bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nanomaterial Inhalation During Pregnancy Alters Systemic Vascular Function in a Cyclooxygenase-Dependent Manner
Authors: Griffith Julie A , Garner Krista L , Bowdridge Elizabeth C , DeVallance Evan , Schafner Kallie J , Engles Kevin J , Batchelor Thomas P , Goldsmith William T , Wix Kimberley , Hussain Salik , Nurkiewicz Timothy R 
Published: June 2022

Abstract
Pregnancy requires rapid adaptations in the uterine microcirculation to support fetal development. Nanomaterial inhalation is associated with cardiovascular dysfunction, which may impair gestation. We have shown that maternal nano-titanium dioxide (nano-TiO2) inhalation impairs microvascular endothelial function in response to arachidonic acid and thromboxane (TXA2) mimetics. However, the mechanisms underpinning this process are unknown. Therefore, we hypothesize that maternal nano-TiO2 inhalation during gestation results in uterine microvascular prostacyclin (PGI2) and TXA2 dysfunction. Pregnant Sprague-Dawley rats were exposed from gestational day 10–19 to nano-TiO2 aerosols (12.17  ± 1.67 mg/m3) or filtered air (sham-control). Dams were euthanized on gestational day 20, and serum, uterine radial arterioles, implantation sites, and lungs were collected. Serum was assessed for PGI2 and TXA2 metabolites. TXB2, the stable TXA2 metabolite, was significantly decreased in nano-TiO2 exposed dams (597.3 ± 84.4 vs 667.6 ± 45.6 pg/ml), whereas no difference was observed for 6-keto-PGF1α, the stable PGI2 metabolite. Radial arteriole pressure myography revealed that nano-TiO2 exposure caused increased vasoconstriction to the TXA2 mimetic, U46619, compared with sham-controls (−41.3% ± 4.3% vs −16.8% ± 3.4%). Nano-TiO2 exposure diminished endothelium-dependent vasodilation to carbaprostacyclin, a PGI2 receptor agonist, compared with sham-controls (30.0% ± 9.0% vs 53.7% ± 6.0%). Maternal nano-TiO2 inhalation during gestation decreased nano-TiO2 female pup weight when compared with sham-control males (3.633 ± 0.064 vs 3.995 ± 0.124 g). Augmented TXA2 vasoconstriction and decreased PGI2 vasodilation may lead to decreased placental blood flow and compromise maternofetal exchange of waste and nutrients, which could ultimately impact fetal health outcomes.
Recovered Hepatocytes Promote Macrophage Apoptosis Through CXCR4 After Acetaminophen-Induced Liver Injury in Mice
Authors: Nguyen Nga T , Umbaugh David S , Huang Eileen L , Adelusi Olamide B , Sanchez Guerrero Giselle , Ramachandran Anup , Jaeschke Hartmut 
Published: June 2022

AbstractAcetaminophen (APAP) overdose is the main cause of acute liver failure in Western countries. The mechanism of APAP hepatotoxicity is associated with centrilobular necrosis which initiates infiltration of neutrophils, monocytes, and other leukocytes to the area of necrosis. Although it has been recognized that this infiltration of immune cells plays a critical role in promoting liver repair, mechanism of immune cell clearance that is important for resolution of inflammation and the return to normal homeostasis are not well characterized. CXCR4 is a chemokine receptor expressed on hepatocytes as well as neutrophils, monocytes, and hematopoietic stem cells. CXCR4 function is dependent on its selective expression on different cell types and thus can vary depending on the pathophysiology. This study aimed to investigate the crosstalk between hepatocytes and macrophages through CXCR4 to promote macrophage apoptosis after APAP overdose. C57BL/6J mice were subjected to APAP overdose (300 mg/kg). Flow cytometry and immunohistochemistry were used to determine the mode of cell death of macrophages and expression pattern of CXCR4 during the resolution phase of APAP hepatotoxicity. The impact of CXCR4 in regulation of macrophage apoptosis and liver recovery was assessed after administration of a monoclonal antibody against CXCR4. RNA sequencing analysis was performed on flow cytometry sorted CXCR4+ macrophages at 72 h to confirm the apoptotic cell death of macrophages. Our data indicate that the inflammatory response is resolved by recovering hepatocytes through induction of CXCR4 on macrophages, which triggers their cell death by apoptosis at the end of the recovery phase.
Long-Term Health and Neurodevelopment in Children After Antenatal Exposure to Low-Dose Aspirin for the Prevention of Preeclampsia and Fetal Growth Restriction: A Systematic Review of Randomized Controlled Trials
Authors: Landman Anadeijda J. E. M. C. , van Limburg Stirum Emilie V. J. , de Boer Marjon A. , van ‘t Hooft Janneke , Ket Johannes C. F. , Leemhuis Aleid G. , Finken Martijn J. J. , Oudijk Martijn A. , Painter Rebecca C. 
Published: June 2022

