bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-Year Outcomes of Heparin-Bonded Stent-Graft Therapy for Real-World Femoropopliteal Lesions and the Association of Patency With the Prothrombotic State Based on the Prospective, Observational, Multicenter Viabahn Stent-Graft Placement for Femoropopliteal Diseases Requiring Endovascular Therapy (VANQUISH) Study
Authors: Iida Osamu , Takahara Mitsuyoshi , Soga Yoshimitsu , Yamaoka Terutoshi , Nanto Shinsuke , Kuratani Toru , Sakata Yasushi , Mano Toshiaki 
Published: September 2020

Purpose: To evaluate the real-world primary patency of heparin-bonded stent-graft therapy for femoropopliteal (FP) occlusive disease and identify any clinical factors, including the prothrombotic state, associated with the loss of patency. Materials and Methods: This multicenter study prospectively enrolled 424 limbs of 371 patients (mean age 75±8 years; 247 men) scheduled for Viabahn stent-graft placement in the FP segment. A full-coverage strategy using only a Viabahn stent-graft was preferred, but “spot stenting” with the Viabahn was also allowed. The prothrombotic state was assessed by measuring platelet reactivity. Vascular morphology was evaluated using intravascular ultrasound (IVUS). Primary patency was estimated using the Kaplan-Meier method in the subgroup of patients having full lesion stent-graft coverage (n=343 limbs, 81.1%). The secondary outcomes were major amputation, surgical reconstruction, target lesion revascularization (TLR), and thrombotic occlusion. Regression analyses were used to explore associations of baseline and clinical variables with loss of patency; the results are given as the odds ratio (OR) and 95% confidence interval (CI). Results: The 1-year primary patency estimate was 80.3% (95% CI 75.5% to 85.1%) in the full-coverage group. There were 7 surgical reconstructions, 46 TLRs, 21 acute thrombotic occlusions, and 1 major amputation during the 1-year follow-up in the full-coverage group. Only angiography- and IVUS-determined vessel diameters were significantly associated with loss of patency, with crude ORs of 0.64 (95% CI 0.45 to 0.89, p=0.009) and 0.67 (95% CI 0.51 to 0.90, p=0.009), respectively, per 1-mm increase, whereas other variables, including the prothrombotic state (p=0.74), were not. Multivariable analysis demonstrated that only IVUS-determined vessel diameter was independently associated with loss of patency (adjusted OR per 1-mm increase 0.72, 95% CI 0.52 to 1.00, p=0.049). Conclusion: FP stent-graft placement achieved acceptable patency at 1 year in a real-world setting. A smaller vessel size was significantly associated with loss of patency, whereas the prothrombotic state was not.
A novel program of self-administration of medications within an acute inpatient rehabilitation unit
Authors: Meng Kwok Kah , Chao Wee Tze , San San Tay 
Published: September 2020

Introduction: Self-administration of medications (SAM) is a critical component of independent living in the face of chronic illnesses. The current local practice, where nurses manage all aspects of inpatient medication administration, has significant limitations in promoting this important activity post-discharge. Inpatient SAM is considered novel in Singapore. In this paper, we aim to describe the process of establishing a SAM program in a local rehabilitation inpatient ward. Materials and methods: In 2016, a multidisciplinary workgroup was formed in a local general hospital to develop a SAM protocol to empower participants to better self-manage their medications post-discharge through a series of graduated assessments and targeted education. The program started as a pilot in April 2017, and was eventually expanded to all rehabilitation wards within the hospital. Medication errors and near-misses were tracked, and surveys targeting participating patients and staff were given at the end of each encounter. Results: As of 31 December 2019, 160 patients were enrolled into the SAM program. Of these, 75, 63 and 22 patients were in SAM 1, SAM 2 and SAM 3 (tiers representing differing independence levels), respectively, at discharge. There were no medication errors. One near-miss was reported. The program was well-received by both patients and staff. Conclusions: We present a novel and viable protocol for the inpatient selection and assessment of patients, with the aim of supporting safe SAM post-discharge through educational empowerment and early identification of barriers with interventions.
Accuracy of Peripheral Arterial Disease Registers in UK General Practice: Case-Control Study
Authors: Kyle Daniel , Boylan Luke , Wilson Lesley , Haining Shona , Oates Crispian , Sims Andrew , Guri Ina , Allen John , Wilkes Scott , Stansby Gerry 
Published: September 2020

