bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical myelitis in patients with multiple sclerosis: Characterization and comparison with typical multiple sclerosis and neuromyelitis optica spectrum disorders
Authors: Bigaut K , Lambert C , Kremer L , Lebrun C , Cohen M , Ciron J , Bourre B , Créange A , Kerschen P , Montcuquet A , Carra-Dalliere C , Ayrignac X , Labauge P , de Seze J , Collongues N 
Published: February 2020

Background: Atypical myelitis in multiple sclerosis (MS) is characterized by extensive myelitis in the longitudinal (longitudinally extensive transverse myelitis) or axial plane (transverse myelitis). Objective: To characterize a cohort of MS patients with atypical myelitis. Methods: Atypical myelitis was extracted from the French and Luxembourg MS databases and compared to two cohorts of MS patients with typical myelitis and neuromyelitis optica spectrum disorders (NMOSDs) patients with myelitis. Results: We enrolled 28 MS patients with atypical myelitis, 68 MS patients with typical myelitis and 119 NMOSD patients with a first episode of myelitis. MS patients with atypical myelitis were characterized by a mean age of 34.0 (±10.7) years and 64.3% were women. In 82.1% of the patients, atypical myelitis was the first episode of MS. Mean Expanded Disability Status Scale (EDSS) scores at nadir and 3–6 months after onset were 4.1 ± 2.1 and 3.3 ± 2, respectively. Differences between groups revealed a predominance of cervicothoracic myelitis and a higher level of disability in NMOSD patients. Disability in MS patients with atypical myelitis was more severe than in the MS patients with typical myelitis; 28% had already converted to progressive MS within our mean follow-up of 39.6 (±30.4) months. Conclusion: Atypical myelitis may be the first presentation of MS and is associated with poorer prognosis.
Prohibitin 1 in liver injury and cancer
Authors: Barbier-Torres Lucía , Lu Shelly C 
Published: February 2020

Prohibitin 1 is an evolutionary conserved and ubiquitously expressed protein that exerts different biological functions depending on its subcellular localization. The role of prohibitin 1 in liver cancer is controversial as it can be pro- or anti-tumorigenic. However, most of the studies to date have described prohibitin 1 primarily as a tumor suppressor in the liver. Its deficiency sensitizes the liver to cholestatic liver injury, non-alcoholic fatty liver disease, inflammatory insults, and cancer. Liver-specific Phb1-knockout mice spontaneously develop hepatocellular carcinoma, Phb1 heterozygotes are more susceptible to develop cholangiocarcinoma, and the majority of human hepatocellular carcinomas and cholangiocarcinomas have reduced prohibitin 1 expression. Consistent with a tumor suppressive role in the liver, prohibitin 1 negatively regulates proliferation in hepatocytes and human hepatocellular carcinoma and cholangiocarcinoma cell lines, and multiple oncogenic signaling pathways are activated when prohibitin 1 is deficient. Although best known as a mitochondrial chaperone, prohibitin 1 can protect the liver by mitochondrial-independent mechanisms. This review summarizes what’s known about prohibitin 1’s role in liver pathology, with the focus on hepatoprotection and carcinogenesis. Impact statement This review summarizes the last decades of research on PHB1 in liver pathobiology. PHB1 is a key player for liver health as it is hepatoprotective and tumor suppressive. We highlight the importance of PHB1’s subcellular localization, post-translational modifications, and interacting proteins as major determinants of PHB1 cytoprotective function and anti-tumor activity in the liver.
Discrepancies between current and ideal endovascular stroke treatment practice in Europe and North America: Results from UNMASK EVT, a multidisciplinary survey
Authors: Ospel Johanna M , Kashani Nima , Turjman Francis , Fischer Urs , Baxter Blaise , Rabinstein Alejandro , Coutts Sheilagh , Menon Bijoy K , Almekhlafi Mohammed , Hill Michael D , Saposnik Gustavo , Goyal Mayank 
Published: February 2020