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2021;267:213–220)
Pregnant women with increased risk of preeclampsia are advised by international guidelines to take low-dose aspirin throughout their pregnancy. As this indicates that a substantial portion of fetuses experience exposure to aspirin, the question of long-term effects on child health is raised.
A Two-stage Approach for Rapid Assessment of the Proportion Achieving Viral Suppression Using Routine Clinical Data
Authors: Edwards Jessie K. , Donastorg Yeycy , Zadrozny Sabrina , Hileman Sarah , Gómez Hoisex , Seamans Marissa J. , Herce Michael E. , Ramírez Edwin , Barrington Clare , Weir Sharon 
Published: June 2022

Background:
Improving viral suppression among people with HIV reduces morbidity, mortality, and transmission. Accordingly, monitoring the proportion of patients with a suppressed viral load is important to optimizing HIV care and treatment programs. But viral load data are often incomplete in clinical records. We illustrate a two-stage approach to estimate the proportion of treated people with HIV who have a suppressed viral load in the Dominican Republic.

Methods:
Routinely collected data on viral load and patient characteristics were recorded in a national database, but 74% of patients on treatment at the time of the study did not have a recent viral load measurement. We recruited a subset of these patients for a rapid assessment that obtained additional viral load measurements. We combined results from the rapid assessment and main database using a two-stage weighting approach and compared results to estimates obtained using standard approaches to account for missing data.

Results:
Of patients with recent routinely collected viral load data, 60% had a suppressed viral load. Results were similar after applying standard approaches to account for missing data. Using the two-stage approach, we estimated that 77% (95% confidence interval [CI] = 74, 80) of those on treatment had a suppressed viral load.

Conclusions:
When assessing the proportion of people on treatment with a suppressed viral load using routinely collected data, applying standard approaches to handle missing data may be inadequate. In these settings, augmenting routinely collected data with data collected through sampling-based approaches could allow more accurate and efficient monitoring of HIV treatment program effectiveness.
A single-center, cross-sectional study of cross-professional faculties’ perception to virtual class under different scenarios: A stepwise approach
Authors: Lin Yu-Fan , Chen Chen-Huan , Yang Ying-Ying , Kuo Nai-Rong , Li Tzu-Hao , Lirng Jiing-Feng , Hou Ming-Chih , Sheu Wayne Huey-Herng 
Published: June 2022

Background:
Virtual teaching in medical education is rising with the increased need caused by the recent pandemic. However, evaluations of the perception of clinical teachers across professions for setting a virtual class in different teaching scenarios are limited. This study aims to identify cross-professional clinical teachers’ perception of virtual classes and the acceptability of the virtual class-specific checklist for setting a virtual class.

Methods:
We conducted a cross-sectional study to investigate clinical teachers’ need to set and teach a virtual class and then designed a virtual class-specific checklist with five essential steps and a related training program in July 2021. After the training, 186 participants were randomly enrolled in October 2021 to evaluate their perceptions about setting virtual classes and the acceptability of the virtual class-specific checklist using an online assessment questionnaire.

Results:
In our institution, the number of faculty-led virtual classes has recently been on the increase. Our study revealed that most teachers agreed that virtual classes could break space and time limitations, but that the Internet environment could affect the fluency of the virtual class. They further agreed that the essential five steps in the checklist should vary depending on the type of teaching scenario. Most clinical teachers, with the exception of those who teach in the operating room, considered the operating room as the most difficult scenario for setting virtual classes.

