bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implications of Dorsalis Pedis Artery Anatomical Variants for Dorsal Midfoot Surgery
Authors: Tonogai Ichiro , Tsuruo Yoshihiro , Sairyo Koichi 
Published: March 2022

Background: The dorsalis pedis artery (DPA) usually branches into the arcuate artery (AA) from its lateral side which in turn crosses the bases of the lateral four metatarsals. The DPA then passes into the first interosseous space, where it divides into the first metatarsal artery and the deep plantar artery. In this study, we aimed to determine the extent of variation in the DPA and the distance between the AA and the tarsometatarsal (TMT) joint with the aim of reducing the risk of vascular complications arising from dorsal midfoot surgery. Methods: In 29 fresh cadaveric feet, we examined the course of the DPA and the distance between the AA and the TMT joint on computed tomography images with barium sulfate contrast. Results: The DPA was observed to have a standard course in 11 of the 29 cases (37.9%) but did not give rise to the AA and lateral tarsal artery or branches of the plantar arterial arch supplying to the second to fourth metatarsal spaces in 10 of 29 cases (34.5%). The mean closest distance from the TMT joint to the AA at the second, third, and fourth metatarsal level in the sagittal plane was 11.4, 14.6, and 17.1 mm, respectively. Conclusion: We found substantial variation in the arterial anatomy of the DPA system across the dorsal midfoot. Clinical Relevance: The risk of pseudoaneurysm and frank arterial disruption may be mitigated if the surgeon is aware of the variations of the course of the DPA when performing dorsal midfoot surgery.
Investigating the potential disease-modifying and neuroprotective efficacy of exercise therapy early in the disease course of multiple sclerosis: The Early Multiple Sclerosis Exercise Study (EMSES)
Authors: Riemenschneider Morten , Hvid Lars G , Ringgaard Steffen , Nygaard Mikkel Karl Emil , Eskildsen Simon Fristed , Gaemelke Tobias , Magyari Melinda , Jensen Henrik Boye , Nielsen Helle Hvilsted , Kant Matthias , Falah Masoud , Petersen Thor , Stenager Egon , Dalgas Ulrik 
Published: March 2022

Background: Potential supplemental disease-modifying and neuroprotective treatment strategies are warranted in multiple sclerosis (MS). Exercise is a promising non-pharmacological approach, and an uninvestigated ‘window of opportunity’ exists early in the disease course. Objective: To investigate the effect of early exercise on relapse rate, global brain atrophy and secondary magnetic resonance imaging (MRI) outcomes. Methods: This randomized controlled trial ( n = 84, disease duration <2 years) included 48 weeks of supervised aerobic exercise or control condition. Population-based control data (Danish MS Registry) was included ( n = 850, disease duration <2 years). Relapse rates were obtained from medical records, and patients underwent structural and diffusion-kurtosis MRI at baseline, 24 and 48 weeks. Results: No between-group differences were observed for primary outcomes, relapse rate (incidence-rate-ratio exercise relative to control: (0.49 (0.15; 1.66), p = 0.25) and global brain atrophy rate (−0.04 (−0.48; 0.40)%, p = 0.87), or secondary measures of lesion load. Aerobic fitness increased in favour of the exercise group. Microstructural integrity was higher in four of eight a priori defined motor-related tracts and nuclei in the exercise group compared with the control (thalamus, corticospinal tract, globus pallidus, cingulate gyrus) at 48 weeks. Conclusion: Early supervised aerobic exercise did not reduce relapse rate or global brain atrophy, but does positively affect the microstructural integrity of important motor-related tracts and nuclei.
The spectrum of attitudes towards the spectrum of autism and its relationship to psychological distress in mothers of children with autism
Authors: Ferenc Kinga , Byrka Katarzyna , Król Magdalena Ewa 
Published: March 2022

