bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive-behavioral therapy for insomnia in adolescents with comorbid psychiatric disorders: A clinical pilot study
Authors: Åslund Lie , Lekander Mats , Wicksell Rikard K , Henje Eva , Jernelöv Susanna 
Published: June 2020

Background: Insomnia is common in adolescents and often comorbid with psychiatric disorders. This study evaluated changes in insomnia, sleep, and comorbid symptoms following cognitive-behavioral therapy for insomnia (CBT-I) in adolescents with comorbid psychiatric disorders and chronic pain. Methods: In this non-controlled clinical pilot study, participants ( n = 23, 78% female) were recruited from adolescent psychiatry and pediatric pain clinics. Assessments of self-reported insomnia, sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency and depression, anxiety, functional disability, and pain intensity were completed at pre- and post-intervention and 3 months follow-up. Results: From pre- to post-intervention, statistically significant improvements were found for insomnia symptoms ( p < .001; d = 1.63), sleep onset latency ( p < .001; d = 1.04), wake after sleep onset ( p < .001; d = 0.38), total sleep time ( p = .015; d = 0.22), sleep efficiency ( p < .001; d = 1.00), depression ( p < .001; d = 0.87), and anxiety ( p = .001; d = 0.31). Only eight participants reported data at follow-up with maintained improvements for all measures. Conclusion: This study provides support that insomnia symptoms and sleep can improve following CBT-I delivered in a clinical setting and that co-occurring psychiatric symptoms can be reduced. The results should be interpreted with caution due to the uncontrolled conditions and limited sample size. Well-powered clinical trials are needed to validate the suggested effects.
A score to predict one-year risk of recurrence after acute ischemic stroke
Authors: Strambo Davide , Zachariadis Alexandros , Lambrou Dimitris , Schwarz Ghil , Sirimarco Gaia , Aarnio Karolinaa , Putaala Jukka , Ntaios George , Vemmos Kostantinos , Michel Patrik 
Published: June 2020

Background An acute ischemic stroke carries a substantial risk of further recurrences. We aimed at developing and validating a prognostic tool to predict one-year stroke recurrence after acute ischemic stroke. Methods An integer score was derived by Cox regression analysis on a hospital-referred cohort of 3246 acute ischemic stroke patients from Switzerland, and tested for external validity in three similar independent cohorts from Athens ( n = 2495), Milan ( n = 1279), and Helsinki ( n = 714) by means of calibration and discrimination. Results In the derivation cohort, the recurrence rate was 7% ( n = 228/3246). We developed a nine-point score comprising: previous stroke or transient ischemic attack (1-point), stroke mechanism (small vessel disease and unknown mechanism: 0-points; rare stroke mechanism: 3-points; other mechanisms: 1-point), pre-stroke antiplatelets (1-point), active malignancy (2-points), chronic cerebrovascular lesions on imaging (1-point) and absence of early ischemic changes on first imaging (1-point). In the derivation cohort, the one-year risk of re-stroke was 3.0% (95%CI 1.9–4.1) in 932 (29%) patients with a score 0–1, 7.2% (6.1–8.3) in 2038 (63%) with a score 2–4, and 19.2% (14.6–23.9) in 276 (8%) with a score ≥ 5. The score calibrated well in the Athens (recurrences = 208/2495), but not in the Helsinki (recurrences = 15/714) or Milan (recurrences = 65/1279) cohorts. The AUC was 0.67 in the derivation cohort, and 0.56, 0.70, and 0.63 in the Athens, Helsinki, and Milan cohorts, respectively. Conclusion We developed a score to predict one-year stroke recurrence risk in patients with acute ischemic stroke. Since the score was not completely validated when applied to external datasets where it displayed poor to fair calibration and discrimination, additional efforts are required to ameliorate our accuracy for predicting stroke recurrence, by better refining this prognostic tool or developing new ones. Clinical and radiological markers of established cerebrovascular disease and stroke etiology were better predictors than the usual demographic vascular risk factors.
Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: A systematic review and meta-analysis of randomized controlled trials
Authors: Dai Lei , Zuo Yuyue , You Qiqi , Zeng Hesong , Cao Shiyi 
Published: June 2020

Abstract

Aim
Bempedoic acid is a novel oral drug, which has been increasingly researched to play an important role in the treatment of hypercholesterolemia recently. However, results from original studies were inconsistent and inconclusive. We aimed to conduct a meta-analysis to quantitatively appraise the efficacy and safety of bempedoic acid.

