bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local aldosterone synthesis in the large intestine of mouse: An ex vivo incubation study
Authors: Pang Zan , Launonen Hanna , Korpela Riitta , Vapaatalo Heikki 
Published: June 2022

Objective To investigate the regulation of local aldosterone synthesis by physiological stimulants in the murine gut. Methods Male mice were fed for 14 days with normal, high (1.6%) or low (0.01%) sodium diets. Tissue liver receptor homolog-1 and aldosterone in the colon and caecum were detected using an enzyme-linked immunosorbent assay (ELISA). Released corticosterone and aldosterone in tissue incubation experiments after stimulation with angiotensin II (Ang II) and dibutyryl-cAMP (DBA; the second messenger of adrenocorticotropic hormone) were assayed using an ELISA. Tissue aldosterone synthase (CYP11B2) protein levels were measured using an ELISA and Western blots. Results In incubated colon tissues, aldosterone synthase levels were increased by a low-sodium diet; and by Ang II and DBA in the normal diet group. Release of aldosterone into the incubation buffer was increased from the colon by a low-sodium diet and decreased by a high-sodium diet in parallel with changes in aldosterone synthase levels. In mice fed a normal diet, colon incubation with both Ang II and DBA increased the release of aldosterone as well as its precursor corticosterone. Conclusion Local aldosterone synthesis in the large intestine is stimulated by a low-sodium diet, dibutyryl-cAMP and Ang II similar to the adrenal glands.
Evaluation of the evidence for self-management post-stroke within clinical practice guidelines for people with stroke: A systematic review
Authors: Henry Leah , Leahy Siobhan , McCurtin Arlene , Boland Pauline 
Published: June 2022

Introduction Self-management post-stroke is essential where healthcare systems are stretched and stroke prevalence remains high. Self-management is recommended in stroke guidelines however, the quality of guidelines can vary and the evidence underpinning recommendations is unclear. The objectives of this paper are to identify and appraise current stroke guidelines, synthesise self-management recommendations and assess the evidentiary basis of these recommendations. Method Stroke guidelines were retrieved from a search of four databases and stroke association websites in July 2021. Four independent reviewers assessed their quality using the Appraisal of Guidelines Research and Evaluation 2nd Edition instrument. Self-management recommendations were extracted by hand, evaluated, synthesised and the evidence underpinning them appraised using the Canadian Stroke Best Practice Recommendations framework. Results Eleven guidelines were included in this systematic review, all of excellent methodological quality overall. One hundred and sixty-one recommendations were extracted from these guidelines and grouped into ten principles of self-management. A quarter of the recommendations were underpinned by level A evidence, 32% level B and 43% level C. Conclusion Although current stroke guidelines are of high methodological quality, there are considerable inconsistencies in self-management recommendations within and between these guidelines, with varying strengths of underpinning evidence. This article identifies a need for universal consensus regarding evidence-based self-management post-stroke.
Penumbra of the pandemic workplace for psychiatrists and trainees in Australia
Authors: Looi Jeffrey CL , Maguire Paul A. , Bastiampillai Tarun , Allison Stephen 
Published: June 2022

Objective: A commentary on the workforce, infrastructure and health of psychiatrists and trainees providing psychiatric care during the COVID-19 pandemic in Australia. Conclusions The wide-ranging workplace, health system and societal changes necessitated by the SARS-CoV-2 virus have altered the practice and working lives of psychiatrists, trainees and other healthcare workers, as well as the general population. There have been workplace innovations, recalibrations and losses. There is a new baseline upon which to build better psychiatric services, as the pandemic’s penumbra recedes.
Assessing Efficacy and Use Patterns of Medical Cannabis for Symptom Management in Elderly Cancer Patients
Authors: Nathan Rachel , Mupamombe Charles T. , Elibol John , Case Amy A. , Smith Danielle , Hyland Andrew , Attwood Kristopher , Hansen Eric D. 
Published: June 2022