Attitude of mothers towards their children’s autism may play a role in mothers’ psychological well-being. We investigated the predictive value of how mothers understand autism (as a neurodivergence or a developmental disorder) on their psychological distress. A group of 371 mothers of children on the autism spectrum participated in this study. We found that understanding autism as a neurodivergence was related to lower psychological distress in mothers, even after controlling for the level of autism symptoms. However, when controlling for caregiver burden, their attitude towards autism was no longer significant in explaining their psychological distress. These findings suggest that the way mothers understand autism may be important for their psychological adjustment. However, it also suggests that mothers of children on the autism spectrum may adopt different attitudes towards autism, depending on their child’s level of autism symptoms and the caregiver burden. Lay abstract Mothers of children on the autism spectrum experience high levels of emotional distress. Mothers cope with stress by having their own thoughts and opinions about their children. In this study, we tested whether the way mothers perceive autism may contribute to the level of distress they feel. Some mothers see autism as a developmental disorder that needs to be cured, but some see autism as a type of mind that needs to be accepted. Our findings showed that mothers who see autism more as a type of mind are generally less stressed. But we also showed that it matters how severe are the child’s symptoms, and how heavy was the perceived burden of caring for the child. These results imply that it is worth working on attitudes towards autism to help mothers cope better. But at the same time, we argue that mothers should not be judged for their perceptions of autism, as there is a huge spectrum of a child’s characteristics and family’s life circumstances.
Robotically-assisted neuro-endovascular procedures: Single-Center Experience and a Review of the Literature
Authors: Costa Matias , Tataryn Zachary , Alobaid Abdullah , Pierre Clifford , Basamh Mohammed , Somji Mohamed , Loh Yince , Patel Akshal , Monteith Stephen 
Published: March 2022

Introduction Robotics could expand treatment of rapidly progressive pathologies such as acute ischemic stroke, with the potential to provide populations in need prompt access to neuro-endovascular procedures. Methods Robotically-assisted (RA) neuro-endovascular procedures (RANPs) performed at our institution were retrospectively examined (RA-group, RG). A control group of manual neuro-endovascular procedures was selected (manual group, MG). Total operating room (OR) time, procedural time, contrast media use, fluoroscopy time, conversion from RA to manual control, procedural success, and complication rates were compared. A learning curve was identified. Results Forty-one (41) RANPs were analyzed. Ages ranged from 20–82 y.o. Indications included diagnostic cerebral angiography (37), extracranial carotid artery stenting (3), and transverse sinus stent (1). Total OR time was longer in RG (median 86 vs. 71 min, p < 0.01). Procedural time (median 56 vs. 45 min, p = 0.12), fluoroscopy time (median 12 vs. 12 min, p = 0.69) and contrast media usage (82 vs. 92 ml, p = 0.54) were not significantly different. Patient radiation exposure was similar, considering similar fluoroscopy times. Radiation exposure and lead apron use were virtually absent for the main surgeon in RG. Procedural success was 83% and conversion from RA to manual control was 17% in RG. No treatment-related complications occurred. A learning curve showed that, after the fifth procedure, procedural times reduced and stabilized. Conclusions This series may contribute to further demonstrating the safety and feasibility of RANPs. RANPs can potentially reduce radiation exposure and physical burden for health personnel, expand acute cerebrovascular treatment to underserved areas, and enhance telementoring. Prospective studies are necessary for results to be generalized.
Influence of probenecid on endoxifen systemic exposure in breast cancer patients on adjuvant tamoxifen treatment
Authors: Buck Stefan A. J. , Braal C. Louwrens , Hofman Maaike M. , Oomen-de Hoop Esther , Bruijn Peter de , Ghobadi Moghaddam-Helmantel Inge M. , Hussaarts Koen G. A. M. , Vastbinder Mijntje B. , van Rossum-Schornagel Quirine C. , van Schaik Ron H. N. , Jager Agnes , Koolen Stijn L. W. , Mathijssen Ron H. J. 
Published: March 2022