Background: Approximately 20% of the UK population aged 55 to 75 years have evidence of peripheral arterial disease (PAD). PAD affects quality of life and life expectancy if not appropriately diagnosed and managed. At risk patients require accurate diagnosis to ensure optimal treatment to slow disease progression and minimize adverse outcomes. Aim: To assess the accuracy of general practice (GP) registration of the diagnosis of peripheral arterial disease (PAD). Design and Setting: An observational analytic case-control study. As part of a National Institute for Health Research–funded (ISRCTN13301188) project assessing novel diagnostic methods set in GP practice. Methods: A total of 125 patients registered as having PAD and 125 age- and sex-matched controls were recruited from 15 general practices across North East England. The register was then assessed for accuracy of diagnosis. Duplex vascular ultrasound scanning (DUS) undertaken by vascular scientists was used as the gold standard reference for PAD. Results: The PAD register had a sensitivity of 86% (95% CI 77%-92%) and specificity of 74% (95% CI 67%-81%) when compared with DUS. The positive predictive value, however, was 69.6% (95% CI 63%-75%) and negative predictive value 88.8% (95% CI 82%-92%). The overall diagnostic effectiveness of the PAD register was 79.2% (95% CI 73%-84%). Conclusion: This analysis indicates that while PAD is detected with reasonable sensitivity in primary care, many patients registered with a diagnosis of PAD lacked DUS-proven disease. Improved approaches to the objective diagnosis of PAD may improve diagnosis and management of PAD in primary care.
Effect of periarticular multimodal injection versus femoral nerve block on in-hospital rehabilitation after total knee arthroplasty in Chinese population: A prospective randomized control trial study
Authors: Yeung Ip Hoi , Kan Yeung Yip , Cheong Lo Kim , Andy Tse Choi Yeung , Ho Wong Kwok 
Published: September 2020

Introduction: Total knee arthroplasty has been adopted to be the most successful treatment for advanced knee osteoarthritis. The adoption of multimodal periarticular analgesic (MPI) has been shown to have satisfactory pain control after surgery. However, there is relatively lack of data investigating whether this mode of pain control is effective in enhancing rehabilitation. Method: This is a prospective randomized control trial from July 2017 to June 2018, including 82 patients, in which 43 of them had MPI injection and 39 of them had no MPI injection. Primary outcome measures included the number of days required to perform straight leg raise, length of hospital stay, and Insall knee score upon discharge. Secondary outcome measures included total dose of patient-controlled analgesia (PCA) consumption postoperatively and visual analog scale (VAS) at rest and on motion during postoperative days 1–4. Result: The MPI group performed significantly better than the femoral nerve block (FNB) group in terms of early functional outcome, namely the number of days required to perform straight leg raising and length of hospital stay. The total postoperative PCA consumption and VAS score on motion during postoperative day 1 were also significantly better for MPI group. There was no difference in Insall knee score upon discharge between these two groups. Conclusion: Compared to FNB, MPI depicts a faster inpatient rehabilitation, accounted by its quadriceps-sparing, and better pain relief especially in the early postoperative period.
Comparison Between Surgical and Nonsurgical Treatment for Primary Patellar Dislocations in Adolescents: A Systematic Review and Meta-analysis of Comparative Studies
Authors: Zhang Kaibo , Jiang Hua , Li Jian , Fu Weili 
Published: September 2020

