bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is replacing red meat with other protein sources associated with lower risks of coronary heart disease and all-cause mortality? A meta-analysis of prospective studies
Authors: Hidayat Khemayanto , Chen Jing-Si , Wang Hai-Peng , Wang Tian-Ci , Liu Yu-Jie , Zhang Xue-Ying , Rao Chun-Ping , Zhang Jian-Wei , Qin Li-Qiang 
Published: February 2022

AbstractContextA high amount of red meat consumption has been associated with higher risks of coronary heart disease (CHD) and all-cause mortality in a single food-exposure model. However, this model may overlook the potentially differential influence of red meat on these outcomes depending on the foods replaced by red meat.ObjectiveA PRISMA-compliant meta-analysis of prospective observational studies was performed to quantify the risks of CHD and all-cause mortality associated with the replacement of total, unprocessed, or processed red meat with fish/seafood, poultry, dairy, eggs, nuts, and legumes.Data sourcesThe PubMed and Web of Science databases were searched to identify relevant articles published in any language from database inception to October 30, 2021.Data extractionThe prospective observational studies were considered relevant if they reported relative risks (RRs) and 95%CIs for the associations of interest.Data analysisThirteen articles were included. A random-effects model was used to estimate the summary RRs and 95%CIs for the associations of interest. Replacing total red meat with poultry (RR, 0.88, 95%CI, 0.82–0.96; I2 = 0%), dairy (RR, 0.90, 95%CI, 0.88–0.92; I2 = 0%), eggs (RR, 0.86, 95%CI, 0.79–0.94; I2 = 7.1%), nuts (RR, 0.84, 95%CI, 0.74–0.95; I2 = 66.8%), or legumes (RR, 0.84, 95%CI, 0.74–0.95; I2 = 7.3%) was associated with a lower risk of CHD, whereas substituting fish/seafood (RR, 0.91, 95%CI, 0.79–1.04; I2 = 69.5%) for total red meat was not associated with the risk of CHD. The replacement of total red meat with fish/seafood (RR, 0.92, 95%CI, 0.89–0.96; I2 = 86.9%), poultry (RR, 0.92, 95%CI, 0.90–0.95; I2 = 61.6%), eggs (RR, 0.91, 95%CI, 0.87–0.95; I2 = 33.8%), or nuts (RR, 0.92, 95%CI, 0.87–0.97; I2 = 81.9%) was associated with a lower risk of all-cause mortality, whereas the substitution of dairy (RR, 0.97, 95%CI, 0.93–1.01; I2 = 33.9%) or legumes (RR, 0.97, 95%CI, 0.93–1.01; I2 = 53.5%) for total red meat was not associated with the risk of all-cause mortality. Lower risks of CHD and all-cause mortality were more consistently observed for processed red meat replacements than for unprocessed red meat replacements. The results did not materially change when the analyses of total, processed, and unprocessed red meat were restricted to the studies that used a uniform substitution amount per unit of 1 serving/d.ConclusionKeeping red meat, particularly processed red meat, consumption to a minimum along with increasing healthier alternative protein sources to replace red meat in the diet may contribute to the prevention of CHD and premature death.Systematic review registrationPROSPERO registration no. CRD42021259446.
Neural Stem Cell-Derived Exosomal Netrin1 Contributes to Neuron Differentiation of Mesenchymal Stem Cells in Therapy of Spinal Bifida Aperta
Authors: Ma Ling , Wei Xiaowei , Ma Wei , Liu Yusi , Wang Yanfu , He Yiwen , Jia Shanshan , Wang Yu , Luo Wenting , Liu Dan , Huang Tianchu , Yan Jiayu , Gu Hui , Bai Yuzuo , Yuan Zhengwei 
Published: February 2022