Conclusion:
Faculty training for setting virtual classes is essential, and the essential virtual-class-specific five steps are suitable for different teachers and teaching scenarios. However, the virtual class-specific checklist should be further adjusted according to the limitations caused by emerging innovative virtual teaching technology.
Evaluation of a remote telemedicine platform using a novel handheld fundus camera: Physician and patient perceptions from real-world experience
Authors: Yeh Tsai-Chu , Lo Kang-Jung , Hwang De-Kuang , Lin Tai-Chi , Chou Yu-Bai 
Published: June 2022

Background:
Although teleophthalmology has gained traction in recent years, it is at the center of the coronavirus disease pandemic. However, most hospitals are not ready owing to a severe lack of real-world experience. Furthermore, a limited number of studies have evaluated telemedicine applications on remote islands. This study aimed to evaluate real-world clinical and referral accuracy, image quality, physician-perceived diagnostic certainty, and patient satisfaction with telemedicine eye screening using a novel handheld fundus camera in a rural and medically underserved population.

Methods:
This prospective study included 176 eyes from a remote island. All participants underwent a comprehensive ophthalmic examination. Nonmydriatic retinal images obtained using a handheld fundus camera were reviewed by two retinal specialists to determine image quality, diagnosis, and need for referrals. The agreement of diagnosis between image-based assessments was compared with that of binocular indirect ophthalmoscopic assessments.

Results:
Image quality of fundus photographs was considered acceptable or ideal in 97.7% and 95.5% of eyes assessed by two reviewers, respectively. There was considerable agreement in diagnosis between the indirect ophthalmoscopic assessment and image-based assessment by two reviewers (Cohen’s kappa = 0.80 and 0.78, respectively). Likewise, substantial agreement was achieved in the referrals. The sensitivity for referable retinopathy from the two reviewers was 78% (95% confidence interval [CI], 57%-91%) and 78% (95% CI, 57%-91%), whereas specificity was 99% (95% CI, 95%-99%] and 98% (95% CI, 93%-99%), respectively. For physicians’ perceived certainty of diagnosis, 93.8% and 90.3% were considered either certain or reliable. Overall, 97.4% of participants were satisfied with their experiences and greatly valued the telemedicine services.

Conclusion:
Novel fundus camera-based telemedicine screening demonstrated high accuracy in detecting clinically significant retinopathy in real-world settings. It achieved high patient satisfaction and physician-perceived certainty in diagnosis with reliable image quality, which may be scaled internationally to overcome geographical barriers under the global pandemic.
Pregnancy-Related Stroke: A Review
Authors: Doiron Tucker , Ramseyer Abigail , Phelps Emily N. , Williams Anne J. , Teal Linda N. , Hollenbach Laura L. , Magann Everett F. 
Published: June 2022

Importance
The maternal risk of strokes in the United States is approximately 30/100,000 pregnancies, and strokes are the eighth leading cause of maternal death. Because of the relationship between stroke and significant neurological disability/maternal death, obstetrical health care providers must be able to identify, evaluate, diagnosis, and treat these women.

Evidence Acquisition
PubMed was searched using the search terms “stroke” OR “cerebrovascular accident” OR “intracranial hemorrhage” AND “pregnancy complications” OR “risk factors” OR “management” OR “outcome.” The search was limited to the English language and was restricted to articles from 2000 to 2020.

Results
There were 319 abstracts identified, and 90 of the articles were ultimately used as the basis of this review. Presenting stroke signs and symptoms include headache, composite neurologic defects, seizures, and/or visual changes. Diagnosis is typically made with computed tomography scan using abdominal shielding or magnetic resonance imaging without contrast. Management options for an ischemic stroke include reperfusion therapy with intravenous recombinant tissue plasminogen activator catheter-based thrombolysis and/or mechanical thrombectomy. Hemorrhagic strokes are treated similarly to strokes outside of pregnancy, and that treatment is based on the severity and location of the hemorrhage.

Conclusions and Relevance
Early recognition and management are integral in decreasing the morbidity and mortality associated with a stroke in pregnancy.

Relevance Statement
This study was an evidence-based review of stroke in pregnancy and how to diagnose and mange a pregnancy complicated by a stroke.

