bluuebunny/crossref_metadata_2025_split huggingface dataset:
The involvement of long noncoding RNA APOA1-AS in the pathogenesis of preeclampsia
Authors: Yang Hai-Yan , Jiang Ling 
Published: February 2022

Objective Long noncoding RNAs (lncRNAs) are involved in preeclampsia (PE), and apolipoprotein A-1 antisense RNA (APOA1-AS) and has been found to be associated with a number of diseases. Our study aims to understand the involvement of APOA1-AS in PE. Methods Clinically, APOA1-AS expression in early-onset severe PE (EOSPE) patients and healthy controls was detected by real-time quantitative polymerase chain reaction. In vitro experiments were divided into control [coculturing trophoblasts with human uterine microvascular endothelial cells (UtMVECs)], TNF-α [coculturing trophoblasts with UtMVECs treated with tumor necrosis factor-α (TNF-α)], and TNF-α + control siRNA/APOA1-AS siRNA groups (UtMVECs transfected with control siRNA/APOA1-AS siRNA were cocultured with trophoblasts in the presence of TNF-α). The animals were divided into normal group, PE group (PE model was established by administrating nitro-L-arginine methyl ester (L-NAME) in rats), PE + control siRNA group (PE rats were treated with control siRNA), and PE + APOA1-AS siRNA group (PE rats were treated with APOA1-AS siRNA). Results Increased APOA1-AS was found in the placental tissues of EOSPE patients. APOA1-AS siRNA abolished the decreased integration of trophoblasts into UtMVEC networks induced by TNF-α. Furthermore, APOA1-AS siRNA improved pregnancy outcomes in PE rats with increased expression of vascular endothelial growth factor, placental growth factor, and fms-like tyrosine kinase receptor (Flt-1) but decreased expression of E-cadherin, intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1). Conclusion Downregulation of APOA1-AS protected against TNF-α-induced inhibition of trophoblast integration into endothelial networks, thus exerting protective effects against PE rats.
Determinants of Vancomycin Trough Concentration in Patients Receiving Continuous Veno-Venous Hemodialysis
Authors: Quinn Nicholas J. , Sacha Gretchen L. , Wanek Matthew R. , Yerke Jason , Srinivas Pavithra , Hohlfelder Benjamin 
Published: February 2022

Background: Vancomycin pharmacokinetics are altered in the critically ill and are further distorted by renal replacement therapy. Limited literature is available evaluating vancomycin dosing in continuous veno-venous hemodialysis (CVVHD). Objective: The goal of this analysis was to identify factors that affect vancomycin trough concentration in patients on CVVHD and to determine an appropriate dosing strategy. Methods: This was a single-center, retrospective cohort study of adult inpatients admitted to the Cleveland Clinic from May 2016-December 2017. Patients in the intensive care unit who received ≥ 2 doses of vancomycin during CVVHD were included. Patients with interruptions of CVVHD inappropriately timed troughs, a change in dialysate rate, and those who received different vancomycin dosages were excluded. Multivariable linear regression including age, sex, weight, Sequential Organ Failure Assessment score, albumin, 24-hour urine output (UOP), dialysate rate, filter type, and vancomycin dose was run to determine predictors of vancomycin concentration. Results: A total of 160 patients were included. The median vancomycin dose was 12.6 mg/kg with a trough of 24.6 mcg/mL. Weight, 24-hour UOP, vancomycin dose (mg/kg), and dialysate rate (mL/kg/h) were all determined to be independent predictors of vancomycin trough level. Patients who received <10 mg/kg doses of vancomycin (N=18) achieved a median trough of 21.5 mcg/mL, with 83% being therapuetic. In patients who received >10 mg/kg (N=142), the median trough was 25.5 mcg/mL, with 47% being therapeutic. Conclusion and Relevance: Vancomycin dose, dialysate rate, UOP, and weight are independently associated with vancomycin trough concentration. In CVVHD patients, vancomycin dosed at 10 mg/kg every 24 hours may be an appropriate recommendation.
Impact of metformin on tyrosine kinase inhibitor response in chronic myeloid leukemia
Authors: Pokorny Rebecca , Stenehjem David D. , Gilreath Jeffrey A. 
Published: February 2022

