bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midterm Results of Retrograde In Situ Needle Fenestration During Thoracic Endovascular Aortic Repair of Aortic Arch Pathologies
Authors: Luo Mingyao , Fang Kun , Fan Bowen , Li Quanming , Li Ming , He Hao , Li Xin , Guo Yuanyuan , Xue Yunfei , Zhao Jiawei , Wang Tun , Yang Chenzi , Li Jiehua , Nienaber Christoph A. , Shu Chang 
Published: September 2020

Purpose: To evaluate the safety and feasibility of the in situ needle fenestration (ISNF) technique for reconstruction of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR) of complicated aortic arch pathologies. Materials and Methods: A retrospective review was conducted from January 2014 to December 2019 of 50 patients (mean age 60.2±11.1; 45 men) who underwent ISNF to revascularize the LSA during TEVAR. Twenty-one of the patients also required revascularization of the left common carotid artery (LCCA; n=19) and innominate artery (IA; n=2) using physician-modified in vitro fenestration. Overall, 73 supra-aortic branches were targeted for revascularization. Results: ISNF was successful in 48 patients (96%); one LSA could not be stented and a tortuous LSA prevented the needle from fenestrating the graft. No perioperative major adverse event occurred. There were no type I and 4 type III endoleaks (8%), 3 of which occurred among the first 20 cases. Types II and IV endoleaks were found in 3 (6%) and 6 (12%) cases, respectively; all disappeared during a median follow-up of 15 months (range 3–66). One death (2%) occurred within 12 months due to cerebral hemorrhage. Two patients (4%) required open reinterventions at 6 and 62 months. Conclusion: ISNF for revascularization of the LSA during TEVAR seems to be feasible with acceptable midterm outcomes. The learning curve and evolving patient selection criteria affected technical success, complications, and the need for reinterventions. Long-term durability requires further evaluation.
Anatomical Suitability of the Aortic Arch Arteries for a 3-Inner-Branch Arch Endograft
Authors: Spanos Konstantinos , Haulon Stephan , Eleshra Ahmed , Rohlffs Fiona , Tsilimparis Nikolaos , Panuccio Giuseppe , Kölbel Tilo 
Published: September 2020

Purpose: To analyze aortic arch anatomy of patients who were already treated with a 2-inner-branch arch endograft (2-IBAE) in order to assess the anatomical suitability of the supra-aortic arteries as target vessels for a 3-IBAE. Materials and Methods: Three different configurations of the Cook Zenith Arch endograft were designed with distances of 110 mm (model 1), 90 mm (model 2), and 70 mm (model 3) between the orifices of the first and third inner branches. Preoperative measurements of the aortic arch anatomy from 104 consecutive patients treated electively with custom-made 2-IBAEs at 2 European centers between 2014 and 2019 were analyzed. A previously described standard methodology with a planning sheet was used. Data and measurements included the treatment indication for the aortic arch pathology, the type of landing zone, the type of arch, and the inner and outer lengths of the ascending aorta from the sinotubular junction to the innominate artery (IA). Additionally, the diameters and clock positions of the IA, left common carotid artery (LCCA), and left subclavian artery (LSA) were assessed, along with the distances between the IA and the LCCA, the IA and the LSA, and the distal landing zone. Results: Type I was the most common arch configuration (75/104, 72%). The mean clock positions were 12:30±00:28 for the IA, 12:00±00:23 for the LCCA, and 12:15±00:29 for the LSA. The mean diameters were 14.2±2.2 mm for the IA, 8.8±1.8 mm for the LCCA, and 10.5±2 mm for the LSA. The mean distances between the IA and LCCA and between the IA and LSA were 14.7±5.8 mm and 33±9.4 mm, respectively. Model 2 (branch distance 90 mm) had the highest suitability (79%), while models 1 and 3 showed suitability rates of 73% and 68%, respectively. The most frequent exclusion criterion in all models was the diameter of the LSA, followed by the IA to LSA distance. Conclusion: The suitability for a 3-IBAE among patients who had a 2-IBAE implanted is high, favoring a 90-mm distance between the retrograde LSA branch and baseline.
Intravascular Lithotripsy for Treatment of Calcified Lesions During Carotid Artery Stenting
Authors: Giannopoulos Stefanos , Speziale Francesco , Vadalà Giuseppe , Soukas Peter , Kuhn Brian A. , Stoltz Chad L. , Foteh Mazin I. , Mena-Hurtado Carlos , Armstrong Ehrin J. 
Published: September 2020

