bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac hypertrophic risk markers of left ventricle and left atrium in chronic heart failure due to aortic and mitral valve disease
Authors: Jan Muhammad Ishtiaq , Khan Riaz Anwar , Khan Naeem , Mahak Aisha , Shah Azhar Ul Haq Ali , Hussain Syed Tasleem , Kakakhel Ahaq ullah , Murtaza Iram 
Published: June 2020

Background Chronic valvular heart disease leads to systolic dysfunction and left atrial enlargement that ultimately results in heart failure. Purpose To investigate prognostic importance of Echocardiography and plasma natriuretic peptide levels that increase as a compensatory response and can be used as predictive markers for cardiac hypertrophy. Material and Methods The patients were divided into three groups: 51 with left ventricle hypertrophy due to aortic valve disease; 126 with left atrial enlargement due to mitral valve dysfunction; and 76 with both conditions. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) plasma levels were measured in all three respective groups showing dilated cardiomyopathy. Results The mean left ventricular end-diastolic dimension at 64.3 ± 1.6 mm ( P < 0.00) and left atrial dimension at 58.3 ± 3.7 mm ( P < 0.00) were significantly high. However, patients with both conditions showed significantly high values for left ventricular end-diastolic dimension (63.3 ± 3 mm, P < 0.00) and left atrial dimension (54.9 ± 4 mm, P < 0.00) when compared with controls. A significant positive correlation was found between plasma natriuretic peptides levels and dilated cardiomyopathy. The mean values of ANP were 173 ± 46.6 pg/mL ( P < 0.00), 140.4 ± 42.4 pg/mL ( P < 0.00), and 295.1 ± 67.5 pg/mL ( P < 0.00), significantly high in all three respective disease groups. The levels of BNP were also significantly high at 189 ± 44.5 pg/mL ( P < 0.00), 166.6 ± 36.6 pg/mL ( P < 0.00), and 323 ± 69.1 pg/mL ( P < 0.00) in the disease groups with left ventricular hypertrophy, left atrial enlargement, and the disease group showing both characteristics, respectively. Conclusion Significant positive associations were found between left ventricle hypertrophy and left atrial enlargement with ANP and BNP.
Identifying patients with chronic pain who respond to acupuncture: results from an individual patient data meta-analysis
Authors: Foster Nadine E , Vertosick Emily A , Lewith George , Linde Klaus , MacPherson Hugh , Sherman Karen J , Witt Claudia M , Vickers Andrew J ,   on behalf of the Acupuncture Trialists Collaboration
Published: June 2020

Background In a recent individual patient data meta-analysis, acupuncture was found to be superior to sham and non-sham controls in patients with chronic pain. It has been suggested that a subgroup of patients has an exceptional response to acupuncture. We hypothesized the presence of exceptional acupuncture responders would lead to a different distribution of pain scores in acupuncture versus control groups, with the former being skewed to the right. Methods This individual patient data meta-analysis included 39 high-quality randomized trials of acupuncture for chronic headache, migraine, osteoarthritis, low back pain, neck pain and shoulder pain published before December 2015 (n = 20,827). In all, 25 involved sham acupuncture controls (n = 7097) and 25 non-acupuncture controls (n = 16,041). We analyzed the distribution of change scores and calculated the difference in the skewness statistic—which assesses asymmetry in the data distribution—between acupuncture and either sham or non-acupuncture control groups. We then entered the difference in skewness along with standard error into a meta-analysis. Findings Control groups were more right-skewed than acupuncture groups, although this difference was very small. The difference in skew was 0.124 for non-acupuncture-controlled trials (p = 0.047) and 0.141 for sham-controlled trials (p = 0.029). In a pre-specified sensitivity analysis excluding three trials with outlying results known a priori, the difference in skew between acupuncture and sham was no longer statistically significant (p = 0.2). Conclusion We did not find evidence to support the notion that there are exceptional acupuncture responders. The challenge remains to identify features of chronic pain patients that can be used to distinguish those that have a good response to acupuncture treatment.
Trifarotene for the Treatment of Facial and Truncal Acne
Authors: Bell Katheryn A. , Brumfiel Caitlin M. , Haidari Wasim , Boger Laura 
Published: June 2020