Objective Oral tyrosine kinase inhibitors (TKIs) are first line therapy for chronic myeloid leukemia (CML). A complete cytogenetic response (CCyR) correlates with increased overall survival, however only 66%–88% of patients achieve CCyR after one year of TKI treatment. Because TKI therapy alone cannot eliminate CML stem cells, strategies aimed at achieving faster and deeper responses are needed to improve long-term survival. Metformin is a widely prescribed glucose-lowering agent for patients with diabetes and in preclinical studies, has been shown to suppress cell viability, induce apoptosis, and downregulate the mTORC1 signaling pathway in imatinib resistant CML cell lines (K562R). This study aims to investigate the utility of metformin added to TKI therapy in patients with CML. Data Sources An observational study at an academic medical center (Salt Lake City, UT) was performed for adults with newly diagnosed, chronic-phase CML to evaluate attainment of CCyR from TKI therapy with or without concomitant metformin use. Descriptive analyses were used to describe baseline characteristics and attainment of response to TKI therapy. Data Summary Fifty-nine patients were evaluated. One hundred percent (5 of 5) in the metformin group and 73.6% (39 of 54) in the non-metformin group achieved CCyR. Approximately 20% of patients in both groups relapsed (defined by a loss of CCyR during study) after a median 34.5 months of follow-up. Conclusions Future research is warranted to validate these findings and determine the utility of metformin added to TKI therapy.
Pericardial effusion with pembrolizumab
Authors: Fernández Madrigal Laura , Montero Pérez Olalla , Rodriguez Garcés Maria Yeray , Inoriza Rueda Ángel , Martínez Marcos Francisco Javier 
Published: February 2022

Introduction The treatment of non-small cell lung cancer (NSCLC) has profoundly changed on account of the arrival of new therapies, like immunotherapy. Within this group of drugs, those aimed at the programmed cell death-1 or programmed cell death ligand-1(PD1/PDL-1) are very relevant, for example, Pembrolizumab. Although its adverse reactions are generally mild and well tolerated, it has been associated with certain immune-related adverse events (IrAEs) than can be serious and affect any organ. Case report A 62-year-old woman diagnosed with stage IV NSCLC with a single bone metastasis and PD-L1 expression of 60% started treatment with cisplatin-pemetrexed-pembrolizumab, and maintenance with pembrolizumab. Management and outcome The patient attended the ER with pericardial effusion that was assumed to be a Pembrolizumab IrAE and was managed with corticosteroids. The patient fully recovered but immunotherapy was not reintroduced due to the severity of the AE. Discussion The cardiovascular system is among the least affected organs by immunotoxicity, with an incidence between 0.09–0.6%. However, some authors suspect the incidence is underestimated. Median time to onset is highly variable, ranging from 6 weeks since the first dose to 2 years after discontinuation of the treatment. There are not guidelines on the most effective management of the IrAEs, but according to the pharmaceutical reference, corticosteroids should be initiated followed by a progressive reduction. If no response is obtained, another immunosuppressive agent should be added. The determination to restart immunotherapy depends on the severity of the adverse reaction, the availability of other alternative treatments, and the cancer response.
Health care seeking behaviors and perspective on indigenous palliative care among cancer patients in Kenya
Authors: Cheboi Solomon , Kariuki Peris , Mutai Joseph , Kibet Staline , Nyamanga Philemon 
Published: February 2022