Purpose: To report the use of intravascular lithotripsy (IVL) in the treatment of calcified carotid artery lesions. Materials and Methods: The records of 21 high-surgical-risk patients (mean age 75.1±8.1 years; 17 men) who were treated at 8 centers for carotid artery stenosis ≥70% were retrospectively reviewed. Twelve patients had a history of cerebrovascular disease. All patients had heavily calcified carotid artery lesions: 19 de novo and 2 in-stent restenoses (ISR). The mean baseline stenosis was 82.3%±9.7%. IVL was utilized at the discretion of the operator, followed by balloon angioplasty. Embolic protection devices were used in all cases. Results: In 19 patients, IVL was followed by stent implantation; the 2 ISR lesions were dilated only. The mean IVL balloon diameter was 4.64±1.13 mm, and the mean number of IVL pulses applied was 67.2±61.4 (range 10–180). All procedures were technically successful (<30% residual stenosis). No patients developed symptomatic bradycardia or hypotension due to IVL, and there were no adverse events associated with IVL delivery. All patients were discharged on dual antiplatelet therapy. Seventeen days after the procedure, 1 patient experienced an ischemic stroke that was deemed due to aortic arch manipulation during transfemoral access. Carotid duplex ultrasound examination identified significant restenosis (>70%) in 1 asymptomatic patient at 12 months after the index procedure. No patients required reintervention during a median follow-up of 6 months (range 1–12). Conclusion: This preliminary experience demonstrates that IVL can be a safe and effective approach for the management of severely calcified carotid lesions. Further research is warranted to determine the longer-term safety and efficacy of IVL for dilation of calcified carotid artery lesions as an adjunct to carotid artery stenting.
Ponatinib coronary microangiopathy: novel bedside diagnostic approach and management with N-acetylcysteine
Authors: Wu Melinda D. , Hodovan James , Kumar Kris , Moulton Bart , Olson Sven , Gilbert Aubre , Wood Matthew D. , Lindner Jonathan R. 
Published: September 2020

Key Points
Ponatinib produces a coronary microangiopathy that mimics myocardial infarction and can be detected rapidly by contrast echocardiography. N-acetylcysteine therapy can potentially resolve ischemic complications caused by ponatinib-related microangiopathy.
Exosomal miR-223 derived from natural killer cells inhibits hepatic stellate cell activation by suppressing autophagy
Authors: Wang Ling , Wang Yinghao , Quan Jun 
Published: September 2020

Abstract
Background
Activation of hepatic stellate cells (HSCs) is a prominent driver of liver fibrosis. We previously demonstrated that exosomes derived from natural killer (NK) cells (NK-Exo) attenuated TGF-β1-induced HSC activation. Herein, this study was designed to investigate the mechanism underlying the action of NK-Exo.

Methods
NK-Exo was isolated from NK-92MI cells and then administered into TGF-β1-treated LX-2 (human HSC line) cells. MiR-223 expression in NK-Exo was downregulated by transfecting NK-92MI cells with miR-223 inhibitor followed by exosome isolation. The HSC activation was evaluated by determining cell proliferation using CCK-8 assay and measuring the protein levels of α-SMA and CoL1A1 using western blot in LX-2 cells. The expression of miR-223 was detected by qRT-PCR. The interaction between miR-223 and ATG7 was analyzed by a dual-luciferase activity assay. The autophagy was evaluated by measuring the autophagy-related proteins using western blot.

Results
miR-223 was highly expressed in NK-Exo and inhibition of miR-223 expression in NK-Exo abrogated the inhibitory effect of NK-Exo on TGF-β-induced HSC activation. ATG7 was confirmed as a direct target of miR-223. Furthermore, treatment with the autophagy activator rapamycin and ATG7 overexpression in LX-2 cells abolished the HSC activation-suppressive effect of NK-Exo.