Target Audience
Obstetricians and gynecologist, family physicians

Learning Objectives
After completing this learning activity, the participant should be better able to identify the pregnancy-related risk factors for a stroke; explain the presenting signs and symptoms of a stroke in pregnancy; describe the imaging modalities available to diagnose a stroke; and outline treatment options for an ischemic stroke and a hemorrhagic stroke.
A 13-Year Study of Fatal Falls From Height in Northern Tunisia
Authors: Kort Ikram , Belhaj Azza , Kebsi Dhouha , Gharbaoui Meriem , Bellali Mohamed , Allouche Mohamed 
Published: June 2022

Introduction
Falls from height are a major cause of unintentional injury death, resulting in high disability and mortality. We investigated the characteristics of fatal falls and their relationship with intentionality, injury patterns, and death on impact.

Materials and Methods
In this retrospective study, we examined 545 cases of fatal falls from height that underwent autopsy in the forensic department of the Charles Nicolle hospital of Tunis (Tunisia) between January 2008 and December 2020. Cases were reviewed in terms of demographics, fall characteristics, and autopsy findings.

Results
The population was predominately male (86.6%). Four hundred twenty-one (77.3%) originated from accidents, 120 (22%) were found to be suicidal, with 4 homicide cases. A notable decline in cases was noticed following the Jasmine revolution, 2011 (R squared = 0.8). The mean height of falls was 8 m. Higher falls were associated with a set of organ-specific injuries. Organ injury pattern did not differ based on intentionality. Female victims were 2.4 times more likely to sustain pelvic injuries than males. The majority of victims deceased before reaching health care structures. Death on impact was strongly associated with higher falls, cranial impact, and organ-specific injuries, including cardiac, pulmonary, and skull injuries.
Falls from height are in many cases preventable. A clearly defined fall safety policy, strict implementation of evidence-based interventions, efficient allocation of resources, and raising safety awareness must to be urgently implemented.

Conclusion
Understanding patterns of injury and the factors that influence death on impact may be of further interest in the prevention and management of survivors in the acute period.
The Oxford Brain Health Clinic: Protocol and Research Database
Authors: O’Donoghue M.C. , Blane J. , Gillis G. , Mitchell R. , Lindsay K. , Semple J. , Pretorius P.M. , Griffanti L. , Fossey J. , Raymont V. , Martos L. , Mackay C.E. 
Published: June 2022

ABSTRACTIntroductionDespite major advances in the field of neuroscience over the last three decades, the quality of assessments available to patients with memory problems in later life has barely changed. At the same time, a large proportion of dementia biomarker research is conducted in selected research samples that often poorly reflect the demographics of the population of patients who present to memory clinics. The Oxford Brain Health Clinic (BHC) is a newly developed clinical assessment service with embedded research in which all patients are offered high quality clinical and research assessments, including MRI, as standard.Methods and analysisHere we describe the BHC protocol, including aligning our MRI scans with those collected in the UK Biobank. We evaluate rates of research consent for the first 108 patients (data collection ongoing) and the ability of typical Psychiatry-led NHS memory-clinic patients to tolerate both clinical and research assessments.Ethics and disseminationOur ethics and consenting process enables patients to choose the level of research participation that suits them. This generates high rates of consent, enabling us to populate a research database with high quality data that will be disseminated through a national platform (the Dementias Platform UK data portal).ARTICLE SUMMARYThe Oxford Brain Health Clinic embeds high-quality assessments into routine clinical care for typical patients with memory problems.The BHC MRI protocol is aligned with the UK Biobank providing a unique opportunity to link the power of big-data and individual patients at the clinical interface.The BHC ethics and consenting process, designed in partnership with an active PPI advisory group, enables patients to choose the level of research participation that suits them.The BHC research database and associated information governance will facilitate research use of real-world clinical information where consent is given.The Oxford BHC pilot required that patients were not contraindicated for MRI. Future work to expand the model will remove this constraint.
Fat infiltration in the vastus medialis implicates joint structural abnormalities in early-stage symptomatic knee osteoarthritis
Authors: Hoki Atsushi , D’Amico Ella , Ambrosio Fabrisia , Iwasaki Tsubasa , Matsuda Yoshikazu , Iijima Hirotaka 
Published: June 2022