Objective: This article reviews clinical trials to assess the efficacy, safety, and clinical application of trifarotene 0.005% cream (Aklief). Data Sources: A systematic review of the literature was performed using the terms trifarotene OR Aklief OR CD5789 in MEDLINE (PubMed) and EMBASE databases. Articles prior to May 2020 were considered for inclusion. Bibliographies and ClinicalTrials.gov were also searched to identify further studies. Study Selection and Data Extraction: Relevant English language and human studies related to pharmacology, clinical trials, and safety were considered. Data Synthesis: In the 52-week phase III trial, treatment success rates for facial acne (Investigator Global Assessment [IGA] rating of no or almost no acne) and truncal acne (Physician’s Global Assessment [PGA] rating of no or almost no acne) were 65.1% and 66.9%, respectively. Overall success rates (IGA and PGA success in the same patient) were 57.9%; 52.8% of patients had a Dermatology Quality of Life Index score of 0 or 1, compared with 22.6% at baseline. Trifarotene was well tolerated, with pruritus, irritation, and sunburn as the most common adverse effects. Relevance to Patient Care and Clinical Practice: Trifarotene is a newly Food and Drug Administration–labeled fourth-generation topical retinoid that shows particular promise in the treatment of facial and truncal acne vulgaris. It is an effective and safe addition to currently available retinoids. Conclusion: Trifarotene is effective and safe for treatment of facial and truncal acne. Future trials should compare its efficacy and tolerability with that of the older, clinically established retinoids. Despite efficacy, cost may be a prohibitive factor.
Prevalence of Abnormal Ultrasound Findings in Asymptomatic Posterior Tibial Tendons
Authors: Mills F. Baker , Williams Kevin , Chu Christopher H. , Bornemann Paul , Jackson J. Benjamin 
Published: June 2020

Background: Posterior tibial tendon dysfunction (PTTD) is a pathological condition that can cause failure of the posterior tibial tendon (PTT). Initially, patients with PTTD are often asymptomatic, making early identification and treatment challenging. Certain ultrasound (US) characteristics have been implicated in the presence of tendinopathy, but their frequency has yet to be assessed in the PTT. The purpose of this study was to identify and report on the frequency of incidental, or potentially early subclinical, tendinopathic US characteristics in asymptomatic PTTs. Methods: Following institutional review board approval, 150 participants underwent a bilateral-comprehensive US assessment. The resulting images were reviewed and assessed to identify the presence of abnormalities demonstrated to represent tendinopathy. Results: Overall, 266 tendons were assessed and 128 (48.1%) were determined to have at least one tendinopathic trait. Specifically, 51 (19.2%) had circumferential fluid, 69 (25.9%) had noncircumferential fluid, 22 (8.3%) had thickening, 31 (11.7%) had heterogenicity, 19 (7.1%) had hyperemia, and 2 (0.8%) had calcification. Additionally, Caucasian participants were found to be nearly 3 times more likely to have tendinopathic findings when compared with African American participants. Conclusion: Sixty-seven percent of participants and 48.1% of PTTs evaluated had at least one tendinopathic feature identified on US. The prevalence rates of these findings, observed in participants, were as follows: noncircumferential fluid, circumferential fluid, heterogenicity, and thickening. Knowing the frequency of these traits may help clinicians to identify subclinical tendinopathy in the PTT before it progresses to PTTD. Level of Evidence: Level IV, case series.
Suprasellar meningioma presenting with glaucomatous type cupping
Authors: Pellegrini Francesco , Marullo Michele , Zappacosta Antonio , Liberali Tatiana , Cuna Alessandra , Lee Andrew G 
Published: June 2020

Purpose: To describe a case of a suprasellar meningioma compressing the chiasm from below and producing a unilateral fascicular (nasal) visual field defect that mimicked glaucomatous cupping. Case report: A 78-year-old man presented with painless, progressive, unilateral arcuate visual field defect. He was diagnosed with “normal tension glaucoma” based on an asymmetric cup to disc ratio. Despite treatment with anti-glaucoma drops, the visual field defect progressed. Neurophthalmic evaluation was consistent with a compressive optic neuropathy OD. Brain MRI showed a suprasellar meningioma compressing on the junction of the optic nerve and chiasm from below. Conclusion: Although junctional visual field loss (e.g. junctional scotoma and junctional scotoma of Traquair) are well-known presentations of compressive lesions at the optic chiasm, we describe a monocular, ipsilateral compressive superior nasal defect and asymmetric cupping as the presenting sign of a junctional compressive lesion mimicking glaucomatous cupping.
Medical students’ perceptions and expectations regarding digital health education and training: A qualitative study
Authors: Edirippulige Sisira , Gong Sophie , Hathurusinghe Malshi , Jhetam Sarah , Kirk Jasmine , Lao Henry , Leikvold Annalise , Ruelcke Jayde , Yau Nim Chi , Zhang Qichen , Armfield Nigel , Senanayake Buddhika , Zhou Xiaoyun , Smith Anthony C , Judd Madelaine-Marie , Coulthard Mark G 
Published: June 2020

