bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Macular Retinal Thickness in Patients With Pterygium
Authors: Wang Feng , Liu Li Qi , Liang Rong Bin , Zhang Li Juan , Shu Hui Ye , Liao Xu Lin , Pan Yi Cong , Wu Jie Li , Su Ting , Shao Yi 
Published: June 2022

PurposeTo explore alterations in macular retinal thickness (RT) and analyze correlation between macular RT and pterygium area, length in pterygium patients.MethodsTotally 13 patients with pterygium (left eye) and 13 healthy controls (left eye) were recruited. OCTA was applied to scan each eye to generate three-dimensional images. Based on the Early Treatment Diabetic Retinopathy Study (ETDRS) method, each image was divided into nine subregions for the ETDRS: central (C); inner superior (IS); outer superior (OS); inner nasal (IN); outer nasal (ON); inner inferior (II); outer inferior (OI); inner temporal (IT); and outer temporal (OT). The macular RT in each subregion was measured. Furthermore, the correlation between RT and the area, length of pterygium was analyzed.ResultsThe visual acuity of pterygium patient was different from that of the control (P &lt; 0.05). Besides, decreased intraretinal thickness of the IN and ON, increased intraretinal thickness of OT, decreased extraretinal thickness of OT, IN, ON, OS, and decreased retinal full layer thickness of medial superior, OS, IN, ON, and II subregions in pterygium group were observed. There was a negative correlation between RT of the IN and ON subregions and the length of pterygium (r = −0.5803 and r = −0.6013, P = 0.0376 and P = 0.0297). The RT of IN subregion was negatively correlated with pterygium area (r = −0.5844, P = 0.0359). According to the receiver operating characteristic analysis, in the ON subregion, the areas under the curve of the inner retinal thickness, outer retinal thickness and the whole retinal thickness were 1.0 (95% CI: 1.0), 0.882 (95% CI: 0.715 and 0.963), and 1.0 (95% CI: 1.0). The smallest area under the curve of retinal thickness in OT subregion was 0.018 (95% CI: 0–0.059).ConclusionRT of pterygium patients was significantly decreased, and the main alterations occurred in the temporal side suggesting there might exist retinal structural alterations in pterygium.
Change of Serum Biomarkers to Post-Thrombolytic Symptomatic Intracranial Hemorrhage in Stroke
Authors: Cui Yu , Wang Xin-Hong , Zhao Yong , Chen Shao-Yuan , Sheng Bao-Ying , Wang Li-Hua , Chen Hui-Sheng 
Published: June 2022

BackgroundSymptomatic intracranial hemorrhage (sICH) is a terrible complication after intravenous alteplase in stroke, and numerous biomarkers have been investigated. However, the change of biomarkers to sICH has not been well determined.AimTo investigate the association between the change of biomarkers and sICH.MethodsThis is a prospective cohort study, and patients with sICH within 24 h after thrombolysis were enrolled, while patients without sICH were matched by propensity score matching with a ratio of 1:1. The blood samples were collected before and 24 h after intravenous thrombolysis (IVT), and preset 49 serum biomarkers were measured by microarray analysis. Protein function enrichment analyses were performed to detect the association between the change of biomarkers and sICH.ResultsOf consecutive 358 patients, 7 patients with sICH in 24 h were assigned to the sICH group, while 7 matched patients without any ICH were assigned to the non-sICH group. A total of 9 biomarkers were found to significantly change before vs. after thrombolysis between groups, including increased biomarkers, such as brain-derived neurotrophic factor, C-C motif chemokine ligand (CCL)-24, interleukin (IL)-6, IL-10, IL-18, and vascular endothelial growth factor, and decreased biomarkers, such as CCL-11, intercellular adhesion molecule-1, and IL-7.ConclusionsThis is the first study to identify changes in serum biomarkers in patients with sICH after IVT, and found that 6 neuroinflammatory and 3 neuroprotective biomarkers may be associated with brain injury following post-thrombolytic sICH.Clinical Trial Registrationhttps://www.clinicaltrials.gov, identifier: NCT02854592.
“I Give It Everything for an Hour Then I Sleep for Four.” The Experience of Post-stroke Fatigue During Outpatient Rehabilitation Including the Perspectives of Carers: A Qualitative Study
Authors: Bicknell Erin D. , Said Catherine M. , Haines Kimberley J. , Kuys Suzanne 
Published: June 2022