Methods
PubMed, Embase, Web of Science and Scopus were searched from inception to 30 January 2020. We included randomized controlled trials that compared the efficacy and safety of bempedoic acid with placebo in patients with hypercholesterolemia. Results from trials were presented as mean differences or odds ratios (ORs) with 95% confidence intervals (CIs) and were pooled by random or fixed effects model. The risk of bias and heterogeneity among trials were also assessed and analyzed.

Results
Pooled analysis of 10 eligible trials showed that bempedoic acid treatment resulted in greater lowering of the low-density lipoprotein cholesterol level than the placebo group (mean difference –23.16%, 95% CI –26.92% to –19.04%). We also found that improvements in lipid parameters and biomarkers were still maintained at weeks 24 and 52 from the long-term trials. As for safety, bempedoic acid did not increase the risk of overall adverse events (OR 1.02, 95% CI 0.88 to 1.18). However, the incidence of adverse events leading to discontinuation was higher in the bempedoic acid group (OR 1.44, 95% CI 1.14 to 1.82).

Conclusions
Available evidence from randomized controlled trials suggests that bempedoic acid provides a well-tolerated and effective therapeutic option for lipid lowering in patients with hyperlipidemia
Rare case of abdominal scar endometriosis by direct communication between fallopian tube and abdominal wall
Authors: Bartels Chantal B , Luciano Anthony A , Luciano Danielle E 
Published: June 2020

Introduction: Endometriosis involving a surgical scar occurs in 1%–2% of patients after cesarean section. There are three theories of pathogenesis: direct seeding of endometrium during surgery, distal migration by hematogenous or lymphatic routes, and scar tissue metaplasia. Retrograde menstruation, theorized to result in local pelvic endometriosis, has not been previously described to play a role in surgical scar endometriosis. Case report: A 36-year-old woman presented with a catamenial painful nodule in her cesarean section scar. She underwent laparoscopy with lysis of adhesions and excision of the abdominal wall nodule. The fimbriated end of the right fallopian tube was scarred to her abdominal wall at the site of the nodule, and chromopertubation proved direct communication between the painful nodule and the fallopian tube. Pathology confirmed surgical scar endometriosis. Conclusion: Retrograde menstruation remains a possible theory for pathogenesis of endometrial scar endometriosis, and laparoscopy should be considered at the time of resection when pelvic pain is present.
Use of Arterial Grafts in Hypothenar Hammer Syndrome: Application of Perforator Flap Anatomy
Authors: Diaz-Abele Julian , Saganski Emily , Islur Avinash 
Published: June 2020

Background: Hypothenar hammer syndrome (HHS) is traditionally treated with venous bypass grafting, but controversy has arisen as arterial grafts have become more available. Methods: A retrospective review of all patients undergoing ulnar artery bypass grafting for HHS with an arterial graft from 2008 to 2017 was performed. We also review the literature for patency rates and discuss the scenarios that favor different graft choices. Results: Six patients were included in our series. Five had primary surgery and 1 had revision surgery for HHS. Five arterial grafts were from the deep inferior epigastric artery and 1 was from the lateral circumflex femoral artery. The proximal anastomotic site was the ulnar artery for all: n = 6. The distal anastomosis site was the palmar arch and common digital artery (CDA) of the ring/small finger and CDA of the middle/ring finger: n = 3; the palmar arch and the CDA of the ring/small finger: n = 3. All patients were symptom-free at follow-up and had a patent ulnar artery on Allen’s testing or angiogram. Conclusion: Patency rates of arterial grafts for HHS appear to be excellent and this small series and may offer an alternative to traditional venous grafts and end-to-end arterial anastomoses. We suggest using arterial perforator grafts from free flap donor sites. These have well-described anatomy, are easily harvested, and carry minimal donor site morbidity. Lateral circumflex femoral artery graft is favored in patients requiring a single distal anastomosis, who have a ventral hernia, or who are obese. Deep inferior epigastric artery graft is preferred when multiple distal targets or versatile configurations are needed, in thin patients, or in female patients.
Megakaryocyte TGFβ1 partitions erythropoiesis into immature progenitor/stem cells and maturing precursors
Authors: Di Giandomenico Silvana , Kermani Pouneh , Mollé Nicole , Yabut Maria Mia , Abu-Zeinah Ghaith , Stephens Thomas , Messali Nassima , Schreiner Ryan , Brenet Fabienne , Rafii Shahin , Scandura Joseph M. 
Published: June 2020