Introduction Digital health – the convergence of digital technologies within health and health care to enhance the efficiency of health-care delivery – is fast becoming an integral part of routine medical practice. The integration of digital health into traditional practice brings significant changes. Logic dictates that for medical practitioners to operate in this new digitally enabled environment, they require specific knowledge, skills and competencies relating to digital health. However, very few medical programmes in Australia and globally include digital health within their regular curriculum. This pilot study aimed to explore medical students’ perceptions and expectations of digital health education and training (ET). Methods An online survey and focus groups were used to collect information about medical students’ perceptions and expectations relating to digital health and ET relating to this field within the medical programme at the University of Queensland. Sixty-three students took part in the survey, and 17 students were involved in four focus groups. Results Most participants had no formal ET in digital health. Most participants ( n = 43; 68%) expressed a willingness to learn about digital health as part of their medical programme. Discussion Primarily, knowledge- and practice-related factors have motivated students to learn about digital health. The analysis of focus group data identified two superordinate themes: (a) drivers of digital health ET and (b) expectations relating to digital health ET. Students agreed that digital health is a relevant field for their future practice that should be taught as part of their regular curriculum.
Cardiac injury is associated with severe outcome and death in patients with Coronavirus disease 2019 (COVID-19) infection: A systematic review and meta-analysis of observational studies
Authors: Parohan Mohammad , Yaghoubi Sajad , Seraji Asal 
Published: June 2020

Abstract
Coronavirus disease 2019 (COVID-19) is a global pandemic impacting 213 countries/territories and more than 5,934,936 patients worldwide. Cardiac injury has been reported to occur in severe and death cases. This meta-analysis was done to summarize available findings on the association between cardiac injury and severity of COVID-19 infection. Online databases including Scopus, PubMed, Web of Science, Cochrane Library and Google Scholar were searched to detect relevant publications up to 20 May 2020, using relevant keywords. To pool data, a fixed- or random-effects model was used depending on the heterogeneity between studies. In total, 22 studies with 3684 COVID-19 infected patients (severe cases=1095 and death cases=365) were included in this study. Higher serum levels of lactate dehydrogenase (weighted mean difference (WMD) =108.86 U/L, 95% confidence interval (CI)=75.93–141.79, p&lt;0.001) and creatine kinase-MB (WMD=2.60 U/L, 95% CI=1.32–3.88, p&lt;0.001) were associated with a significant increase in the severity of COVID-19 infection. Furthermore, higher serum levels of lactate dehydrogenase (WMD=213.44 U/L, 95% CI=129.97–296.92, p&lt;0.001), cardiac troponin I (WMD=26.35 pg/mL, 95% CI=14.54–38.15, p&lt;0.001), creatine kinase (WMD=48.10 U/L, 95% CI=0.27–95.94, p = 0.049) and myoglobin (WMD=159.77 ng/mL, 95% CI=99.54–220.01, p&lt;0.001) were associated with a significant increase in the mortality of COVID-19 infection. Cardiac injury, as assessed by serum analysis (lactate dehydrogenase, cardiac troponin I, creatine kinase (-MB) and myoglobin), was associated with severe outcome and death from COVID-19 infection.
TLR-mediated activation of Waldenström macroglobulinemia B cells reveals an uncoupling from plasma cell differentiation
Authors: Shrimpton Jennifer , Care Matthew A. , Carmichael Jonathan , Walker Kieran , Evans Paul , Evans Charlotte , de Tute Ruth , Owen Roger , Tooze Reuben M. , Doody Gina M. 
Published: June 2020