BackgroundFatigue is a debilitating post-stroke symptom negatively impacting rehabilitation. Lack of acknowledgment from carers can be additionally distressing. The purpose of this study was to describe the experience of post-stroke fatigue during outpatient rehabilitation, including the perspectives of carers.MethodsThis qualitative study was guided by descriptive phenomenology within a constructivist paradigm. Semi-structured interviews were conducted with stroke survivors experiencing fatigue (Fatigue Assessment Scale &gt;23) and attending outpatient rehabilitation. Carers were also interviewed where identified, providing insight into their own and stroke survivor experiences. Data were analyzed according to Colaizzi's analytic method.ResultsFourteen stroke survivors (50% culturally and linguistically diverse), and nine carers participated. Six themes were identified: 1. The unpredictable and unprepared uncovering of fatigue; 2. Experience and adjustment are personal 3. Being responsible for self-managing fatigue; 4. The complex juggle of outpatient stroke rehabilitation with fatigue; 5. Learning about fatigue is a self-directed problem-solving experience; 6. Family and carers can support or constrain managing fatigue.ConclusionDespite engaging in outpatient rehabilitation, stroke survivors largely learnt to manage fatigue independent of healthcare professionals. Carers often facilitated learning, monitoring rehabilitation, daily routines and fatigue exacerbation. Conversely, family could be dismissive of fatigue and possess unrealistic expectations. Post-stroke fatigue must be considered by clinicians when delivering outpatient rehabilitation to stroke survivors. Clinicians should consistently screen for fatigue, provide flexible session scheduling, and educate about individual indicators and strategies for management. Clinicians should also explicitly engage carers who play a critical role in the management of fatigue.
Effects of Qihuang Needling on Motor Function for Patients With Parkinson's Disease: Study Protocol for a Multicenter, Randomized Controlled Trial
Authors: Yang Lian-Sheng , Li Yang-Mei , Zhou Dan-Feng , Zhao Bai-Ming , Zheng Shu-Zhen , Chen Zhen-Hu , Zhang Kun , Lu Li-Ming 
Published: June 2022

BackgroundAlthough significant progress has been made in the pharmacologic management of Parkinson's Disease (PD), effective management of movement disorders is still a hurdle for therapeutics targeting PD. Acupuncture is one therapeutic option that could potentially improve the motor function of PD and is widely used as adjuvant therapy. Among the various acupuncture approaches, Qihuang Needling (QHN) therapy has been found to improve motor-function control for patients with PD. However, evidence regarding its efficacy remains scarce. Therefore, to address this need, this study will determine the effects of QHN therapy on motor function in patients with PD and compare it to placebo effects.MethodsThis trial is a multicenter, prospective randomized controlled clinical trial. We randomly allocated 144 participants to two groups of 72 patients. Patients in the treatment group were treated with QHN therapy. The control group had undergone insertion of acupuncture needles at sham acupoints not corresponded to acupuncture points. Participants in the verum treatment group and sham-acupuncture control group received 9 sessions over 6 weeks followed by 8 weeks of follow-up. The primary outcome was the change of motor function from baseline to weeks 6 and 14 measured by the PD Rating Scale-Part III Motor Examination (UPDRS-III). Secondary outcome measures included the change of PD daily quality of life-39 (PDQ-39) and Non-Motor Symptoms Scale for PD (NMSS) from baseline to weeks 6 and 14.DiscussionThe results of this trial will generate data to improve our general understanding of the efficacy of QHN therapy on motor function in patients with PD and thoroughly compare these responses to the placebo effect.Trial RegistrationThe trial was registered at the Chinese Clinical Trials Registry (ChiCTR- 2000030871) on 16 March 2020.
Hyperhomocysteinemia Is a Predictor for Poor Postoperative Angiogenesis in Adult Patients With Moyamoya Disease
Authors: He Qiheng , Ge Peicong , Ye Xun , Liu Xingju , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong 
Published: June 2022