Introduction: In breast cancer patients treated with the anti-estrogen tamoxifen, low concentrations of the active metabolite endoxifen are associated with more disease recurrence. We hypothesized that we could increase endoxifen concentrations by induction of its formation and inhibition of its metabolism by co-administration of probenecid. Methods: We conducted a crossover study and measured endoxifen concentrations in patients on steady-state tamoxifen monotherapy and after 14 days of combination treatment with probenecid. Eleven evaluable patients were included. Results: Treatment with tamoxifen and probenecid resulted in a 26% increase of endoxifen area under the plasma concentration–time curve from 0 to 24 h (AUC0–24h) compared to tamoxifen monotherapy (95% confidence interval [CI]: 8–46%; p < 0.01), while the maximum observed endoxifen concentration increased with 24% (95% CI: 7–44%; p < 0.01). The metabolic ratio of endoxifen to tamoxifen increased with 110% (95% CI: 82–143%; p < 0.001) after the addition of probenecid. Conclusion: Probenecid resulted in a clinically relevant increase of endoxifen concentrations in breast cancer patients treated with adjuvant tamoxifen. This combination therapy could provide a solution for patients with a CYP2D6-poor metabolizer phenotype or endoxifen concentrations below the threshold despite earlier tamoxifen dose.
Delayed treatment with a tumor necrosis factor alpha blocker associated with worse outcomes in patients with spondyloarthritis: data from the Czech National Registry ATTRA
Authors: Milota Tomas , Hurnakova Jana , Pavelka Karel , Kristkova Zlatuse , Nekvindova Lucie , Horvath Rudolf 
Published: March 2022

Introduction: The administration of biologic disease-modifying antirheumatic drugs, including tumor necrosis factor (TNF)-α inhibitors, is observed to interfere with the disease activity and progression. In this study, we aimed to assess the effectiveness and response predictors of adalimumab (ADA), a TNF-α blocker, in patients with axial spondyloarthritis (AxSpA). Methods: This study was a historical prospective, registry-based observational study on patients with AxSpA treated with first-line ADA after conventional drug failure. For evaluation and comparison, patients were divided into three groups according to the number of years from AxSpA diagnosis to initiation of ADA treatment: (A) <5 years, (B) 5–10 years, and (C) >10 years. The assessment instruments ankylosing spondylitis disease activity score (ASDAS), Bath ankylosing spondylitis activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), health assessment questionnaire (HAQ), Short Form 36 questionnaire (SF-36), and EuroQoL 5 dimension questionnaire (EQ-5D) were regularly administered for up to 24 months of follow-up. Results: This study included 1043 patients with AxSpA (9.2% with non-radiographic AxSpA, 68.9% men). By month 6, a significantly higher proportion of patients with ASDAS remission (<1.3) was achieved upon earlier intervention in group A (30.1%) and B (32.9%) than in the late intervention group C (22.6%) ( p ⩽ 0.05). At month 6, lower age and better BASFI at treatment initiation were identified as the strongest predictors of ASDAS remission in both univariable [odds ratio (OR): 0.956, p ⩽ 0.001; OR: 0.834, p ⩽ 0.001, respectively] and multivariable analyses (OR: 0.963, p ⩽ 0.001; OR: 0.859, p ⩽ 0.001, respectively). Earlier intervention also led to improvement in most patient-reported outcomes (PROs) based on HAQ, SF-36, and EQ-5D. Conclusion: Results from the ATTRA registry concur with previous clinical trials that supported efficacy of TNF-α blockers and showed better treatment outcomes with early interventions, including reduction of disease activity and improvement in PROs. We identified age and BASFI as the main factors influencing treatment effectiveness.
Evolution of the public relations profession in Latin America: A brief review of the development of public relations in Latin American countries
Authors: Suárez-Monsalve Ana-María 
Published: March 2022

