bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wound Healing Following Palatoplasty Using Either Honey or Warm Saline Mouth Bath for Postoperative Wound Care: A Randomized-Controlled Study
Authors: Adekunle Adegbayi Adeola , James Olutayo , Onuoha Emmanuel Onyebuchi , Adeyemo Wasiu Lanre 
Published: March 2022

Objective To evaluate and compare the effect of honey or saline mouth bath for wound care on the rate of re-epithelisation of the lateral palatal defects and occurrence of early postoperative complications following palatoplasty. Methodology This was a prospective randomized study on participants with non-syndromic cleft palate conducted at a tertiary health institution in Lagos, Nigeria. The test group received oral honey drops for post-operative care for an initial period of two weeks post-surgery, while the control group had regular oral toileting using a warm saline solution. The primary outcome was epithelisation of lateral palatal defect at 2- and 4-weeks post repair. Descriptive and comparative statistics were computed, and the p-value was set at <0.05. Results Fifty participants were recruited into the study, 24 in the Test group and 26 in the Control group. The frequency of occurrence of oronasal fistula in the Test group was 4.0% while in the Control group was 10.0%, however, this was not statistically significant. Complete epithelisation of the lateral palatal defect was clinically observed in 66.7% of the participants in the Test group at 2 weeks post-operation, while only 38.5% of participants in the Control group had clinically observed complete epithelisation at the same time point (β = 1.70, p = .035, 95% CI 1.122–26.533). At four weeks, all wounds had epithelised irrespective of the study group. Conclusion The application of honey appears to aid earlier epithelization of palatal surgical wounds following cleft palate repair and reduced the incidence of palatal fistula.
Treatment and prophylaxis of radiation optic neuropathy: A systematic review and meta-analysis
Authors: Yu Caberry W. , Joarder Ishraq , Micieli Jonathan A. 
Published: March 2022

Purpose Radiation optic neuropathy (RON) generally follows radiation therapy that exceed 50 Gy to the visual axis and occurs within three years of therapy. Currently, there are no universally accepted treatments or prophylaxis for RON. The review aimed to examine the efficacy of all treatments and prophylaxis for RON. Methods MEDLINE, Embase, the Cochrane Library, and gray literature were searched to December 2020. Studies on treatment(s) and/or prophylaxis of RON were included. Results were meta-analyzed using a random-effects model. Primary outcomes included the proportions of patients who experienced improvement, no change, or worsening of visual acuity (VA) for each treatment. Secondary outcome was the incidence of RON for studies on prophylaxis. Results Overall, 50 studies (n = 5397) were included. Meta-analysis (n = 1752) showed significantly lower incidence of RON in patients who underwent intravitreal anti-VEGF prophylaxis compared to control (RR 0.64, 95%CI [0.48, 0.86]) for uveal melanoma. Intravitreal anti-VEGF injections (n = 68), hyperbaric oxygen therapy alone (n = 14), and pentoxifylline (n = 5) resulted in improved or stable vision ≤1 logMAR in 54.5%, 42.9%, and 40.0% of patients, respectively. Systemic corticosteroids (n = 82), anticoagulants (n = 12), and systemic bevacizumab (n = 7) showed improved or stable vision ≤1 logMAR in 17.1%, 33.3%, and 14.3% of patients, respectively. Overall risk of bias was low, but evidence was limited to retrospective studies. Conclusion Intravitreal anti-VEGF injections reduced incidence of RON in irradiated uveal melanoma patients. Systemic corticosteroids, systemic bevacizumab, and warfarin alone are likely ineffective treatments. Early hyperbaric oxygen therapy and intravitreal anti-VEGF injections were most effective among those investigated and require further investigation.
Automated 3D ultrasound enables novice users to measure arteriovenous fistula maturation parameters with comparable accuracy to conventional duplex by trained sonographers: Results of a benchtop study
Authors: Calotta Nicholas A , Astor Brad C , Ross John R 
Published: March 2022