Background: Whether surgical or nonsurgical management is more appropriate for primary patellar dislocations (PPDs) in adolescents (younger than 18 years) remains controversial. Purpose: To compare the clinical outcomes of surgical versus nonsurgical treatment for adolescents and children with PPDs. Study Design: Systematic review; Level of evidence, 3. Methods: There were 2 reviewers who independently searched the PubMed, Embase, Ovid, and Cochrane databases for English-language studies of randomized controlled trials (RCTs), quasi-RCTs, and observational studies comparing surgical with nonsurgical treatment for PPDs. The primary outcomes were redislocations, the Kujala score, and the Knee injury and Osteoarthritis Outcome Score (KOOS), and the secondary outcome was subsequent surgery. Results: A total of 6 studies were included in our systematic review and meta-analysis. Among patients younger than 18 years, surgery was associated with a lower redislocation rate compared with nonsurgical treatment within 5 years of treatment (risk ratio [RR], 0.58 [95% CI, 0.37-0.91]; P = .02; I 2 = 47%) but not beyond 5 years (RR, 0.80 [95% CI, 0.59-1.07]; P = .14; I 2 = 34%). However, surgery resulted in worse Kujala and KOOS scores compared with nonsurgical treatment. Yet, the treatment difference between the 2 groups tended to decrease over time. Conclusion: The available evidence suggests that for adolescents with PPDs, surgery was superior to nonsurgical treatment in the short term to reduce the redislocation rate but resulted in poorer outcomes of knee function based on the Kujala and KOOS scores. However, the superiority of either surgical or nonsurgical treatment in adolescents did not appear to persist in the long term.
Wikipedia: A Medical Student Educational Project to Edit Wikipedia in Preparation for Practicing Evidence-Based Pain Medicine
Authors: Kantarovich Diana , Vollbrecht Hanna B , Cruz Sebastian A , Castillo Hector , Lee Cody S , Kushner Josef , Leng Jim X , Morgan Vince K , Hellman Kevin M 
Published: September 2020

Objective: Wikipedia is commonly used to acquire information about various medical conditions such as chronic pain. Ideally, better online pain management content could reduce the burden of opioid use disorders. Our goal was to improve the quality of the content available on Wikipedia to make it more accurate and applicable to medical students and the general public while training medical students to practice evidence-based medicine and critically assess their sources of information. Methods: An elective class in Neuroscience, Pain, and Opioids composed of 10 medical students met biweekly to discuss landmark and practice-changing research articles in the fields of acute pain, chronic pain, and opioid management. The professor chose Wikipedia articles relevant to this course. Three independent viewers analyzed the quality of citations, anecdotal medical content, and content value for both patients and medical professionals. As part of their coursework, students then edited the Wikipedia articles. Results: Although some of the Wikipedia pain topic content (6.7% ± 2.0) was anecdotal, financially biased, or inconsistent with Western Medical Practice content, overall articles included primarily high-quality citations (85.6% ± 3.1). On a 0-5 Likert scale, students felt content would be moderately helpful for both medical students/professionals (3.4 ± 0.2) and laypersons (3.5 ± 0.2). Editing and adding citations was feasible, but novel material was often reverted. Conclusion: A significant amount of pain medicine content was relevant and amenable to student editing. Therefore, future use of this tactic could provide a unique opportunity to integrate evidence-based medicine into the medical curriculum and have a direct impact on the widely available medical information. Future refinement in the editorial process may also further improve online information.
Microbial Spectrum and Antibacterial Susceptibility of Endophthalmitis Cultures in a Tertiary Referral Center in the Midwestern United States: An Analysis From 295 Patients
Authors: Gemayel Michael , Neiweem Ashley , Aebi Brent , Bracha Peter , Ciulla Thomas 
Published: September 2020

Purpose: This work evaluates the microbial spectrum and antibiotic susceptibility pattern of endophthalmitis cases in a large tertiary referral center in the Midwestern United States. Methods: This retrospective case series included patients with clinically diagnosed endophthalmitis between April 14, 2006 and April 14, 2016, in whom ocular samples were submitted to the Microbiology Department at Indiana University. The patients were assessed by 11 vitreoretinal surgeons from 6 different sites in Indianapolis, including Indiana University and private practices, who receive patients from urban, suburban, and rural agricultural areas. Submitted specimens were cultured with the following media: blood agar, chocolate agar, MacConkey agar, and thioglycolate broth. Results: A total of 327 specimens from 295 patients were analyzed, with 96 (32.5%) samples from 90 (30.5%) patients meeting the criteria of confirmed growth. Of these 96 positive specimens, 83 (86.5%) organisms were identified as bacterial, and 13 (13.5%) were identified as fungal. Coagulase-negative Staphylococcus was the most common isolate (37.5%). Fifty gram-positive isolates and 10 gram-negative isolates underwent susceptibility testing. All 40 of the gram-positive isolates tested for vancomycin sensitivity were susceptible, whereas all 7 of the gram-negative isolates tested for ceftazidime sensitivity were susceptible. Conclusions: Empiric treatment with vancomycin and ceftazidime remains appropriate in most cases of endophthalmitis in the Midwestern United States, with 100% susceptibility of bacterial organisms tested with these antibiotics in this series. The high fungal culture rates in this study highlight the utility of obtaining vitreous cultures and potential need for antifungal agents in suspicious cases.
Noncanonical effector functions of the T-memory–like T-PLL cell are shaped by cooperative TCL1A and TCR signaling
Authors: Oberbeck S. , Schrader A. , Warner K. , Jungherz D. , Crispatzu G. , von Jan J. , Chmielewski M. , Ianevski A. , Diebner H. H. , Mayer P. , Kondo Ados A. , Wahnschaffe L. , Braun T. , Müller T. A. , Wagle P. , Bouska A. , Neumann T. , Pützer S. , Varghese L. , Pflug N. , Thelen M. , Makalowski J. , Riet N. , Göx H. J. M. , Rappl G. , Altmüller J. , Kotrová M. , Persigehl T. , Hopfinger G. , Hansmann M. L. , Schlößer H. , Stilgenbauer S. , Dürig J. , Mougiakakos D. , von Bergwelt-Baildon M. , Roeder I. , Hartmann S. , Hallek M. , Moriggl R. , Brüggemann M. , Aittokallio T. , Iqbal J. , Newrzela S. , Abken H. , Herling M. 
Published: September 2020