Conclusion
NK-Exo attenuated TGF-β-induced HSC activation by transferring miR-223 that inhibited autophagy via targeting ATG7.
Genome-wide survey, characterization, and expression analysis of bZIP transcription factors in Chenopodium quinoa
Authors: Li Feng , Liu Jianxia , Guo Xuhu , Yin Lili , Zhang Hongli , Wen Riyu 
Published: September 2020

AbstractBackgroundChenopodium quinoaWilld. (quinoa) is a pseudocereal crop of the Amaranthaceae family and represents a promising species with the nutritional content and high tolerance to stressful environments, such as soils affected by high salinity. The basic leucine zipper (bZIP) transcription factor represents exclusively in eukaryotes and can be related to many biological processes. So far, the genomes of quinoa and 3 other Amaranthaceae crops (Spinacia oleracea,Beta vulgaris, andAmaranthus hypochondriacus) have been fully sequenced. However, information about thebZIPsin these Amaranthaceae species is limited, and genome-wide analysis of thebZIPfamily is lacking in quinoa.ResultsWe identified 94bZIPsin quinoa (named asCqbZIP1-CqbZIP94). All theCqbZIPswere phylogenetically splitted into 12 distinct subfamilies. The proportion ofCqbZIPswas different in each subfamily, and members within the same subgroup shared conserved exon-intron structures and protein motifs. Besides, 32 duplicatedCqbZIPgene pairs were investigated, and the duplicatedCqbZIPshad mainly undergone purifying selection pressure, which suggested that the functions of the duplicatedCqbZIPsmight not diverge much. Moreover, we identified thebZIPmembers in 3 other Amaranthaceae species, and 41, 32, and 16 orthologous gene pairs were identified between quinoa andS. oleracea,B. vulgaris, andA. hypochondriacus, respectively. Among them, most were a single copy being present inS. oleracea,B. vulgaris, andA. hypochondriacus, and two copies being present in allotetraploid quinoa. The function divergence within thebZIPorthologous genes might be limited. Additionally, 11 selectedCqbZIPshad specific spatial expression patterns, and 6 of 11CqbZIPswere up-regulated in response to salt stress. Among the selectedCqbZIPs, 3 of 4 duplicated gene pairs shared similar expression patterns, suggesting that these duplicated genes might retain some essential functions during subsequent evolution.ConclusionsThe present study provided the first systematic analysis for the phylogenetic classification, motif and gene structure, expansion pattern, and expression profile of thebZIPfamily in quinoa. Our results would lay an important foundation for functional and evolutionary analysis of CqbZIPs, and provide promising candidate genes for further investigation in tissue specificity and their functional involvement in quinoa’s resistance to salt stress.
Why do women not prepare for pregnancy? Exploring women’s and health care providers’ views on barriers to uptake of preconception care in Mana District, Southwest Ethiopia: a qualitative study
Authors: Teshome Firanbon , Kebede Yohannes , Abamecha Fira , Birhanu Zewdie 
Published: September 2020

Abstract
Background
Preconception care has the potential to reduce maternal and child morbidities and mortalities. It is a window of opportunity to timely alter or eliminate risk factors for adverse pregnancy outcomes. However, despite strong evidence on the effectiveness of preconception care in safeguarding maternal and child health, its uptake remains low. Therefore, this study aimed to explore barriers to the uptake of preconception care.

Methods
A descriptive qualitative study was conducted in Mana district, Jimma Zone, Oromia region, Southwest Ethiopia from March 02 to April 10, 2019. A purposive sampling approach was used, and 13 key informant interviews (6 in rural and 7 in urban areas) were held with women of different age groups, health extension workers, and health care providers of different professions. In addition, 4 focused group discussions with women of reproductive age groups (two with rural women only and two with urban women only) were conducted. The data were collected by trained experts using semi-structured guides. An inductive process of thematic analysis was employed and the data were coded, categorized, and thematized using Atlas ti version 7.0.71 software.

Results
Four women of reproductive age groups, 1 older woman (grandmother), 2 health extension workers, and 6 health care providers of different professions were interviewed. In addition, a total of 38 women of reproductive age groups participated in the 4 focused group discussions: 20 in the two rural-focused group discussions and 18 in the two urban-focused group discussions. The findings indicated the presence of many barriers affecting the uptake of preconception care and organized into five themes: women-related barriers, husband-related barriers, community-related barriers, health-service-related barriers, and media-related barriers.

Conclusions
This study found a diverse array of potentially modifiable barriers to the uptake of preconception care. The findings imply the importance of scaling up health education and counseling, establishing preconception care strategies and functional units that can address all the components at all levels of health care facilities. Therefore, we recommend all stakeholders, such as program planners and managers, non-governmental organizations, media personnel, and health care providers to work in collaboration to increase the uptake of preconception care.
Outcomes of a postoperative perfluorocarbon liquid tamponade for complex retinal detachments: 12 years of experience in southern Thailand
Authors: Bhurayanontachai Patama , Seepongphun Usanee 
Published: September 2020

Abstract
Background
The study evaluates both functional and anatomical outcomes of retinal detachment (RD) repair by vitrectomy and perfluorocarbon liquid (PFCL) tamponade.