Introduction Holistic integrated community palliative care services remain a mirage to cancer patients. Nonetheless, a number of cancer patients are jamming traditional medicinal places seeking therapy. The results of these visits are undocumented. This study explored healthcare seeking behaviors and perspectives on cancer indigenous palliative care among patients visiting traditional health practitioners in Kenya. Methods A cross-sectional study was undertaken through client exit survey. Face to face interviews were conducted using semi-structured questionnaires with all consenting cancer patients exiting mapped outlets. Data was analyzed using Statistical Package for Social Science Version 22.0. Results A total of 433 respondents were interviewed and the majority were female 59.6%, Christians 97.2%, married 89.8% and educated 85.7%. Their mean age was 48.25 ± 15. 58. Education, sex and religion were significantly associated with perceived improvement. The predominant cancer types were breast cancer (22.4%); throat (14.8%), prostate (12.9%), bone (12.5%), cervical (9.9%), stomach (6.0%) and skin cancer (5.1%). The most frequently used traditional medicine was herbal medicine that was driven by unresponsive conditions (42.2%), inaccessible biomedical services (18.8%) and yearning for second opinion (18%) over a condition. Seventy six percent of the respondents reported improved and prolonged quality of life. 78.2% reported improved eating, drinking, standing, walking and doing light duties alone. Patients felt healthier, hopeful, happier, confident and bonded to their families. Conclusions Use of indigenous palliative care is predominant to all major cancer conditions and driven by the quest for cure, successful stories, trustworthiness and beliefs, previous experience and avoiding medical procedures such as surgery.
Fecal shedding of extended-spectrum beta-lactamase-producing Enterobacterales in cats admitted to an animal shelter
Authors: Weese J Scott , O’Brien Tyler , Bateman Shane 
Published: February 2022

Objectives The objective of this study was to evaluate shedding of extended-spectrum beta-lactamase (ESBL)-producing bacteria in cats admitted to an animal shelter. Methods Fecal samples were collected from cats admitted to an animal shelter between 12 June and 23 August 2018. Selective enrichment culture for ESBL-producing bacteria was performed and isolates were speciated and tested for selected ESBL genes using PCR. Results ESBL-producing Enterobacterales were identified in fecal samples from 2/87 (2.3%; 95% confidence interval 0.6–8.0) cats. One isolate was an Escherichia coli that possessed blaCTX-M-1, blaCMY-2 and blaTEM genes. The other was Enterobacter cloacae possessing blaCTX-M-1 and blaCMY-2. Conclusions and relevance While the study sample size and prevalence rate for ESBL-producing bacteria were low, these data document that cats admitted to similar shelters could harbor these agents. The risk posed by ESBL-producing bacterium shedding in cats, both to cats and other species, is currently unclear. However, these findings support the need for more investigation of interspecies transmission of ESBL-producing bacteria and ESBL genes, as well as the importance of antimicrobial stewardship and routine infection control measures.
Results of a Hepatitis C Micro-Elimination Program in Two Addiction Centers Among Subjects With Substance Use Disorder
Authors: Vega-Astudillo Pablo , Basurte-Villamor Ignacio , De Ema López Inés , Olmos Espinos Ruth , Mesías-Pérez Beatriz , Szerman Nestor 
Published: February 2022

Objectives: We aimed to evaluate a hepatitis C (HCV) micro-elimination program in 2 addiction centers among subjects with substance use disorders (SUD). Methods: The program was based on simplifying the diagnosis of HCV infections by avoiding referral to primary care for the diagnosis and performing the necessary tests at the point of care (ie, the addition center) and simplifying the patient pathway by directly referring patients to the specialized care for treatment. Descriptive and multivariate analyses are presented. Results: Of the 1497 subjects included in the program, 327 reported that they were anti-HCV-positive. Among the 1170 patients who were offered the HCV rapid antibody test, 180 (15.4%) did not perform the test. Performing the HCV rapid antibody test only contributed ten patients (3%) to the 337 who were anti-HCV-positive. A high proportion (147 out of 327 [45%]) of subjects who reported being anti-HCV-positive also reported that they had not been treated for HCV. Among the 67 subjects who were HCV-RNA-positive and were referred for treatment, 53 (79%) ultimately received and completed antiviral treatment. Unfortunately, we did not find any factors associated with not performing dry blood testing, and the factors associated with not performing the HCV rapid antibody test were difficult to interpret, and the model showed low goodness of fit. Conclusions: Our results suggest that a micro-elimination program focused on patients with SUD attending an addiction center is not effective for screening the presence of hepatitis C but is successful for linking patients with hepatitis C to antiviral treatment.
A randomized controlled trial of a web-based mindfulness programme for people with MS with and without a history of recurrent depression
Authors: Sesel Amy-Lee , Sharpe Louise , Beadnall Heidi N , Barnett Michael H , Szabo Marianna , Naismith Sharon L 
Published: February 2022

