bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of an outpatient telestroke clinic on management of rural stroke patients
Authors: Garcia‐Esperon Carlos , Chew Beng Lim Alvin , Minett Fiona , Cheah Joseph , Rutherford Jennifer , Wilsmore Bradley , Parsons Mark W. , Levi Christopher R. , Spratt Neil J. 
Published: April 2022

AbstractObjectiveReport on feasibility, use and effects on investigations and treatment of a neurologist‐supported stroke clinic in rural Australia.DesignData were collected prospectively for consecutive patients referred to atelehealth stroke clinic from November 2018 to August 2021.Settings, participants and interventionsPatients attended the local hospital, with a rural stroke care coordinator, and were assessed by stroke neurologist over videoconference.Main outcome measuresThe following feasibility outcomes on the first appointments were analysed: (1) utility (a) change in medication, (b) request of additional investigations, (c) enrolment/offering clinical trials or d) other; (2) acceptability (attendance rate); and (3) process of care (waiting time to first appointment, distance travelled).ResultsDuring the study period, 173 appointments were made; 125 (73.5%) were first appointments. The median age was 70 [63–79] years, and 69 patients were male. A diagnosis of stroke or transient ischemic attack was made by the neurologist in 106 patients. A change in diagnosis was made in 23 (18.4%) patients. Of the first appointments, 102 (81.6%) resulted in at least one intervention: medication was changed in 67 (53.6%) patients, additional investigations requested in 72 (57.6%), 15 patients (12%) were referred to a clinical trial, and other interventions were made in 23 patients. The overall attendance rate of booked appointments was high. The median waiting time and distance travelled (round‐trip) for a first appointment were 38 [24–53] days and 60.8 [25.6–76.6] km respectively.ConclusionThe telestroke clinic was very well attended, and it led to high volume of interventions in rural stroke patients.
Anatomical features of inferior mesenteric and left colic arteries and surgery in colorectal cancer patients with persistent descending mesocolon
Authors: Nozawa Hiroaki , Okamoto Kazuaki , Kawai Kazushige , Sasaki Kazuhito , Emoto Shigenobu , Murono Koji , Sonoda Hirofumi , Ishihara Soichiro 
Published: April 2022

AbstractBackgroundPersistent descending mesocolon (PDM) is a fetal abnormality in which the left‐sided colon is not fused to the retroperitoneum, and it is often accompanied by the adhesion between the mesocolon and small bowel mesentery. Due to its rarity, whether PDM exhibits anatomical characteristics of the inferior mesenteric artery (IMA) and left colic artery (LCA), and how the anomaly affects laparoscopic surgery are largely unknown. We investigated the branches of these arteries and outcomes of patients who underwent laparoscopic surgery.MethodsBased on computed tomography (CT) and three‐dimensional CT angiography, branching patterns of the IMA, LCA and branches originating from the LCA were analysed in 954 patients with left‐sided colon or rectal cancer. PDM was diagnosed by preoperative CT colonography, and confirmed at time of surgery. The anatomical features of the vessels and short‐term outcomes of laparoscopic surgery were compared between patient groups stratified by PDM.ResultsTwelve patients (1.3%) were diagnosed with PDM. No branching pattern of the IMA specific to PDM was noted. On the other hand, patients with PDM had fewer branches (mean: 1.0) from the LCA than those without PDM (mean: 1.8, p = 0.009). In patients undergoing laparoscopic surgery, outcomes such as operative time, intraoperative blood loss, and number of harvested nodes were comparable between the two patient groups.ConclusionFew branches of the LCA characterize PDM. PDM does not complicate laparoscopic surgery of the left‐sided colon and rectum. However, the above anatomical feature increases the risk of poor colonic perfusion when dividing the LCA.
Preventive treatment of allograft rejection after endothelial keratoplasty: A systematic review and meta‐analysis
Authors: Magnier Florent , Dutheil Frédéric , Pereira Bruno , Watson Stephanie L. , Baker Julien S. , Chiambaretta Frédéric , Navel Valentin 
Published: April 2022