Abstract
T-cell prolymphocytic leukemia (T-PLL) is a poor-prognostic neoplasm. Differentiation stage and immune-effector functions of the underlying tumor cell are insufficiently characterized. Constitutive activation of the T-cell leukemia 1A (TCL1A) oncogene distinguishes the (pre)leukemic cell from regular postthymic T cells. We assessed activation-response patterns of the T-PLL lymphocyte and interrogated the modulatory impact by TCL1A. Immunophenotypic and gene expression profiles revealed a unique spectrum of memory-type differentiation of T-PLL with predominant central-memory stages and frequent noncanonical patterns. Virtually all T-PLL expressed a T-cell receptor (TCR) and/or CD28-coreceptor without overrepresentation of specific TCR clonotypes. The highly activated leukemic cells also revealed losses of negative-regulatory TCR coreceptors (eg, CTLA4). TCR stimulation of T-PLL cells evoked higher-than-normal cell-cycle transition and profiles of cytokine release that resembled those of normal memory T cells. More activated phenotypes and higher TCL1A correlated with inferior clinical outcomes. TCL1A was linked to the marked resistance of T-PLL to activation- and FAS-induced cell death. Enforced TCL1A enhanced phospho-activation of TCR kinases, second-messenger generation, and JAK/STAT or NFAT transcriptional responses. This reduced the input thresholds for IL-2 secretion in a sensitizer-like fashion. Mice of TCL1A-initiated protracted T-PLL development resembled such features. When equipped with epitope-defined TCRs or chimeric antigen receptors, these Lckpr-hTCL1Atg T cells gained a leukemogenic growth advantage in scenarios of receptor stimulation. Overall, we propose a model of T-PLL pathogenesis in which TCL1A enhances TCR signals and drives the accumulation of death-resistant memory-type cells that use amplified low-level stimulatory input, and whose loss of negative coregulators additionally maintains their activated state. Treatment rationales are provided by combined interception in TCR and survival signaling.
Mutational landscape of gray zone lymphoma
Authors: Sarkozy Clémentine , Hung Stacy S. , Chavez Elizabeth A. , Duns Gerben , Takata Katsuyoshi , Chong Lauren C. , Aoki Tomohiro , Jiang Aixiang , Miyata-Takata Tomoko , Telenius Adèle , Slack Graham W. , Molina Thierry Jo , Ben-Neriah Susana , Farinha Pedro , Dartigues Peggy , Damotte Diane , Mottok Anja , Salles Gilles A. , Casasnovas Rene-Olivier , Savage Kerry J. , Laurent Camille , Scott David W. , Traverse-Glehen Alexandra , Steidl Christian 
Published: September 2020

