bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of two electronic-rehabilitation programmes for persistent knee pain: protocol for a randomised feasibility trial
Authors: Groves-Williams Dawn , McHugh Gretl A , Bennell Kim L , Comer Christine , Hensor Elizabeth M A , Conner Mark , Nelligan Rachel K , Hinman Rana S , Kingsbury Sarah R , Conaghan Philip G 
Published: June 2022

IntroductionPersistent, knee pain is a common cause of disability. Education and exercise treatment are advocated in all clinical guidelines; however, the increasing prevalence of persistent knee pain presents challenges for health services regarding appropriate and scalable delivery of these treatments. Digital technologies may help address this, and this trial will evaluate the feasibility and acceptability of two electronic-rehabilitation interventions: ‘My Knee UK’ and ‘Group E-Rehab’.Methods and analysisThis protocol describes a non-blinded, randomised feasibility trial with three parallel groups. The trial aims to recruit 90 participants (45 years or older) with a history of persistent knee pain consistent with a clinical diagnosis of knee osteoarthritis. Participants will be randomly assigned in a 1:1:1 allocation ratio. The ‘My Knee UK’ intervention arm will receive a self-directed unsupervised internet-based home exercise programme plus short message service support (targeting exercise behaviour change) for 12 weeks; the ‘Group E-Rehab’ intervention arm will receive group-based physiotherapist-prescribed home exercises delivered via videoconferencing accompanied by internet-interactive educational sessions for 12 weeks; the control arm will receive usual physiotherapy care or continue with their usual self-management (depending on their recruitment path). Feasibility variables, patient-reported outcomes and clinical findings measured at baseline, 3 and 9 months will be assessed and integrated with qualitative interview data from a subset of Group E-Rehab and My Knee UK participants. If considered feasible and acceptable, a definitive randomised controlled trial can be conducted to investigate the clinical effectiveness and cost-effectiveness of one or both interventions with a view to implementation in routine care.Ethics and disseminationThe trial was approved by the West of Scotland Research Ethics Committee 5 (Reference: 20/WS/0006). The results of the study will be disseminated to study participants, the study grant funder and will be submitted for publication in peer-reviewed journals.Trial registration numberISRCTN15564385.
Underuse of Catheter Ablation as First‐Line Therapy for Supraventricular Tachycardia
Authors: Hollanda Oliveira Lucas , Viana Mateus dos Santos , Luize Christian Moreno , de Carvalho Ricardo Sobral , Cirenza Claudio , de Oliveira Dietrich Cristiano , Correia Luis Claudio , das Virgens Claudio , Medeiros Filgueiras Juliana , Barreto Mauricio , Porto Emerson , Coutinho Enia , de Paola Ângelo 
Published: June 2022

Background
Catheter ablation (CA) is a safe, effective, cost‐effective technique and may be considered a first‐line strategy for the treatment of symptomatic supraventricular tachycardias (SVT). Despite the high prospect of cure and the recommendations of international guidelines in considering CA as a first‐line treatment strategy, the average time between diagnosis and the procedure may be long. The present study aims to evaluate predictors related to non‐referral for CA as first‐line treatment in patients with SVT.

Methods and Results

The model was derived from a retrospective cohort of patients with SVT or ventricular pre‐excitation referred for CA in a tertiary center. Clinical and demographical features were used as independent variables and non‐referral for CA as first‐line treatment the dependent variable in a stepwise logistic regression analysis. Among 20 clinical‐demographic variables from 350 patients, 10 were included in initial logistic regression analysis: age, women, presence of pre‐excitation on ECG, palpitation, dyspnea and chest discomfort, number of antiarrhythmic drugs before ablation, number of concomitant symptoms, symptoms’ duration and evaluations in the emergency room due to SVT. After multivariable adjusted analysis, age (odds ratio [OR], 1.2; 95% CI 1.01–1.32;
P
=0.04), chest discomfort during supraventricular tachycardia (OR, 2.7; CI 1.6–4.7;
P
<0.001) and number of antiarrhythmic drugs before ablation (OR, 1.8; CI 1.4–2.3;
P
<0.001) showed a positive independent association for non‐referral for CA as SVT first‐line treatment.

