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Platelet Rich Plasma Concentration Improves Biologic Mesh Incorporation and Decreases Multinucleated Giant Cells in a Dose Dependent Fashion.

J Tissue Eng Regen Med 2021 Sep 22. Epub 2021 Sep 22.

Houston Methodist Research Institute, Department of Nanomedicine.

Platelet rich plasma (PRP) has been shown to improve incorporation and reduce inflammation in ventral hernia repair (VHR) with acellular dermal matrix (ADM). The concentration of platelets in PRP varies in clinical studies and an ideal concentration has yet to be defined. The effects of varied concentrations of PRP on ADM incorporation and inflammatory cell infiltration in a rat model of VHR. Read More

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September 2021

Medullary thyroid carcinoma (MTC): unusual metastatic sites.

Endocrinol Diabetes Metab Case Rep 2021 Sep 1;2021. Epub 2021 Sep 1.

Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Summary: Medullary thyroid carcinoma (MTC) has a varying clinical course; distant metastases are frequently present even at diagnosis. We present two MTC cases with unusual metastatic sites. Two female patients are presented with slow progressive MTC. Read More

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September 2021

Effects of Organic Acids on Drug Release from Ternary Polypeptide Nanoparticles Entrapping Carfilzomib.

J Pharm Sci 2021 Sep 19. Epub 2021 Sep 19.

Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA. Electronic address:

Carfilzomib (CFZ) is an FDA-approved proteasome inhibitor with antineoplastic properties against various cancers, yet its short blood retention time after intravenous injection (< 30 min) makes clinical applications limited to multiple myeloma. We previously developed ternary polypeptide nanoparticles (tPNPs) as a new nanoparticle formulation of CFZ to overcome these limitations. The formulation was prepared by polyion complexation between poly(ethylene glycol)-poly(L-glutamate) block copolymers (PEG-PLE) and CFZ-cyclodextrin (CD) inclusion complexes, where CDs were positively charged with 7 primary amines attached while PEG-PLE carried 100 carboxyl groups per polymer chain. Read More

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September 2021

Exosomal OTULIN from M2 macrophages promotes the recovery of spinal cord injuries via stimulating Wnt/β-catenin pathway-mediated vascular regeneration.

Acta Biomater 2021 Sep 19. Epub 2021 Sep 19.

Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, 410008, Changsha, China; Hunan Engineering Research Center of Sports and Health; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China. Electronic address:

Vascularization following spinal cord injury (SCI) provides trophic support for rebuilding up and maintaining the homeostasis of neuronal networks, and the promotion of angiogenesis is beneficial for functional recovery after SCI. M2 macrophages have been reported to exhibit powerful pro-angiogenic functions during tissue repair. Exosomes are important paracrine mediators of their parent cells and play critical roles in tissue regeneration. Read More

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September 2021

A Robust Prognostic Signature of Tumor Microenvironment in Colorectal Cancer.

Cancer Biother Radiopharm 2021 Sep 22. Epub 2021 Sep 22.

Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P.R. China.

Colorectal cancer (CRC) has been a major public health problem. Tumor microenvironment (TME) greatly contributes to the heterogeneity of CRC and is crucial for the regulation of CRC progression. The authors' study wanted to develop a robust prognostic signature for CRC patients based on TME-related genes. Read More

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September 2021

Factors Associated With Variation in Pediatric Systemic Lupus Erythematosus Care Delivery.

ACR Open Rheumatol 2021 Sep 22. Epub 2021 Sep 22.

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Objective: Patients with pediatric systemic lupus erythematosus (pSLE) and mixed connective tissue disease (MCTD) receive only a fraction of recommended care. Using published quality indicators and guidelines, we developed a 13-item pediatric lupus care index (p-LuCI) to quantify the proportion of recommended clinical evaluations and comorbidity prevention interventions completed and the timeliness of follow-up. Our objective was to assess baseline index performance and identify sources of p-LuCI variation. Read More

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September 2021

Increased serum exosomal long non-coding RNA SNHG15 expression predicts poor prognosis in non-small cell lung cancer.