Abstract
The mutational landscape of gray zone lymphoma (GZL) has not yet been established, and differences from related entities are largely unknown. Here, we studied coding sequence mutations of 50 Epstein-Barr virus (EBV)-negative GZLs and 20 polymorphic EBV+ diffuse large B-cell lymphoma (DLBCL) not otherwise specified (poly-EBV-L) in comparison with classical Hodgkin lymphoma (cHL), primary mediastinal large B-cell lymphoma (PMBCL), and DLBCL. Exomes of 21 GZL and 7 poly-EBV-L cases, along with paired constitutional DNA, were analyzed as a discovery cohort, followed by targeted sequencing of 217 genes in an extension cohort of 29 GZL and 13 poly-EBV-L cases. GZL cases with thymic niche involvement (anterior mediastinal mass) exhibited a mutation profile closely resembling cHL and PMBCL, with SOCS1 (45%), B2M (45%), TNFAIP3 (35%), GNA13 (35%), LRRN3 (32%), and NFKBIA (29%) being the most recurrently mutated genes. In contrast, GZL cases without thymic niche involvement (n = 18) had a significantly distinct pattern that was enriched in mutations related to apoptosis defects (TP53 [39%], BCL2 [28%], BIRC6 [22%]) and depleted in GNA13, XPO1, or NF-κB signaling pathway mutations (TNFAIP3, NFKBIE, IKBKB, NFKBIA). They also exhibited more BCL2/BCL6 rearrangements compared with thymic GZL. Poly-EBV-L cases presented a distinct mutational profile, including STAT3 mutations and a significantly lower coding mutation load in comparison with EBV− GZL. Our study highlights characteristic mutational patterns in GZL associated with presentation in the thymic niche, suggesting a common cell of origin and disease evolution overlapping with related anterior mediastinal lymphomas.
Human GATA2 mutations and hematologic disease: how many paths to pathogenesis?
Authors: Bresnick Emery H. , Jung Mabel M. , Katsumura Koichi R. 
Published: September 2020

AbstractThe surge of human genetic information, enabled by increasingly facile and economically feasible genomic technologies, has accelerated discoveries on the relationship of germline genetic variation to hematologic diseases. For example, germline variation in GATA2, encoding a vital transcriptional regulator of multilineage hematopoiesis, creates a predisposition to bone marrow failure and acute myeloid leukemia termed GATA2 deficiency syndrome. More than 300 GATA2 variants representing missense, truncating, and noncoding enhancer mutations have been documented. Although these variants can diminish GATA2 expression and/or function, the functional ramifications of many variants are unknown. Studies using genetic rescue and knockin mouse systems have established that GATA2 mutations differentially affect molecular processes in distinct target genes and within a single target cell. Considering that target genes for a transcription factor can differ in sensitivity to altered levels of the factor, and transcriptional mechanisms are often cell type specific, the context-dependent consequences of GATA2 mutations in experimental systems portend the complex phenotypes and interindividual variation of GATA2 deficiency syndrome. This review documents GATA2 human genetics and the state of efforts to traverse from physiological insights to pathogenic mechanisms.
Hypoxia induces the translocation of glucose transporter 1 to the plasma membrane in vascular endothelial cells
Authors: Mamun Abdullah Al , Hayashi Hisaki , Yamamura Aya , Nayeem Md Junayed , Sato Motohiko 
Published: September 2020

AbstractGlucose uptake and adenosine triphosphate (ATP) generation are important for the survival and growth of endothelial cells. An increase of glucose uptake under hypoxia was previously shown to be associated with the increased expression of glucose transporters (GLUTs). However, the regulation of GLUT trafficking to the cell surface has not been examined in detail. Here, we report the characterization of GLUT1 translocation to the plasma membrane during hypoxia in endothelial cells. Human umbilical vein endothelial cells (HUVECs) were exposed to hypoxia (1% O2) for 12 h, which significantly induced GLUT1 expression and translocation to the plasma membrane. GLUT1 translocation was associated with a decrease of intracellular ATP by hypoxia. Decreasing ATP levels with antimycin-A and 2-deoxyglucose induced GLUT1 translocation under normoxia. The induction of hypoxia-inducible factor-1α under normoxia did not influence the cell surface expression of GLUT1 or cellular ATP concentration. Interestingly, the translocation of GLUT1 induced by hypoxia was inhibited by the ATP-sensitive potassium (KATP) channel inhibitor glibenclamide, while the mitochondrial KATP channel inhibitor 5-HD did not influence GLUT1 translocation during hypoxia. These observations indicate that a decrease of intracellular ATP triggers GLUT1 translocation to the plasma membrane and is mediated by KATP channels, which would contribute to glucose uptake in HUVECs during hypoxia.