Background and PurposesThe risk factors of poor postoperative angiogenesis in moyamoya disease (MMD) patients remain unknown. We aimed to investigate the association between hyperhomocysteinemia (HHcy) and postoperative angiogenesis of adult patients with MMD.MethodsA total of 138 adult patients with MMD were prospectively recruited from July 1 to December 31, 2019. After excluding 10 patients accepting conservative therapy and 77 individuals without postoperative digital subtraction angiography (DSA), all 51 MMD patients were enrolled, and 28 patients received bilateral operations separately. Patients were grouped according to postoperative angiogenesis and HHcy presentation, respectively. Clinical data and laboratory examinations were compared. Potential risk factors were evaluated by univariate and multivariate logistic regression analysis. Nomogram was further performed. The biological functions of homocysteine (Hcy) were explored in vitro.ResultsComparing to the normal, patients with poor postoperative angiogenesis were higher in serum Hcy (p = 0.004), HHcy ratio (p = 0.011), creatinine (Cr) (p &lt; 0.001), uric acid (UA) (p = 0.036), Triglyceride (p = 0.001), high-density lipoprotein cholesterol (HDL-C) (p = 0.001), low-density lipoprotein cholesterol (LDL-C) (p = 0.009), ApoA (p = 0.022), apolipoprotein B (ApoB) (p = 0.013). Furthermore, HHcy was more common in men (p = 0.003) than women. Logistic analysis results showed that Hcy (OR = 0.817, 95% CI = 0.707–0.944, p = 0.006) was an independent risk factor. HHcy and Cr were significantly associated with poor postoperative angiogenesis in MMD patients. Further, Hcy could inhibit the proliferation, migration, and tube formation of human brain microvascular endothelial cells (HBMECs), which can be reversed by vascular endothelial growth factor (VEGF).ConclusionThe HHcy was significantly correlated with poor postoperative angiogenesis in adult patients with MMD. Hcy significantly inhibits HBMECs proliferation, migration, and tube formation. Furthermore, VEGF could reverse the inhibition effect induced by Hcy. Lowering the level of Hcy may be beneficial for postoperative MMD patients. Focusing on the pathophysiology and mechanism of HHcy might help to guide postoperative clinical management.
Impaired Functional Homotopy and Topological Properties Within the Default Mode Network of Children With Generalized Tonic-Clonic Seizures: A Resting-State fMRI Study
Authors: Li Yongxin , Qin Bing , Chen Qian , Chen Jiaxu 
Published: June 2022

IntroductionThe aim of the present study was to examine interhemispheric functional connectivity (FC) and topological organization within the default-mode network (DMN) in children with generalized tonic-clonic seizures (GTCS).MethodsResting-state functional MRI was collected in 24 children with GTCS and 34 age-matched typically developing children (TDC). Between-group differences in interhemispheric FC were examined by an automated voxel-mirrored homotopic connectivity (VMHC) method. The topological properties within the DMN were also analyzed using graph theoretical approaches. Consistent results were detected and the VMHC values were extracted as features in machine learning for subject classification.ResultsChildren with GTCS showed a significant decrease in VMHC in the DMN, including the hippocampal formation (HF), lateral temporal cortex (LTC), and angular and middle frontal gyrus. Although the patients exhibited efficient small-world properties of the DMN similar to the TDC, significant changes in regional topological organization were found in the patients, involving the areas of the bilateral temporal parietal junction, bilateral LTC, left temporal pole, and HF. Within the DMN, disrupted interhemispheric FC was found between the bilateral HF and LTC, which was consistent with the VMHC results. The VMHC values in bilateral HF and LTC were significantly correlated with clinical information in patients. Support vector machine analysis using average VMHC information in the bilateral HF and LTC as features achieved a correct classification rate of 89.34% for the classification.ConclusionThese results indicate that decreased homotopic coordination in the DMN can be used as an effective biomarker to reflect seizure effects and to distinguish children with GTCSs from TDC.
Necrosulfonamide Alleviates Acute Brain Injury of Intracerebral Hemorrhage via Inhibiting Inflammation and Necroptosis
Authors: Zhang Xiangyu , Zhang Yan , Wang Fei , Liu Yang , Yong V. Wee , Xue Mengzhou 
Published: June 2022

