bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total small vessel disease score and cerebro-cardiovascular events in healthy adults: The Kashima scan study
Authors: Suzuyama Kohei , Yakushiji Yusuke , Ogata Atsushi , Nishihara Masashi , Eriguchi Makoto , Kawaguchi Atsushi , Noguchi Tomoyuki , Nakajima Junko , Hara Hideo 
Published: February 2020

Background and aims We explored the association between the total small vessel disease score obtained from baseline magnetic resonance imaging and subsequent cerebro-cardiovascular events in neurologically healthy Japanese adults. Methods The presence of small vessel disease features, including lacunae, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on magnetic resonance imaging, was summed to obtain a “total small vessel disease score” (range, 0–4). After excluding participants with previous stroke or ischemic heart disease, intracranial artery stenosis (≥50%), or cerebral aneurysm (≥4 mm), a total of 1349 participants (mean age, 57.7 years; range, 22.8–85.0 years; 46.9% male) were classified into three groups by total small vessel disease score: 0 ( n = 984), 1 ( n = 269), and ≥2 ( n = 96). Cerebro-cardiovascular events (i.e., any stroke, transient ischemic attack, ischemic heart disease, acute heart failure, and aortic dissection) were defined as the primary end point. The hazard ratio (HR) of events during follow-up was calculated using Cox proportional hazards modeling with adjustments for age, sex, hypertension, diabetes mellitus, and smoking. Cumulative event-free rates were estimated using the Kaplan–Meier method. Results During follow-up (mean, 6.7 years), 35 cerebro-cardiovascular (16 cerebrovascular) events were identified. Higher small vessel disease score was associated with increased risk of cerebro-cardiovascular events (HR per unit increase, 2.17; 95% confidence interval, 1.36–3.46; P = 0.001). Events were more frequent among participants with higher score ( P < 0.001, log-rank test). Conclusions This study offered additional evidence for the clinical relevance of total small vessel disease score, suggesting the score as a promising tool to predict the risk of subsequent vascular events even in healthy populations.
Primary intraventricular hemorrhage outcomes in the CLEAR III trial
Authors: Nelson Sarah E , Mould W Andrew , Gandhi Dheeraj , Thompson Richard E , Salter Sarah , Dlugash Rachel , Awad Issam A , Hanley Daniel F , Ziai Wendy 
Published: February 2020

Background Intraventricular hemorrhage occurs due to intracerebral hemorrhage with intraventricular extension or without apparent parenchymal involvement, known as primary intraventricular hemorrhage. Aims We evaluated the prognosis of primary intraventricular hemorrhage patients in the CLEAR III trial (Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage). Methods In patients with primary intraventricular hemorrhage versus those with secondary intraventricular hemorrhage, we compared intraventricular alteplase response and outcomes including modified Rankin Scale, Barthel Index, National Institutes of Health Stroke Scale (NIHSS), and extended Glasgow Outcome Scale (eGOS) at 30, 180, and 365 days. Outcomes were also compared in primary intraventricular hemorrhage patients who received intraventricular alteplase versus placebo (normal saline) and in matched primary and secondary intraventricular hemorrhage patients using inverse-probability-weighted regression adjustment. Results Of 500 patients enrolled in CLEAR III, 46 (9.2%) had primary intraventricular hemorrhage. Combining both treatment groups, primary intraventricular hemorrhage patients had larger intraventricular hemorrhage volumes (median: 34.2 mL vs. 20.8 mL, p < 0.01) but similar intraventricular hemorrhage removal (51.0% vs. 59.0%, p = 0.24) compared to secondary intraventricular hemorrhage patients, respectively. Confirming previous studies, primary intraventricular hemorrhage patients achieved better NIHSS, modified Rankin Scale, Barthel Index, and eGOS scores at days 30, 180, and 365, respectively (all p < 0.01), although mortality was similar to secondary intraventricular hemorrhage patients; matching analysis yielded similar results. Primary intraventricular hemorrhage patients who received intraventricular alteplase ( n = 19) and saline ( n = 27) achieved similar outcomes. Conclusions In CLEAR III, primary intraventricular hemorrhage patients who survived achieved better long-term outcomes than surviving secondary intraventricular hemorrhage patients with similar mortality. Outcomes and safety were similar between primary intraventricular hemorrhage patients receiving alteplase and those receiving saline.
Chinese consensus on the diagnosis and treatment of gastric cancer with liver metastases
Authors: Zhang Kecheng , Chen Lin 
Published: February 2020