Conclusions
The independent predictors of non‐referral for CA as first‐line treatment in our logistic regression analysis indicate the existence of biases in the decision‐making process in the referral process of patients who would benefit the most from catheter ablation. They very likely suggest a skewed medical decision‐making process leading to catheter ablation underuse.
p53‐Dependent Mitochondrial Compensation in Heart Failure With Preserved Ejection Fraction
Authors: Chen Xiaonan , Lin Hao , Xiong Weiyao , Pan Jianan , Huang Shuying , Xu Shan , He Shufang , Lei Ming , Chang Alex Chia Yu , Zhang Huili 
Published: June 2022

Background
Heart failure with preserved ejection fraction (HFpEF) accounts for 50% of patients with heart failure. Clinically, HFpEF prevalence shows age and gender biases. Although the majority of patients with HFpEF are elderly, there is an emergence of young patients with HFpEF. A better understanding of the underlying pathogenic mechanism is urgently needed. Here, we aimed to determine the role of aging in the pathogenesis of HFpEF.

Methods and Results
HFpEF dietary regimen (high‐fat diet + Nω‐Nitro‐L‐arginine methyl ester hydrochloride) was used to induce HFpEF in wild type and telomerase RNA knockout mice (second‐generation and third‐generation telomerase RNA component knockout), an aging murine model. First, both male and female animals develop HFpEF equally. Second, cardiac wall thickening preceded diastolic dysfunction in all HFpEF animals. Third, accelerated HFpEF onset was observed in second‐generation telomerase RNA component knockout (at 6 weeks) and third‐generation telomerase RNA component knockout (at 4 weeks) compared with wild type (8 weeks). Fourth, we demonstrate that mitochondrial respiration transitioned from compensatory state (normal basal yet loss of maximal respiratory capacity) to dysfunction (loss of both basal and maximal respiratory capacity) in a p53 dosage dependent manner. Last, using myocardial‐specific p53 knockout animals, we demonstrate that loss of p53 activation delays the development of HFpEF.

Conclusions
Here we demonstrate that p53 activation plays a role in the pathogenesis of HFpEF. We show that short telomere animals exhibit a basal level of p53 activation, mitochondria upregulate mtDNA encoded genes as a mean to compensate for blocked mitochondrial biogenesis, and loss of myocardial p53 delays HFpEF onset in high fat diet + Nω‐Nitro‐L‐arginine methyl ester hydrochloride challenged murine model.
Pyruvate Kinase M2 Protects Heart from Pressure Overload‐Induced Heart Failure by Phosphorylating RAC1
Authors: Ni Le , Lin Bowen , Hu Lingjie , Zhang Ruoyu , Fu Fengmei , Shen Meiting , Yang Jian , Shi Dan 
Published: June 2022

Background
Heart failure, caused by sustained pressure overload, remains a major public health problem. PKM (pyruvate kinase M) acts as a rate‐limiting enzyme of glycolysis. PKM2 (pyruvate kinase M2), an alternative splicing product of PKM, plays complex roles in various biological processes and diseases. However, the role of PKM2 in the development of heart failure remains unknown.

Methods and Results

Cardiomyocyte‐specific
Pkm2
knockout mice were generated by crossing the floxed
Pkm2
mice with α‐MHC (myosin heavy chain)‐Cre transgenic mice, and cardiac specific
Pkm2
overexpression mice were established by injecting adeno‐associated virus serotype 9 system. The results showed that cardiomyocyte‐specific
Pkm2
deletion resulted in significant deterioration of cardiac functions under pressure overload, whereas
Pkm2
overexpression mitigated transverse aortic constriction‐induced cardiac hypertrophy and improved heart functions. Mechanistically, we demonstrated that PKM2 acted as a protein kinase rather than a pyruvate kinase, which inhibited the activation of RAC1 (rho family, small GTP binding protein)‐MAPK (mitogen‐activated protein kinase) signaling pathway by phosphorylating RAC1 in the progress of heart failure. In addition, blockade of RAC1 through NSC23766, a specific RAC1 inhibitor, attenuated pathological cardiac remodeling in
Pkm2
deficiency mice subjected to transverse aortic constriction.