Abstract
Spinal bifida aperta (SBA) is a congenital malformation with a high incidence. Bone marrow mesenchymal stem cell (BMSC) transplantation has the potential to repair the structure of damaged tissues and restore their functions. This is an optional treatment that can be used as a supplement to surgery in the treatment of SBA. However, the application of BMSCs is limited, as the neuronal differentiation rate of BMSCs is not satisfactory when used in treating severe SBA. Thus, we aimed to assess the effect of neural stem cell (NSC)-derived exosomes on BMSC neuronal differentiation and observe the therapeutic effect in an ex vivo rat SBA embryo model. We found that NSC-derived exosomes increased the neuronal differentiation rate of BMSCs in vitro and in the SBA embryo model ex vivo. Proteomic analysis showed that NSC-derived exosomes were enriched in Netrin1, which positively regulated neuronal differentiation. Netrin1 increased the neuronal differentiation rate of BMSCs and NSCs and upregulated the expression of the neuronal markers, microtubule-associated protein (Map2), neurofilament, and β3-tubulin. Bioinformatic analysis revealed that Netrin1 treatment increased the expression of the transcription factors Hand2 and Phox2b, related to neuronal differentiation. Furthermore, the Netrin1-induced NSC neuronal differentiation was significantly blocked by Phox2b knockdown. We suggest that NSC-derived exosomal Netrin1 induces neuronal differentiation via the Hand2/Phox2b axis by upregulating the expression of Hand2 and Phox2b. Therefore, NSC-derived exosomes are a critical inducer of BMSC neuronal differentiation and represent a potential treatment agent that can benefit BMSC treatment in SBA.
Characteristics of allergen profile, sensitization patterns and Allergic Rhinitis in SouthEast Asia
Authors: Pham Duy Le , Trinh Tu Hoang Kim , Le Kieu_Minh , Pawankar Ruby 
Published: February 2022

Purpose of review
To highlight the characteristics of allergic rhinitis, local allergic rhinitis (LAR), and importance of allergens in Southeast Asian countries.

Recent findings
The Asia-Pacific region is very diverse with disparities in the epidemiological data between countries as well as in the unmet needs. The prevalence of allergic rhinitis has markedly increased in the past decades, with a high variation between countries, ranging from 4.5--80.3%. In terms of LAR, the reported prevalence in Southeast Asia is similar to that of other Asian countries (3.7–24.9%) but lower than that in western countries. House dust mites, cockroach, pollens, and molds are major allergens that are known triggers for of allergic rhinitis in this region, whereas the association with helminth infection requires further investigation.

Summary
There are gaps and high variation between countries in Southeast Asia regarding the prevalence of allergic rhinitis and LAR. Further studies are needed to fully elucidate the association between allergens and allergic rhinitis in Southeast Asia.
Atopic dermatitis endotypes: knowledge for personalized medicine
Authors: Kim Jihyun , Ahn Kangmo 
Published: February 2022

Purpose of review
Endotypes are clinically relevant phenotypes that can be explained by molecular mechanisms, and are defined to predict the development, progression, prognosis and responses to treatment on the individual level. This review summarizes atopic dermatitis phenotypes, endotypes and their potential application for personalized medicine.

Recent findings
Atopic dermatitis can be classified into several phenotypes according to disease courses that likely have common pathophysiology. The genotype is important to define endotypes, but the value of genotype alone remains somewhat limited in most atopic dermatitis patients. Recent studies have demonstrated that atopic dermatitis phenotypes according to ethnicity or age can be classified into endotypes based on the dominant immunologic markers, that is TH1/TH2/TH17/TH22 cells. Newly developed biologic agents targeting specific cytokines show therapeutic potential in a personalized medicine approach.

Summary
Cytokine-based endotypes in different age groups or ethnic groups have contributed to expanding our understanding of atopic dermatitis. Recent biologics or small molecules can be used for more personalized treatment of atopic dermatitis. Further research using integrated multiomic analysis is needed to define a more detailed classification of endotypes and provide endotype-driven targeted therapies for personalized medicine.
Drug allergy desensitization is not a unique recipe
Authors: Madrigal-Burgaleta Ricardo , Guzman-Melendez Maria Antonieta , Alvarez-Cuesta Emilio 
Published: February 2022

Purpose of review
Drug desensitization is the only therapeutic option for patients with drug allergies who need to receive the drugs they are allergic to, and it is especially critical in patients with an urgent need for chemotherapy, biologics, or antibiotics, where equally effective alternatives might not be available. However, drug desensitization is not a cookbook where anyone with no experience or specific training can find a general recipe. This review article will approach the singularities that make personalized and highly specialized care essential in this field.

Recent findings
Drug desensitization needs to be personalized for each individual patient bearing in mind countless factors. Recent articles have tried to define the optimal resources and the most important factors to account for in personalization. However, drug desensitization is only a tool within the wider management pathway, and we will discuss recent findings in allergy delabelling in chemotherapy, biologics, and antibiotics.