Background: Arteriovenous fistulae (AVF) are considered the preferred hemodialysis access but up to 50% of all AVF created in the United States never mature. Doppler ultrasound (DUS) is useful for predicting fistula maturity and impending fistula failure. DUS is resource-intensive and is associated with poor compliance rates in dialysis patients, ranging from 12% to 33%. Methods: EchoSure is an FDA-cleared 3D Doppler ultrasound device that automatically delivers quantitative blood flow and anatomic vascular information. The technology can be used at the bedside by personnel without formal sonographic training, nullifying limitations of traditional Duplex ultrasound imaging. This study compared the EchoSure system in the hands of inexpert personnel to a traditional expert-operated DUS for rapid assessment of a benchtop model vascular system with flow, diameter, and depth expected in a human AVF. Results: Both Duplex and EchoSure performed within the expected tolerance of ultrasound readings (35%) for volume flow, with the average error (AE) between the observed measurement and the ground truth being 8% for Duplex and 8% for EchoSure. However, the average coefficient of variation (CV) for Duplex pooled over all flow rate measurements was 17% versus 4% for EchoSure. Regarding diameter, Duplex measurements had AE of 15% with an average CV of 6% across all measurements versus EchoSure AE of 4% and average CV of 2%. Duplex and EchoSure measurements over all depths had the same AE of 2%. The two modalities were not statistically different for depth measurement ( p = 0.05) but EchoSure measured closer to the ground truth for flow rate and vessel diameter (flow: p = 0.028, ρ = −0.07; diameter: p < 0.001, ρ = 0.69). The inexpert personnel using EchoSure acquired data 62% faster than the expert sonographers using the Duplex ultrasound (141 min for Duplex vs 87 min for EchoSure). Conclusions: EchoSure may offer an accurate and convenient alternative for imaging fistulas in the clinic.
Montessori mealtimes for dementia: A pathway to person-centred care
Authors: Cartwright Jade , Roberts Karen , Oliver Elizabeth , Bennett Michelle , Whitworth Anne 
Published: March 2022

Purpose This study examined the impact of a Montessori mealtime intervention for people living with dementia to support the mealtime experience of residents and mealtime care practices of staff in a memory support unit. The mealtime intervention was part of a broader culture change project. Method An observational research design was used to evaluate changes in the mealtime experience and care practices across three time points (baseline, post-implementation, maintenance), spanning 30 months. Five video recordings of the lunch time service (range: 19–32 min) were analysed. The coding protocol comprised pre-determined indicators related to accepted dimensions of person-centred care. Resident and staff behaviours were quantified across four categories: providing choice and preferences, promoting the social side of eating, supporting independence and showing respect towards residents. Staff behaviours that reflected personal enhancing actions and personal detractors were also coded during each mealtime service. Results A significant increase in staff providing residents with the opportunity for choice and a subsequent significant increase in residents demonstrating choice behaviours was evident. Staff and residents both significantly increased their interactional behaviours, with greater social interaction between staff and residents. Staff further demonstrated greater support for mealtime independence that reached and maintained significance during the final two sampling points. Significant gains observed post implementation were largely maintained and, on specific measures, further increased over time. A significant increase in staff use of personal enhancing actions during mealtime care was also evident. Variability in individual staff and resident behaviour highlighted the complexity of mealtime care and culture change processes. Implications The study provides novel evidence to support the use of a Montessori mealtime intervention to achieve more person-centred mealtime care, and which resulted in a more respectful, enabling and social dining experience. Clinical implications and direction for future research are presented to build on these findings.
A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design
Authors: Albers Gregory W , Campbell Bruce CV , Lansberg Maarten G , Broderick Joseph , Butcher Ken , Froehler Michael T , Schwamm Lee H , Nouh Amre M , Liebeskind David S , Toy Florence , Yang Ming , Massaro Lori , Schoeffler Megan , Purdon Barbara 
Published: March 2022