ABSTRACTObjectiveEarly knee osteoarthritis (KOA) presents as minor structural abnormalities in joint tissues, such as cartilage and subchondral bone, that cannot be assessed radiographically. Identification of a sensitive and convenient marker for early disease has the potential to enhance patient outcomes. This study determined 1) whether fat infiltration in muscle (i.e., muscle quality), as measured by ultrasound, is associated with structural abnormalities seen in early KOA and 2) which quadriceps muscles are appropriate as a novel marker for early KOA.MethodsParticipants with early symptomatic KOA (Kellgren Lawrence grade 1-2) underwent ultrasound assessment to measure the echo intensity of the vastus medialis and rectus femoris. The echo intensity corrected for ultrasound wave attenuation caused by subcutaneous fat was then calculated (i.e., corrected echo intensity). Structural abnormalities were assessed using the whole-organ magnetic resonance score (WORMS). A generalized linear mixed model was used to assess the relationship between the corrected echo intensity and WORMS score.ResultsForty-nine participants (ages: 44-78 years, 65.3% women) with 52 knees were included. After adjustment for covariates, increased corrected echo intensity (i.e., poor muscle quality) in the vastus medialis muscle was significantly associated with greater structural abnormalities, including disrupted cartilage integrity in the medial tibiofemoral joint. The association was not significant in the rectus femoris muscle.ConclusionIndividuals with poor muscle quality in the vastus medialis displayed compromised joint integrity. This study suggests that fat infiltration in vastus medialis assessed by ultrasound is an indicator of early symptomatic KOA.
Modelling the potential influence of human migration and strain mutation on Ebola virus disease dynamics
Authors: Njankou Sylvie Diane Djiomba , Nyabadza Farai 
Published: June 2022

AbstractMigration of infected animals and humans, and mutation are considered as the source of the introduction of new pathogens and strains into a country. In this paper, we formulate a mathematical model of Ebola virus disease dynamics, that describes the introduction of a new strain of ebolavirus, through either mutation or immigration (which can be continuous or impulsive) of infectives. The mathematical analysis of the model shows that when the immigration of infectives is continuous, the new strain invades a country if its invasion reproduction number is greater than one. When the immigration is impulsive, a newly introduced strain is controllable when its reproduction number is less than the ratio of mortality to the population inflow and only locally stable equilibria exist. This ratio is one if the population size is constant. In case of mutation of the resident strain of ebolavirus, the coexistence of the resident and mutated strains is possible if their respective reproduction numbers are greater than one. Results indicate that the competition for the susceptible population is the immediate consequence of the coexistence of two different strains of ebolavirus in a country and this competition is favourable to the most infectious strain. Results also indicate that impulsive immigration of infectives when compared to continuous immigration of infectives gives time for the implementation of control measures. Our model results suggest controlled movements of people between countries that have had Ebola outbreaks despite the fact that closing boundaries is impossible.
The Development of the Substance Use Disorder Screening Test (SUDST) according to the DSM-5
Authors: Saengduenchai Sukuma , Nilaban Sumnao , Singtho Tanya , Ranuwattananon Apichart , Kalayasiri Rasmon 
Published: June 2022

AbstractObjectivesA screening tool for substance use disorders is most needed for patient care and referral. The study aims to develop the Substance Use Disorder Screening Test (SUDST) to classify the severity of substance use disorders based on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).MethodsEleven items of the SUDST, developed based on the DSM-5, were tested on 207 participants who were receiving treatment for methamphetamine use. Participants were interviewed with the SUDST, the screening test of the Ministry of Public Health Version 2 (V.2), the Mini International Neuropsychiatric Inventory (M.I.N.I) and were clinically diagnosed by attending psychiatrists.ResultsCronbach’s alpha coefficient was 0.79. The SUDST was highly significantly associated with the M.I.N.I., V.2, and the clinical diagnosis (p < 0.001). Factor analysis showed three components: 1) preoccupation and loss of control 2) risky/harmful use and 3) impact to bio-psychosocial aspects. Of the total score of 11, the cut-off points to identify severe, moderate, and mild levels of risk were ≥7, 5-6, and 3-4, respectively with sensitivity = 72.7%-96.5% and specificity = 61.9%-88.7%.ConclusionsThe SUDST had high reliability and validity that could be used for screening risk for substance use disorders.