bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Psychosocial Stress from Life Trauma and Racial Discrimination on Epigenetic Aging—A Systematic Review
Authors: Lim Sungju , Nzegwu Dumebi , Wright Michelle L 
Published: February 2022

Purpose The purpose of this review was to explore the effects of psychosocial stress from life trauma and racial discrimination on epigenetic aging. Design A systematic review of the last 10 years was conducted using four databases: PubMed/MEDLINE, Web of Science, PsychInfo, and CINAHL. Methods Articles were identified using the following terms: ([(DNA methylation) AND (epigenetic clock)] OR [(DNA methylation) AND (epigenetic age)]) AND (discrimination OR trauma)). Original research articles published in English measuring life trauma, post-traumatic stress, experience of discrimination, and epigenetic clocks or aging were analyzed using PRISMA guidelines. Results Ten articles met inclusion criteria. The study sample size ranged from 96 to 1163 and most study populations had a mean age under 50 and included predominantly White male participants. One study identified accelerated epigenetic aging associated with discrimination using Hannum’s clock; 33% of studies evaluating life trauma reported epigenetic age acceleration using GrimAge or Horvath’s clock; 25% of studies evaluating childhood trauma reported epigenetic age acceleration using Horvath’s clock; and 71% of studies assessing post-traumatic stress observed epigenetic age acceleration with all clocks, while one study reported deceleration using Horvath’s clock. Conclusions The experiences of life trauma, post-traumatic stress, and discrimination may be associated with accelerated epigenetic aging that can be consistently detected using different epigenetic clocks. Additional studies inclusive of diverse populations and other psychosocial stressors are needed. Relevance Nursing scholars and other health scientists who utilize epigenetic age acceleration to assess health risks may need to consider including psychosocial stressors in their studies as covariates.
Assessment of Lacrijet monocanalicular intubation for congenital nasolacrimal duct obstruction
Authors: Hamed Azzam Shirin , Hartstein Morris , Dolmetsch Angela , Mukari Abed 
Published: February 2022

Purpose To assess the success rate and complications of Lacrijet monocanalicular stent (FCI S.A.S, Paris, France) intubation in children treated for congenital nasolacrimal duct obstruction (CNLDO). Methods Retrospective review study which included children with CNLDO that were intubated with Lacrijet monocanalucilar silicone tube.The Lacrijet tube remained in place for 11–15 weeks post operatively and was removed in the clinic with topical anesthesia. Operative time was recorded for each case. All children were evaluated using the following parameters preoperatively and postoperatively: tear meniscus height, Fluorescein dye disappearance test (FDDT), and MUNK score. Results The study included 20 eyes with mean age of 26.25 ± 11.25 months. 17 eyes (85%) had undergone probing previously. Mean operation time of Lacrijet intubation was 8.5 min (95% CI 7.04–9.95). Mean follow-up period was 204.65 ± 105.27 days. Lacrijet intubation resulted in statistically significant improvements in tear meniscus height ( P < .001), FDDT ( P < 0.001), and MUNK score ( P < 0.001) in all children. Two different sizes of Lacrijet intubations were used. Complete success was obtained in all cases. No complications were observed. Conclusions Lacrijet lacrimal intubation has a high rate of success, shortens surgical time and has a low rate of complications in children with CNLDO.
Fifteen years of central catheter applications and outcomes in intensive care patients: A single-center pediatric experience
Authors: Silahli Musa , Kesim Çağrı 
Published: February 2022

