bluuebunny/crossref_metadata_2025_split huggingface dataset:
Refractive outcomes of high-magnitude astigmatism correction using femtosecond LASIK versus transepithelial PRK
Authors: Reitblat Olga , Gershoni Assaf , Mimouni Michael , Vainer Igor , Livny Eitan , Nahum Yoav , Segev Fani , Bahar Irit 
Published: December 2020

Purpose: To compare the outcomes of femtosecond laser assisted in situ keratomileusis (FS-LASIK) with transepithelial photorefractive keratectomy (T-PRK) for the correction of high-grade astigmatism. Methods: Medical records of patients with astigmatism of 2 diopters (D) or higher, who were treated with FS-LASIK or T-PRK in 2013 through 2014 at a private practice laser clinic, were retrospectively analyzed. Efficacy, safety, predictability and vector analysis of astigmatism correction were compared between the treatment groups. Results: The study included 93 eyes treated with FS-LASIK and 186 eyes treated with T-PRK. No significant differences in postoperative spherical equivalent (−0.10 ± 0.7 D and −0.11 ± 0.7 D, respectively, p = 0.958) and postoperative refractive astigmatism (0.79 ± 0.54 D and 0.82 ± 0.63 D, respectively, p = 0.685) were demonstrated. A significant advantage of FS-LASIK over T-PRK was seen for the efficacy (1.00 ± 0.18 and 0.86 ± 0.22, respectively, p < 0.001) and safety (1.03 ± 0.17 and 0.89 ± 0.21, respectively, p < 0.001) indices. Results remain statistically significant in a multivariate analysis model. Vector analysis for the astigmatism correction showed no significant difference between the surgery methods in the surgically induced astigmatism, difference vector, correction index and index of success. Conclusion: Both procedures demonstrated desirable post-operative SE outcomes for high-grade astigmatism correction. However, FS-LASIK achieved better results than T-PRK in the efficacy and safety parameters.
Distal transradial artery access for vascular access intervention
Authors: Watanabe Shingo , Usui Michio 
Published: December 2020

Background: Vascular access intervention is a useful treatment method for maintaining arteriovenous fistula (AVF) in dialysis patients. The outflow vein is commonly used as the access site for vascular access intervention. In cases where it is difficult to puncture veins due to multiple lesions or poor AVF development, vascular access intervention is performed using the radial artery. However, it is difficult to perform a vascular access intervention with radial artery access to the AVF in the distal forearm. We reported the efficacy and safety of vascular access intervention with distal transradial artery access (dTRA). Case series: We have been conducting vascular access intervention with dTRA access since January 2019. We evaluated complications and procedure time for 12 cases of vascular access intervention with dTRA access performed from January to December 2019. The success rate of the procedure was 100% and no puncture hemorrhagic complication was observed in 12 cases performed at our institution. No radial artery occlusion was observed in 12 cases. The average fluoroscopy time was 11.5 min and the average contrast volume was 41 ml. Conclusion: dTRA for vascular access intervention has advantages over conventional radial artery access in terms of safety of the procedure and ease of hemostasis.
Cross-Match as an Immuno-Oncological Risk Factor for Hepatocellular Carcinoma Recurrence and Inferior Survival After Living Donor Liver Transplantation: A Call for Further Investigation
Authors: Ho Cheng-Maw , Hu Rey-Heng , Wu Yao-Ming , Ho Ming-Chih , Lee Po-Huang 
Published: December 2020