Summary
Risk-assessment, delabelling, and desensitization protocols, as a part of wider management pathways, can be adapted locally along with comprehensive and multifactorial risk-management strategies. These high-complexity and high-risk procedures, such as drug desensitization, need to be managed by expert allergists who can provide personalization, innovation, continuous improvement, research, and teaching in expert centres.
Direct Exchange of PerfluoroCarbon Liquid for Silicone Oil: A Surgical Technique to Control Pressure and Avoid Retinal Slippage
Authors: Treacy Maxwell P. , Conway Marcus P. , Hammoud Mohammad Al , Duignan Emma S. , Ahearne Mark , Ezra Eric 
Published: February 2022

Background/Purpose:
Perfluorocarbon heavy liquid (PFCL) is used in vitreoretinal surgery to flatten the unsupported detached retina before insertion of silicone oil in cases of giant retinal tear or relaxing retinectomy. Direct exchange of PFCL for silicone oil is recommended to reduce retinal slippage when compared with fluid–air exchange, but it is commonly regarded as a difficult procedure. We describe our technique for direct PFCL–silicone oil exchange using a 20-gauge drainage cannula, reliably avoiding the complications of retinal slippage and high intraoperative intraocular pressure.

Methods:
We present a consecutive case series of patients undergoing PFCL–oil exchange and explain, using Poiseuille's equation for laminar fluid flow through a cannula, the rationale for using a 20-gauge drainage cannula rather than smaller gauges to avoid high intraocular pressure.

Results:
Twenty-six patients underwent PFCL–oil exchange from February 1, 2019, to September 30, 2019. There was no intraoperative retinal slippage or pressure-related complications. Postoperatively 20 patients underwent oil removal. Six suffered retinal redetachment, and 14 remained attached. The vision postoil removal ranged from 6/6 to hand movements.

Conclusion:
We are confident that the PFCL–oil exchange technique described here is reliable and safe. The use of a 20-gauge drainage cannula is recommended regardless of vitrectomy gauge.
OUTCOMES IN PRIMARY UNCOMPLICATED RHEGMATOGENOUS RETINAL DETACHMENT REPAIR USING PARS PLANA VITRECTOMY WITH OR WITHOUT SCLERAL BUCKLE
Authors: Hébert Mélanie , You Eunice , Garneau Jérôme , Qi Susan Ruyu , Bourgault Serge , Caissie Mathieu , Tourville Éric , Dirani Ali 
Published: February 2022

Purpose:
To compare outcomes after primary uncomplicated rhegmatogenous retinal detachment repair using pars plana vitrectomy (PPV) or PPV with scleral buckle (PPV-SB).

Methods:
This is a retrospective cohort study with propensity score analysis in a single tertiary care center between 2014 and 2018 comparing patients with primary uncomplicated rhegmatogenous retinal detachment repaired using PPV only or PPV-SB (full cohort: n = 1,516, propensity-matched cohort: n = 908). The primary outcome was single surgery anatomic success, whereas secondary outcomes were 3-month and final pinhole visual acuity in logarithm of the minimum angle of resolution and final retina status.

Results:
In the full cohort, single surgery anatomic success was achieved in 745 (91%) PPV patients versus 623 (89%) PPV-SB patients (P = 0.13). This was 390 (92%) versus 314 (88%) in phakic patients (P = 0.06) compared with 353 (91%) versus 301 (90%) in pseudophakic patients (P = 0.79), respectively. After matching, single surgery anatomic success was achieved in 424 (93%) PPV patients versus 412 (91%) PPV-SB patients (P = 0.14). Median pinhole visual acuity after PPV was better at 3 months (PPV: 20/40 vs. PPV-SB: 20/50; both cohorts: P < 0.001) and final follow-up (PPV: 20/29 vs. PPV-SB: 20/38; full cohort: P < 0.001 and PPV: 20/29 vs. PPV-SB: 20/36; matched cohort: P < 0.001).

Conclusion:
Addition of scleral buckle does not significantly change the rate of single surgery anatomic success compared with PPV only in primary uncomplicated rhegmatogenous retinal detachment. It is also associated with worse pinhole visual acuity at follow-up.
AUTOMATIC DETECTION AND GRADING OF DIABETIC MACULAR EDEMA BASED ON A DEEP NEURAL NETWORK
Authors: Guo Xiaoxin , Lu Xinfeng , Zhang Baoliang , Hu Xiaoying , Che Songtian 
Published: February 2022

Purpose:
To solve the problem of automatic grading of macular edema in retinal images in a more stable and reliable way and reduce the workload of ophthalmologists, an automatic detection and grading method of diabetic macular edema based on a deep neural network is proposed.