Abstract
Waldenström macroglobulinemia (WM) is a rare malignancy in which clonal B cells infiltrate the bone marrow and give rise to a smaller compartment of neoplastic plasma cells that secrete monoclonal immunoglobulin M paraprotein. Recent studies into underlying mutations in WM have enabled a much greater insight into the pathogenesis of this lymphoma. However, there is considerably less characterization of the way in which WM B cells differentiate and how they respond to immune stimuli. In this study, we assess WM B-cell differentiation using an established in vitro model system. Using T-cell–dependent conditions, we obtained CD138+ plasma cells from WM samples with a frequency similar to experiments performed with B cells from normal donors. Unexpectedly, a proportion of the WM B cells failed to upregulate CD38, a surface marker that is normally associated with plasmablast transition and maintained as the cells proceed with differentiation. In normal B cells, concomitant Toll-like receptor 7 (TLR7) activation and B-cell receptor cross-linking drives proliferation, followed by differentiation at similar efficiency to CD40-mediated stimulation. In contrast, we found that, upon stimulation with TLR7 agonist R848, WM B cells failed to execute the appropriate changes in transcriptional regulators, identifying an uncoupling of TLR signaling from the plasma cell differentiation program. Provision of CD40L was sufficient to overcome this defect. Thus, the limited clonotypic WM plasma cell differentiation observed in vivo may result from a strict requirement for integrated activation.
Pharmacologic thromboprophylaxis in adult patients undergoing neurosurgical interventions for preventing venous thromboembolism
Authors: Yepes-Nuñez Juan José , Rajasekhar Anita , Rahman Maryam , Dahm Philipp , Anderson David R. , Colunga-Lozano Luis Enrique , Ross Stephanie , Bhatt Meha , Orozco Kelly Estrada , Popoff Federico , Ventresca Matthew , Barbara Angela M. , Balduzzi Sara , Begum Housne , Agarwal Arnav , Wiercioch Wojtek , Nieuwlaat Robby , Morgano Gian Paolo , Schünemann Holger J. 
Published: June 2020

Abstract
The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosurgical intervention remains uncertain. We reviewed the efficacy and safety of pharmacologic compared with nonpharmacologic thromboprophylaxis in neurosurgical patients. Three databases were searched through April 2018, including those for randomized controlled trials (RCTs) and for nonrandomized controlled studies (NRSs). Independent reviewers assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Seven RCTs and 3 NRSs proved eligible. No studies reported on symptomatic proximal and distal deep vein thrombosis (DVT). Two RCTs reported on screening-detected proximal and distal DVTs. We used the findings of these 2 RCTs as the closest surrogate outcomes to inform the proximal and distal DVT outcomes. These 2 RCTs suggest that pharmacologic thromboprophylaxis may decrease the risk of developing asymptomatic proximal DVT (relative risk [RR], 0.50; 95% confidence interval [CI], 0.30-0.84; low certainty). Findings were uncertain for mortality (RR, 1.27; 95% CI, 0.57-2.86; low certainty), symptomatic pulmonary embolism (PE) (RR, 0.84; 95% CI, 0.03-27.42; very low certainty), asymptomatic distal DVT (RR, 0.54; 95% CI, 0.27-1.08; very low certainty), and reoperation (RR, 0.43; 95% CI, 0.06-2.84; very low certainty) outcomes. NRSs also reported uncertain findings for whether pharmacologic prophylaxis affects mortality (RR, 0.72; 95% CI, 0.46-1.13; low certainty) and PE (RR, 0.18; 95% CI, 0.01-3.76). For risk of bleeding, findings were uncertain in both RCTs (RR, 1.57; 95% CI, 0.70-3.50; low certainty) and NRSs (RR, 1.45; 95% CI, 0.30-7.12; very low certainty). In patients undergoing neurosurgical procedures, low certainty of evidence suggests that pharmacologic thromboprophylaxis confers benefit for preventing asymptomatic (screening-detected) proximal DVT with very low certainty regarding its impact on patient-important outcomes.
Effect of age on pharmacokinetics, efficacy, and safety of galcanezumab treatment in adult patients with migraine: results from six phase 2 and phase 3 randomized clinical trials
Authors: Stauffer Virginia L. , Turner Ira , Kemmer Phebe , Kielbasa William , Day Kathleen , Port Martha , Quinlan Tonya , Camporeale Angelo 
Published: June 2020

Abstract
Background
Migraine clinical profile may change with age, making it necessary to verify that migraine treatments are equally safe and effective in older patients. These analyses evaluated the effects of patient age on the pharmacokinetics (PK), efficacy, and safety of galcanezumab for prevention of migraine.