J Clin Lab Anal 2021 Sep 22:e23979. Epub 2021 Sep 22.

Department of Respiratory and Critical Care Medicine, the First Hospital of Yulin City, Yulin City, Shaanxi Province, China.

Background: Circulating long non-coding RNAs (lncRNAs) are emerging as promising biomarkers for non-small cell lung cancer (NSCLC). This study aimed to detect serum exosomal lncRNA SNHG15 expression in NSCLC and evaluate its potential clinical value.

Methods: A total of 238 serum samples were collected from 118 patients with NSCLC, 40 patients with benign pulmonary lesions and 80 healthy volunteers. Read More

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September 2021

Metabolomics approach to study in vivo toxicity of graphene oxide nanosheets.

J Appl Toxicol 2021 Sep 22. Epub 2021 Sep 22.

Cancer Gene Therapy Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.

Although graphene oxide (GO) nanosheets are widely used in different fields, the mechanism of their toxicity remains relatively unknown. NMR-based metabolomics was used to study in vivo time and dose-dependent toxicity of GO nanosheets in mice. Sixty serum samples from mice in four different time intervals including 24 and 72 h and 7 and 21 days after injection of 0-, 1-, and 10-mg/kg b. Read More

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September 2021

Phase and amplitude EEG correlations change with disease progression in people with idiopathic rapid eye-movement sleep behavior disorder.

Sleep 2021 Sep 22. Epub 2021 Sep 22.

Department of Informatics, Bioengineering, Robotics and System engineering (DIBRIS), University of Genoa, Genoa, Italy.

Study Objectives: Increased phase synchronization in electroencephalography (EEG) bands might reflect the activation of compensatory mechanisms of cognitive decline in people with neurodegenerative diseases. Here, we investigated whether altered large-scale couplings of brain oscillations could be linked to the balancing of cognitive decline in a longitudinal cohort of people with idiopathic rapid eye-movement sleep behavior disorder (iRBD).

Methods: We analyzed 18 patients (17 males, 69. Read More

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September 2021

The effects of transitions in metabolic health and obesity status on incident cardiovascular disease: Insights from a general Chinese population.

Eur J Prev Cardiol 2021 Sep;28(11):1250-1258

Department of Cardiology, The First Hospital of China Medical University, China.

Background: Recent studies have investigated the association of transitions in metabolic health and obesity status over time with the risk of cardiovascular disease, focusing on the subgroup demonstrating metabolically healthy obesity. However, these studies have produced inconsistent results. This study evaluates the relation in a general Chinese population. Read More

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September 2021

Non-adherence to established dietary guidelines associated with increased mortality: the Copenhagen General Population Study.

Eur J Prev Cardiol 2021 Sep;28(11):1259-1268

Department of Internal Medicine, Zealand University Hospital, Denmark.

Aims: The relevance of adherence to established dietary guidelines is repeatedly challenged. We hypothesised that non-adherence to established dietary guidelines is associated with an excess risk of cardiovascular, non-cardiovascular and all-cause mortality.

Methods: We studied 100,191 white adult Danes aged 20-100 years recruited in 2003-2015 and followed up until December 2018. Read More

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September 2021

DIAGNOSTIC STRATEGIES FOR ENDEMIC CORONAVIRUS DISEASE 2019 (COVID-19): RAPID ANTIGEN TESTS, REPEAT TESTING, AND PREVALENCE BOUNDARIES.

Authors:
Gerald J Kost

Arch Pathol Lab Med 2021 Sep 22. Epub 2021 Sep 22.

From the Department of Pathology and Laboratory Medicine, POCT•CTR, School of Medicine, University of California, Davis.

Context: - Coronavirus disease 2019 (COVID-19) rapid antigen tests generate intrinsically fast, inherently spatial, and immediately actionable results. They quickly confirm COVID-19, but weakly rule out infection. Test performance depends on prevalence and testing protocol. Read More

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September 2021

A natural anthocyanin-based multifunctional theranostic agent for dual-modal imaging and photothermal anti-tumor therapy.