Background: Evidence shows small positive effects associated with psychological treatments for people with multiple sclerosis (PwMS). In a recent meta-analysis, the treatment with the largest effect size was a mindfulness-based intervention (MBI). Objectives: We aimed to determine whether an Internet-delivered MBI was beneficial for PwMS. Furthermore, we aimed to investigate history of recurrent depression as a moderator of treatment outcome. Methods: Participants ( N = 132) were assessed based on whether they had a history of recurrent depression, then stratified and randomized to MBI or waitlist. Outcomes were assessed at baseline, post-intervention, and 3 and 6 months. Results: The MBI group reported significantly improved depressive symptoms (primary outcome) compared with the waitlist ( p = 0.046, Cohen’s d = 0.39). Those with a history of recurrent depression benefitted significantly more than those without ( p = 0.034, d = 0.66). There were benefits for health-related quality of life (HRQoL) in the MBI, irrespective of depression history ( p = 0.009, d = 0.5). Pain interference was less overall in the MBI group ( p < 0.001, d = 0.2), but change over time did not differ from waitlist. There were no treatment effects for anxiety, pain severity or fatigue. Conclusion: The Internet-delivered MBI significantly improved depressive symptoms and HRQoL in PwMS. For depression, the benefits were greater for those with a history of recurrent depression. Trial Registration: ACTRN12618001260213, available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375598
Stressors and coping strategies in Chinese family caregivers of people with dementia in long-term care facilities: A qualitative descriptive study
Authors: Hui Zhaozhao , Yang Chen , Fan Lee Diana Tze 
Published: February 2022

Objectives This study aimed to explore the stressors along with coping strategies in Chinese family caregivers whose relative with dementia had been placed into a long-term care facility. Methods A qualitative descriptive study was conducted with 17 Chinese family caregivers of institutionalised older adults with dementia, recruited via purposeful sampling. Information regarding stressors along with coping strategies was collected through face-to-face semi-structured individual interviews. The interviews were audio-recorded, transcribed, anonymised and imported into MAXQDA 2018.2. Data were analysed with qualitative content analysis. Findings Three categories of stressors emerged: socioeconomic pressure, hassles arising from continuing caregiving and suboptimal care provided by the facility. In particular, the family caregivers’ experienced tremendous pressure of negative comments from people around since long-term care placement was traditionally viewed as unfilial in Chinese societies. Various coping strategies were adopted by Chinese family caregivers to deal with the stressors; however, they were not always adaptive. Implications Health care authorities and professionals should recognise family caregivers’ stressors after long-term care placement of a relative with dementia with the consideration of the unique socio-cultural needs. Appropriate and effective interventions should be developed and implemented to facilitate family caregivers to cope with stressful situations after long-term care placement and further to safeguard their psychosocial well-being.
Torsional behavior of non-crimp orthogonal woven composite using experimental and numerical methods
Authors: Aghaei Hamid Reza , Varsei Mehdi , Ajeli Saeed , Dolatabadi Mehdi Kamali , Yazdanshenas Mohammad Esmail 
Published: February 2022

Nowadays, using three dimensional fabric as a reinforcement part in the composite has been increased. Non-crimp three dimensional orthogonal woven fabric is a subgroup of 3D woven fabrics that in this study was used to fabricate composite preforms. The fabrics were produced by glass yarn in two different fiber volume fractions. All fabric preforms were utilized to produce composites with polyester and epoxy resins. To compare the torsional behavior of the composites, a torsion test was applied to all samples and torque-revolution curves from the experimental results were compared together. Results showed that composites that were fabricated by epoxy resin have more torsional strength in comparison with composites in that their matrix is polyester resin. Moreover, preforms with high fiber volume fractions showed high torsional strength in each type of matrix. The torsion strength of high volume fraction for polyester matrix was 47.34 KPa, however for the sample with epoxy matrix the torsion strength was determined 81.26 KPa. Furthermore, a multiscale finite element model was applied to calculate elastic constants and predict the torsional behavior of the composites. The numerical results were compared with experimental results that a good agreement between numerical and experimental results was observed. Therefore, the proposed model can predict the torsional behavior of the composite with different fiber volume fractions.
Radiographic and Clinical Outcomes of Radioscapholunate Arthrodesis in Patients With Inflammatory and Posttraumatic Arthritis
Authors: Zelenski Nicole A. , Trentadue Taylor P. , Moran Steven L. , Rizzo Marco 
Published: February 2022