Methods
A retrospective chart review of patients who underwent vitrectomy using PFCL tamponade for RD repair from causes such as giant tear, chronic RD, or RD with previously failed surgery.

Results
This study included 122 eyes from 121 patients. One-hundred fourteen eyes (93.5%) had baseline vision worse than 20/200. The median duration of intraocular PFCL retainment was 14 days before gas or silicone oil replacement. The retinal reattachment rate was 80.3%. At 1 year, the retention probability of retinal reattachment was 0.84 (95% confidence interval, 0.77–0.91). Although visual improvement was found in 45.9% of patients, the median of final vision was not different between baseline and the last visit.

Conclusion
The rate of retinal reattachment operated with a short- to medium-term PFCL tamponade achieved a high satisfaction rate. However, postoperative hypotony was a predictor for unfavorable visual and anatomical outcomes.
The synergistic hepatoprotective potential of Beta vulgaris juice and 2,3- dimercaptosuccinic acid in lead-intoxicated rats via improving the hepatic oxidative and inflammatory stress
Authors: Shaban Nadia Z. , Abdelrahman Samah A. , El-Kersh Mohamed A. L. , Mogahed Fayed A. K. , Talaat Iman M. , Habashy Noha H. 
Published: September 2020

Abstract
Background
Lead (Pb) is observed in all areas of the environment, mainly derived from human operations such as mining, processing, and burning fossil fuels. Pb toxicity is one of the most prevalent causes of human hepatotoxicity. The available chelator drugs used now have many adverse effects and therefore the world is looking for natural and secure alternatives.

Methods
Here, we evaluated the hepatoprotective role of the oral administration (1 g/kg b.w.) of the lyophilized Beta vulgaris juice (BVJ) against Pb-induced rat hepatotoxicity. We also examined the possible synergistic hepatoprotective impact of the combination between BVJ and 2,3- dimercaptosuccinic acid (DMSA, the currently approved drug for Pb-toxicity). The evaluation depends on the ability of BVJ, DMSA, or their combination (BVJ-DMSA) to reduce serum and hepatic Pb level and to avoid oxidative stress and inflammation caused by Pb. The level of lipid peroxidation, reduced glutathione (GSH), total antioxidant capacity, and the activity of the antioxidant enzymes were quantified. In addition, the level of interleukin (IL)-6, nitric oxide (NO), DNA fragmentation, and liver histology were studied.

Results
The results showed that BVJ contained considerable amounts of betalains, vitamin C, and various types of phenolic compounds. Therefore, BVJ displayed a significant (p < 0.05) preventive influence on the elevation of Pb levels in blood and liver as well as the hepatic DNA fragmentation. In addition, it significantly (p < 0.05) improved most of the studied antioxidant and inflammatory markers in the Pb-intoxicated rats. However, the combined extract (BVJ-DMSA) revealed synergistic (combination index < 1) activities in most of the tested parameters. The histopathological results verified the biochemical findings of this research.

Conclusion
BVJ has a potent efficiency in the protection from Pb-induced hepatotoxicity through the reduction of its accumulation in blood and liver and the prevention of the oxidative stress and inflammation induced by Pb. Additionally, the treatment of hepatotoxicity with BVJ and DMSA in combination showed a synergistic effect and reduced the adverse effects induced by DMSA. Thus, BVJ can be a promising hepatoprotective extract against lead toxicity and its combination with DMSA potentiates this effect.
Inequitable access to an outpatient parenteral antimicrobial therapy service: linked cross-sectional study
Authors: Sumpter Colin , Russell Clark D. , Mackintosh Claire 
Published: September 2020

Abstract
Study aim
To assess whether Outpatient Parenteral Antimicrobial Therapy (OPAT) is provided equitably across gender and social groups in a tertiary care setting.

Background
OPAT is a widely used and growing approach in high income countries to early discharge or admission avoidance for patients requiring intravenous antimicrobials. There is however a risk that equitable access to healthcare could be eroded unintentionally by expansion of outpatient or ambulatory approaches such as this. Anecdotal evidence in our service, and from published studies, have identified a gender and social group equity gap in outpatient services.