Background Since 2015, endovascular therapy has been established as a standard of care for acute stroke. This has caused major challenges regarding the organization of systems of care, which have to meet the increasing demand for thrombectomies. This study aims to evaluate how endovascular therapy decisions made by European and North American physicians under their current local resources differ from those made under assumed ideal conditions. Methods In an international, multidisciplinary survey, physicians involved in acute stroke care were asked to give their treatment decisions to 10 out of 22 randomly assigned stroke case-scenarios. Participants stated (a) their treatment approach under assumed ideal conditions (without any external limitations) and (b) the treatment they would pursue under their current local resources. Resources gaps (ideal minus current endovascular therapy rates) were calculated for different countries/states/provinces and correlated to economic and healthcare key metrics (gross domestic product-per-capita, public or private health insurance coverage, etc.). Results A total of 607 physicians, among them 218 from North America and 136 from 25 European countries, responded to the survey. Resources gaps in the majority of North American states/provinces and European countries were small (<5%). The highest gaps were observed among few European countries, namely Poland (30%) and the United Kingdom (33%). The magnitude of the resources gap did not correlate to national economic or healthcare metrics. Discussion and conclusion In the majority of North American states/provinces and European countries covered in this study, the discrepancy between endovascular therapy decisions under current local resources and assumed ideal conditions seems to be small, even in countries with a limited economic status and healthcare infrastructure.
The association between vascular access type and depressive symptoms in geriatric hemodialysis population
Authors: Keser Betul Nur , Kirman Ulku Nur , Kocaaslan Cemal , Aydin Ebuzer 
Published: February 2020

Objectives A well-functioning vascular access is crucial for hemodialysis treatment, and arteriovenous fistula is the recommended vascular access type. Arteriovenous fistula is superior to other vascular access types in many aspects, but the effect of arteriovenous fistula on patients’ psychiatric state is not well described yet. The aim of this study is to determine whether there is an association between vascular access type and depression scores. Methods This cross-sectional study was conducted at two hemodialysis centers. Geriatric Depression Scale-15 was administered to geriatric hemodialysis patients, using ≥5 score as the cut-off value for the presence of depressive symptoms. Descriptive tests, Kolmogorov–Smirnov test, Pearson’s Chi-square test, Mann–Whitney test, Kruskal–Wallis test, Spearman’s rank correlation calculation, and multiple logistic regression analysis were performed accordingly to analyze the data. Results Of 75 participants, 34 (45.3%) were female and the mean age was 73.4 ± 5.9 years (range: 65–92). The prevalence of depressive symptoms in the geriatric hemodialysis population was 53.3%. Central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for higher depression scores (aOR 10.505 (95% CI 1.435–76.900), p = 0.021; aOR 9.783 (95% CI 2.508–38.169), p = 0.001; aOR 1.019 (95% CI 1.003–1.035), p = 0.017, respectively). Among patients with arteriovenous fistula, those with hypertension had higher depression scores ( p = 0.008). Conclusions Geriatric hemodialysis patients were found to have depressive symptoms commonly, and central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for presence of depressive symptoms. To the best of our knowledge, this is the first study highlighting that arteriovenous fistula is associated with lower depression scores and lower prevalence of depressive symptoms.
Cost of hospitalization for stroke in a low–middle-income country: Findings from a public tertiary hospital in the Philippines
Authors: Diestro Jose Danilo Bengzon , Omar Abdelsimar Tan , Sarmiento Robert Joseph Cruz , Enriquez Clare Angeli Guinto , Castillo Lennie Lynn Chua-De , Ho Beverly Lorraine , Khu Kathleen Joy Ong Lopez , Pascual V Jose Leonard Rivera 
Published: February 2020