Abstract
Erythropoietin (EPO) provides the major survival signal to maturing erythroid precursors (EPs) and is essential for terminal erythropoiesis. Nonetheless, progenitor cells can irreversibly commit to an erythroid fate well before EPO acts, risking inefficiency if these progenitors are unneeded to maintain red blood cell (RBC) counts. We identified a new modular organization of erythropoiesis and, for the first time, demonstrate that the pre-EPO module is coupled to late EPO-dependent erythropoiesis by megakaryocyte (Mk) signals. Disrupting megakaryocytic transforming growth factor β1 (Tgfb1) disorganized hematopoiesis by expanding the pre-EPO pool of progenitor cells and consequently triggering significant apoptosis of EPO-dependent EPs. Similarly, pharmacologic blockade of TGFβ signaling in normal mice boosted the pre-EPO module, leading to apoptosis of EPO-sensitive EPs. Subsequent treatment with low-dose EPO triggered robust RBC production in both models. This work reveals modular regulation of erythropoiesis and offers a new strategy for overcoming chronic anemias.
Gut dysbiosis modulates the immune response to factor VIII in murine hemophilia A
Authors: Tarrant Julie , Cormier Matthew , Nesbitt Kate , Dwyer Courtney , Hough Christine , Lillicrap David 
Published: June 2020

Abstract
The development of neutralizing FVIII antibodies is the most serious complication of hemophilia A treatment. The currently known patient- and treatment-related risk factors for inhibitor development do not accurately predict this adverse event in all patients. The composition of the gut microbiota has been shown to influence immune-mediated diseases at distant anatomical sites (eg, lungs, brain, and joints). We demonstrate that a disrupted gut microbiota can be created in a mouse model of hemophilia A using a broad-spectrum antibiotic. Under controlled conditions, this sustained dysbiosis was associated with an increase in splenic B cells and the development of higher titer, FVIII-specific immunoglobulin G antibodies after FVIII challenge. Splenic and mesenteric lymph node cytokines, T cells, and dendritic cells were unaffected before administration of FVIII. However, the immune transcriptome of both aforementioned secondary lymphoid organs was significantly modified. Short-chain fatty acids (SCFAs), which are immunomodulatory microbial metabolites, were depleted in cecal contents of the dysbiotic mice. Furthermore, supplementation of the drinking water with butyrate, the most immunologically active SCFA, successfully achieved attenuation of the FVIII immune response. Collectively, data from this exploratory study suggest that the composition of the gut microbiota alters the FVIII immune response via the action of specific microbial metabolites on the immune cell transcriptome and that oral supplementation with butyrate effectively reduces the FVIII immune response.
Quality of surgical care can impact survival in patients with bladder cancer after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium
Authors: Ahmed Youssef , Hussein Ahmed A. , May Paul R. , Ahmad Basel , Khan Amir , Benkowski John , Durrani Ayesha , Khan Saira , Kozlowski Justen , Saar Matthias , Wijburg Carl J. , Richstone Lee , Wagner Andrew , Yuh Bertram , Redorta Joan Palou , Dasgupta Prokar , Khan Mohammad Shamim , Menon Mani , Peabody James O. , Hosseini Abolfazl , Gaboardi Franco , Pini Giovannalberto , Schanne Francis , Mottrie Alexandre , Rha Koon-ho , Hemal Ashok , Stockle Michael , Kelly John , Tan Wei Shen , Maatman Thomas J. , Poulakis Vassilis , Kaouk Jihad , Canda Abdullah Erdem , Balbay Mevlana Derya , Wiklund Peter , Guru Khurshid A. 
Published: June 2020