J Mater Chem B 2021 Sep 22;9(36):7447-7460. Epub 2021 Sep 22.

Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, 030032, China.

Nowadays, cancer is one of the most serious diseases threatening the health of human beings, and imaging-guided photothermal therapy (PTT) is rapidly emerging as a potent oncotherapy strategy due to its unique advantages of high efficiency, noninvasiveness, visualization, and accuracy. In this study, a multifunctional nanoplatform based on gadolinium ion chelated natural anthocyanins (ACNs) is reported, which can be used not only as an excellent photoacoustic/magnetic resonance (PA/MR) dual-modal contrast agent but also for imaging-guided tumor PTT. The nanoparticles obtained have a suitable size, good dispersity, and physiological stability. Read More

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September 2021

Aminopeptidase N-targeting nanomolecule-assisted delivery of VEGF siRNA to potentiate antitumour therapy by suppressing tumour revascularization and enhancing radiation response.

J Mater Chem B 2021 Sep 22;9(36):7530-7543. Epub 2021 Sep 22.

Department of Radiology, Tianjin Medical University Second Hospital, No. 23, Pingjiang Road, Hexi District, Tianjin 300211, P. R. China.

Tumour revascularization and the consequent radioresistance activated by the up-regulated angiogenic pathway after radiation exposure remain a major bottleneck for improving the tumouricidal effect of radiotherapy (RT) in hepatocellular carcinoma (HCC). Herein, we show that fabricated aminopeptidase N (ANP/CD13)-targeting Gd-hybridized gold nanomolecules (tGd-GNMs) can efficaciously suppress tumour revascularization and the consequent radioresistance, and then synergize in augmenting the RT response. Both and experiments demonstrate that the targeted delivery of vascular endothelial growth factor (VEGF) siRNA into the tumour site and the generation of an abundance of intratumourally cytotoxic reactive oxygen species (ROS) under X-ray radiation by the tGd-GNMs complex has the capability to down-regulate VEGF gene expression and strengthen the radiation response. Read More

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September 2021

Anticoagulation Therapy for Portal Vein Thrombosis in Patients with Cirrhosis in a Tertiary Center Experience.

J Gastrointestin Liver Dis 2021 Sep 21;30(3):374-379. Epub 2021 Sep 21.

Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Bucharest; Centre for Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania.

Background And Aims: The evidence regarding the use of anticoagulant (AC) agents in portal vein thrombosis (PVT) is increasing and, most patients undergo chronic treatment with low molecular weight heparin (LMWH) or vitamin K antagonists (VKA). Nevertheless, there are no clear data about who should receive antithrombotic therapy, when to initiate it, how long and what dose should be used for this set of patients. The aim of the study was to assess the outcome of patients with cirrhosis and portal vein thrombosis who received AC therapy, in terms of thrombus regression, bleeding events and survival rates. Read More

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September 2021

Breast cancer patient experiences through a journey map: A qualitative study.

PLoS One 2021 22;16(9):e0257680. Epub 2021 Sep 22.

Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain.

Background: Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients' lives (physical, emotional, cognitive, social, and spiritual).

Objective: This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey. Read More

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September 2021

Implementation of artificial intelligence algorithms for melanoma screening in a primary care setting.

PLoS One 2021 22;16(9):e0257006. Epub 2021 Sep 22.

Image Research Center, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Skin cancer is currently the most common type of cancer among Caucasians. The increase in life expectancy, along with new diagnostic tools and treatments for skin cancer, has resulted in unprecedented changes in patient care and has generated a great burden on healthcare systems. Early detection of skin tumors is expected to reduce this burden. Read More

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September 2021

Hemodynamics-driven mathematical model of first and second heart sound generation.

PLoS Comput Biol 2021 Sep 22;17(9):e1009361. Epub 2021 Sep 22.

Department of Biomedical Engineering Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.