ObjectiveIntracerebral hemorrhage (ICH) is the most lethal subtype of stroke, without effective treatment. Necrosulfonamide (NSA), a specific inhibitor for mixed lineage kinase domain-like protein, has been reported to exert neuroprotective effects in neurological diseases by ameliorating neuroinflammation and necroptosis. We hypothesized that NSA would alleviate acute brain injury and improve behavioral outcomes after ICH.Materials and MethodsMale adult C57BL/6 mice were assigned randomly into three groups. In vehicle and treatment groups, animals were injected with collagenase VII to induce ICH. The solvent (0.25% DMSO) and NSA (5 mg/kg) were administrated intraperitoneally twice a day, respectively. The sham group was injected with saline and administrated with DMSO. The brain hematoma volume, inflammatory factors, and blood-brain barrier permeability were measured on day 3 after the operation. Fluorescent double immunostaining was performed to evaluate the neuronal death. Neurological functions were assessed.ResultsIn the NSA group, the hematoma size was significantly reduced, inflammatory cells and cytokines were suppressed, and the blood-brain barrier was protected compared to vehicle controls. NSA dramatically reduced the death of neurons and improved the performance of neurological functions after ICH.ConclusionNecrosulfonamide has a neuroprotective role in alleviating acute brain injury in a mouse ICH model, and this is associated with reduced neuroinflammation and necroptosis.
Comprehensive Evaluation of Clinical Application of Balanced Compound Amino Acid Injection
Authors: Shi Yingqin , Song Hai , Liu Jinyan , Lin Jie , Fang Lingzhi 
Published: June 2022

BackgroundTo provide a reference for hospital drug selection and rational clinical drug selection based on the evaluation of the safety, nutritional quality, and economy of 27 manufacturers of five varieties (18AA, 18AA-I, 18AA-II, 18AA-IV, 18AA-V) of balanced compound amino acids for injection and (18AA-IIoriginal research).MethodsThe safety of compound amino acids for injection was evaluated by comparing the antioxidant sulfite contents. Based on the amino acid scoring standard mode and the whole egg protein mode as proposed by the Food and Agriculture Organization of the United Nations/World Health Organization (FAO/WHO) in 1973, we compared the formula. The first limiting amino acid content and the comprehensive quality of the total essential amino acid (EAA) contents of the six formulations were studied. The price/content ratio was used to evaluate their economy.ResultsSimilar variety produced by different manufacturers have the same formula and contents of balanced compound amino acids for injection. Safety: 18AA-IIoriginal research and 18AA-II had the lowest sulfite content. Compared with 18AA-IIoriginal research, the sulfite content of 18AA-I, 18AA, 18AA-V, and 18AA-IV were higher (10 times, 16.67 times, 16.67 times, and 33.33 times, respectively). The lower the sulfite content, the safer the product. Nutritional quality: The proportions of amino acids in the five varieties of compound amino acid injection were all suitable. The order of the first limiting amino acids for the formulations was 18AA-IIoriginal research = 18AA-II&gt;18AA &gt;18AA-I = 18AA-IV&gt;18AA-V. The order of the EAA values for the formulations was 18AA-IIoriginal research = 18AA-II&gt;18AA&gt;18AA-I &gt; 18AA-IV &gt; 18AA-V. The overall effectiveness order was 18AA-IIoriginal research = 18AA-II&gt;18AA &gt; 18AA-I&gt;18AA-IV&gt;18AA-V. Economy: Among the 27 manufacturers, 12 manufacturers had a price/content ratio higher than that of 18AA-II original research manufacturers, and 15 manufacturers had a price/content ratio lower than original research manufacturers.ConclusionThrough its security, effectiveness, and economy of the comprehensive research, we recommended 18AA-II and 18AA-IIoriginal research with high safety, efficacy, and reasonable price as the first choice. 18AA and 18AA-I with better safety and reasonable price, secondary recommendation. 18AA-IV or 18AA-V with poor safety, efficacy, and economy are not recommended.
Practicing Level and Determinants of Safe Cord Care and Skin-To-Skin Contact Among Post-partum Women in Public Hospitals of Eastern Ethiopia
Authors: Eyeberu Addis , Getachew Tamirat , Debella Adera , Birhanu Abdi , Alemu Addisu , Dessie Yadeta 
Published: June 2022