AbstractPurposeTo evaluate the efficacy of preventive treatment against allograft rejection after endothelial keratoplasty (EK), we conducted a systematic review and meta‐analysis.MethodPubMed, Cochrane Library, Embase and ScienceDirect databases were searched until May 2021. We computed a random‐effect meta‐analysis on graft rejection rate stratified by the intervention (i.e. Descemet membrane EK (DMEK) and Descemet stripping (Automated) EK (DS(A)EK) or ultrathin (UT)‐DSAEK), and postoperative treatment. Meta‐regressions were performed to compare intervention, treatment and influence of putative confusion factors.ResultsWe included 49 studies and 12 893 EK (6867 DMEK and 6026 DS(A)EK/UT‐DSAEK). Topical steroids were merged in two efficacy regimens: standard steroids (prednisolone acetate 1% or dexamethasone 0.1%) and soft steroids (fluorometholone 0.1% or loteprednol etabonate 0.5%). Globally, DMEK had a lower graft rejection rate than DS(A)EK/UT‐DSAEK (coefficient − 3.3, 95 CI, −4.60 to −1.90; p < 0.001). No significant differences were observed between standard and soft steroids to prevent graft rejection after DMEK. After EK, the rate of ocular hypertension was 20% (95 CI, 14 to 26%) with the use of standard steroids and 7% (5 to 9%) with soft steroids. Comparisons of treatments were not feasible in DS(A)EK/UT‐DSAEK due to a lack of studies.ConclusionsDescemet membrane endothelial keratoplasty (DMEK) has less risk of graft rejection compared with DS(A)EK/UT‐DSAEK. Furthermore, soft steroids seemed to be a valuable alternative to standard steroids to prevent graft rejection after DMEK, involving a safe profile against ocular hypertension. Further studies are needed to compare other drugs in the prevention of graft rejection after EK.
Primary intraocular lens implantation in infants with unilateral congenital cataract operated before 12 weeks of age
Authors: Sand Mari Kathrine , Cholidis Symira , Kristianslund Olav , Drolsum Liv 
Published: April 2022

AbstractPurposeThe aim of this study was to report visual outcome and safety after cataract surgery with primary intraocular lens implantation before 12 weeks of age.MethodsInfants with visually significant unilateral congenital cataract having primary IOL implantation in the capsular bag before 12 weeks of age in 2007–2016 were enrolled for a prospective study examination in 2017. The medical records were also reviewed.ResultsIn total, 23 patients with a median age at cataract surgery of 32 days (range, 12–75 days) were included. Seventeen (74%) eyes had persistent foetal vasculature (PFV). After a median follow‐up of 6.3 years (range, 1.4–10.9 years), the corrected distance visual acuity was 0.8 logMAR (range, 3.0–0.1 logMAR). All, except one eye, required surgery for visual axis opacification (VAO), with a median of two (range 0–5) additional surgical procedures. Four (17%) eyes developed secondary glaucoma.ConclusionCataract surgery with primary IOL implantation before 12 weeks of age resulted in a high number of VAO operations, and the visual outcome varied considerably, showing the range in outcome for this challenging patient group. Co‐existent PFV in these young patients was common. The incidence of secondary glaucoma was similar to other studies, despite the young age at surgery, high percentage of PFV and number of surgical procedures for VAO.
Understanding the experience of rumination and worry: A descriptive qualitative survey study
Authors: Joubert Amy E. , Moulds Michelle L. , Werner‐Seidler Aliza , Sharrock Maria , Popovic Bojana , Newby Jill M. 
Published: April 2022

AbstractObjectivesRumination and worry have been implicated in the onset, severity, maintenance and relapse risk of depression and anxiety disorders. Despite this, little research has examined individuals' personal experiences of these processes. This study investigates how individuals experience these processes, which will provide insight into these common features of mental disorders and inform the development of an online intervention specifically targeting rumination and worry.DesignAn online qualitative survey was conducted to gain insight into people's personal definitions, experiences with and understandings of rumination and worry.MethodsParticipants answered open‐ and close‐ended questions about their personal understanding of rumination and worry, typical thought content, triggers, frequency, duration and coping strategies. Participant responses were coded into themes. Participants also completed self‐report questionnaires of depression, anxiety and stress and repetitive negative thinking.ResultsTwo hundred and seven adults completed the online survey (76% female; mean age = 28.2 years, range = 17–71), 51% of whom reported previously experiencing depression and anxiety. All participants were familiar with the concept of worry, whereas 28% of participants indicated they had never heard of rumination. Participants reported most commonly ruminating and/or worrying about personal relationships, past mistakes, negative experiences and conversations/social interactions. The most commonly reported triggers for rumination and/or worry were social situations/interpersonal interactions (25%) and negative events/experiences (24%). Distraction was the most common coping strategy (48%); however, 21% reported being unable to stop themselves from ruminating and/or worrying.ConclusionsThe results provide a unique insight into the personal experiences and understandings of rumination and worry of potential end users of treatment programs targeting these processes.
Measurement of erythrocyte membrane mannoses to assess splenic function
Authors: Cao Huan , Mathur Abhinav , Robertson Charlotte , Antonopoulos Aristotelis , Henderson Sadie , Girard Louis‐Pierre , Wong Jin Hien , Davie Adam , Wright Sonja , Brewin John , Rees David C. , Dell Anne , Haslam Stuart M. , Vickers Mark A. 
Published: April 2022