Background: To investigate the clinical outcome of central line placement in the pediatric age group and to evaluate the risk factors for central line-associated bloodstream infection (CLABSI). Methods: We retrospectively examined the outcomes and CLABSI risk factors of pediatric patients aged 0–17 years admitted to intensive care units who had central catheters placed between January 2005 and December 2020. Results: Of the 2718 catheter admissions, 1502 catheter admissions were eligible for the regression and other outcome analyses. Fifty-seven percent of the study group were umbilical artery and vein catheters and 43% were other central catheter admissions, including ultrasound-guided catheter admissions. Logistic regression analysis showed us that right internal jugular vein (RIJV) (OR = 1.5, 95% CI = 1.15–2.02, p = 0.030) was the insertion site and ultrasound-guided interventional radiology catheter placement was the technique (OR = 1.7, 95% CI = 1.07–2.90, p = 0.024), duration of catheter stay (OR = 1.07, 95%CI = 1.06–1.08, p < 0.001), catheter placement in patients older than 2 years (OR = 2.42, 95% CI = 1.69–3.45, p < 0.001), were risk factors for CLABSI. Conclusion: Although CLABSI has variable risk factors, the most important risk factor seems to be the length of catheter stay.
Early initiation of thromboembolic prophylaxis in critically ill trauma patients with high-grade blunt liver and splenic lacerations is not associated with increased rates of failure of non-operative management
Authors: Moore Kerry , Barton Cassie A , Wang Yuxuan , Ran Ran , Chi Albert , Rowell Susan , Schreiber Martin 
Published: February 2022

Background Non-operative management (NOM) is the current standard of care of hemodynamically stable patients with traumatic blunt solid abdominal organ injuries. Guidelines do not define the optimal timing of initiation of venous thromboembolism (VTE) prophylaxis in this population, and fear of failure of NOM may lead to delayed initiation of prophylaxis specifically in patients with high-grade injuries. Methods This was a single-center, retrospective study of patients with high-grade (AAST grades ≥3) blunt liver and splenic lacerations presenting to our level 1 trauma center between January 2010 and October 2017. Patients were divided into groups based on timing of low-molecular weight heparin (LMWH) initiation for VTE prophylaxis. The primary outcome was rate of failure of NOM, defined as the need for interventional radiology or surgical intervention for management of abdominal organ bleeding. Secondary outcomes included rates of VTE, lengths of ICU and hospital stay, and in-hospital mortality. Results A total of 207 patients with high-grade blunt liver and splenic injuries undergoing an initial attempt at NOM were identified. The distribution of grades 3, 4, and 5 liver and splenic injuries were similar across all groups. Overall, 55.5% of patients received LMWH during their index admission. Early administration of LMWH was not associated with a statistically significant increased risk of failure of NOM ( p = 0.054). Rates of VTE and in-hospital mortality were similar. Conclusions Early initiation of VTE prophylaxis was not associated with an increased rate of failure of NOM in patients with high-grade blunt abdominal organ injuries in patients who survived 24 h post-admission and did not require massive transfusion; however, the study was likely underpowered to detect a difference among groups due to small sample size.
Endovascular treatment for acute basilar artery occlusion: A multicenter randomized controlled trial (ATTENTION)
Authors: Tao Chunrong , Li Rui , Zhu Yuyou , Qun Sen , Xu Pengfei , Wang Li , Zhang Chao , Liu Tianlong , Song Jianlong , Sun Wen , Wang Guoping , Baxter Blaise , Qureshi Adnan , Liu Xinfeng , Nogueira Raul G , Hu Wei 
Published: February 2022

Background and hypothesis: Recently, two multicenter randomized controlled trials (RCT) failed to show a significantly beneficial effect of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO). However, both trials suffered from equipoise issues which may have hindered the validity of the trial results. Therefore, additional RCT studies are needed to explore the potential benefit of EVT in patients presenting with BAO. Study design: ATTENTION is an investigator-initiated, multicenter, prospective, randomized, controlled clinical trial with open-label treatment and blinded outcome assessment (PROBE) of EVT versus best medical management (BMM). The primary effect parameter is a modified Rankin Score of 0–3 at day 90. Discussion: ATTENTION will provide evidence for the efficacy and safety of EVT in stroke patients within 12 h after BAO. Trial registration: ClinicalTrials.gov NCT04751708
IMproving Physical ACtivity after stroke via Treadmill training (IMPACT) and self-management: A randomized trial
Authors: Brauer Sandra G , Kuys Suzanne S , Ada Louise , Paratz Jennifer D 
Published: February 2022