BackgroundEven though practicing levels of safe cord care and skin-to-skin contact among post-partum women are critical to reducing neonatal deaths, limited data revealed the low practice. Thus, the purpose of this study was to determine the level of practice and determinants of safe cord care and skin-to-skin contact among post-partum women in public hospitals of Eastern Ethiopia.MethodsA facility-based cross-sectional study was conducted at the public hospitals of Harari reginal state, eastern Ethiopia. A random sample of 820 post-partum women was included in the study. A pre-tested and structured questionnaire was used to collect data through a face-to-face interview. STATA version 14 was used for data analysis. Bivariable and multivariable logistic regression analyses were employed to determine the association between independent and outcome variables.ResultsThe practicing level of safe cord care was 71.7% (95% Confidence Interval (CI): 64.5, 81.7). While the practicing level of Skin-To-Skin contact was 53.2% (95% CI: 43.6, 58.8). Being in age of 20–29 [adjusted odds ratio (AOR) = 2.93, 95% CI: 1.24, 6.96], attending tertiary education [AOR = 1.83, 95% CI (1.08, 3.13)], and having good knowledge about safe cord care [AOR = 11.3, 95% CI: (7.49, 17.18)] were determinants of safe cord care practice. While mothers aged 20–29, 30–39, and above 40 [(AOR = 11.17, 95% CI: 4.71, 26.5; AOR = 4.1, 95% CI: 1.77, 9.55, and AOR = 14.3, 95% CI: 7.2, 28.6), respectively], Being married [AOR = 3.70, 95% CI (1.58, 8.70)], being a merchant and self-employed ([AOR = 0.55, 95% CI: 0.34,0.87] and [AOR = 0.49, 95% CI: 0.27, 0.86], respectively), having good knowledge about SSC [AOR = 2.11, 95% CI: (1.53, 2.92)], giving birth at gestational age of 37–42 weeks [AOR = 1.82, 95% CI (1.31, 2.5)], and multigravidity (AOR = 2.83, 95% CI (1.90,4.21) were significantly associated with skin to skin contact.ConclusionsThe practicing level of safe cord care and skin-to-skin contact was high. In this study, the age of mothers, educational status, and knowledge of post-partum women on safe cord care were determinants of a safe cord care practice. While the age of mothers, marital status, occupational status, knowledge of mother, and gestational age at birth were significantly associated with skin-to-skin contact practice. Safe cord care should be strengthened and intensified to reduce neonatal mortality due to avoidable umbilical cord infections. Furthermore, skin-to-skin contact practice should be strengthened to enhance the survival of at-risk neonates.
Sonographic Evaluation of the Endotracheal Tube Position in the Neonatal Population: A Comprehensive Review and Meta-Analysis
Authors: Congedi Sabrina , Savio Federica , Auciello Maria , Salvadori Sabrina , Nardo Daniel , Bonadies Luca 
Published: June 2022

BackgroundEndotracheal intubation in neonates is challenging and requires a high level of precision, due to narrow and short airways, especially in preterm newborns. The current gold standard for endotracheal tube (ETT) verification is chest X-ray (CXR); however, this method presents some limitations, such as ionizing radiation exposure and delayed in obtaining the radiographic images, that point of care ultrasound (POCUS) could overcome.Primary ObjectiveTo evaluate ultrasound efficacy in determining ETT placement adequacy in preterm and term newborns.Secondary ObjectiveTo compare the time required for ultrasound confirmation vs. time needed for other standard of care methods.Search MethodsA search in Medline, PubMed, Google Scholar and in the Cochrane Central Register of Controlled Trials (CENTRAL) was performed. Our most recent search was conducted in September 2021 including the following keywords: “newborn”, “infant”, “neonate”, “endotracheal intubation”, “endotracheal tube”, “ultrasonography”, “ultrasound”.Selection CriteriaWe considered randomized and non-randomized controlled trials, prospective, retrospective and cross-sectional studies published after 2012, involving neonatal intensive care unit (NICU) patients needing intubation/intubated infants and evaluating POCUS efficacy and/or accuracy in detecting ETT position vs. a defined gold-standard method. Three review authors independently assessed the studies' quality and extracted data.Main ResultsWe identified 14 eligible studies including a total of 602 ETT evaluations in NICU or in the delivery room. In about 80% of cases the gold standard for ETT position verification was CXR. Ultrasound was able to identify the presence of ETT in 96.8% of the evaluations, with a pooled POCUS sensitivity of 93.44% (95% CI: 90.4–95.75%) in detecting an appropriately positioned ETT as assessed by CXR. Bedside ultrasound confirmation was also found to be significantly faster compared to obtaining a CXR.ConclusionPOCUS appears to be a fast and effective technique to identify correct endotracheal intubation in newborns. This review could add value and importance to the use of this promising technique.