This paper reviews the historical background of public relations and its development in Latin America in order to understand the evolution and current state of this profession. The questions are how has the academic study of public relations evolved, and what is the current state of the modern public relations profession in Latin America? The following is an explanation of how the academic development of the public relations profession has taken place. For this purpose, a literature review is conducted and empirical data from the longitudinal study published every two years by the Latin American Communication Monitor (LCM) are analyzed. In this way, we identify historical turning points in public relations education Latin America, key issues for practitioners in the region according to LCM data.
The paradox of pulmonary arterial hypertension in Italy in the COVID-19 era: is risk of disease progression around the corner?
Authors: Badagliacca Roberto , Papa Silvia , D'Alto Michele , Ghio Stefano , Agostoni Piergiuseppe , Ameri Pietro , Argiento Paola , Brunetti Natale Daniele , Casamassima Vito , Casu Gavino , Cedrone Nadia , Confalonieri Marco , Corda Marco , Correale Michele , D'Agostino Carlo , De Michele Lucrezia , Famoso Giulia , Galgano Giuseppe , Greco Alessandra , Lombardi Carlo Mario , Manzi Giovanna , Madonna Rosalinda , Mercurio Valentina , Mulè Massimiliano , Paciocco Giuseppe , Romaniello Antonella , Romeo Emanuele , Scelsi Laura , Serra Walter , Stolfo Davide , Toma Matteo , Vatrano Marco , Vitulo Patrizio , Vizza Carmine Dario 
Published: March 2022

ObjectiveThe coronavirus disease 2019 (COVID-19) outbreak has led to significant restrictions on routine medical care. We conducted a multicentre nationwide survey of patients with pulmonary arterial hypertension (PAH) to determine the consequences of governance measures on PAH management and risk of poor outcome in patients with COVID-19.Materials and methodsThe present study, which included 25 Italian centres, considered demographic data, the number of in-person visits, 6-min walk and echocardiographic test results, brain natriuretic peptide/N-terminal pro-brain natriuretic peptide test results, World Health Organization functional class assessment, presence of elective and non-elective hospitalisation, need for treatment escalation/initiation, newly diagnosed PAH, incidence of COVID-19 and mortality rates. Data were collected, double-checked and tracked by institutional records between March 1 and May 1, 2020, to coincide with the first peak of COVID-19 and compared with the same time period in 2019.ResultsAmong 1922 PAH patients, the incidences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 were 1.0% and 0.46%, respectively, with the latter comparable to that in the overall Italian population (0.34%) but associated with 100% mortality. Less systematic activities were converted into more effective remote interfacing between clinicians and PAH patients, resulting in lower rates of hospitalisation (1.2%versus1.9%) and related death (0.3%versus0.5%) compared with 2019 (p<0.001). A high level of attention is needed to avoid the potential risk of disease progression related to less aggressive escalation of treatment and the reduction in new PAH diagnoses compared with 2019.ConclusionA cohesive partnership between healthcare providers and regional public health officials is needed to prioritise PAH patients for remote monitoring by dedicated tools.
Child maltreatment, anxiety and depression, and asthma among British adults in the UK Biobank
Authors: Han Yueh-Ying , Yan Qi , Chen Wei , Celedón Juan C. 
Published: March 2022

BackgroundChild maltreatment is associated with asthma in adults. We examined whether lifetime major depressive disorder (MDD) or lifetime generalised anxiety disorder (GAD) mediate an association between child maltreatment and current asthma among 81 105 British adults in the UK Biobank who completed a mental health survey and had complete data on child maltreatment, GAD, MDD, asthma and relevant covariates but no diagnosis of chronic obstructive pulmonary disease.MethodsChild maltreatment was ascertained based on answers to the five questions in the Childhood Trauma Screener. Two mediators, lifetime MDD and GAD, were assessed based on the Composite International Diagnostic Interview Short Form. Current asthma was defined as physician-diagnosed asthma and wheeze or whistling in the chest in the previous year. Logistic regression was used for the multivariable analysis of child maltreatment and current asthma, and a mediation analysis was conducted to estimate the contributions of lifetime MDD and lifetime GAD to the child maltreatment–current asthma association.ResultsIn a multivariable analysis, any child maltreatment was associated with asthma (adjusted OR 1.22, 95% CI 1.15–1.28; p<0.01). In a mediation analysis adjusted for household income, educational attainment, smoking status, pack-years of smoking and other covariates, lifetime GAD and lifetime MDD explained 21.8% and 32.5%, respectively, of the child maltreatment–current asthma association. Similar results were obtained after excluding current smokers and former smokers with ≥10 pack-years of smoking from the mediation analysis.ConclusionOur findings suggest that GAD and MDD mediate an association between child maltreatment and asthma in adults, independently of smoking.
Breath octane and acetaldehyde as markers for acute respiratory distress syndrome in invasively ventilated patients suspected to have ventilator-associated pneumonia
Authors: Heijnen Nanon F.L. , Hagens Laura A. , van Schooten Frederik-Jan , Bos Lieuwe D.J. , van der Horst Iwan C.C. , Mommers Alex , Schultz Marcus J. , Smit Marry R. , Bergmans Dennis C.J.J. , Smolinska Agnieszka , Schnabel Ronny M. 
Published: March 2022