New & Noteworthy: To the best of our knowledge, this is the first hemodynamic-based heart sound generation model embedded in a complete real-time computational model of the cardiovascular system. Simulated heart sounds are similar to experimental and clinical measurements, both quantitatively and qualitatively. Our model can be used to investigate the relationships between heart sound acoustic features and hemodynamic factors/anatomical parameters. Read More

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September 2021

The Goldilocks Procedure with and without Implant-Based Immediate Breast Reconstruction in Obese Patients: The Mayo Clinic Experience.

Plast Reconstr Surg 2021 Oct;148(4):703-716

From the Divisions of Plastic and Reconstructive Surgery and Departments of Surgery, Mayo Clinic Rochester, Jacksonville, and Scottsdale; and Mayo Clinic Alix School of Medicine.

Background: Obesity is a risk factor for complications in breast reconstruction. Thus, implant-based immediate breast reconstruction in obese women may be controversial. The authors analyzed obese patients who underwent skin-sparing mastectomy using Wise-pattern incisions (Goldilocks procedure) and compared outcomes between two groups: Goldilocks with immediate breast reconstruction and Goldilocks only. Read More

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October 2021

Applying the Ottawa Ankle Rules in a Pediatric Emergency Department.

Pediatr Emerg Care 2021 Sep 7. Epub 2021 Sep 7.

From the Pediatric Department, Hospital Beatriz Ângelo, Loures, Portugal.

Objectives: Ankle and midfoot injuries constitute one of the most frequent reasons to visit the pediatric emergency department (ED). The aims of the study were (1) to determine the feasibility of the Ottawa Ankle Rules (OARs) in a pediatric ED and its reliability to safely manage ankle and midfoot injuries and (2) to verify the impact in reducing the number of radiographs, healthcare costs, and time spent in the ED.

Methods: The prospective study enrolled 90 patients for the control group and 94 for the case group. Read More

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September 2021

Algorithmic surveillance of CU patients with acute respiratory distress syndrome (ASIC): protocol for a multicentre stepped-wedge cluster randomised quality improvement strategy.

BMJ Open 2021 Apr 8;11(4):e045589. Epub 2021 Apr 8.

SMITH consortium of the German Medical Informatics Initiative, Leipzig, Germany.

Introduction: The acute respiratory distress syndrome (ARDS) is a highly relevant entity in critical care with mortality rates of 40%. Despite extensive scientific efforts, outcome-relevant therapeutic measures are still insufficiently practised at the bedside. Thus, there is a clear need to adhere to early diagnosis and sufficient therapy in ARDS, assuring lower mortality and multiple organ failure. Read More

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Implementation of an anticoagulation practice guideline for COVID 19 via a clinical decision support system in a large academic health system and its RE-AIM evaluation.

JMIR Med Inform 2021 Sep 17. Epub 2021 Sep 17.

University of Minnesota, Department of Surgery, 420 Delaware St SE, MMC 195, Minneapolis, US.

Background: Studies evaluating strategies for the rapid development, implementation and evaluation of clinical decision support(CDS) systems supporting guidelines for diseases with poor knowledge base, such as COVID-19, are limited.

Objective: We developed an anticoagulation clinical practice consensus guideline(CPG) for COVID-19 delivered and scaled via CDS across a 12-hospital Midwest healthcare system. This study represents a pre-planned 6-month post-implementation evaluation guided by the RE-AIM framework. Read More

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September 2021

The State of Mind of Healthcare Professionals in the Light of the COVID-19: Insights from Text Analysis of Twitter's Online Discourses.

J Med Internet Res 2021 Jul 23. Epub 2021 Jul 23.

Department of Nursing, Ben-Gurion University of the Negev, Beer Sheva, IL.

Background: The COVID-19 pandemic has affected populations worldwide, with extreme health, economic, social, and political implications. Healthcare professionals (HCPs) are at the core of pandemic response and are among the most crucial factors in maintaining coping capacities. Yet, they are also vulnerable to mental health effects, managing a long-lasting emergency under lack of resources and complicated personal concerns. Read More

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Augmented hip proprioception influences mediolateral foot placement during walking.