Conclusions
This study revealed that PKM2 attenuated overload‐induced pathological cardiac hypertrophy and heart failure, which provides an attractive target for the prevention and treatment of cardiomyopathies.
Delayed Infiltration of Peripheral Monocyte Contributes to Phagocytosis and Transneuronal Degeneration in Chronic Stroke
Authors: Park Keun Woo , Ju Hyunwoo , Kim Il-doo , Cave John W. , Guo Yang , Wang Wei , Wu Zhuhao , Cho Sunghee 
Published: June 2022

Background:
Mononuclear phagocytes, including monocyte-derived macrophages (MDMs) and microglia, contribute to infarct development as well as tissue repair in the postischemic brain. Here, we identify the origin and function of MDMs in the brain during poststroke repair processes.

Methods:
Adult mice were subjected to transient middle cerebral artery occlusion. Longitudinal brain atrophy and secondary degeneration were evaluated during acute to recovery phases of stroke. Adoptive transfer of GFP+ splenocytes into asplenic mice was used to distinguish MDMs from resident microglia. Fluorescence beads were injected into stroked animals to examine phagocytic function.

Results:
Progressive atrophy and neuronal degeneration in remote regions were observed in chronic stroke, which also was accompanied by MDM infiltration into the ipsilateral hemisphere. Compared with microglia, MDMs had significantly higher phagocytic activity. MDM trafficking and phagocytosis was spatiotemporally regulated with acute and prolonged infiltration into infarcted tissue, as well as delayed entry in remote areas such as the thalamus and substantia nigra.

Conclusions:
The stepwise and long-lasting involvement of MDMs at multiple poststroke stages shows that MDMs have a role in progressive stroke-induced injury and repair processes. These findings suggest that manipulating monocyte entry at different stroke stages may be an effective immune-based strategy to limit injury propagation in chronic stroke.
Reflections of the Real
Authors: Privitelli Giulia 
Published: June 2022

Abstract
In this paper, Caravaggio’s painting of The Beheading of St John the Baptist located in the Oratory of the Co-Cathedral of St John the Baptist, in Valletta, Malta, will serve as a backdrop to qualify and analyze the religious and aesthetic experiential value that such an artwork could generate within the beholder, by considering its eschatological and soteriological implications and context, as well as the notion of ‘image as mirror’ and its effect on the viewer’s consciousness. This will primarily be discussed across two binaries: early seventeenth-century Hospitaller spirituality and the precarious condition of the artist, himself a novice of the Hospitaller Order of St John the Baptist. Guided by the changing artistic, didactic, and functional uses of the Oratory, and the theological implications of the painting, the Beheading will thus be analyzed in its affordance for both transcendental and self-reflective revelation, and as a turning point for the aspiring novice, the artist and, ultimately, the contemporary beholder.
Acceleration of Tropical Cyclone Development by Cloud-Radiative Feedbacks
Authors: Wing Allison A. 
Published: June 2022

Abstract
A complete understanding of the development of tropical cyclones (TC) remains elusive and forecasting TC intensification remains challenging. This motivates further research into the physical processes that govern TC development. One process that has, until recently, been under-investigated is the role of radiation. Here, the importance of radiative feedbacks in TC development and the mechanisms underlying their influence is investigated in a set of idealized convection-permitting simulations. A TC is allowed to form after initialization from a mesoscale warm, saturated bubble on an f plane, in an otherwise quiescent and moist neutral environment. Tropical storm formation is delayed by a factor of 2 or 3 when radiative feedbacks are removed by prescribing a fixed cooling profile or spatially homogenizing the model-calculated cooling profiles. The TC’s intensification rate is also greater when longwave radiative feedbacks are stronger. Radiative feedbacks in the context of a TC arise from interactions between spatially and temporally varying radiative heating and cooling (driven by the dependence of radiative heating and cooling rate on clouds and water vapor) and the developing TC (the circulation of which shapes the structure of clouds and water vapor). Further analysis and additional mechanism denial experiments pinpoint the longwave radiative feedback contributed by ice clouds as the strongest influence. Improving the representation of cloud-radiative feedbacks in forecast models, therefore, has the potential to yield critical advancements in TC prediction.