Objectives Our study sought to further characterize patterns of medical cannabis use in elderly cancer patients. Furthermore, we sought to assess efficacy of medical cannabis for the treatment of pain, nausea, anorexia, insomnia and anxiety in elderly cancer patients. Background Medical cannabis use is growing for symptom management in cancer patients, but limited data exists on the safety or efficacy of use in elderly patients. Methods A retrospective chart review assessing changes in numerical symptom scores reported at clinic visits before and after medical cannabis initiation. Results There was no statistically significant difference in pain, nausea, appetite, insomnia or anxiety scores reported before and after initiation of medical cannabis. Oil was the most common form used, followed by vape, and the most common ratios used were high tetrahydrocannabinol (THC) to cannabidiol (CBD) and equal parts THC/CBD products. Conclusion This study did not find a statistically significant change in symptom scores with medical cannabis use, although further study is warranted given the limitations of the present study. Elderly patients most commonly are using equal parts THC/CBD or high THC ratio products initially.
Prognostic Factors for Orthognathic Surgery in Children With Cleft Lip and/or Palate: Dentition and Palatal Morphology
Authors: Lim Jaeyeon , Tanikawa Chihiro , Kogo Mikihiko , Yamashiro Takashi 
Published: June 2022

To determine dental and palatal morphology in children with cleft lip and/or palate (CL/P) and identify morphological prognostic factors for orthognathic surgery (OGS).Retrospective cohort study.Orthodontic department of a university dental hospital.This study included 80 patients with bilateral and unilateral CL/P who had lateral cephalograms at the ages of 7 (T1), 15 (T2) years, and a dental plaster model at T1.Plaster models at T1 were scanned with a three-dimensional (3D) scanner. Morphological features were extracted from 3D models with geometric morphometrics software as principal components (PCs). The combinations of the PCs and other predictive factors (ie, the No. of clefts in the lip and alveolus, the palatal repair method, sex, cephalometric variables at T1, and the No. of missing teeth) were examined by logistic regression to determine the predictability for OGS. The need for OGS and skeletal and dental discrepancies at T2 were examined as outcomes.Shrinkage of the palate, including vertical shallowing and transverse narrowing of the posterior maxilla and cleft-side asymmetry of the anterior maxilla at T1, as well as the No. of clefts in the lip and alveolus, the palatal repair method, male sex, several cephalometric variables for the sagittal and vertical dimensions, and the No. of missing teeth, were found to be predictive factors for OGS.Morphological prognostic factors for OGS in children with CL/P were determined.
Orbital myeloid sarcoma treated with low-dose venetoclax and a potent cytochrome P450 inhibitor
Authors: De la Garza-Salazar Fernando , Peña-Lozano Samantha P , Gómez-Almaguer David , Colunga-Pedraza Perla R 
Published: June 2022

Case report We report the first case of orbital myeloid sarcoma that was successfully treated with a standard venetoclax dose of 25%. A 38-year-old man with acute myeloid leukemia (AML) post-haplo-hematopoietic stem cell transplantation (HSCT) presented with a nine-month history of progressive right proptosis and a visual acuity deficit. The patient was treated with venetoclax (100 mg orally on days 1–28), cytarabine (40 mg subcutaneously, days 1–10), and itraconazole (100 mg twice daily orally on days 1–28). Management and outcome The present case report shows that using cytochrome P450 (CYP) inhibitors is a helpful strategy to reduce the cost of expensive treatments. Discussion There are limited data on the use of CYP inhibitors as a strategy to reduce the costs of expensive drugs (i.e. venetoclax). This approach has some advantages over standard dose venetoclax (400 mg/day) such as significantly reduced costs (which is relevant for patients in low-income countries). In this case, we used itraconazole—a potent CYP3A4 inhibitor—which can theoretically reduce the dose to 100 mg/day without losing serum therapeutic concentrations.
Pegylated asparaginase in feline high-grade lymphoma: clinical results of single injection and continued incorporation into a modified COP regimen
Authors: Krupa Adriana , de Vos Johan , Van Eetvelde Lynn , Teske Erik 
Published: June 2022