Methods:
The enhanced green channels of fundus images are input into the YOLO network for training and testing. Diabetic macular edema is graded according to the distance of the macula and hard exudate. We used multiscale feature fusion to form more comprehensive features on different grain images to improve the effect of hard exudate detection. We adopted K-means++ algorithm to cluster anchor box size and use

loss of the original network to guide the regression of hard exudate bounding box and improve the regression accuracy of anchor boxes. We increased the diversity of samples for sample training by data augmentation, including cropping, flipping, and rotating of fundus images, so that each batch of training data can better represent the distribution of samples.

Results:
The detection accuracy of the proposed method can reach 96% on the MESSIDOR data set. The detection rates of hard exudate with high, median, and low probability are 100%, 79.12%, and 60.40%, respectively.

Conclusion:
The proposed method exhibits a very good detection stability on healthy and diseased fundus images.
BACILLARY LAYER DETACHMENT IN A KOREAN COHORT WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Kim Jae Hui , Kim Jong Woo , Kim Chul Gu 
Published: February 2022

Purpose:To evaluate the incidence and characteristics of bacillary layer detachment (BALAD) in neovascular age-related macular degeneration.Methods:This retrospective study was performed at Kim's Eye Hospital in South Korea. Patients who were diagnosed with neovascular age-related macular degeneration between January 2017 and December 2017 were included. The incidence of BALAD was compared among different types of macular neovascularization (MNV). The best-corrected visual acuity and central retinal thickness at diagnosis were compared between patients showing BALAD at diagnosis and those who did not.Results:Among the 442 patients included, BALAD was observed in 20 patients (4.5%). There was a significant difference in the incidence of BALAD between Type 1 MNV (2.7%), Type 2 MNV (12.5%), and Type 3 MNV (0%) (P< 0.001). The best-corrected visual acuity was significantly worse (mean 1.26 ± 0.79 vs. 0.62 ± 0.50,P= 0.001), and the central retinal thickness was significantly greater (mean 648.2 ± 211.1µm vs. 464.0 ± 175.5µm,P< 0.001) in patients with BALAD than in those without it. After antivascular endothelial growth factor therapy, all BALADs resolved.Conclusion:This study first reported the incidence of the BALAD in neovascular age-related macular degeneration in a Korean population. The incidence of BALAD was the highest in Type 2 MNVs. Bacillary layer detachment generally develops in eyes with great macular thickness and poor visual acuity.
Personality Organization and Depressive Symptoms Among Psychiatric Outpatients
Authors: Jakšić Nenad , Marčinko Darko , Bjedov Sarah , Mustač Filip , Bilić Vedran 
Published: February 2022

Abstract
Previous research has demonstrated relations between lower level of personality organization (PO) and multiple indices of mental health disturbances. The goal of this research was to examine whether experience of shame would mediate the relationship between PO and depressive symptoms in a sample of 321 Croatian psychiatric outpatients (64% female; mean age, 38.67 years). The total PO level exhibited positive associations with depressive symptoms and with all three subscales of shame (p < 0.01). Characterological, behavioral, and bodily shame showed significant mediating effects in the PO-depression relationship, while controlling for the influence of age and sex. PO level seems to be strongly related to depressive disturbances, with the experience of shame representing one of the underlying mechanisms of this relationship. Given that patients with personality disorders (i.e., low PO level) suffer from poorer treatment outcomes for major mental disorders, more emphasis should be placed on psychotherapeutic management of shame-proneness.
Changing dynamics of COVID-19 deaths during the SARS-CoV2 B.1.617.2 (Delta variant) outbreak in England and Wales: Reduced COVID-19 deaths among the Care Home residents
Authors: Emani Venkata R. , Reddy Raghunath , Emani Shaila R. , Goswami Kartik K. , Maddula Kailash R. , Reddy Nikhila K. , Nakka Abirath S. , Reddy Nidhi K. , Nandanoor Dheeraj , Goswami Sanjeev 
Published: February 2022