Methods
Analyses included efficacy data from three double-blind phase 3 clinical trials: two 6-month studies in episodic migraine (EVOLVE-1, EVOLVE-2: N = 1773) and one 3-month study in chronic migraine (REGAIN:N = 1113). Patients were randomized 2:1:1 to placebo, galcanezumab 120 mg, or galcanezumab 240 mg. Safety and PK data included additional phase 2 and phase 3 trials for a larger sample size of patients > 60 years (range = 18–65 for all studies). Subgroup analyses assessed efficacy measures, adverse event (AE) occurrence, and cardiovascular measurement changes by patient age group. Galcanezumab PK were evaluated using a population analysis approach, where age was examined as a potential covariate on apparent clearance (CL/F) and apparent volume of distribution (V/F) of galcanezumab.

Results
Numbers of baseline monthly migraine headache days were similar across age groups. There were no statistically significant treatment-by-age group interactions for any efficacy measures, except in episodic migraine studies where older patients appeared to have a larger reduction than younger patients in the number of monthly migraine headache days with acute medication use. Age (18–65) had a minimal effect on CL/F, and no effect on V/F. Galcanezumab-treated patients ≥60 years experienced no clinically meaningful increases in blood pressure and no increased frequency in treatment-emergent AEs, discontinuations due to AEs, serious adverse events (SAEs) overall, or cardiovascular SAEs, compared to age-matched placebo-treated patients.

Conclusions
Age (up to 65 years) does not affect efficacy in migraine prevention and has no clinically meaningful influence on galcanezumab PK to warrant dose adjustment. Furthermore, older galcanezumab-treated patients experienced no increases in frequency of AEs or increases in blood pressure compared with age-matched placebo-treated patients.

Trial registrations
EVOLVE-1 (NCT02614183, registered 23 November 2015), EVOLVE-2 (NCT02614196, 23 November 2015), REGAIN (NCT02614261, 23 November 2015), ART-01 (NCT01625988, 20 June 2012, ), I5Q-MC-CGAB (NCT02163993, 12 June 2014, ), I5Q-MC-CGAJ (NCT02614287, 23 November 2015, ), all retrospectively registered.
Modulation of Magnetoresistance Polarity in BLG/SL-MoSe2 Heterostacks
Authors: Khan Muhammad Farooq , Rehman Shania , Rehman Malik Abdul , Basit Muhammad Abdul , Kim Deok-kee , Ahmed Faisal , Khalil H. M. Waseem , Akhtar Imtisal , Jun Seong Chan 
Published: June 2020

AbstractTwo-dimensional (2D) layered materials have an atomically thin and flat nature which makes it an ultimate candidate for spintronic devices. The spin-valve junctions (SVJs), composed of 2D materials, have been recognized as unique features of spin transport polarization. However, the magnetotransport properties of SVJs are highly influenced by the type of intervening layer (spacer) inserted between the ferromagnetic materials (FMs). In this situation, the spin filtering effect at the interfaces plays a critical role in the observation of the magnetoresistance (MR) of such magnetic structures, which can be improved by using promising hybrid structure. Here, we report MR of bilayer graphene (BLG), single-layer MoSe2 (SL-MoSe2), and BLG/SL-MoSe2 heterostack SVJs. However, before annealing, BLG and SL-MoSe2 SVJs demonstrate positive MR, but after annealing, BLG reverses its polarity while the SL-MoSe2 maintains its polarity and demonstrated stable positive spin polarizations at both interfaces due to meager doping effect of ferromagnetic (FM) contacts. Further, Co/BLG/SL-MoSe2/NiFe determines positive MR, i.e., ~ 1.71% and ~ 1.86% at T = 4 K before and after annealing, respectively. On the contrary, NiFe/BLG/SL-MoSe2/Co SVJs showed positive MR before annealing and subsequently reversed its MR sign after annealing due to the proximity-induced effect of metals doping with graphene. The obtained results can be useful to comprehend the origin of polarity and the selection of non-magnetic material (spacer) for magnetotransport properties. Thus, this study established a new paragon for novel spintronic applications.