Methods
Service data on inpatient cellulitis episodes over a seven-year period were matched to OPAT referral data to create a retrospective cross-sectional linked dataset. All individuals admitted from 2012 to 2017 inclusive for a primary diagnosis of cellulitis were included: 6295 admissions of 4944 individuals. Demographics, number of co-morbidities, length of hospital stay, number of admissions, distance from OPAT unit and Scottish Index of Multiple Deprivation (SIMD; as a metric of deprivation) were recorded. Adjusted odds of a referral to OPAT across SIMD quintiles and for females compared to males were calculated using multiple logistic regression.

Results
Inequitable access to OPAT was identified. Deprivation was negatively associated with likelihood of OPAT referral. Inpatients from the most affluent SIMD quintile were more than twice as likely to have received an OPAT referral compared to those resident in the most deprived quintile (adjusted OR 2.08, 95% CI: 1.60–2.71, p <  0.0001). Women were almost a third less likely to receive an OPAT referral than men (adjusted OR 0.69, 95% CI: 0.58 to 0.82, p <  0.001). Results were adjusted for age, number of co-morbidities, admissions, length of stay, distance from nearest OPAT unit, time since first admission, deprivation and gender.

Conclusions
OPAT services and other ambulatory care programmes should routinely evaluate the equity of their service provision and consider how they can reduce any identified imbalance. It is a critical responsibility of service planning to ensure an inequitable system does not develop, with those least able to access ambulatory care dispossessed of the associated benefits.
Effect of resilience on infertile couples’ quality of life: an actor–partner interdependence model approach
Authors: Ha Ju-Young , Ban Seon-Hwa 
Published: September 2020

Abstract
Background
Infertility is an emerging socioeconomic issue affecting an individual’s life and the nation. However, only few studies have examined the influence of resilience on the quality of life (QoL) of spouses as actors and partners. Hence, this study aimed to analyze the influence of resilience, a positive factor that infertile couples may have, on QoL using the actor–partner interdependence model (APIM).

Methods
By the analyses of couples’ data, we analyzed the effect of resilience on the QoL of infertile couples as actors and partners. This cross-sectional study included 150 infertile couples. The Fertility Quality of Life and Resilience Scale was used to measure couples’ QoL and resilience. APIM was applied to analyze QoL.

Results
In terms of actor effects, the resilience of both wives (β = 0.201, p <  0.001) and husbands (β = 0.713, p <  0.001) had a significant effect on individual QoL. With regard to partner effects, husbands’ resilience (β = 0.351, p <  0.001) had a significant impact on wives’ QoL and the wives’ resilience (β = 0.219, p = 0.009) had a significant impact on husbands’ QoL.

Conclusions
The resilience of an infertile actor was found to affect both his/her own QoL and his/her partner’s QoL. In the future, if a program is to be developed to improve couples’ QoL, both spouses should work together to improve their resilience, thereby improving their QoL.
Risk factors of lymph node metastasis in the splenic hilum of gastric cancer patients: a meta-analysis
Authors: Du Jun , Shen Yangchao , Yan Wenwu , Wang Jinguo 
Published: September 2020

AbstractBackgroundThe issue of whether or not splenic hilum lymph nodes (SHLN) should be excised in radical gastrectomy with D2 lymph node dissection remains controversial. In this study, we identified the clinicopathological features in patients with gastric cancer that could serve as predictive risk factors of SHLN metastasis.MethodsWe searched Medline, Embase, PubMed, and Web of Science databases from inception to May 2020 and consulted the related references. Overall, 15 articles evaluating a total of 4377 patients were included for study. The odds ratios (OR) of each risk factor and corresponding 95% confidence intervals (CI) were determined using the Revman 5.3 software.ResultsOur meta-analysis revealed tumor size greater than 5 cm (p< 0.01), tumor localization in the greater curvature (p< 0.01), diffuse type (Lauren’s classification) (p< 0.01), Borrmann types 3–4 (p< 0.01), poor differentiation and undifferentiation (p< 0.01), depth of invasion T3–T4 (p< 0.01), number of lymph node metastases N2–N3 (p< 0.01), distant metastasis M1 (p< 0.01), TNM stages 3–4 (p< 0.01), vascular invasion (p= 0.01), and lymphatic invasion (p< 0.01) as potential risk factors of SHLN metastasis. Moreover, positivity of Nos. 1, 2, 3, 4sa, 4sb, 4d, 6, 7, 9, 11, and 16 lymph nodes for metastasis was strongly associated with SHLN metastasis.ConclusionsTumor size, tumor location, Lauren’s diffuse type, Borrmann type, degree of differentiation, T stage, N stage, M stage, TNM stage, vascular invasion, lymphatic infiltration, and other positive lymph nodes are risk factors for SHLN metastasis.