Background: The success of immunotherapy for patients with hepatocellular carcinoma (HCC) suggests that immune dysregulation occurs in HCC patients. This warrants an immuno-oncological risk assessment in the platform of liver transplantation. Methods: This retrospective single-center study analyzed risk factors for—particularly cross-matching performed through conventional complement-dependent cytotoxicity cross-match tests—and the outcomes of HCC recurrence following living donor liver transplant. Results: A total of 71 patients were included. The median follow-up period was 29.1 months; 17 (23.9%) patients had posttransplant HCC recurrence, and their 1-, 3-, and 5-year-survival rates were 70.6%, 25.7%, and 17.1%, respectively, which were inferior to those of patients without HCC recurrence (87.0%, 80.7%, and 77.2%, respectively; P < .001). In addition to microvascular invasion, positive cross-match results for B cells at 37°C (B- 37°C) or T cells at 4°C (T- 4°C) were associated with inferior overall survival in multivariable analysis after adjustment for tumor status beyond Milan criteria and elevated alpha-fetoprotein levels. Rejection alone cannot be the mechanism underlying the effects of positive cross-match results on patient outcomes. Adjusted survival curves suggested that positive cross-match B- 37°C or T- 4°C was associated with inferior recurrence-free and patient survival, but the robustness of the finding was limited by insufficient power. Conclusions: Additional large-scale studies are required to validate positive cross-match as an immuno-oncological factor associated with HCC recurrence and inferior patient survival.
Structural constraints of functional connectivity drive cognitive impairment in the early stages of multiple sclerosis
Authors: Koubiyr Ismail , Deloire Mathilde , Brochet Bruno , Besson Pierre , Charré-Morin Julie , Saubusse Aurore , Tourdias Thomas , Ruet Aurélie 
Published: December 2020

Background: The relationship between structural and functional deficits in multiple sclerosis (MS) is unclear. Objective: This study explored structure-function relationships during the 5 years following a clinically isolated syndrome and their role in cognitive performance. Methods: Thirty-two patients were enrolled after their first neurological episode suggestive of MS and followed for 5 years, along with 10 matched healthy controls. We assessed structural (using diffusion tensor imaging) and functional (using resting-state functional magnetic resonance imaging (fMRI)) brain network metrics, clinical and cognitive scores at each follow-up visit. Structural–functional coupling, calculated as the correlation coefficient between strengths of structural and functional networks, was used to assess structure–function relationships. Results: Structural clustering coefficient was significantly increased after 5 years, whereas characteristic path length decreased. Structural connections decreased after 1 year and increased after 5 years. Functional connections and related path lengths were decreased after 5 years. Structural–functional coupling had increased significantly after 5 years. This structural–functional coupling was associated with cognitive and clinical evolution, with stronger coupling associated with a decline in both domains. Conclusion: Our findings provide novel biological evidence that MS leads to a more constrained anatomical-dependant functional connectivity. The collapse of this network seems to lead to both cognitive worsening and clinical disability.
Clinical significance of a single cerebrospinal fluid immunoglobulin band: A retrospective study
Authors: Tusseau Maud , Cheli Estelle , Marignier Romain , Poitevin Françoise , Malcus Christophe , Gossez Morgane , Bancel Julien , Monneret Guillaume , Vukusic Sandra 
Published: December 2020

Background: To demonstrate an inflammatory process in the central nervous system, the presence of at least two immunoglobulin (Ig) bands in the cerebrospinal fluid (CSF) is required. So far, the presence of a single abnormal Ig band is considered as negative. Objective: The objective was to assess retrospectively the significance of a single CSF Ig band in clinical practice. Methods and results: Out of 10,286 CSF analyses, we retained 214 results with single Ig. An inflammatory neurological disorder was diagnosed in 41% of patients. Conclusion: Despite a modest sensitivity, the presence of a single CSF Ig band may be a biomarker of an inflammatory mechanism and, as such, may prompt the clinician to repeat the analysis when the clinical context remains suggestive.
Reversal of warfarin and direct-acting oral anticoagulants in traumatic intracranial hemorrhage: Four factor prothrombin complex concentrates for all?
Authors: Moore Kerry K , Barton Cassie A , Levins Elizabeth S , Oetken Heath , Dewey Elizabeth N , Fleming Michael , Schreiber Martin 
Published: December 2020