Objectives The aim of this retrospective study was to determine the response to a single injection of pegylated asparaginase (‘pegaspargase’) and to assess the tolerability and outcome of prolonged incorporation of pegaspargase into a modified COP (cyclophosphamide, vincristine, prednisolone) regimen in pegaspargase sensitive cats. Methods Fifty-six client-owned cats with confirmed macroscopic high-grade lymphoma at any anatomical site were included. Treatment was commenced with a single pegaspargase injection. Cats showing an objective response were eligible to continue therapy with pegaspargase incorporated into a modified COP protocol and had their survival analysed using the Kaplan–Meier method and log-rank test. Results Objective response to pegaspargase was reported in 46 cats (82%), including 21 (38%) complete and 25 (44%) partial responses. Thirty-four responders continued therapy with pegaspargase-COP as the first-line treatment. Of these, 31 cats (92%) achieved complete remission with a median duration of the first remission (disease-free survival [DFS]) of 816 days. The median overall survival time (OST) for all 34 cats treated with pegaspargase-COP was 181 days. Response to the initial pegaspargase injection before COP initiation was significantly associated with DFS ( P = 0.04) and OST ( P = 0.001). Median DFS/OST for cats with complete response to initial pegaspargase injection was significantly longer compared with those with partial remission (>1273 days/>2066 days vs 77 days/108 days, respectively). Cats with gastric lymphoma showed a significantly longer survival (OST 854 days, 1- and 2-year survival rate 57.1%) compared with cats with intestinal lymphoma (OST 102 days, 1-year survival rate 0%). The pegaspargase-COP protocol was generally well tolerated, but two deaths were likely attributable to treatment-related toxicity during the maintenance phase. Importantly, none of the cats experienced hypersensitivity, despite multiple repeated treatments with pegaspargase. Conclusion and relevance Pegaspargase is an effective agent for feline lymphoma. Its incorporation into a COP chemotherapy protocol may confer a survival benefit, especially in cats with complete response to pegaspargase. Treatment is generally well tolerated, but careful monitoring is recommended. Further studies are required to assess the benefits of pegaspargase as monotherapy or as part of different multi-agent chemotherapy regimens.
Animal-Based Dietary Protein Intake Is Not A Risk Factor For Metabolic Syndrome Among Young Or Middle-Aged Females
Authors: Sawyer Bailee , Stone Kara A. , Kotarsky Christopher J. , Johnson Nathaniel , Bradley Adam , Scheffert Rachel A. , Hackney Kyle J. , Byun Wonwoo , Stastny Sherri 
Published: June 2022

Background: Metabolic syndrome (MetS) increases risk for morbidity and premature mortality. Blood pressure, waist circumference, and fasting triglycerides (TG), blood glucose (BG), and high-density lipoprotein cholesterol (HDL) are factors for determining MetS. The Simple Method for Quantifying Metabolic Syndrome (siMS) score and risk score estimate risk of MetS. The purpose for this study was to exam the relationship of animal-based (ABP) and plant-based protein (PLP) with MetS as estimated by siMS score and risk score. Physical activty is another important consideration in MetS as it can reduce blood pressure, waist circumference and blood glucose, and affect blood lipid and lipoprotein concentrations. Methods: A cross-sectional study examined whether physical activity (PA) level and dietary protein source (i.e., animal- or plant-based) among young (18-24 years) and middle-aged (45-60 years) females were associated with siMS score and siMS risk score. Average time spent in sedentary, light, and moderate-to-vigorous PA (MVPA; min/wk), steps (steps/day), energy intake (kcal/day), percent dietary protein to total energy intake, ABP and PLP dietary intake, and ABP:PLP ratio (g/day) were included in the analysis. Volunteers were recruited from North Dakota and Minnesota from 2017 to 2019. Results: Eighty-one female participants (mean ± SD; young, n = 38, 20.4 ± 1.7 years, middle-aged, 52.5 ± 4.8 years) were included in the independent t-tests used to examine group differences in age, body mass index, HDL, BG, TG, systolic blood pressure, waist circumference, energy intake, energy intake percentage of total carbohydrates, fat, protein, ABP, and PLP, ABP:PLP, siMS score, and siMS risk score. Stepwise linear regressions were used to evaluate whether PA level and dietary protein source were predictors of siMS score and siMS risk score among young and middle-aged adult females. There was an inverse relationship between PLP intake and siMS score. The model explained 6.9% of the variance in siMS risk score (F1, 80 = 5.93). Plant-based protein intake was inversely related to siMS risk score while light PA was positively associated with siMS risk score. The model explained 16% of the variance in siMS risk score (F1, 80 = 7.53). Animal-based dietary protein intake did not impact siMS score ( p = 0.180) and siMS risk score ( p = 0.283). Conclusions: Plant-based protein intake was associated with a lower risk of MetS via siMS scores, while ABP was not associated. Given the nature of the cross-sectional design of this study, no causal relationship can be determined, but longitudinal studies or randomized control trials to confirm the results from this study are needed in the future.
Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies
Authors: Porwal Mokshal H. , Salter Amber , Patel Dhruvkumar , Obeidat Ahmed Z. 
Published: June 2022