Rationale: While thrombolysis is standard of care for patients with acute ischemic stroke (AIS) within 4.5 h of symptom onset, the benefit of tenecteplase beyond this time window is less certain. Aim: The TIMELESS trial (NCT03785678) aims to determine if treatment with tenecteplase increases the proportion of good clinical outcomes among patients with stroke due to a large vessel occlusion who present beyond 4.5 h after symptom onset. Sample size estimates: A total of 456 patients will provide ⩾90% power to detect differences in the distribution of modified Rankin Scale scores at Day 90 at the two-sided 0.049 significance level. Methods and design: TIMELESS is a Phase III, double-blind, randomized, placebo-controlled trial of tenecteplase with or without endovascular thrombectomy in patients with AIS and evidence of salvageable tissue via imaging who present within the 4.5- to 24-h time window with an internal carotid artery (ICA) or middle cerebral artery (MCA) (M1/M2) occlusion. Study outcomes: The primary efficacy objective of tenecteplase compared with placebo will be evaluated with ordinal modified Rankin Scale scores at Day 90. Safety will be evaluated via incidence of symptomatic intracranial hemorrhage, incidence and severity of adverse events, and mortality rate. Discussion: Results from TIMELESS will contribute to understanding of the safety and efficacy of tenecteplase administered 4.5–24 h following symptom onset for patients with an ICA or MCA occlusion.
Knowledge and awareness of COVID-19 epidemic preparedness and response among health care workers in Makkah city
Authors: Alrajhi Asrar Mansoor , Hussain Waleed Abdul-Halim , Rafie Basmah Amin , Taj Mehar , Elgarf Abdelaziz Moustafa 
Published: March 2022

Objective: This study determined and examined the knowledge and awareness of COVID-19 pandemic preparedness and response measures by health care workers (HCWs) in Makkah city. Methods: This descriptive study used a quantitative method with a cross-sectional design. A survey (questionnaire) collected data from 251 HCWs working in 10 hospitals and 80 health care centers. Results: The total score for the knowledge level was high (range: 50–76, mean ± SD = 65.370 ± 4.805). There was a relationship between the participants’ workplace and education levels to the nature of the disease ( p = 0.009*, 0.037*, respectively). Job descriptions were related to the transmission of the disease ( p = 0.003*). The participants’ age groups and years of experience were also associated with their actions in suspected, probable, and confirmed cases ( p = 0.015*, 0.03*, respectively). The HCWs’ knowledge of precautionary measures was not related to their demographic data, except for the education level shown ( p = 0.037*). Discussion: A similar level of knowledge and awareness was detected in Saudi Arabia in Riyadh and Al-Jouf, the UAE, Vietnam, and Uganda. Further study is recommended to measure the factors affecting HCWs’ knowledge and awareness during an epidemic situation.
Real-world effectiveness and safety profile of teriflunomide in the management of multiple sclerosis in the Gulf Cooperation Council countries: An expert consensus narrative review
Authors: Alroughani Raed , Inshasi Jihad , Al Khawajah Mona , Ahmed Samar Farouk , Al Malik Yaser , Alkhabouri Jaber , Shatila Ahmed , Aljarallah Salman , Cupler Edward J , Qureshi Shireen Al , Thakre Mona , Elhasin Heba , Ezzat Aly , Roushdy Sherif 
Published: March 2022

Background The prevalence of multiple sclerosis (MS) is increasing in Gulf Cooperation Council (GCC) countries. Multiple sclerosis contributes to significant burden on patients and caregivers. The pharmacological treatment in MS involves treating acute exacerbations and preventing relapses and disability progression using disease-modifying therapies. Clinical evidence suggests that teriflunomide is one of the therapeutic choices for patients with relapsing–remitting MS (RRMS). However, genetic and cultural differences across different regions may contribute to variations in drug use. Therefore, it is necessary to consider real-world evidence for teriflunomide usage in GCC countries. Methods An expert group for MS gathered from GCC countries in December 2020. The consensus highlighting role of teriflunomide in MS management has been developed using clinical experiences and evidence-based approach. Results The expert-recommended patient profile for teriflunomide usage includes individuals aged 18 years and above, both men and women (on effective contraceptives) with clinically isolated syndrome or RRMS. The factors considered were cost-effectiveness of the drug, patient preference, adherence, monitoring, established safety profile, and coronavirus disease 2019 status. Conclusion Expert recommendations based on their clinical experience will be more helpful to clinicians in clinical settings regarding the usage of teriflunomide and provide valuable insights applicable in day-to-day practice.
Patient-Reported Outcomes of Primary Total Ankle Arthroplasty in Patients Aged <50 Years
Authors: Pierce Ebaugh M. , Alford Travis , Kutzarov Kamen , Davis Elizabeth , Greaser Michael , McGarvey William C. 
Published: March 2022