Background: Radioscapholunate (RSL) fusion is performed for painful radiocarpal arthritis that is typically posttraumatic or inflammatory in nature. The purpose of this study was to determine whether patients with inflammatory conditions undergoing RSL fusion had comparable outcomes as those with posttraumatic arthritis and to determine factors impacting union. Methods: This was a retrospective review of all RSL fusions over a 25-year period. Demographic information, wrist range of motion, postoperative complications, and surgical technique, including presence or absence of resection of distal scaphoid pole, data were collected. Radiographs were examined for evidence of healing of the RSL fusion site as well as development of midcarpal arthritis. Results: Fifty-six patients underwent RSL fusion. Eight patients required revision of radiocarpal arthrodesis for painful nonunion. The fusion rate was 85.7%, and median 25th to 75th percentile (time to healing was 4.0 3.2-5.2) months. There were no differences in time to or rate of union by inflammatory arthropathy status. Grip strength increased significantly and pain decreased significantly with surgery. Union rate was 90% with the use of K-wires, screws, or staples, which was significantly greater than plates, fusion cups, or multiple implant types. The use of autologous bone graft significantly decreased the rate of nonunion and significantly decreased time to union by 3 months compared to allograft alone. Extension was significantly improved with scaphoid distal pole resection versus without distal scaphoid pole resection. Conclusions: Radioscapholunate (RSL) fusion is an effective treatment for radiocarpal arthritis but has high nonunion rates. Fixation with K-wires, screws, or staples and use of autograft confers improved union rate.
The DNA damage repair landscape in Black women with breast cancer
Authors: Mazumder Aloran , Jimenez Athena , Ellsworth Rachel E. , Freedland Stephen J. , George Sophia , Bainbridge Matthew N. , Haricharan Svasti 
Published: February 2022

Background: Estrogen receptor positive (ER+) breast cancer is one of the most commonly diagnosed malignancies in women irrespective of their race or ethnicity. While Black women with ER+ breast cancer are 42% more likely to die of their disease than White women, molecular mechanisms underlying this disparate outcome are understudied. Recent studies identify DNA damage repair (DDR) genes as a new class of endocrine therapy resistance driver that contributes to poor survival among ER+ breast cancer patients. Here, we systematically analyze DDR regulation in the tumors and normal breast of Black women and its impact on survival outcome. Method: Mutation and up/downregulation of 104 DDR genes in breast tumor and normal samples from Black patients relative to White counterparts was assessed. For DDR genes that were differently regulated in the tumor samples from Black women in multiple datasets associations with survival outcome were tested. Results: Overall, Black patient tumors upregulate or downregulate RNA levels of a wide array of single strand break repair (SSBR) genes relative to their white counterparts and uniformly upregulate double strand break repair (DSBR) genes. This DSBR upregulation was also detectable in samples of normal breast tissue from Black women. Eight candidate DDR genes were reproducibly differently regulated in tumors from Black women and associated with poor survival. A unique DDR signature comprised of simultaneous upregulation of homologous recombination gene expression and downregulation of SSBR genes was enriched in Black patients. This signature associated with cell cycle dysregulation ( p < 0.001), a hallmark of endocrine therapy resistance, and concordantly, with significantly worse survival outcomes in all datasets analyzed (hazard ratio of 9.5, p < 0.001). Conclusion: These results constitute the first systematic analysis of DDR regulation in Black women and provide strong rationale for refining biomarker profiles to ensure precision medicine for underserved populations.