Abstract
Background
Although pathological factors remain the main determinate of survival for patients with bladder cancer, quality of surgical care is crucial for satisfactory outcomes. Using a validated quality score, we investigated the impact of surgical factors on the overall survival (OS), recurrence-free survival (RFS) and disease-specific survival (DSS) in patients with locally advanced and organ-confined disease (OCD). Retrospective review of IRCC database includes 2460 patients from 29 institutions across 11 countries. The final cohort included 1343 patients who underwent RARCs between 2005 and 2016. Patients with locally advanced disease (LAD) (> pT2 and/or N +) were compared with OCD (≤ pT2/N0). Validated Quality Cystectomy Score (QCS) based on four sets of quality metrics was used to compare surgical performance. Kaplan–Meier method was used to compute RFS, CSS and OS rates. Multivariable stepwise logistic regression was used to evaluate variables associated with RFS, DSS and OS.

Results
48% had LAD. When compared to patients with OCD, they received neobladders less frequently (17% vs. 28%, p < 0.001) and experienced higher estimated blood loss (513 vs. 376 ml, p = 0.05). Postoperatively, more patients in the LAD group received adjuvant chemotherapy (24% vs. 4%, p < 0.001) and positive surgical margins (14% vs. 2%, p < 0.001) and had higher 90-day mortality (6% vs. 2%, p < 0.001). On multivariable analysis, female gender, higher QCS score, intracorporeal diversion, pT stage, positive lymph node status and recurrence are considered as predictors of survival. Patients with OCD exhibited better RFS, DSS and OS than patients with LAD. For patients with OCD, higher QCS was associated with improved OS but not RFS or DSS. On the other hand, patients with LAD and higher QCS exhibited higher RFS, DSS and OS when compared to those with lower QCS.

Conclusion
Quality of surgical care can affect disease control and OS in patients with bladder cancer treated with robot-assisted radical cystectomy.
Origin-destination matrix estimation with a conditionally binomial model
Authors: Kuusela Pirkko , Norros Ilkka , Kilpi Jorma , Räty Tomi 
Published: June 2020

AbstractA doubly stochastic, conditionally binomial model is proposed to describe volumes of vehicular origin-destination flows in regular vehicular traffic, such as morning rush hours. The statistical properties of this model are motivated by the data obtained from inductive loop traffic counts. The model parameters can be expressed as rational functions of the first and second order moments of the observed link counts. Challenges arising from the inaccuracy of moment estimates are studied. A real origin-destination traffic problem of Tampere city is solved by optimisation methods and the accuracy of the solution is examined.
Phylogenomics of expanding uncultured environmental Tenericutes provides insights into their pathogenicity and evolutionary relationship with Bacilli
Authors: Wang Yong , Huang Jiao-Mei , Zhou Ying-Li , Almeida Alexandre , Finn Robert D. , Danchin Antoine , He Li-Sheng 
Published: June 2020

Abstract
Background
The metabolic capacity, stress response and evolution of uncultured environmental Tenericutes have remained elusive, since previous studies have been largely focused on pathogenic species. In this study, we expanded analyses on Tenericutes lineages that inhabit various environments using a collection of 840 genomes.

Results
Several environmental lineages were discovered inhabiting the human gut, ground water, bioreactors and hypersaline lake and spanning the Haloplasmatales and Mycoplasmatales orders. A phylogenomics analysis of Bacilli and Tenericutes genomes revealed that some uncultured Tenericutes are affiliated with novel clades in Bacilli, such as RF39, RFN20 and ML615. Erysipelotrichales and two major gut lineages, RF39 and RFN20, were found to be neighboring clades of Mycoplasmatales. We detected habitat-specific functional patterns between the pathogenic, gut and the environmental Tenericutes, where genes involved in carbohydrate storage, carbon fixation, mutation repair, environmental response and amino acid cleavage are overrepresented in the genomes of environmental lineages, perhaps as a result of environmental adaptation. We hypothesize that the two major gut lineages, namely RF39 and RFN20, are probably acetate and hydrogen producers. Furthermore, deteriorating capacity of bactoprenol synthesis for cell wall peptidoglycan precursors secretion is a potential adaptive strategy employed by these lineages in response to the gut environment.