Background: The incidence of gastric cancer with liver metastases (GCLM) is 9.9–18.7%, with a median survival time of 11 months and a 5-year survival rate <20%. Multidisciplinary treatment (MDT) is gradually gaining recognition as the most important method. However, specific treatment plans remain unclear. The aim of study was to provide a consensus to improve the diagnosis and treatment of GCLM. Methods: We brought together experts from relevant medical fields across China, including the Chinese Research Hospital Association Digestive Tumor Committee, Chinese Association of Upper Gastrointestinal Surgeons, Chinese Gastric Cancer Association, and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association, to discuss and formulate this consensus. Results: A consensus was reached on the diagnosis and treatment of GCLM. Moreover, we have developed a new clinical classification system, the Chinese Type for Gastric Cancer Liver Metastases, based on the likelihood of a surgical treatment being successful. Conclusions: The MDT mode should be implemented throughout all treatment of GCLM. A Chinese version of this expert consensus has been published in the Chinese Journal of Practical Surgery (Volume 39, Issue 10, p. 405-411). Written permission was obtained from the Chinese Journal of Practical Surgery to disseminate the expert consensus in English.
Knowledge and preventive practices against Lassa fever among heads of households in Abakaliki metropolis, Southeast Nigeria: A cross-sectional study
Authors: Ossai Edmund Ndudi , Onwe Ogah Emeka , Okeagu Nnaemeka Philips , Ugwuoru Amarachi Laura , Eze Thankgod Kelechi , Nwede Augustine Sunday 
Published: February 2020

Background: Lassa fever is associated with high morbidity and mortality. Objectives: This study aimed to determine the knowledge and preventive measures against Lassa fever among heads of households in Abakaliki metropolis, Southeast Nigeria. Methods: This was a descriptive cross-sectional study. A four-stage sampling design was used to select 420 respondents from Abakaliki metropolis. A good knowledge of Lassa fever was determined by the proportion of respondents scoring ⩾50% in 15 variables. Good preventive practices against Lassa fever were determined by the proportion of respondents obtaining a score of ⩾50% in 12 variables. Results: The mean age of respondents was 34.1±9.4 years, and the majority (56.5%) were males. Major sources of information included television (66.4%) and radio (64.3%). A minority (11.0%) consume rats at present, while 86.7% knew that rats could transmit Lassa fever to humans. The majority (60.0%) had a good knowledge of Lassa fever, while 66.4% demonstrated good preventive practices. A predictor of good knowledge included being a consumer of rats, (adjusted odds ratio (AOR)=2.3; 95% confidence interval (CI) 1.1–4.9). Predictors of good preventive practices included being in a low socio-economic class (AOR=2.1; 95% CI 1.3–3.6) and having a good knowledge of Lassa fever (AOR=10.2; 95% CI: 6.2–10.6). Conclusions: The majority of respondents had a good knowledge of Lassa fever and demonstrated good preventive practices against it. A good knowledge of Lassa fever was associated with good preventive practices. There is need for a good understanding of Lassa fever among the population, as this will improve preventive practices. Health workers have an important role to play in disseminating information concerning Lassa fever.
Bisoprolol transdermal patch treatment for patients with atrial fibrillation after noncardiac surgery: A single-center retrospective study of 61 patients
Authors: Yasui Taku , Oka Toru , Shioyama Wataru , Oboshi Makiko , Fujita Masashi 
Published: February 2020