Significance Statement
Our understanding of the development of tropical cyclones, hurricanes, and typhoons is incomplete, and, thus, forecasting tropical cyclone formation and intensification remains challenging. This study investigates the importance of interactions between clouds and solar and infrared radiation for tropical cyclone development. I find that in idealized convection-permitting simulations, tropical cyclone development is accelerated by a factor of 2 or more with the inclusion of these cloud–radiation feedbacks. The interaction of ice clouds associated with strong thunderstorms with infrared radiation has the biggest effect. These results indicate that improving the representation of ice clouds and their radiative feedbacks in forecast models has the potential to yield critical advancements in tropical cyclone prediction.
The Vertical Profile of Radiative Cooling and Lapse Rate in a Warming Climate
Authors: Hartmann Dennis L. , Dygert Brittany D. , Blossey Peter N. , Fu Qiang , Sokol Adam B. 
Published: June 2022

Abstract
The vertical profile of clear-sky radiative cooling places important constraints on the vertical structure of convection and associated clouds. Simple theory using the cooling-to-space approximation is presented to indicate that the cooling rate in the upper troposphere should increase with surface temperature. The theory predicts how the cooling rate depends on lapse rate in an atmosphere where relative humidity remains approximately a fixed function of temperature. Radiative cooling rate is insensitive to relative humidity because of cancellation between the emission and transmission of radiation by water vapor. This theory is tested with one-dimensional radiative transfer calculations and radiative–convective equilibrium simulations. For climate simulations that produce an approximately moist adiabatic lapse rate, the radiative cooling profile becomes increasingly top-heavy with increasing surface temperature. If the temperature profile warms more slowly than a moist adiabatic profile in midtroposphere, then the cooling rate in the upper troposphere is reduced and that in the lower troposphere is increased. This has important implications for convection, clouds, and associated deep and shallow circulations.
The Benefits of Local Anesthesia Used in Mastectomy Without Reconstruction
Authors: Sarcon Aida K. , Zhang Wenxia , Degnim Amy C. , Johnson Rebecca L. , Harmsen William S. , Glasgow Amy E. , Jakub James W. 
Published: June 2022

Background The opioid epidemic has driven renewed interest in local anesthesia to reduce postoperative opioid use. Our objective was to determine if local anesthesia decreased hospital pain scores, oral morphine equivalents (OME), length of stay (LOS), and nausea/vomiting. Methods Single institution retrospective study of females who underwent mastectomy without reconstruction. Results Overall, 712 patients were included; 63 (8.8%) received bupivacaine (B), 512 (72%) liposomal bupivacaine (LB), and 137 (19%) no local. 95% were discharged on POD1. Liposomal bupivacaine use increased from 2014 to 2019. Additional factors associated with use of local regimen were surgeon and extent of axillary surgery. Fewer patients used postop opioids during their hospital stay if any local was used compared to none (76 vs 88%; 0.003). Compared to none, local had shorter mean PACU LOS (95 vs 87 min; P = .02), lower mean intraoperative-OME (96 vs 106; P < .001), and lower mean postoperative OME/hr (1.4 vs 1.8 P = .001). Multivariable analysis (MVA) showed lower OME/hr with LB compared to B and none ( P = .002); this translates to 22 mg and 30 mg of oxycodone in a 24-hr period, respectively. MVA showed lower POD1 pain scores with LB relative to none ( P = .049). Local did not impact nausea/emesis. Conclusion Local anesthesia was superior to no local in several measures. However, a consistent benefit of a specific local anesthetic agent was not demonstrated (LB vs B). A prospective study is warranted to determine the optimal local regimen for this cohort and further inform clinical relevance.
Youth suicide and hospital-presenting suicide attempts: Examination of risk factors for multiple suicide attempts in adolescence
Authors: Tubaş Filiz , Husrevoglu Esen Feyza , Öztelcan Gündüz Bahar , Ünay Bülent 
Published: June 2022

Background: The suicide rate among adolescents around the world has increased rapidly. There are many risk factors for attempting suicide, but not all have been clarified yet. Therefore, it is very important to identify risk factors. This study evaluated adolescents with a history of suicide attempts and their association with chronic diseases. Besides, to check whether they attempted suicide multiple times. Other clinical features related to multiple suicide attempts were investigated. Method: This study used a multicentre, retrospective cross-sectional design; 253 adolescents admitted to emergency departments in 2019 for suicide attempts were evaluated. Results: Adolescents with chronic disease were at greater risk for both single and multiple suicide attempts and patients had a 6.14 times higher risk of multiple attempts ( p = .013). The likelihood of multiple attempts did not differ according to the presence of somatic or psychiatric disease. Multiple attempters were more likely to poison themselves with their therapeutic drugs ( p = .002). Conclusion: When adolescents with a chronic disease present to the emergency services after a single suicide attempt using their therapeutic drugs, families should be informed regarding the potential for further attempts.
Association between plant and animal proteins intake with lipid profile and anthropometric indices: A cross-sectional study
Authors: Kohansal Atefeh , Zangene Ali , Turki Jalil Abduladheem , Hooshang Hamed , Leilami Kimia , Gerami Shirin , Najafi Maryam , Nouri Mehran , Faghih Shiva 
Published: June 2022