ABSTRACTObjectivesCare Homes faced crisis during the SARS-CoV2 pandemic with increased mortality and various corrective interventions were undertaken. The impact of current SARS-CoV2 B.1.617.2 (Delta variant) outbreak on COVID-19 deaths in Care Homes is not completely known.DesignObservational studySetting and ParticipantsWe included nationwide data of deaths from all causes and COVID-19 in England and Wales during March 7, 2020-November 26, 2021.MethodsImpact of COVID-19 deaths in Care Homes, Hospital and Homes relative to total deaths from all causes was investigated.ResultsDuring March 7-August 28,2020; 15,414 (29.8%) of the 51,740 COVID-19 deaths occurred in Care Homes. During August 29, 2020-May 28, 2021, there were significant decrease in COVID-19 deaths in Care Homes ([19.2%]; RR 0.64; 95%CI 0.63-0.65;p<0.0001], which significantly declined further ([8.9%]; RR 0.46; 95%CI 0.43-0.48;p<0.0001) during May 29-November 26, 2021. During the March 7-August 28, 2020; 20.0% (15,514/76,906) of all Care Home deaths were caused by COVID-19, which significantly declined to 18.5% (RR 0.92; 95%CI 0.90-0.93; p<0.0001) during August 29, 2020-May 28, 2021 and declined further to 2.5% (RR 0.13; 95% CI 0.12-0.14;p<0.0001) during May 29-November 26, 2021. Increased percentages of COVID-19 deaths occurred in Hospitals ([72.3%]; RR 1.14; 95% CI 1.1-1.15;p<0.0001) and Homes ([6.3%]; RR 1.33; 95% CI 1.27-1.40; p<0.0001) during August 29, 2020-May 28, 2021 and further increases in the Hospitals ([80.8%]; RR 1.11; 95% CI 1.10-1.12; p<0.0001) and Homes ([8.8%]; RR 1.39; 95% CI 1.31-1.47; p<0.0001) during May 29-November 26, 2021.Conclusions and ImplicationsThere was a significantly lower number of COVID-19 deaths occurred in Care Homes and a significantly lower number of Care Homes deaths caused by COVID-19 during the Delta variant surge in England and Wales than the prior surges. Care Home residents are at highest risk for mortality, continuous monitoring and research on COVID-19 preventive interventions are essential.
Coronavirus Disease 2019 (COVID-19) Vaccine Boosting in Persons Already Protected by Natural or Vaccine-Induced Immunity
Authors: Shrestha Nabin K. , Shrestha Priyanka , Burke Patrick C. , Nowacki Amy S. , Terpeluk Paul , Gordon Steven M. 
Published: February 2022

ABSTRACTBackgroundThe purpose of this study was to evaluate whether boosting healthcare personnel, already reasonably protected by prior infection or vaccination, with a vaccine developed for an earlier variant of COVID-19 protects against the Omicron variant.MethodsEmployees of Cleveland Clinic who were previously infected with or vaccinated against COVID-19, and were working in Ohio the day the Omicron variant was declared a variant of concern, were included. The cumulative incidence of COVID-19 was examined over two months during an Omicron variant surge. Protection provided by boosting (analyzed as a time-dependent covariate) was evaluated using Cox proportional hazards regression. Analyses were adjusted for time since proximate overt immunologic challenge (POIC) as a time-dependent covariate.ResultsAmong 39 766 employees, 8037 (20%) previously infected and the remaining previously vaccinated, COVID-19 occurred in 6230 (16%) during the study. Risk of COVID-19 increased with time since POIC. In multivariable analysis, boosting was independently associated with lower risk of COVID-19 among those with vaccine-induced immunity (HR, .43; 95% CI, .41-.46) as well as those with natural immunity (HR, .66; 95% CI, .58-.76). Among those with natural immunity, receiving 2 compared to 1 dose of vaccine was associated with higher risk of COVID-19 (HR, 1.54; 95% CI, 1.21-1.97).ConclusionsAdministering a COVID-19 vaccine not designed for the Omicron variant, 6 months or more after prior infection or vaccination, protects against Omicron variant infection in both previously infected and previously vaccinated individuals. There is no evidence of an advantage to administering more than 1 dose of vaccine to previously infected persons.SummaryAmong 39 766 Cleveland Clinic employees already protected by prior infection or vaccination, vaccine boosting after 6 months was associated with significantly lower risk of COVID-19. After COVID-19 infection, there was no advantage to more than one dose of vaccine.