Objectives: Atrial fibrillation after surgery is associated with increased rates of heart failure and ischemic stroke, and extension of hospitalization. Bisoprolol is a β-blocker used to reduce heart rate and manage arrhythmias during atrial fibrillation. However, the safety and efficacy of bisoprolol transdermal patch treatment in patients with postoperative atrial fibrillation remain unclear. Methods: We retrospectively assessed the electronic health records of our hospital between September 2013 and July 2018 and identified patients with postoperative atrial fibrillation who had been treated with a bisoprolol transdermal patch. We excluded patients with sinus rhythm using bisoprolol transdermal patch to prevent atrial fibrillation recurrence and those with sustained atrial fibrillation before surgery. Data on heart rhythm, heart rate, and blood pressure at the baseline and after 24 h of treatment were obtained from the electronic health records. Results: Of the 603 patients treated with the bisoprolol transdermal patch, 61 patients with postoperative atrial fibrillation after noncardiac surgery were included. The bisoprolol transdermal patch was discontinued due to bradycardia in two patients (3.3%). In both cases, the heart rate increased after the removal of the bisoprolol transdermal patch and no additional treatment was necessary. Among the 61 patients, sinus rhythm was restored within 24 h of bisoprolol treatment in 47 patients (77.0%). The heart rate significantly decreased from 124.8 ± 26.3 bpm at the baseline to 78.9 ± 16.6 bpm at 24 h after treatment ( p < 0.001). There were no significant differences in the systolic and diastolic blood pressures between patients before and at 24 h after treatment. Conclusion: The results of this study indicate that the bisoprolol transdermal patch is well tolerated and effective in patients with atrial fibrillation after noncardiac surgery.
Mobile health applications for improving the sexual health outcomes among adults with chronic diseases: A systematic review
Authors: Karim Hesam , Choobineh Hamid , Kheradbin Niloofar , Ravandi Mohammad Hosseini , Naserpor Ahmad , Safdari Reza 
Published: February 2020

Aims Chronic diseases may affect sexual health as an important factor for well-being. Mobile health (m-health) interventions have the potential to improve sexual health in patients with chronic conditions. The aim of this systematic review was to summarise the published evidence on mobile interventions for sexual health in adults with chronic diseases. Methods Five electronic databases were searched for English language peer-reviewed literature from 1 January 2009 to 31 December 2019. Appropriate keywords were identified based on the study’s aim. Study selection was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The full texts of potential studies were reviewed, and final studies were selected. The m-health evidence reporting and assessment (mERA) checklist was used to assess the quality of the selected studies. After data extraction from the studies, data analysis was conducted. Results Nine studies met the inclusion criteria. All interventions were delivered through websites, and a positive effect on sexual problems was reported. Prostate and breast cancer were considered in most studies. Interventions were delivered for therapy, self-help and consultation purposes. Quality assessment of studies revealed an acceptable quality of reporting and methodological criteria in the selected studies. Replicability, security, cost assessment and conceptual adaptability were the criteria that had not been considered in any of the reviewed studies. Conclusions Reviewed studies showed a positive effect of mobile interventions on sexual health outcomes in chronic patients. For more effective interventions, researchers should design web-based interventions based on users’ needs and consider the m-health essential criteria provided by mERA. Additionally, mobile interventions can be more effective in combination with smartphone apps.
Physician attitudes towards—and adoption of—mobile health
Authors: Kong Tracie , Scott Mary Morgan , Li Yang , Wichelman Cynthia 
Published: February 2020

Objective Smartphone apps and mobile devices are an emerging method of healthcare data collection. This study sought to understand how physicians currently view mobile health (mHealth) technologies and use them in patient care. Methods A total of 186 physicians affiliated with Washington University School of Medicine in St. Louis, Missouri, USA completed a survey in 2016 regarding their current implementation of mHealth technologies for patient care and support for further development. Results More than half of respondents were willing to discuss health apps and mobile devices with patients. However, most were not currently recommending them to patients. Apps/devices that encouraged a healthy diet and weight or tracked heart rate received the highest satisfaction ratings. Apps/devices that accessed the EMR (electronic medical record) remotely, provided medication reminders, or enrolled research subjects garnered the most interest despite respondents lacking prior experience. A majority agreed that collected biometrics are useful for promoting a healthy lifestyle (68%), tracking medical treatment (64%), or conducting research (56%); and agreed that proof of accuracy and precision (81%) and the efficient integration of collected data (68%) are necessary improvements. Uploading data automatically and updating physicians in real-time was the most preferred method of data integration into the EMR. Conclusions Physicians show interest in using mHealth technologies for patient care but have limited experience, usually with those specific to their specialties. Proof of quality and a method to integrate data into the EMR are necessary for a mainstream role in healthcare.
An In Vitro Biomechanical Evaluation of a Lateral Lumbar Interbody Fusion Device With Integrated Lateral Modular Plate Fixation
Authors: DenHaese Ryan , Gandhi Anup , Ferry Chris , Farmer Sam , Porter Randall 
Published: February 2020