Background: Compared to more prevalent arthritic conditions, ankle arthritis is complicated by an earlier age of onset. Recently published data demonstrates excellent survivorship and complication rates in short-/midterm follow-up of younger patients who received a primary total ankle arthroplasty (TAA). Additionally, older TAA patients display comparable reported outcomes relative to hip/knee arthroplasty. However, there remains a paucity of literature surrounding the reported outcomes of younger patients undergoing TAA. Thus, our aim was to assess the reported outcomes of individuals aged <50 years receiving a primary TAA. Methods: A retrospective cohort analysis of adult patients <50 years who received a primary total ankle replacement was conducted. Patient demographics, diagnosis, treatment, and outcome characteristics were recorded from a chart review of 41 patients with at least 1 year of postoperative clinical follow-up. Postoperative reported outcomes were obtained via telephone interviews. Primary outcomes that were measured included emotional and physical health, activity limitation, ambulation, and global health. Measures used included the 36-Item Short Form Health Survey (SF-36), Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health, and Sickness Impact Profile Ambulation. The functional outcomes in our study sample were compared with age- and gender-matched norms from a general US population, and 95% CIs were calculated for each functional outcome mean. Student t test was used for continuous variables, and χ2 analysis was used for categorical variables. Results: Thirty-one of 41 eligible patients were reached for interview. The average age at surgery was 39.7 years. Clinical and radiographic follow-up was a mean of 51.6 months and 31.2 months following TAA, respectively. General health as measured with the SF-36 was not significantly different from age-/gender-matched norms. Eighty-seven percent of patients would choose to have a TAA again. Although 58% reported being limited in vigorous activities, 61% were able to ambulate frequently for long periods of time. On average, the patients did not report ongoing pain, and only 16% reported fatigue that hindered activities. Eighty-one percent reported returning to full employment and performing their duties without difficulty, and 84% reported they resumed all normal social activities. Primary implant survivorship was 93%. Conclusion: Despite a younger age and potentially increased demands, patients aged <50 years undergoing primary TAA are generally satisfied with their index procedure at a mean follow-up of nearly 5 years. Our findings of positive outcomes on their health and well-being may improve surgeon insight for TAA as an alternative treatment for younger individuals with end-stage ankle arthritis. Level of Evidence: Level IV, case series.
Natural history of PF4 antibodies in vaccine-induced immune thrombocytopenia and thrombosis
Authors: Craven Brian , Lester William , Boyce Sara , Thomas Will , Kanny Angela , Davies Claire , Pavord Sue , Hermans Joannes , Makris Michael , Bart-Smith Emily , Arnott Sarah , Hunt Beverley J. , Chudakou Pavel , Calvert Anthony , Singh Deepak , Scully Marie 
Published: March 2022