SummaryRed blood cells (RBCs) lose plasma membrane in the spleen as they age, but the cells and molecules involved are yet to be identified. Sickle cell disease and infection by Plasmodium falciparum cause oxidative stress that induces aggregates of cross‐linked proteins with N‐linked high‐mannose glycans (HMGs). These glycans can be recognised by mannose‐binding lectins, including the mannose receptor (CD206), expressed on macrophages and specialised phagocytic endothelial cells in the spleen to mediate the extravascular haemolysis characteristic of these diseases. We postulated this system might also mediate removal of molecules and membrane in healthy individuals. Surface expression of HMGs on RBCs from patients who had previously undergone splenectomy was therefore assessed: high levels were indeed observable as large membrane aggregates. Glycomic analysis by mass spectrometry identified a mixture of Man5‐9GlcNAc2 structures. HMG levels correlated well with manual pit counts (r = 0.75–0.85). To assess further whether HMGs might act as a splenic reticuloendothelial function test, we measured levels on RBCs from patients with potential functional hyposplenism, some of whom exhibited high levels that may indicate risk of complications.
Cyclic‐AMP signalling, MYC and hypoxia‐inducible factor 1α intersect to regulate angiogenesis in B‐cell lymphoma
Authors: Ethiraj Purushoth , Sasi Binu , Holder Kenneth N. , Lin An‐Ping , Qiu Zhijun , Jaafar Carine , Elkhalili Alia , Desai Parth , Saksena Annapurna , Ritter Jacob P. , Aguiar Ricardo C. T. 
Published: April 2022

SummaryAngiogenesis and MYC expression associate with poor outcome in diffuse large B‐cell lymphoma (DLBCL). MYC promotes neo‐vasculature development but whether its deregulation in DLBCL contributes to angiogenesis is unclear. Examination of this relationship may uncover novel pathogenic regulatory circuitry as well as anti‐angiogenic strategies in DLBCL. Here, we show that MYC expression positively correlates with vascular endothelial growth factor (VEGF) expression and angiogenesis in primary DLBCL biopsies, independently of dual expressor status or cell‐of‐origin classification. We found that MYC promotes VEGFA expression, a correlation that was validated in large datasets of mature B‐cell tumours. Using DLBCL cell lines and patient‐derived xenograft models, we identified the second messenger cyclic‐AMP (cAMP) as a potent suppressor of MYC expression, VEGFA secretion and angiogenesis in DLBCL in normoxia. In hypoxia, cAMP switched targets and suppressed hypoxia‐inducible factor 1α, a master regulator of VEGFA/angiogenesis in low oxygen environments. Lastly, we used the phosphodiesterase 4b (Pde4b) knockout mouse to demonstrate that the cAMP/PDE4 axis exercises additional anti‐angiogenesis by directly targeting the lymphoma microenvironment. In conclusion, MYC could play a direct role in DLBCL angiogenesis, and modulation of cAMP levels, which can be achieved with clinical grade PDE4 inhibitors, has cell and non‐cell autonomous anti‐angiogenic activity in DLBCL.
Cardiometabolic risk factors in adults with normal weight obesity: A systematic review and meta‐analysis
Authors: Rakhmat Iis Inayati , Putra Iwan Cahyo Santosa , Wibowo Arief , Henrina Joshua , Nugraha Gaga Irawan , Ghozali Mohammad , Syamsunarno Mas Rizky A. A. , Pranata Raymond , Akbar Mohammad Rizki , Achmad Tri Hanggono 
Published: April 2022