Study Design: In vitro cadaveric biomechanical study. Objective: Biomechanically characterize a novel lateral lumbar interbody fusion (LLIF) implant possessing integrated lateral modular plate fixation (MPF). Methods: A human lumbar cadaveric (n = 7, L1-L4) biomechanical study of segmental range-of-motion stiffness was performed. A ±7.5 Nċm moment was applied in flexion/extension, lateral bending, and axial rotation using a 6 degree-of-freedom kinematics system. Specimens were tested first in an intact state and then following iterative instrumentation (L2/3): (1) LLIF cage only, (2) LLIF + 2-screw MPF, (3) LLIF + 4-screw MPF, (4) LLIF + 4-screw MPF + interspinous process fixation, and (5) LLIF + bilateral pedicle screw fixation. Comparative analysis of range-of-motion outcomes was performed between iterations. Results: Key biomechanical findings: (1) Flexion/extension range-of-motion reduction with LLIF + 4-screw MPF was significantly greater than LLIF + 2-screw MPF ( P < .01). (2) LLIF with 2-screw and 4-screw MPF were comparable to LLIF with bilateral pedicle screw fixation in lateral bending and axial rotation range-of-motion reduction ( P = 1.0). (3) LLIF + 4-screw MPF and supplemental interspinous process fixation range-of-motion reduction was comparable to LLIF + bilateral pedicle screw fixation in all directions ( P ≥ .6). Conclusions: LLIF with 4-screw MPF may provide inherent advantages over traditional 2-screw plating modalities. Furthermore, when coupled with interspinous process fixation, LLIF with MPF is a stable circumferential construct that provides biomechanical utility in all principal motions.
Does the Application of Platelet-Rich Fibrin in Anterior Cruciate Ligament Reconstruction Enhance Graft Healing and Maturation? A Comparative MRI Study of 44 Cases
Authors: Beyzadeoglu Tahsin , Pehlivanoglu Tuna , Yildirim Kerem , Buldu Halil , Tandogan Reha , Tuzun Umit 
Published: February 2020

Background: Anterior cruciate ligament (ACL) reconstruction performed with growth factors and activated platelets has been suggested to accelerate tendon ligamentization, leading to earlier return to daily activities and sports. Hypotheses: Platelet-rich fibrin (PRF) will result in improved graft maturation and healing as evaluated by magnetic resonance imaging (MRI) in patients undergoing hamstring ACL reconstruction. Hemostatic and analgesic properties of PRF will lead to less postoperative blood loss and pain. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 44 patients with isolated ACL injuries who underwent arthroscopic all-inside anatomic single-bundle ACL reconstruction with semitendinosus tendon graft were enrolled. Group 1 included 23 patients who had PRF sprayed to the surface of the graft; group 2 included 21 patients for whom no PRF was used. Patients were discharged after 24 hours and examined for hemarthrosis that needed to be aspirated. MRI was performed at the fifth postoperative month. A blinded radiologist evaluated graft maturation according to its signal intensity and the presence of synovial fluid at the tunnel-graft interface. Results: PRF-treated grafts demonstrated lower MRI signal intensity and less fluid in the graft-tunnel interface as compared with controls for the entire length of the graft. The mean full-length MRI signal intensities were 9.19 versus 16.59 ( P = .047) for groups 1 and 2, respectively. Subgroup analysis of the semitendinosus grafts demonstrated a signal intensity of 11.57 versus 23.98 ( P = .044) for the proximal third, 9.53 versus 13.83 ( P = .237) for the midbody, and 6.48 versus 11.98 ( P = .087) for the distal third. Synovial fluid at the graft-tunnel interface was detected in 1 patient in group 1 (4.3%) and 3 patients in group 2 (14.3%; P < .001). Patients in group 1 had significantly less hemarthrosis that needed to be aspirated ( P = .003), while postoperative analgesia requirements were similar in both groups ( P = .08). No clinical benefit of PRF could be demonstrated in clinical outcomes. Conclusion: Application of PRF led to superior graft integration and maturation in the proximal third of the ACL graft. There was no significant difference in MRI signal intensity in the midbody or distal tibial graft. Application of PRF also resulted in significantly lower rates of postoperative hemarthrosis that needed to be aspirated.
BIVV001, a new class of factor VIII replacement for hemophilia A that is independent of von Willebrand factor in primates and mice
Authors: Seth Chhabra Ekta , Liu Tongyao , Kulman John , Patarroyo-White Susannah , Yang Buyue , Lu Qi , Drager Douglas , Moore Nancy , Liu Jiayun , Holthaus Amy M. , Sommer Jurg M. , Ismail Ayman , Rabinovich Deana , Liu Zhan , van der Flier Arjan , Goodman Allison , Furcht Chris , Tie Mark , Carlage Tyler , Mauldin Randy , Dobrowsky Terrence M. , Liu Zhiqian , Mercury Oblaise , Zhu Lily , Mei Baisong , Schellenberger Volker , Jiang Haiyan , Pierce Glenn F. , Salas Joe , Peters Robert 
Published: February 2020