Background Determining the cost of hospitalization for acute stroke is important in the appropriate allocation of resources for public health facilities and in the cost effectiveness analysis of interventions. Despite being the second leading cause of mortality in the Philippines, there are no published data on the cost of stroke in the country. Aim The study aims to determine the in-hospitalization cost for stroke (IHCS) in a tertiary public hospital in the Philippines and identify the factors influencing IHCS. Methods The study was a retrospective review of the medical and billing records of the hospital. Adult patients admitted for acute stroke between 1 June 2017 and 31 May 2018 were included in the analysis. After the mean cost of stroke was determined, multivariate logistic regression analysis was done to determine demographic and clinical characteristics that were predictive of stroke cost. Results A total of 863 patient records were analyzed. The median in-hospitalization cost for stroke was PHP 17,141.50 or US$329.52. Independent determinants of higher cost include male sex (p = 0.021), stroke type (hemorrhagic stroke, p = 0.001; subarachnoid hemorrhage, p < 0.001), lower GCS on admission (p = 0.023), surgical intervention (p < 0.001), intravenous thrombolysis (p < 0.001), infection (p < 0.001), length of hospital stay (p < 0.001), and mechanical ventilation (p = 0.008). Conclusion The study provided current data on the in-hospitalization cost of acute stroke in a public tertiary hospital in the Philippines. Male sex, stroke type, lower GCS on admission, surgical intervention, intravenous thrombolysis, infection, length of hospital stay, and mechanical ventilation were independent predictors of cost.
Barreras y facilitadores para una alimentación saludable y actividad física en mujeres embarazadas con sobrepeso y obesidad
Authors: Orozco Emanuel , Pacheco Selene , Arredondo Armando , Torres Christian , Resendiz Oscar 
Published: February 2020

Objetivo: identificar barreras y facilitadores sobre dieta saludable y actividad física en mujeres embarazadas con sobrepeso y obesidad que viven en entornos de vulnerabilidad social y económica, destacando determinantes socioeconómicos y culturales. Metodología: estudio cualitativo longitudinal, donde las entrevistadas corresponden a mujeres embarazadas seleccionadas de una cohorte prospectiva en México. Se aplicó una guía semiestructurada de entrevista que exploró barreras y facilitadores para llevar una dieta saludable y poder realizar actividad física. Las entrevistas se transcribieron y codificaron en Atlas Ti, generando 23 códigos temáticos. Resultados: existen barreras y facilitadores contextuales y sociales que predisponen un mayor riesgo de padecer sobrepeso y obesidad durante el embarazo. Destacan conocimientos limitados sobre una dieta saludable, condiciones de vulnerabilidad social, así como un sentido de fragilidad en las mujeres que incrementa su sedentarismo. Conclusiones: en el diseño e implementación de intervenciones en promoción de la salud es fundamental considerar las barreras y facilitadores culturales y socioeconómicas sobre alimentación saludable y actividad física durante el embarazo, para desarrollar intervenciones de salud pública que favorezcan una mayor prevención de sobrepeso y obesidad en mujeres embarazadas.
Effects of Birthing Room Design on Maternal and Neonate Outcomes: A Systematic Review
Authors: Nilsson Christina , Wijk Helle , Höglund Lina , Sjöblom Helen , Hessman Eva , Berg Marie 
Published: February 2020

Aim: To summarize, categorize, and describe published research on how birthing room design influences maternal and neonate physical and emotional outcomes. Background: The physical healthcare environment has significant effects on health and well-being. Research indicates that birthing environments can impact women during labor and birth. However, summaries of the effects of different environments around birth are scarce. Methods: We conducted a systematic review, searching 10 databases in 2016 and 2017 for published research from their inception dates, on how birthing room design influences maternal and neonate physical and emotional outcomes, using a protocol agreed a priori. The quality of selected studies was assessed, and data were extracted independently by pairs of authors and described in a narrative analysis. Results: In total, 3,373 records were identified and screened by title and abstract; 2,063 were excluded and the full text of 278 assessed for analysis. Another 241 were excluded, leaving 15 articles presenting qualitative and quantitative data from six different countries on four continents. The results of the analysis reveal four prominent physical themes in birthing rooms that positively influence on maternal and neonate physical and emotional outcomes: (1) means of distraction, comfort, and relaxation; (2) raising the birthing room temperature; (3) features of familiarity; and (4) diminishing a technocratic environment. Conclusions: The evidence on how birthing environments affect outcomes of labor and birth is incomplete. There is a crucial need for more research in this field.
A Scoping Review of the Impact on Children of the Built Environment Design Characteristics of Healing Spaces
Authors: Gaminiesfahani H. , Lozanovska M. , Tucker R. 
Published: February 2020