Background Patients receiving oral anticoagulation who experience a traumatic intracranial hemorrhage (ICH) should receive anticoagulation reversal. Four factor prothrombin complex concentrate (4FPCC) is indicated for reversal of warfarin, and is frequently used for reversal of direct-acting oral anticoagulants (DOACs). The purpose of this study is to compare the safety and efficacy of 4FPCC reversal for traumatic ICH in DOAC- and warfarin-anticoagulated patients. Methods This was a single-center, retrospective review of adult patients with traumatic ICH who received 4FPCC for reversal of anticoagulation between April 2013 and August 2018. The ICH volume on the pre- and post-reversal head CT scans was measured. The primary endpoint was the incidence of expansion of ICH volume of blood using pre-and post-4FPCC imaging. Results A total of 102 patients meeting inclusion criteria were identified with 75 patients in the warfarin group and 27 patients in the DOAC group. There were no significant differences in baseline characteristics between the groups except DOAC patients had larger ICH volumes at baseline as compared to warfarin patients (23.4 mm3 vs 3.7 mm3, p = 0.0001). There was neither a statistical difference in change in ICH volume pre-and post-4FPCC administration, nor in the rate of >20% ICH expansion between the warfarin and DOAC groups. There was no difference in the rate of adverse events compared between groups. Conclusion There was no difference in the either the change in ICH volume or the rate of >20% ICH expansion in patients receiving 4FPCC for reversal DOAC versus warfarin anticoagulation. Rates of complications were low in both groups.
Higher complication rates after management of lower extremity fractures in lower socioeconomic classes: Are risk adjustment models necessary?
Authors: Henstenburg Jeffrey M , Lieber Alexander M , Boniello Anthony J , Kerbel Yehuda E , Shah Mitesh 
Published: December 2020

Introduction Alternative payment models, such as bundled payments, have been proposed to control rising costs in orthopaedic trauma surgery. Without risk adjustment models, concerns exist about the financial burden incurred by so called “safety-net hospitals” that serve patients of lower socioeconomic status. The purpose of this study was to determine whether lower socioeconomic status was associated with increased complications and subsequently higher resource utilization following surgical treatment of high-energy lower extremity fractures. Methods The National Inpatient Sample database was queried for patients who underwent surgical fixation of the femur and tibia between 2005–2014. The top and bottom income quartiles were compared. Demographics, medical comorbidities, length of stay (LOS), complications, in-hospital mortality were compared between patients of top and bottom income quartiles. Multivariate logistic regression analysis was then performed to identify factors independently associated with complications, mortality, and increased resource utilization. Results Patients with femur fracture in the bottom income quartile had longer length of stay (6.9 days vs 6.5 days, p < 0.001) and a higher mortality rate (1.9% vs 1.7%, p = 0.034). Patients with tibia fracture in the bottom income quartile had greater complication rates (7.3% vs 6.1%, p < 0.001), longer length of stay (5.3 days vs. 4.5 days, p < 0.001), and higher mortality (0.3% vs. 0.2%, p < 0.001). Conclusions Lower income status is associated with increased in-hospital mortality and longer length of stay in patients following lower extremity fractures. Risk adjustment models should consider the role of socioeconomic status in patient resource utilization to ensure continued access to orthopedic trauma care for all patients.
Education Priorities and What Matters to Those Considering Living Kidney Donation
Authors: Schick-Makaroff Kara , Hays Rebecca E. , Hunt Julia , Taylor Laura A. , Rudow Dianne LaPointe 
Published: December 2020

Introduction: Although informed consent content elements are prescribed in detailed regulatory guidance, many live kidney donors describe feeling underprepared and under informed. The goal of this pilot study was to explore the educational components needed to support an informed decision-making process for living kidney donors. Methods/Approach: A qualitative description design was conducted with thematic analysis of 5 focus groups with 2 cohorts: living kidney donor candidates (n = 11) and living kidney donors (n = 8). Findings: The educational components needed to engage in an informed decision-making process were: 1) contingent upon, and motivated by, personal circumstances; 2) supported through explanation of risks and benefits; 3) enhanced by understanding the overall donation experience; and 4) personalized by talking to another donor. Discussion: Tailoring education to meet the needs for fully informed decision-making is essential. Current education requirements, as defined by regulatory bodies, remain challenging to transplant teams attempting to ensure fully informed consent of living kidney donor candidates. Information on the emotional, financial, and overall life impact is needed, along with acknowledgement of relational ties driving donor motivations and the hoped-for recipient outcomes. Discussion of care practices, and access to peer mentoring may further strengthen the informed decision-making process.
Preoperative Trapped Lung Is Associated With Increased Mortality After Orthotopic Liver Transplantation
Authors: Melamed Kathryn H. , Dai David , Cuk Natasha , Markovic Daniela , Follett Robert , Wang Tisha , Lopez Roxana Cortes , Shirali Aditya S. , Yanagawa Jane , Busuttil Ronald , Kaldas Fady , Barjaktarevic Igor 
Published: December 2020