IEEE Trans Neural Syst Rehabil Eng 2021 Sep 22;PP. Epub 2021 Sep 22.

Hip abductor proprioception contributes to the control of mediolateral foot placement, which varies with step-by-step fluctuations in pelvis dynamics. Prior work has used hip abductor vibration as a sensory probe to investigate the link between vibration within a single step and subsequent foot placement. Here, we extended prior findings by applying time and location varying vibration in every step, seeking to predictably manipulate the continuous, step-by-step relationship between pelvis dynamics and foot placement. Read More

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September 2021

Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort.

Elife 2021 Sep 22;10. Epub 2021 Sep 22.

Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Background: Lack of early infection-exposure has been associated with increased allergy-related disease (ARD) susceptibility. In tropical Africa, little is known about which infections contribute to development of ARDs, and at which time.

Methods: We used latent class analysis to characterise the early infection-exposure of participants in a Ugandan birth cohort and assessed ARDs in later childhood. Read More

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September 2021

Hourly Kinetics of Critical Organ Dysfunction in Extremely Preterm Infants.

Am J Respir Crit Care Med 2021 Sep 22. Epub 2021 Sep 22.

University of Florida College of Medicine, 12233, Pediatrics, Gainesville, Florida, United States;

Rationale: Use of severity of illness scores to classify patients for clinical care and research is common outside of the neonatal intensive care unit. Extremely premature (<29 weeks gestation), extremely low birth weight (<1000 grams) infants experience significant mortality and develop severe pathology during the protracted birth hospitalization.

Objective: To measure at high resolution the changes in organ dysfunction that occur from birth to death or discharge home by gestational age, time, and among extremely preterm infants with and without clinically-meaningful outcomes using the neonatal sequential organ failure assessment score. Read More

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September 2021

Effect of renal impairment on the efficacy and safety of intra-arterial treatment: A post-hoc analysis of DIRECT-MT study.

Int J Stroke 2021 Sep 22:17474930211045805. Epub 2021 Sep 22.

Department of Stroke Center, Changhai Hospital, Naval Military Medical University, Shanghai, China.

Objective: To determine the influence of renal impairment on clinical outcomes in patients presenting emergent anterior circulation occlusion treated with mechanical thrombectomy.

Methods: Consecutive patients with anterior circulation stroke treated with mechanical thrombectomy at 41 academic tertiary care centers were included. renal impairment was defined as glomerular filtration rate <60 mL/min/1. Read More

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September 2021

The utility of rapid Group A streptococcus molecular testing compared with throat culture for the diagnosis of Group A streptococcal pharyngitis in a high-incidence rheumatic fever population.

J Clin Microbiol 2021 Sep 22:JCM0097821. Epub 2021 Sep 22.

Department of Microbiology, Middlemore Hospital, Auckland, New Zealand.

Group A (GAS) causes significant morbidity and mortality in New Zealand and is responsible for invasive disease and immune sequelae including acute Rheumatic Fever (ARF). Early treatment of GAS pharyngitis reduces the risk of ARF. In settings with a high-burden of GAS disease, a rapid GAS pharyngitis diagnostic test with a strong negative predictive value is needed to enable prompt and accurate treatment. Read More

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September 2021

Intravenous Versus Oral Acetaminophen Use in Febrile Neurocritical Care Patients.

Ther Hypothermia Temp Manag 2021 Sep 22. Epub 2021 Sep 22.

Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA.

The use of intravenous (IV) acetaminophen (APAP) for fever has not been thoroughly studied in neurocritical care (NCC) patients, in whom a temperature of ≥38°C is associated with poor outcomes and treatment to normothermia is common practice. This retrospective study evaluated NCC patients admitted between May 1, 2012, and April 30, 2013, and received at least one dose of IV or oral (PO) APAP for a body temperature of ≥38°C. The primary aim of this study was to compare the reduction in body temperature (RIT) between IV and PO APAP, calculated as the change in temperature before and 0. Read More

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September 2021