Aim: This article elucidates current understanding in pediatric healthcare building design via scoping review of research on the impacts on the health and well-being of children of the architectural and landscape characteristics of healing spaces. Background: Studies indicate that patients’ phenomenological experiences of the built environment characteristics of healthcare buildings can impact their healing and well-being. It follows that understanding the healing effects of landscape and architecture can inform the design of healthcare settings for increased health benefits. Method: This method comprises five search stages: (1) research question is formed; (2) key words, search terms, and search strategy are identified; (3) databases are searched, and papers are assessed via inclusion and exclusion criteria; (4) information of the selected articles is extracted and summarized; and (5) key findings are interpreted and reported via comparative tabulation. Results: One hundred seventy-three papers were found during the first search stage. After screening and evaluating for relevance and quality, 13 articles were selected for study. Analysis indicates that the built environment characteristics of pediatric healthcare environments that have healing benefits include access to nature, music, art and natural light, reduced crowding, reduced noise, and soft, cyclical, and user-controlled artificial lighting. Conclusions: While it is important to understand the design variables that influence pediatric healthcare, it is also necessary to contextualize them and to distinguish these variables from each other and appreciate their interaction. In other words, a more rounded understanding of these variables is required via research so that their individual and combined impacts are reflected in holistic design recommendations.
Nasolacrimal Obstruction Following the Placement of Maxillofacial Hardware
Authors: Kang J. Minjy , Kalin-Hajdu Evan , Idowu Oluwatobi O. , Vagefi M. Reza , Kersten Robert C. 
Published: February 2020

Purpose: This article reviews cases of nasolacrimal obstruction (NLO) secondary to maxillofacial hardware placement. Methods: A retrospective review was performed at a single institution from 2012 to 2017 of patients with NLO following maxillofacial reconstruction. The study was approved by the Institutional Review Board of the University of California, San Francisco, adhered to the tenets of the Declaration of Helsinki, and was Health Insurance Portability and Accountability Act compliant. Patients were included if external dacryocystorhinostomy (DCR) confirmed previously placed maxillofacial hardware as the primary contributor to lacrimal outflow obstruction and had at least 3 months of follow-up. Results: Of 420 patients who underwent external DCR, 6 cases of implant-related NLO were identified. The mean age was 47.3 ± 9.6 years and 66.7% of patients were male. All patients presented with epiphora and 50% also had chronic dacryocystitis. Patients had prior maxillofacial hardware placement for paranasal sinus tumors (66.7%) or facial fractures (33.3%). In addition to external DCR, all patients had revision or removal of implants that were impeding lacrimal outflow by 2 mechanisms: (1) an orbital implant impinging the lacrimal sac or nasolacrimal duct (NLD) and/or (2) maxillofacial screws placed into the bony NLD or nasolacrimal fossa. Five of the 6 patients (83.3%) had complete resolution of symptoms and patency of the nasolacrimal system at their last follow-up visit (range 3-30 months). Conclusion: NLO secondary to hardware placement, though infrequent, is underreported. Two mechanisms of hardware-induced NLO were encountered in this case series. Specific attention to nasolacrimal anatomy at the time of maxillofacial reconstruction may help minimize implant-induced NLO.
Platelet-Rich Plasma for Knee Osteoarthritis: Internet Marketing and Patient Education—An Appraisal of Content for Websites with the Greatest Search Engine Visibility
Authors: Shai Shemesh S. , Shay Ribenzaft Z. , Pretell-Mazzini Juan , Tal Frenkel Rutenberg , Nir Cohen , Barak Haviv , Steven Velkes 
Published: February 2020