Aim: To determine if treadmill training embedded in self-management education commencing during stroke inpatient rehabilitation results in more physical activity than usual gait training. Method: A prospective, parallel-group, randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis involving 119 stroke survivors undergoing rehabilitation who were able to walk independently was undertaken. The experimental group undertook treadmill training (40–60% heart rate reserve) and self-management education for 30 min, three times a week for 8 weeks, and the control group undertook the same amount of usual gait training. Outcomes were measured at baseline (Week 0), on completion of the intervention (Week 8), and beyond the intervention (Week 26). The primary outcome was physical activity measured as steps/day using an activity monitor. Secondary outcomes were walking ability, cardiorespiratory fitness, cardiovascular risk, depression, self-efficacy, perception of physical activity, participation, and quality of life. Results: After 8 weeks, the experimental group took 1436 more steps/day (95% confidence interval (CI) = 229 to 2643) than the control group. By 6 months, they took 871 more steps/day (95% CI −385 to 2129) than the control group. There was no difference between groups in any other outcome. Conclusion: In individuals undergoing rehabilitation after stroke, 8 weeks of treadmill training embedded in self-management resulted in more physical activity than usual gait training and this was largely maintained at 6 months, despite little effect on walking or cardiorespiratory fitness, suggesting the self-management was responsible.
Syphilis and ischemic stroke: Old question revisited by a nationwide cohort study
Authors: Chang Shu-Han , Kao Chih-Hsiang , Hung Chih-Hsin , Chou Mei-Chia , Yip Hei-Tung , Hung Yao-Min , Chang Renin , Cheng-Chung Wei James 
Published: February 2022

Background and purpose: In the era of easily available antibiotic use, this study provides epidemiological evidence for a re-examination of the relationship between syphilis and ischemic stroke (IS). Methods: Patients aged 18 years and older with newly diagnosed syphilis were included (n = 1585) from 2000 to 2012, and participants without syphilis in the control group (n = 6340) were matched by propensity score (age, sex, index year, insured amount, urbanization, seasons, and comorbidities). The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of IS. Five different Cox regression models, sensitivity analyses, and negative control were conducted to test our findings. Results: In all, 1585 patients (1055 (66.56%) men; mean (SD) age, 49.59 (20.32) years) had syphilis, and 3.8% had new-onset IS. The syphilis group had a higher risk of IS than the controls (adjusted HR, 1.35; 95% CI, 1.01–1.80; p value < 0.05) after full adjustment. Serial sensitivity analyses yielded consistent results. Conclusion: Syphilis patients have higher risk of IS, and our data raise the question of implementation of prophylactic treatment for IS.
Validating the Cambridge Protocol: Reliability of Hip Muscle Strength Measurements Using a Motorized Dynamometer and Electromyography
Authors: Memarzadeh Arman , Morrison Andrew Paul , Merzbach Viviane , Ferrandino Michael , Arora Arvind , Claydon-Mueller Leica S. , Khanduja Vikas 
Published: February 2022

Background: Muscle weakness is common after injury in athletes and in the presence of hip pathology. It will cause abnormal hip biomechanics and can predict future injury. However, objective measurement of hip muscle strength is difficult to perform accurately and reliably. Therefore, it is challenging to determine when an athlete has returned to preinjury levels of strength. In addition, there is currently no standardized method of obtaining measurements, which prevents the data being compared or shared between research centers. Purpose: The purpose of this study is to comprehensively assess the inter- and intraobserver reliability of our standardized muscle strength measurement protocol. Study Design: Descriptive laboratory study. Level of Evidence: Level 3, inception cohort study. Methods: A total of 16 healthy male volunteers (age = 28.3 ± 7.9 years) were recruited. Those with a previous history of hip injuries or disorders were excluded. These volunteers underwent strength testing according to the Cambridge Protocol on 4 separate occasions, performed by 2 independent assessors. Maximal voluntary contractions, fatigue torque fluctuations, and electromyography measurements were recorded. Intra- and interobserver reliability was assessed using intraclass correlation coefficient (ICC). Results: Good-to-excellent correlation was seen for both intra- and interobserver reliability across almost all hip movements for maximal contractions: ICC ranged 0.78 to 0.93 and 0.78 to 0.96, respectively. The standard error of the mean for all hip movements was also extremely low at 2% to 3%. Conclusion: The Cambridge Protocol is a highly reliable method for objective measurement of hip muscle strength. We recommend future studies use this protocol, or the principles underpinning it, to enable data sharing and comparison across different studies. Clinical Relevance: This is a description and analysis of hip muscle strength measurement. If widely used, it will allow for accurate and objective strength assessment and closer monitoring of hip injuries and pathology.
De novo brain AVM following radiotherapy for cerebral cavernous malformation in a child: A 15-year clinical course
Authors: Matsoukas Stavros , Bageac Devin V , DeLeacy Reade , Berenstein Alejandro , Fifi Johanna T 
Published: February 2022

