU. Of them, 444 (66.9%) presented recurrent episodes. In patients with SpA, HLA-B27 positivity is the most important factor linked to the presence of AAU, odds ratio (OR) = 2.70 (95% CI = 2.04–3.6). In patients with pSpA, HLA-B27 positivity was also the most relevant factor linked to the presence of AAU, OR = 6.08 (95% CI = 2.72–15.68). Moreover, disease duration, younger age and higher body mass index (BMI) were the only factors slightly linked to the presence of recurrent episodes, OR = 1.03 (95% CI = 1.01–1.04), OR = 1.01 (95% CI = 1.00–1.03) and OR = 1.04 (95% CI = 1.01–1.08), respectively. Conclusion: HLA-B27 positivity is the most relevant factor linked to AAU risk in SpA patients, and this association is even stronger in those patients with pSpA. Moreover, our study did not find an association between HLA-B27 positivity and recurrent AAU in SpA patients.