RationaleThe concentration of octane and acetaldehyde in exhaled breath has good diagnostic accuracy for acute respiratory distress syndrome (ARDS). We aimed to determine whether breath octane and acetaldehyde are able to distinguish the presence and absence of ARDS in critically ill patients suspected to have ventilator-associated pneumonia (VAP).MethodsThis is a secondary analysis of a prospective observational study into exhaled breath analysis using gas chromatography–time-of-flight mass spectrometry. Difference in the relative abundance of octane and acetaldehyde in exhaled breath was compared between patients with and without ARDS using the Mann–Whitney U-test and the association was quantified using logistic regression. The discriminative accuracy of octane and acetaldehyde, alone or in combination, was calculated using the area under the receiver operating characteristic curve (AUROCC).ResultsWe included 98 patients, of whom 32 had ARDS and 66 did not. The area under the acetaldehyde peak was higher in patients with ARDS (p=0.03), and associated with the presence of ARDS (OR 1.06 per 100 000 count change, 95% CI 1.02–1.13 per 100 000 count change; p=0.01). A combined model with octane and acetaldehyde showed a high specificity and low sensitivity (90% and 40.6%, respectively), with a low accuracy (AUROCC 0.65, 95% CI 0.53–0.78).ConclusionPatients suspected to have VAP with ARDS had a higher acetaldehyde concentration in exhaled breath than patients suspected to have VAP without ARDS. However, in this patient population, discrimination of these breath biomarkers for ARDS was poor, indicating the difficulty of translating diagnostic tests between clinical settings.
Lifetime cannabis exposure and small airway function in a population-based cohort study
Authors: Tan Hua Shin , McAnally Helena M. , Dummer Jack , Hancox Robert J. 
Published: March 2022

Background and objectiveThe long-term effects of cannabis on small airway function remain unclear. We investigated associations between cannabis use and small airway function in a general population sample.MethodsCannabis use was ascertained at multiple ages from age 18 to 45 years and quantified as joint-years among 895 participants in the Dunedin Multidisciplinary Health and Development Study. Small airway function at ages 38 and 45 years was measured using impulse oscillometry (IOS) before and after inhalation of salbutamol. Analyses used multiple linear regression adjusting for tobacco use, body mass index and height. Longitudinal analyses of cannabis use between 38 and 45 years also adjusted for IOS at age 38 years.ResultsAssociations between lifetime cannabis joint-years and IOS differed between men and women: in women, cannabis use was associated with pre-bronchodilator resistance at 5 Hz (R5) and 20 Hz (R20), reactance at 5 Hz, area of reactance and resonant frequency, and marginally associated with the difference betweenR5andR20. Cannabis use was only statistically significantly associated with pre-bronchodilator resonant frequency in men. Cannabis use between the ages of 38 and 45 years was associated with a similar pattern of changes in IOS measures. After salbutamol, cannabis use was only statistically significantly associated withR5andR20among women and none of the IOS measures among men.ConclusionsCannabis use is associated with small airway dysfunction at age 45 years, indicating an increase in peripheral airway resistance and reactance. These associations were greater and mostly only statistically significant among women. Associations were weaker and mostly nonsignificant after bronchodilator use, suggesting that cannabis-induced changes in small airways may be at least partially reversible.