SummaryNormal weight obesity (NWO) is a new emerging phenotype of obesity, defined as a normal body mass index with a high body fat percentage. While several studies have described the impact of NWO on cardiometabolic risk factors, the association between them remains uncertain. This meta‐analysis systematically evaluated cardiometabolic risk factors in adults with NWO compared to adults with normal weight lean (NWL). A systematic literature search was performed from the inception until September 21, 2021 in order to comprehensively search for all observational studies that had three important variables, including adults (age ≥18 years old), NWO and cardiometabolic risk factors including metabolic syndrome, hypertension, diabetes mellitus, dyslipidaemia or all laboratory findings related to cardiometabolic risk factors. Twenty‐four cross‐sectional studies with a total of 75 201 subjects are included in the qualitative and quantitative analysis. Overall, older age and female sex are more likely in NWO population. Compared to NWL, NWO is significantly associated with cardiometabolic risk factors, including metabolic syndrome (OR = 2.24 [1.74, 2.89]; p < .001; I2 = 76%, Pheterogeneity < 0.001), hypertension (OR = 1.60[1.36, 1.89]; p < .001; I2 = 76%, Pheterogeneity < 0.001), diabetes mellitus (OR = 1.72[1.54, 1.92]; p < .001; I2 = 47%, Pheterogeneity < 0.001), dyslipidaemia (OR = 1.50 [1.03, 2.18]; p = .03; I2 = 94%, Pheterogeneity < 0.001) and other laboratory findings, except for C‐reactive protein in both sexes group; and adiponectin levels in female group. Our meta‐analysis showed that NWO was associated with cardiometabolic risk factors. Thus, the traditional definition of obesity using the BMI criteria should be challenged, as those with NWO might still be exposed to a heightened risk of cardiometabolic disorders. Nonetheless, further prospective cohort studies are needed better to understand this syndrome.
Intraclass correlation coefficients for weight loss cluster randomized trials in primary care: The PROPEL trial
Authors: Katzmarzyk Peter T. , Denstel Kara D. , Martin Corby K. , Newton Robert L. , Apolzan John W. , Mire Emily F. , Horswell Ronald , Johnson William D. , Brown Andrew W. , Zhang Dachuan ,   The PROPEL Research Group
Published: April 2022

SummaryThe aim of this study was to compute intra‐class correlations (ICCs) for weight‐related and patient‐reported outcomes in a cluster randomized clinical trial (cRCT) for weight loss. Baseline and follow‐up data from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) cRCT were used in this analysis. ICCs were computed for baseline and follow‐up measures, and changes in body weight, cardiometabolic risk factors and health‐related and weight‐related quality of life at 6, 12, 18 and 24 months. Baseline ICCs ranged from 0 for PROMIS measures of anxiety and fatigue to 0.055 for total cholesterol (median = 0.019). The ICCs were higher for changes and decreased over time during follow‐up. The ICCs for changes were highest in the pooled sample (intervention and usual care combined) followed by the intervention and usual care groups, respectively. The results demonstrated significant ICCs for several outcomes in a weight loss cRCT. The ICCs differed in magnitude depending on whether baseline versus longitudinal data were used, whether data were combined across treatment arms or were considered separately, and varied across the follow‐up period. All these factors must be considered when choosing an ICC to inform sample size estimates for future weight loss cRCTs conducted in primary care settings.
The impact of health status, diet and lifestyle on non‐alcoholic fatty liver disease: Narrative review
Authors: Alalwani Joud , Eljazzar Sereen , Basil Maya , Tayyem Reema 
Published: April 2022