Multiple de novo brain arteriovenous malformations (bAVM) have been reported in the literature, raising questions about the contended purely congenital nature of these lesions. We present the 15-year course of a pediatric patient, who initially presented at age 5 with a thalamic cavernous malformation and was treated with radiosurgery, and then subsequently developed a thalamic de novo bAVM immediately adjacent to the initial lesion location, discovered 2 years later. Treatment of the bAVM entailed two transarterial embolizations and one radiosurgery session which ultimately led to complete angiographic resolution. Finally, this patient’s course was complicated by intraparenchymal hemorrhage and acute obstructive hydrocephalus, and further imaging revealed two newly formed cavernous malformations, also associated with the initial lesion’s location, that have remained stable since their formation. This case likely represents the second-hit model for the formation of vascular malformations, as sparsely supported by the current literature. According to this, genetically aberrant, yet quiescent, brain areas might promote the de novo formation of vascular malformations after brain injury, including radiation.
Virtual Care Access and Health Equity during the COVID-19 Pandemic, a qualitative study of patients with chronic diseases from Canada
Authors: Chan-Nguyen Sophy , Ritsma Benjamin , Nguyen Lisa , Srivastava Siddhartha , Shukla Garima , Appireddy Ramana 
Published: February 2022

Objectives The COVID-19 pandemic has led to the widespread uptake of virtual care in Canada; however, virtual care may also create new barriers to health care. The purpose of this paper was to explore patient perceptions and concerns around virtual care access. Methods Between February and April 2020, we conducted semi-structured interviews with participants from four chronic disease clinics (stroke, epilepsy, amyotrophic lateral sclerosis, obstetrics medicine) in a mid-sized academic hospital in Southern Ontario, Canada. Consecutive sampling was done by including the patients receiving virtual care in those months. Caregivers were invited to participate in the event that patients were unable to participate in the interview. Thematic analysis was employed to identify overarching themes, and codes were reviewed and refined using a consensus process. Results We interviewed 31 participants (27 patients, four caregivers) that had taken part in virtual care. Our findings suggested that the COVID-19 pandemic served to isolate participants and had negatively impacted their access to health care. However, virtual care did provide a safe avenue for patients to receive care and served as a reassuring option during the pandemic. Low technological literacy and access were identified as barriers to virtual care. Greater awareness and patient engagement is needed in future research to improve access. Conclusion Certain populations can be disproportionately affected by differential access to virtual care. Future studies should examine how social determinants intersect to impact virtual health care access in different patient populations.
Apparent diffusion coefficient signature of ischemic tissue predicts neurological progression in isolated pontine infarcts
Authors: Oge Dogan Dinc , Topcuoglu Mehmet A. , Arsava Ethem Murat 
Published: February 2022

Background Early neurological deterioration is encountered in up to a third of patients with isolated pontine infarcts. A limited number of clinical and imaging features have been suggested as predictors of neurological progression in this setting. In this study, we assessed whether quantitative apparent diffusion coefficient (ADC) measurements within the ischemic pontine region could be used as a radiomic feature to forecast clinical deterioration. Methods We calculated the mean ADC value of ischemic voxels within the ischemic region and normalized them to the contralateral non-ischemic tissue (relative ADC, rADC) in patients with isolated pontine infarcts. This imaging signature was then compared among patients with neurological progression (n = 21) and a propensity matched cohort of non-progressors (n = 42), together with other clinical and imaging features in bivariate and multivariate statistical models. Results The rADCmean was significantly lower among patients with progression ( p = 0.008). Female gender and extension of the ischemic lesion to the ventral pontine surface were other features significantly associated with progression. The association between rADCmean and progression persisted in multivariate models with an odds ratio of 13.7 (95% CI 2.6–72.8; p = 0.002) for progression among patients with rADCmean ≤ 0.67 in their ischemic tissue. The probability for worsening was 80% among patients who had an ischemic lesion extending to the ventral pontine surface with a mean rADC ≤ 0.67. Conclusion The mean rADC value within the ischemic lesion is closely related with early neurological deterioration in patients with isolated pontine infarcts.
Technique for Arthroscopic Transtibial Medial Meniscus Posterior Root Repair
Authors: Lynch Danny , Duerr Robert A. 
Published: February 2022