Conclusions
This study uncovers the characteristic functions of environmental Tenericutes and their relationships with Bacilli, which sheds new light onto the pathogenicity and evolutionary processes of Mycoplasmatales.
Multi-nanolayer drug delivery using radiofrequency plasma technology
Authors: Al Dybiat Iman , Baitukha Alibi , Pimpie Cynthia , Kaci Rachid , Pocard Marc , Arefi Khonsari Farzaneh , Mirshahi Massoud 
Published: June 2020

Abstract
Background
It may be impossible to perform cancer surgery with free margins in the presence of an unresectable structure. Local drug treatment after surgery has been proposed to increase the rate of tumor control.

Methods
Multi-nanolayers (10-330 nm) were generated by a low-pressure (375mTorr) inductively coupled plasma (13.56 MHz) reactor for anticancer drug delivery by the deposition of polycaprolactone-polyethylene glycol multistack barrier on the collagen membrane (100 μm thickness). Carboplatin (300 μg/cm2) was used for the in vitro and in vivo investigations. Energy-dispersive X-ray spectroscopy (15 keV), scanning electron microscopy and inductively coupled plasma mass spectrometry were used to detect the presence of carboplatin in the nanolayer, the tumor sample and the culture medium. Preclinical studies were performed on ovarian (OVCAR-3NIH) and colon (CT26) cancer cell lines as xenografts (45 days) and allografts (23 days) in Swiss-nude (n = 6) and immunocompetent BALB/cByJ mice (n = 24), respectively.

Results
The loading of carboplatin or other drugs between the nanofilm on the collagen membrane did not modify the mesh complex architecture or the drug properties. Drugs were detectable on the membrane for more than 2 weeks in the in vitro analysis and more than 10 days in the in vivo analysis. Cytotoxic mesh decreased cell adherence (down 5.42-fold) and induced cancer cell destruction (up to 7.87-fold). Implantation of the mesh on the mouse tumor nodule modified the cell architecture and decreased the tumor size (50.26%) compared to the control by inducing cell apoptosis.

Conclusion
Plasma technology allows a mesh to be built with multi-nanolayer anticancer drug delivery on collagen membranes.
Childhood injuries and food stamp benefits: an examination of administrative data in one US state
Authors: Heflin Colleen M. , Arteaga Irma , Ndashimye Jean Felix , Rabbitt Matthew P. 
Published: June 2020

AbstractBackgroundCurrently in the United States, childhood injuries are the leading cause of mortality and morbidity, resulting in an estimated 9.2 million emergency department visits and $17 billion annually in medical costs. For preschoolers, it is also the leading cause of disability.MethodsWe use linked administrative data for SNAP and Medicaid in Missouri from January 2010 to December 2013 to explore monthly patterns in the association between SNAP receipt and ER claims due to childhood injury for children age 0–5 and to examine if these patterns are sensitive to the timing of SNAP benefits. We chose the state of Missouri because unlike most states that disburse SNAP benefits within the first 10 days of the calendar month, Missouri pays SNAP benefits between the first twenty-two days of the month, based on the recipient’s birthdate and last name.ResultsSNAP benefits received later in the calendar month are associated with reductions in ER claims for childhood injuries. Furthermore, the final week in the SNAP benefit month is associated with an increase in ER claims for childhood injuries.ConclusionIn terms of public policy, our results suggest that having SNAP disbursement later in the month may have benefits for households.
PCNL in COPD patient in the sit position under local infiltration anesthesia case report
Authors: Zhai Jianpo , Wang Hai , Xu Xiao , Liu Zhenhua , Man Libo 
Published: June 2020

Abstract
Background
Percutaneous nephrolithotomy is traditionally performed in the prone or supine position. We report the first case of percutaneous nephrolithotomy in sit position under local infiltration anesthesia.

Case summary
A 69-year-old male presented with left flank pain. Kidney B ultrasound and computed tomography scan showed multiple left renal calculi and hydronephrosis. He had a long history of chronic obstructive pulmonary disease, with severe ventilatory and cardiac dysfunction, and cannot tolerate the prone or supine position. The patient received the surgery in sit position under local infiltration anesthesia. The operative time was 1 h. The visual analogue scale score during the surgery was 3. The patient had no intraoperative and postoperative complications. The postoperative plain radiography showed no residual stone fragments.

Conclusions
We believe that in high-risk patients who need to undergo PCNL, a combination of sit position and local infiltration anesthesia is an alternative method.