SummaryNon‐alcoholic fatty liver disease (NAFLD) is defined as the abnormal accumulation of triglycerides in the liver. NAFLD has a global prevalence of almost 30%, while incidence is rising with increasing levels of obesity, type 2 diabetes mellitus (T2DM) and metabolic syndrome. Nutrition plays a significant role in both the prevention and treatment of NAFLD. Therefore, the aim of this literature review is to explore the associations between dietary, lifestyle and other risk factors and the risk for developing NAFLD. Dietary patterns, lifestyle behaviours, comorbidities, or a combination of any may contribute to either the progression or prevention of NAFLD. Having diabetes, hypertension, or having obesity might increase the progression of NAFLD if not well treated and controlled. Diet influences the progression of NAFLD; following a western diet or simply a high‐fat diet may contribute to the worsening of NAFLD and further progression to non‐alcoholic steatohepatitis (NASH) and cirrhosis in later stages. On the other hand, the Mediterranean diet is the gold standard for both the treatment and prevention of NAFLD. Social behaviours, such as smoking, caffeine consumption and physical activity also play a role in the pathophysiology of NAFLD. Nutrition contributes significantly to the prevention or treatment of NAFLD, since this disease can be managed by diet and physical activity. However, further studies are still needed for a better understanding of the mechanisms of action. Randomized control trials are also needed to confirm findings in observational studies.
Interprofessional perspectives on care for patients with low anterior resection syndrome: A qualitative study
Authors: Pape Eva , Van Haver Dora , Lievrouw An , Van Nieuwenhove Yves , Van De Putte Dirk , Van Ongeval Johan , Rogge Sofie , Van Hecke Ann ,   the Belgian LARS collaborative group
Published: April 2022

AbstractAimMany patients are confronted with low anterior resection syndrome after rectal surgery. The perspectives of both healthcare professionals and patients on the impact of bowel problems may differ. This study aimed to explore experiences of healthcare professionals on how to provide, organise and optimise care for patients with low anterior resection syndrome from an interprofessional perspective.MethodsAn explorative qualitative design was used. Healthcare professionals were recruited in October 2018 in one general teaching hospital and one university hospital. Twenty one healthcare professionals from different professions caring for patients with low anterior resection syndrome were included in three focus group interviews.ResultsHealthcare professionals confirmed a lack of focus on patients who are confronted with low anterior resection syndrome and stated a need for a standardised approach of care. Additionally, three levels for care optimization emerged from the data: information before surgery with strong emphasis on the timing of informing, counselling of patients when confronted with low anterior resection syndrome and organisation of care.ConclusionsHealthcare professionals find it important to adopt the moment and amount of information to the coping mechanism and timing of the trajectory. Counselling and follow‐up of patients with LARS should be organised proactively and should not remain restricted to pharmacological and nutritional advice. A possible strategy is to develop and implement late effects nurse‐led clinics coordinated by the clinical nurse specialist.
Combination of resolvin E1 and lipoxin A4 promotes the resolution of pulpitis by inhibiting NF‐κB activation through upregulating sirtuin 7 in dental pulp fibroblasts
Authors: Liu Xiaochen , Wang Chunmeng , Pang Liping , Pan Liangliang , Zhang Qi 
Published: April 2022

AbstractObjectivesTo determine whether the combination of resolvin E1 (RvE1) and lipoxin A4 (LXA4) could promote resolution of pulpitis and to investigate the mechanism.Materials and MethodsPreliminary screening was first conducted in four specialized pro‐resolving mediators (SPMs). Real‐time quantitative polymerase chain reaction, western blotting, enzyme‐linked immunosorbent assay and double‐immunofluorescence labelling were employed to assess the expression of RelA, SIRT1, SIRT6, SIRT7 and pro‐inflammatory factors. Dental pulp fibroblasts (DPFs) were transfected with siRNA to assess the biological role of SIRT7. A pulpitis model was utilized to evaluate the in vivo curative effect.ResultsPreliminary results showed that RvE1 and LXA4 reduced the expression of RelA more markedly than other two SPMs. Both RvE1 and LXA4 treatment downregulated nuclear factor kappa B (NF‐κB) activation and increased the expression of SIRT1, SIRT6 and SIRT7, more so in combination than alone. Double‐immunofluorescence labelling showed that SIRT7 co‐localized with p‐p65 and Ac‐p65 in the nucleus. Inhibiting ChemR23 and ALX reversed the expression of RelA mRNA, p‐p65 and Ac‐p65 proteins, pro‐inflammatory factors, SIRT1, SIRT6 and SIRT7. Silencing SIRT7 significantly increased p‐p65 and Ac‐p65 protein levels and decreased SIRT1 and SIRT6 expression. In vivo experiments showed that combined administration of RvE1 and LXA4 promoted pulpitis markedly to resolution.ConclusionsCombination of RvE1 and LXA4 effectively inhibited NF‐κB activation by upregulating SIRT7 expression in DPFs, leading to reduced production of pro‐inflammatory factors and promotion of pulpitis resolution.