Background Results of studies on the effects of plant and animal proteins on lipid profile are controversial. So we aimed to assess the relationship between plant and animal protein intake with lipid profile and novel anthropometric indices in healthy individuals. Method In this cross-sectional study, 236 participants have selected from Shiraz medical centers (Iran) through random cluster sampling. Food intakes were assessed using a 168-items food frequency questionnaire (FFQ). Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were measured. Anthropometric indices including a body shape index (ABSI), abdominal volume index (AVI), buddy roundness index (BRI), and conicity index (CI) were calculated. Results In the crude and fully adjusted models, more consumption of plant proteins was associated with TG levels (OR = 2.31; 95% CI: 1.08, 4.95; P = 0.03 and OR = 2.39; 95% CI: 1.03, 5.15; P = 0.04). Also, there was a significant direct association between plant proteins and BRI in the curd model (OR = 3.55; 95% CI: 1.32, 9.54; P = 0.01), and after adjusting for age and energy intake (OR = 3.32; 95% CI: 1.21, 9.14; P = 0.01). More consumption of plant proteins was related to higher CI in the crude model (OR = 3.06; 95% CI: 1.12, 8.31; P = 0.03), but not in the fully adjusted model. Conclusion We found that a higher intake of plant proteins was associated with a higher TG level, BRI, and CI index. However, more research is needed to confirm these relations and provide the evidence needed to exert these findings into clinical practice.
Venovenous extracorporeal CO2 removal to support ultraprotective ventilation in moderate-severe acute respiratory distress syndrome: A systematic review and meta-analysis of the literature
Authors: Worku Elliott , Brodie Daniel , Ling Ryan Ruiyang , Ramanathan Kollengode , Combes Alain , Shekar Kiran 
Published: June 2022

Background A strategy that limits tidal volumes and inspiratory pressures, improves outcomes in patients with the acute respiratory distress syndrome (ARDS). Extracorporeal carbon dioxide removal (ECCO2R) may facilitate ultra-protective ventilation. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of venovenous ECCO2R in supporting ultra-protective ventilation in moderate-to-severe ARDS. Methods MEDLINE and EMBASE were interrogated for studies (2000–2021) reporting venovenous ECCO2R use in patients with moderate-to-severe ARDS. Studies reporting ≥10 adult patients in English language journals were included. Ventilatory parameters after 24 h of initiating ECCO2R, device characteristics, and safety outcomes were collected. The primary outcome measure was the change in driving pressure at 24 h of ECCO2R therapy in relation to baseline. Secondary outcomes included change in tidal volume, gas exchange, and safety data. Results Ten studies reporting 421 patients (PaO2:FiO2 141.03 mmHg) were included. Extracorporeal blood flow rates ranged from 0.35-1.5 L/min. Random effects modelling indicated a 3.56 cmH2O reduction (95%-CI: 3.22–3.91) in driving pressure from baseline ( p < .001) and a 1.89 mL/kg (95%-CI: 1.75–2.02, p < .001) reduction in tidal volume. Oxygenation, respiratory rate and PEEP remained unchanged. No significant interactions between driving pressure reduction and baseline driving pressure, partial pressure of arterial carbon dioxide or PaO2:FiO2 ratio were identified in metaregression analysis. Bleeding and haemolysis were the commonest complications of therapy. Conclusions Venovenous ECCO2R permitted significant reductions in ∆P in patients with moderate-to-severe ARDS. Heterogeneity amongst studies and devices, a paucity of randomised controlled trials, and variable safety reporting calls for standardisation of outcome reporting. Prospective evaluation of optimal device operation and anticoagulation in high quality studies is required before further recommendations can be made.