Introduction: Trapped lung, characterized by atelectatic lung unable to reexpand and fill the thoracic cavity due to a restricting fibrous visceral pleural peel, is occasionally seen in patients with end-stage liver disease complicated by hepatic hydrothorax. Limited data suggest that trapped lung prior to orthotopic liver transplantation may be associated with poor outcomes. Research Question: What is the clinical significance of trapped lung in patients receiving orthotopic liver transplantation? Design: We performed a retrospective analysis of patients who underwent liver transplantation over an 8-year period. Baseline clinical characteristics and postoperative outcomes of adult patients with trapped lung were analyzed and compared to the overall cohort of liver transplant recipients and controls matched 3:1 based on age, sex, Model for End-Stage Liver Disease (MELD) score, and presence of pleural effusion. Results: Of the 1193 patients who underwent liver transplantation, we identified 20 patients (1.68%) with trapped lung. The probability of 1 and 2-year survival were 75.0% and 57.1%, compared to 85.6% and 80.4% (p = 0.02) in all liver transplant recipients and 87.9% and 81.1% (p = 0.03) in matched controls respectively. Patients with trapped lung had a longer hospital length of stay compared to the total liver transplant population (geometric mean 54.9 ± 8.4 vs. 27.2 ± 0.7 days, p ≤ 0.001), when adjusted for age and MELD score. Discussion: Patients with trapped prior to orthotopic liver transplantation have increased probability of mortality as well as increased health care utilization. This is a small retrospective analysis, and further prospective investigation is warranted.
Loading MicroRNA-376c in Extracellular Vesicles Inhibits Properties of Non-Small Cell Lung Cancer Cells by Targeting YTHDF1
Authors: Zhou Jianying , Xiao Dan , Qiu Tingting , Li Jun , Liu Zhentian 
Published: December 2020

Objective: Extracellular vesicles (Evs) secreted from cells have been revealed to mediate signal transduction between cells. Nevertheless, the mechanisms through which molecules transported by EVs function remain to be elucidated. In the present study, the functional relevance of endothelial cells (ECs)-secreted Evs carrying microRNA-376c (miR-376c) in the biological activities of non-small cell lung cancer (NSCLC) cells was investigated, including the related mechanisms. Methods: Two cell lines with the highest YTH N6-methyladenosine (m6A) RNA binding protein 1 (YTHDF1) expression were selected for subsequent experiments. Cellular proliferation, migration, invasion and apoptosis were measured by EdU, wound healing, Transwell assays and flow cytometry, respectively. The binding relationship between miR-376c and YTHDF1 was analyzed by dual-luciferase reporter assays. The miR-376c, YTHDF1 and β-catenin expression was evaluated by qPCR assays and western blot assays. Results: The expression patterns of YTHDF1 were higher in NSCLC cells, whereas miR-376c was reduced versus the normal bronchial epithelial cells. Silencing of YTHDF1 repressed NSCLC cell proliferation, invasion and migration abilities, whereas enhanced apoptosis. miR-376c negatively modulated YTHDF1 expression. Under co-culture conditions, ECs transmitted miR-376c into NSCLC cells through Evs, and inhibited the intracellular YTHDF1 expression and the Wnt/β-catenin pathway activation. Rescue experiments revealed that YTHDF1 overexpression reversed the inhibitory role of miR-376c released by EC-Evs in NSCLC cells. Conclusion: EC-delivered Evs inhibit YTHDF1 expression and the Wnt/β-catenin pathway induction via miR-376c overexpression, thus inhibiting the malignant phenotypes of NSCLC cells.
The Effects of COVID-19 Home Confinement in Dementia Care: Physical and Cognitive Decline, Severe Neuropsychiatric Symptoms and Increased Caregiving Burden
Authors: Borges-Machado Flávia , Barros Duarte , Ribeiro Óscar , Carvalho Joana 
Published: December 2020