BACKGROUND There is currently limited literature addressing the reporting of alopecia in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs). Anecdotal reports of hair thinning from patients on various DMTs prompted further investigation of a large database. OBJECTIVE To analyze total reports, source of reporting, age distribution, and sex distribution of alopecia associated with DMTs. METHODS FDA Adverse Event Reporting System (FAERS) public dashboard and OpenFDA database were analyzed for alopecia reports between January 1, 2009, and June 30, 2020, attributed to usage in MS of FDA approved DMTs. The main outcomes included total reports for each drug, age, sex distribution, and reporting source. OpenFDA data was used for statistical analyses including reporting odds ratios (ROR) and information components. RESULTS 8759 alopecia reports were identified among 44 114 adverse events in skin and subcutaneous tissue disorders (19.9%). 3701 (42.3%) with teriflunomide, 1675 (19.1%) with dimethyl fumarate, 985 (11.2%) with natalizumab, 926 (10.6%) with fingolimod, 659 (7.5%) with interferon beta-1a, 257 (2.9%) with glatiramer acetate, 243 (2.8%) with ocrelizumab, 124 (1.4%) with interferon beta-1b, 117 (1.3%) with alemtuzumab, 36 (.4%) with siponimod, 24 (.3%) with cladribine, and 12 (.1%) with rituximab. Reports were mostly made by patients (78.3%) and highest in fifth and sixth decades of life. OpenFDA analyses showed increased ROR (ROR 95% confidence interval) of alopecia in females with teriflunomide (18.00, 17.12-18.93), alemtuzumab (1.43, 1.16-1.76), dimethyl fumarate (1.26, 1.18-1.34), and ocrelizumab (1.28, 1.11-1.49). Increased ROR in males was associated with teriflunomide (24.65, 20.72-29.31). CONCLUSION We identified many reports of alopecia for DMTs in addition to teriflunomide. Within the limitations of the database, increased RORs of alopecia were observed for females treated with alemtuzumab, dimethyl fumarate, and ocrelizumab. The source of reporting was largely driven by female patients. Possible alopecia, even if transient, should be considered during patient education when starting DMTs.
Comparing medical student experience of face-to-face and remote access consultations during the coronavirus pandemic
Authors: Patterson Caitlin , Collins Kathleen , Hunter Ian 
Published: June 2022

Introduction As a result of the coronavirus pandemic, outpatient consultations in National Health Service Lanarkshire were conducted using various forms of teleconsultation. A qualitative study was undertaken to ascertain how senior medical students valued the experience of outpatient teleconsultations in comparison to face-to-face consultations during the pandemic. Methods Anonymised, voluntary surveys were emailed to all medical students who attended clinical placements in specialties utilising teleconsultations. Participants were asked to compare their experience of and perceived value of virtual consultants to face-to-face consultations. Thematic and statistical analysis was performed on the collected data. Results Participants unanimously agreed face-to-face consultations enabled learning, with 71.4% (n = 7) having similar experiences in video consultations if a senior was physically present beside them. Video consultation, when the senior clinician was also present virtually, was deemed useful to a lesser extent (66.7%, n = 6). Only half (57.1%, n = 14) valued the learning from telephone consultations. Qualitative analysis revealed that although face to face was the preferred consultation style, there was useful learning gained in all modalities. Students appreciated discussion with senior clinicians to facilitate learning and valued involvement in the consultation through history taking, especially in teleconsultations. Discussion Teleconsultation was an effective learning tool for medical students during the coronavirus pandemic, which preserved student exposure to patients during lockdown. This study is optimistic that widespread incorporation of teleconsultation, in all modality, has the ability to support students’ clinical exposure and learning, which is becoming increasingly limited as medical student numbers continue to rise and with the ongoing effects of the pandemic.
Key socio-demographic characteristics of children and adolescents with gender dysphoria: A British Isles surveillance study
Authors: Khadr Sophie , Masic Una , Clarke Venetia , Lynn Richard M , Holt Victoria , Carmichael Polly 
Published: June 2022