AbstractFactor VIII (FVIII) replacement products enable comprehensive care in hemophilia A. Treatment goals in severe hemophilia A are expanding beyond low annualized bleed rates to include long-term outcomes associated with high sustained FVIII levels. Endogenous von Willebrand factor (VWF) stabilizes and protects FVIII from degradation and clearance, but it also subjects FVIII to a half-life ceiling of ∼15 to 19 hours. Increasing recombinant FVIII (rFVIII) half-life further is ultimately dependent upon uncoupling rFVIII from endogenous VWF. We have developed a new class of FVIII replacement, rFVIIIFc-VWF-XTEN (BIVV001), that is physically decoupled from endogenous VWF and has enhanced pharmacokinetic properties compared with all previous FVIII products. BIVV001 was bioengineered as a unique fusion protein consisting of a VWF-DʹD3 domain fused to rFVIII via immunoglobulin-G1 Fc domains and 2 XTEN polypeptides (Amunix Pharmaceuticals, Inc, Mountain View, CA). Plasma FVIII half-life after BIVV001 administration in mice and monkeys was 25 to 31 hours and 33 to 34 hours, respectively, representing a three- to fourfold increase in FVIII half-life. Our results showed that multifaceted protein engineering, far beyond a few amino acid substitutions, could significantly improve rFVIII pharmacokinetic properties while maintaining hemostatic function. BIVV001 is the first rFVIII with the potential to significantly change the treatment paradigm for severe hemophilia A by providing optimal protection against all bleed types, with less frequent doses. The protein engineering methods described herein can also be applied to other complex proteins.
Cancer spectrum and outcomes in the Mendelian short telomere syndromes
Authors: Schratz Kristen E. , Haley Lisa , Danoff Sonye K. , Blackford Amanda L. , DeZern Amy E. , Gocke Christopher D. , Duffield Amy S. , Armanios Mary 
Published: February 2020

Abstract
Short telomeres have been linked to cancer risk, yet other evidence supports them being tumor suppressive. Here, we report cancer outcomes in individuals with germline mutations in telomerase and other telomere-maintenance genes. Among 180 individuals evaluated in a hospital-based setting, 12.8% had cancer. Solid tumors were rare (2.8%); nearly all were young male DKC1 mutation carriers, and they were generally resectable with good short-term outcomes. Myelodysplastic syndrome (MDS) was most common, followed by acute myeloid leukemia (AML); they accounted for 75% of cancers. Age over 50 years was the biggest risk factor, and MDS/AML usually manifested with marrow hypoplasia and monosomy 7, but the somatic mutation landscape was indistinct from unselected patients. One- and 2-year survival were 61% and 39%, respectively, and two-thirds of MDS/AML patients died of pulmonary fibrosis and/or hepatopulmonary syndrome. In one-half of the cases, MDS/AML patients showed a recurrent peripheral blood pattern of acquired, granulocyte-specific telomere shortening. This attrition was absent in age-matched mutation carriers who did not have MDS/AML. We tested whether adult short telomere patients without MDS/AML also had evidence of clonal hematopoiesis of indeterminate potential–related mutations and found that 30% were affected. These patients also primarily suffered morbidity from pulmonary fibrosis during follow-up. Our data show that the Mendelian short telomere syndromes are associated with a relatively narrow cancer spectrum, primarily MDS and AML. They suggest that short telomere length is sufficient to drive premature age-related clonal hematopoiesis in these inherited disorders.