Purpose: This study aims to analyze home confinement impact on individuals with neurocognitive disorders (NCD) through informal caregiver’s perspective and examine how it has affected caregiving burden. Methods: Thirty-six caregivers (64.94 ± 13.54 years, 41.7% female) of individuals with NCD (74.28 ± 6.76 years, 66.7% female) selected from the Body & Brain exercise program were interviewed over the phone. The following instruments were used: Barthel Index (BI) to assess care recipients’ ability to function independently on activities of daily living (ADL), the Neuropsychiatric Inventory (NPI) to evaluate neuropsychiatric symptoms, and the CarerQol-7D/ CarerQol-VAS to determine caregiver subjective burden/well-being. Results: Pre and post-confinement comparisons showed that care recipients significantly declined their independence in ADL (p = 0.003) and increased NPI total score (MD = 5.72; 95% CI: 1.19 to 10.25, p = 0.015). As for caregivers, results also showed an increased caregiving burden (MD = −0.17; 95% CI: −0.27 to −0.08; p = 0.001) and a decline in their well-being (p = 0.015). Discussion: COVID-19 crisis sheds light on how imperative it is to find solutions and design contingency plans for future crisis, in order to ensure properly sustained support to dementia caregiving dyads and mitigate caregivers’ burden.
Perceived stress, self-compassion and job burnout in nurses: the moderating role of self-compassion
Authors: Abdollahi Abbas , Taheri Azadeh , Allen Kelly A. 
Published: December 2020

Background Job burnout is more prevalent among nurses than other medical team members and may have adverse effects on the mental and physical health of both nurses and their patients. Aims To evaluate the associations between job burnout as a dependent variable with perceived stress and self-compassion as independent variables, and test the buffering role of self-compassion in the link between perceived stress and job burnout in nurses. Methods This is a cross-sectional study with a convenience sampling method. A total of 150 nurses from four hospitals in Tehran, Iran participated in this study and completed three questionnaires, namely the Perceived Stress Scale, the Self-Compassion Scale and the Copenhagen Burnout Inventory. Results Partial least square-structural equation modelling showed greater levels of perceived stress associated with greater levels of job burnout (β = 0.795, p < 0.001), and greater levels of self-compassion associated with lower levels of job burnout (β = –0.512, p < 0.001) in nurses. The results of the interaction-moderation analysis showed that self-compassion diminished the effect of perceived stress on job burnout in nurses. Conclusions The results of this study not only showed a significant association between perceived stress and job burnout in nurses, but also increased our understanding about the buffering role of self-compassion in the link between perceived stress and job burnout in nurses.
The efficacy of vitamin E in reducing non-alcoholic fatty liver disease: a systematic review, meta-analysis, and meta-regression
Authors: Abdel-Maboud Mohamed , Menshawy Amr , Menshawy Esraa , Emara Amany , Alshandidy Mohamed , Eid Muhammad 
Published: December 2020

Background: Non-alcoholic fatty liver disease (NAFLD) affects up to 30% of the population. Clinical trials have questioned the role of vitamin E in the treatment of NAFLD with or without other interventions, with still no firm conclusion reached. This study aims to examine the efficiency of vitamin E alone or combined in the management of NAFLD. Methods: We performed a systematic literature search on PubMed, Scopus, Embase, Ovid, EBSCO host, Science Direct, Web of Science, and Cochrane CENTRAL for randomized controlled trials (RCTs) of the role of vitamin E alone or combined in NAFLD patients. Extracted manuscripts reported data on biochemical, histological, anthropometric, and metabolic outcomes. Baseline characteristics, settings, dosage, and frequency were also collected. Research: A total of 1317 patients from 15 RCTs were included in our systematic review and meta-analysis. Vitamin E was superior at improving alanine aminotransferase (ALT), aspartate aminotransferase (AST), NAFLD activity score (NAS), and fibrosis in short- and long-term follow up in the adult population, and long-term follow up in the pediatric population. Improvements in metabolic outcomes were best noticed in pediatric patients. Results from multiple regression models showed a significant association between ALT-AST levels and vitamin E dose. AST levels had a significant effect on NAS, and patients with a baseline AST > 50 IU/l showed more promising results. Changes in weight and body mass index (BMI) were strongly associated with changes in NAS. Conclusion: Current evidence affirms that vitamin E – whether alone or combined – improves biochemical and histological outcomes in adults and pediatric patients.