Objective The internet is increasingly being used as a resource for health-related information by the general public. We sought to establish the authorship, content, and accuracy of the information available online regarding platelet-rich plasma (PRP) therapy for knee osteoarthritis. Design Top 200 search results from each of the 3 leading search engines available online (Google, Yahoo!, Bing) were screened, and 181 websites were finally reviewed for content with emphasis on specific claims, comparing between websites authored by private physicians/groups and other authorship types. Results Nearly 80% of the websites claimed that PRP injections for osteoarthritis of the knee improve patients’ pain. A total of 42.8% of the private websites and 27.6% of nonprivate websites have stated that the procedure can delay or eliminate the need for future surgery. Costs were only mentioned by few (11.6%), and mainly by the nonprivate websites. Both website groups were unlikely to mention that PRP therapy is not the treatment of choice for end-stage knee osteoarthritis (7.9% of private and 17.2% of the nonprivate sites), or to state that patients with less advanced disease may benefit more from the treatment (11.8% and 20.6%, respectively). Private websites were less likely to refer to peer-reviewed literature (18.4% vs. 41.4%) and were more than 3 times less likely to mention lack of adequate evidence (13.2% vs. 48.2%). Conclusions Patients seeking online information regarding PRP therapy are vulnerable to websites presenting a narrow viewpoint of this treatment modality, putting emphasis on unsubstantiated benefits while disregarding potential drawbacks and concerns.
Article 47 CFR and the effective enforcement of EU labour law: Teeth for paper tigers?
Authors: Adams-Prassl Jeremias 
Published: February 2020

‘Social rights’, the late Professor Sir Bob Hepple warned in 2007 ‘are like paper tigers, fierce in appearance but missing in tooth and claw.’ This note sets out to explore the potential of the right to an effective remedy in Article 47 of the European Union’s Charter of Fundamental Rights (‘CFR’) in equipping the Union’s social acquis with credible remedies. Article 47 CFR is one of the most-litigated and important Articles in the Charter. At the same time, however, it has received surprisingly little attention in the context of EU employment law. Discussion is structured as follows: section one explores the rise of the principle of effectiveness, from the early case law of the Court of Justice to the Charter’s entry into force in 2009. Section two sketches the powerful potential of Article 47 CFR, highlighting its utility both in tackling domestic obstacles to effective enforcement, and expanding the horizontal applicability of EU employment law. Section three briefly highlights some of the limitations litigants might encounter, including a general emphasis on broad regulatory discretion for Member States, and the difficult of crafting (positive) duties out of (negative) restraints. A brief concluding section turns to EU law more broadly, as well as the European Convention of Human Rights, for inspirations guiding the potential future development of Article 47 CFR.
Pancreatic cancer‐derived organoids – a disease modeling tool to predict drug response
Authors: Frappart Pierre‐Olivier , Walter Karolin , Gout Johann , Beutel Alica K , Morawe Mareen , Arnold Frank , Breunig Markus , Barth Thomas FE , Marienfeld Ralf , Schulte Lucas , Ettrich Thomas , Hackert Thilo , Svinarenko Michael , Rösler Reinhild , Wiese Sebastian , Wiese Heike , Perkhofer Lukas , Müller Martin , Lechel André , Sainz Bruno , Hermann Patrick C , Seufferlein Thomas , Kleger Alexander 
Published: February 2020

BackgroundOrganotypic cultures derived from pancreatic ductal adenocarcinoma (PDAC) termed pancreatic ductal cancer organoids (PDOs) recapitulate the primary cancer and can be derived from primary or metastatic biopsies. Although isolation and culture of patient‐derived pancreatic organoids were established several years ago, pros and cons for individualized medicine have not been comprehensively investigated to date.MethodsWe conducted a feasibility study, systematically comparing head‐to‐head patient‐derived xenograft tumor (PDX) and PDX‐derived organoids by rigorous immunohistochemical and molecular characterization. Subsequently, a drug testing platform was set up and validated in vivo. Patient‐derived organoids were investigated as well.ResultsFirst, PDOs faithfully recapitulated the morphology and marker protein expression patterns of the PDXs. Second, quantitative proteomes from the PDX as well as from corresponding organoid cultures showed high concordance. Third, genomic alterations, as assessed by array‐based comparative genomic hybridization, revealed similar results in both groups. Fourth, we established a small‐scale pharmacotyping platform adjusted to operate in parallel considering potential obstacles such as culture conditions, timing, drug dosing, and interpretation of the results. In vitro predictions were successfully validated in an in vivo xenograft trial. Translational proof‐of‐concept is exemplified in a patient with PDAC receiving palliative chemotherapy.ConclusionSmall‐scale drug screening in organoids appears to be a feasible, robust and easy‐to‐handle disease modeling method to allow response predictions in parallel to daily clinical routine. Therefore, our fast and cost‐efficient assay is a reasonable approach in a predictive clinical setting.