Background: Medial meniscus posterior root tears (MMPRT) can lead to significant pain, functional limitations, and osteoarthritis (OA). Biomechanically, MMPRT has been shown to be equivalent to total meniscectomy in terms of peak contact pressure in the medial compartment. Transtibial repair of a meniscus root tear has also been shown to restore hoop stresses and reduced peak contact pressure to the normal intact state. Clinically, root repair was shown to reduce rates of OA progression and need for total knee arthroplasty when compared with nonoperative treatment or partial meniscectomy for MMPRT. Indications: Medial meniscus posterior root repair is indicated in patients with a symptomatic MMPRT who are appropriate surgical candidates: age ≤65 years, body mass index ≤40 kg/m2, <5° varus alignment, no more than Kellgren-Lawrence grade 2 changes, and willing and able to undergo the demanding postoperative rehabilitation program. Technique Description: This surgical technique video demonstrates our preferred technique for arthroscopic transtibial medial meniscus posterior root repair using a case example in a commonly encountered patient. The repair is completed using a 3 simple suture triangle configuration with 2 tibial tunnels to create a broad footprint for healing. Results: There are a number of case series and comparative studies published with good clinical outcomes using similar transtibial medial meniscus posterior root repair techniques. In short-term follow-up of 18 patients at a mean of 10.5 months post-operatively, we have demonstrated improvements in pain and functional status with a 16.7% clinical failure rate and 11% rate of conversion to arthroplasty. Discussion: In this surgical technique video, we review the anatomy of the native medial meniscus posterior root and the biomechanical and clinical consequences of a MMPRT. We highlight important technique pearls and pitfalls to avoid failures and complications during the surgical demonstration. Finally, we review postoperative rehabilitation guidelines and clinical outcomes within the existing literature. In patients with MMPRT, transtibial repair provides a safe and reliable technique to achieve healing of the medial meniscus posterior root and return patients to full activities with reduced risk of OA progression.
Efficacy and safety of Z-substances in the management of insomnia in older adults: a systematic review for the development of recommendations to reduce potentially inappropriate prescribing
Authors: Scharner Vincenz , Hasieber Lukas , Sönnichsen Andreas , Mann Eva 
Published: February 2022

Abstract
Background
Z-drugs are usually prescribed as first line pharmacological therapy for insomnia. However, the benefits and risks of Z-drugs may differ for older adults. This systematic review investigated the available evidence on the efficacy and safety of Z-drugs in the management of insomnia in older adults.

Methods
The Cochrane database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed/MEDLINE and EMBASE were searched for systematic reviews, meta-analyses, controlled interventional and observational studies using a pre-formulated search term. The target population was older adults (≥65 years old) with insomnia. Studies were included if they reported efficacy and/or safety outcomes of the use of Z-drugs for the management of insomnia compared to placebo, usual or no treatment, or other pharmacological agents.

Results
Eighteen studies were included (8 interventional and 10 observational studies). In short-term interventional studies, Z-drugs were similarly or better efficacious in improving both sleep and daytime parameters than placebo or other pharmacological treatments, while showing good results on measures of safety. However, in longer-term observational studies, Z-drugs significantly increased the risk for falls and fractures in comparison to no treatment or melatonin agonists.

Conclusions
Analyzing the evidence from short-term interventional studies, Z-drugs appear effective and safe for treatment of insomnia in older adults, but they may have unfavorable side effects when used for longer periods of time. We, therefore, recommend discontinuing Z-drugs, principally because of the high risk for falls and fractures. Nonetheless, quality and quantity of evidence are low. Due to the scarcity of data, especially concerning drug dependence after longer periods of treatment and due to the significantly increased risk for falls and fractures, further studies are needed to evaluate the benefit-risk profile of Z-drugs use in older patients, particularly for long-term use.