Abstract
The COVID-19 pandemic has resulted in the rapid development of a range of vaccines against SARS-CoV-2. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare but life-threatening complication of primarily adenoviral-based vaccines associated with the presence of antibodies to a PF4/polyanion neoepitope and measured by using enzyme-linked immunosorbent assays. Presented are serial anti–PF4/polyanion antibody, platelet, and D-dimer measurements in a large cohort of patients and their relation to relapse. Overall, 51% of patients using the Stago assay had persistently positive anti–PF4/polyanion levels 100 days’ postdiagnosis, whereas 94% of patients monitored by using the Immucor assay remain positive. The median duration of positivity of the PF4 assay is 87 days, with 72% of patients remaining positive after a median follow-up of 105 days. The use of plasma exchange seemed to reduce anti–PF4/polyanion levels and increase platelet counts in the acute setting more rapidly than other therapies. The rate of relapse in this study was 12.6%, with all relapsed cases exhibiting persistently positive PF4 antibodies and falling platelet counts. Only one patient had extension of their thrombosis. Overall, despite the persistence of PF4 antibodies in 72% of patients, the rate of relapse was low and did not seem to result in recrudescence of the aggressive clinical picture seen at index presentation. Monitoring of these patients in the UK cohort is ongoing and will aid in definition of the natural history of this novel condition.
Metabolomics and microbiome reveal potential root microbiota affecting the alkaloidal metabolome in Aconitum vilmorinianum Kom.
Authors: Li Hongrui , Shi Hongdi , Xu Peng , Yu Diqiu 
Published: March 2022

Abstract
Background
The plant microbiome is vital for plant health, fitness, and productivity. Interestingly, plant metabolites and the plant microbiome can influence each other. The combination of metabolomics and microbiome may reveal the critical links between the plant and its microbiome. It is of great significance to agricultural production and human health, especially for Chinese medicine research. Aconitum vilmorinianum Kom. is a herb with alkaloid activities, and its roots are the raw material for some Chinese medicines. Former studies have investigated alkaloidal metabolites and antibacterial activities of endophytes in A. vilmorinianum roots. However, there are limited reports on the root microbiota that can influence the alkaloidal metabolome of A. vilmorinianum.

Results
This research used ultra performance liquid chromatography-tandem mass spectrometry technology and high-throughput sequencing to examine the alkaloidal metabolome, bacterial microbiota, and fungal microbiota in A. vilmorinianum roots at two different sites in China. The results revealed that the samples from the two sites were rich in distinct alkaloidal metabolites and recruited significantly different root microbiota. Based on bioinformatics analysis, we found the potential bacterial and fungal microbiota impacting the alkaloidal metabolome in A. vilmorinianum.

Conclusion
Our findings reveal the composition of the alkaloidal metabolome, bacterial root microbiota, and fungal root microbiota in A. vilmorinianum roots at two different sites. Potential root microbiota that can influence the alkaloidal metabolome of A. vilmorinianum are indicated. This study provides a strategy for the cultivation and research of A. vilmorinianum and other Chinese herbs.
Propofol suppresses adipose-derived stem cell progression via PI3K/AKT-Wnt signaling pathway
Authors: Yin Guoping , Wang Jia , Zhong Yanling , Wu Weidong 
Published: March 2022

AbstractAdipose-derived stem cell (ADSC) transplantation has become a prospective way to treat cardiovascular diseases and skin traumas. Propofol, a short-acting intravenous anesthetic agent, plays an important role in the induction and maintenance of general anesthesia. In this study, we investigated the effects of propofol on ADSCs. The flow cytometry results showed that ADSCs were positive for CD29, CD44, and CD90 and negative for CD31, CD34, and CD45. The results of MTT and BrdU assays demonstrated that propofol impeded the proliferation of ADSCs. The cell scratch test showed that propofol had an inhibitory effect on the migration of ADSCs. Transwell assay showed that invasive ASDC counts decreased significantly after propofol treatment. Propofol also promoted ADSC apoptosis and arrested ADSCs in the G0/G1 phase. All these effects showed in a dose-dependent manner that the higher the concentration, the stronger the effect. Western blot analysis revealed decreased levels of FAK, PI3K, AKT, and GSK3β phosphorylation, while the phosphorylation of β-catenin increased after 48 h of treatment with propofol. The findings above indicated that the PI3K/AKT-Wnt pathways mediated propofol-inhibited ADSC proliferation, providing new insights into the propofol application in ADSCs.