The present research used linked surveillance systems (British Paediatric Surveillance Unit; and the Child and Adolescent Psychiatry Surveillance System) over a 19 month period (1 November 2011–31 May 2013) to notify of young people (4–15.9 years) presenting to secondary care (paediatrics or child and adolescent mental health services) or specialist gender services with features of gender dysphoria (GD). A questionnaire about socio-demographic, mental health, and GD features was completed. Presence of GD was then assessed by experts in the field using then-current criteria (DSM-IV-TR). Incidence across the British Isles was 0.41–12.23 per 100,000. 230 confirmed cases of GD were noted; the majority were white (94%), aged ≥12 years (75.3%), and were assigned female at birth (57.8%). Assigned males presented most commonly in pre-adolescence (63.2%), and assigned females in adolescence (64.7%). Median age-of-onset of experiencing GD was 9.5 years (IQR 5-12); the majority reported long-standing features (2–5 years in 36.1%, ≥5 years in 26.5%). Only 82.5% attended mainstream school. Bullying was reported in 47.4%, previous self-harm in 35.2%, neurodiversity in 16%, and 51.5% had ≥1 mental health condition. These findings suggest GD is rare within this age group but that monitoring wellbeing and ensuring support for co-occurring difficulties is vital.
Persistent post-thyroidectomy hypoparathyroidism: A multicenter retrospective cohort study
Authors: Lončar Ivona , van Kinschot Caroline M.J. , van Dijk Sam P.J. , Franssen Gaston J.H. , Visser Edward E. , Peeters Robin P. , Eijck Casper J.H. van , van Noord Charlotte , van Ginhoven Tessa M. 
Published: June 2022

Background and objective: The reported incidence of persistent hypoparathyroidism varies widely, and consensus on a definition is lacking. The objective was to evaluate the real-life incidence of persistent hypoparathyroidism by investigating a new pragmatic definition. Methods: This retrospective multicenter cohort study evaluated the effect of different definitions for persistent hypoparathyroidism on the incidence of hypoparathyroidism. In addition, risk factors for hypoparathyroidism were analyzed. Results: In total, 749 patients were included. Using the new pragmatic definition, we report an incidence of 7.9% of persistent hypoparathyroidism. When applying other commonly used definitions, incidence varied between 11.8% and 22.1%. Risk factors were parathyroid autotransplantation, presence of another surgical complication, and low postoperative serum calcium. Conclusions: Our data show that the incidence of persistent hypoparathyroidism in the literature may vary through the use of different definitions. This study indicates that a new pragmatic definition of persistent hypoparathyroidism has the potential to enable unbiased comparison between studies.
Securing citizens’ social rights under neoliberal welfare governance: the case of Israeli social services
Authors: Bracha-Sadowitz Sigal , Feldman Guy , Levin Lia 
Published: June 2022

While scholars have examined how neoliberal ideas and policies manifest at the front lines of the welfare state, far less is known about how the neoliberal approach prevalent in such states shapes decisions that senior state actors make about social welfare policy. The current study advances the literature by examining the processes and motivations behind the decision to withdraw from enacting a law designed to secure the social rights of all Israeli citizens. The study is rooted in a critical research paradigm, combining both inductive and deductive analyses of in-depth interviews with 15 senior officials and legislators in the field of social services. Despite their purported support for equality in the provision of social services, their acknowledgment of the shortcomings of current legislation in this respect, and their active role in promoting an alternative thereto, participants were persuaded to act in such a way as to support free-market measures. These findings illustrate an arena of policymaking wherein some state actors “purchase” other actors’ cooperation and compliance with the neoliberal approach. The “behind-the-scenes” account of the legislative process, set against the backdrop of neoliberal welfare governance, provides insights useful to all those who seek to promote parity-enhancing legislation aimed at supporting marginalized social service recipients, in Israel and beyond.