bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular management of critical hand ischemia by ‘palmar arch loop’ technique
Authors: Singh Amit , Kumar Neeraj , Jain Ajitesh P , Verma Rakesh , Krishna Vinay 
Published: October 2020

Introduction Critical hand ischemia with advancing gangrene of digits requires urgent intervention to salvage as much tissue as possible. The purpose of this study was to evaluate the efficacy of “palmar arch loop” technique for endovascular management of critical hand ischemia by establishing inline flow to the palmar arch via both radial artery and ulnar artery, in patients with failed antegrade recanalization. To the best of our knowledge, this is the first case series evaluating the efficacy of “palmar arch loop” technique, with retrograde percutaneous transluminal angioplasty of the involved radial artery and/or ulnar artery. Material and methods We retrospectively investigated 10 patients (60% female; mean age 42 ± 18 years; mean time of presentation post-acute event 24 ± 11 days) with critical hand ischemia undergoing endovascular intervention using “palmar arch loop” technique at a single center in northern India between April 2017 and March 2019. All patients were followed up at regular intervals (weekly for a month, fortnightly for 3 months, and then at 6 and 12 months) with clinical assessment and SpO2 measurement. Study end points were technical success rate, hand healing, and primary patency rate at one year. Results Causes for critical hand ischemia were iatrogenic injuries due to inadvertent intra-arterial injection in 50% ( n = 5) and thromboembolic events in 50% patients ( n = 5). Vessels involved were: both radial artery and ulnar artery along with the PA in 50%; radial artery and palmar arch in 30%; ulnar artery and palmar arch in 20%. All of them had total occlusion of the involved vessel (>2/3rd of total length) with occlusion/diffuse disease of palmar arch as well; 70% technical success rate was achieved ensuring inflow to palmar arch via both the arteries with improved flow distally to the common and proper digital arteries. Retrograde percutaneous transluminal angioplasty of radial artery in 50% ( n = 5) and ulnar artery in 20% ( n = 2) was done successfully by looping the guidewire across the palmar arch; 90% showed subjective improvement in pain with healing of the lesions and/or formation of clear line of demarcation with reversal of pregangrenous changes proximally. Out of the eight patients with gangrene of fingers, three underwent minor amputation of the gangrenous digits and five underwent auto-amputation of the gangrenous tissue with complete healing of the stump. Primary patency rate was 85.7% at one year. There was no access site-related complication or mortality in the follow-up period. Conclusions Endovascular management of critical hand ischemia by “palmar arch loop” technique is an efficient technique to deal with occluded forearm vessels, particularly when antegrade recanalization fails. This technique, with good technical success and patency rates, is potentially a unique tool in the endovascular armamentarium for salvaging hand.
Relational professional identity: How do pharmacy students see themselves in relation to others?
Authors: Neubert Alexandra , Kellar Jamie , Miller Daniel , Kulasegaram Kulamakan (Mahan) , Paradis Elise 
Published: October 2020

Background: As the pharmacy profession moves towards patient-centred care, pharmacy schools have updated their curricula to prepare students for a full scope of practice. A critical objective of the new curricula is the professional socialization of pharmacy students into relational aspects of the profession: how pharmacists should interact with patients and other health care professionals. Through an examination of how one cohort of pharmacy students perceives its relationship to patients and physicians, this study aims to determine how these relational aspects of professional identity evolve with time spent in the program. Methods: At 3 time points over a 2-year period, pharmacy students were asked to detail in writing how they would communicate with a physician concerning a hypothetical drug allergy scenario. A directed content analysis of their responses was conducted based on 3 main analytic categories: patient-centredness, physician collaboration and physician deference. These categories were further divided into 6 subcategories that were used as the variables for analysis. Statistical analyses examined longitudinal group trends for these variables. Results: Over the 2 years of observation, an examination of the proportion of messages demonstrating the subcategories of interest showed that the only measure of the pharmacy students’ relational professional identity that changed significantly over time occurred for the perception of a sense of shared care for the patient. All other aspects of their relational identity were stagnant and did not change as they progressed through training (χ2; 12.772, df = 2, p < 0.002). Conclusion: Our results suggest that the relational professional identity of participants was poorly developed with regards to both patients and physicians. Pharmacy educators must reexamine the methods currently being employed to foster students’ professional identity development to ensure that new graduates are prepared to meet the challenges of a changing scope of practice. Can Pharm J (Ott) 2021;154:xx-xx.
Efficacy of posaconazole prophylaxis in acute myeloid leukemia and myelodysplastic syndrome patients treated with hypomethylating agents
Authors: Kang Ka-Won , Lee Byung-Hyun , Jeon Min Ji , Yu Eun Sang , Sik Kim Dae , Lee Se Ryeon , Sung Hwa Jung , Choi Chul Won , Park Yong , Kim Byung Soo 
Published: October 2020

Background: Although many acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) patients have been treated with hypomethylating agents (HMAs) as a substitute for intensive chemotherapy in recent years, the incidence of invasive fungal infections (IFIs) and the efficacy of posaconazole as antifungal prophylaxis in these patients are not well known to date. Methods: We retrospectively analyzed 280 AML and MDS patients treated with HMAs to identify IFI incidence and posaconazole efficacy as antifungal prophylaxis in these patients. Results: The overall incidence of probable or proven IFIs was 7.9% (22/280 patients): 11.5% in the no-use group (17/148 patients) and 3.8% in the posaconazole group (5/132 patients). Most IFIs occurred during the early cycles of the HMAs (median: 3 cycles; range: 1–8 cycles), especially in patients who had neutropenia or did not respond to HMAs. Posaconazole significantly lowered IFI incidence compared with that in the no-use group in univariate and multivariate analyses. Moreover, patients who had reduced liver function at HMA initiation, were treated with decitabine therapy, and did not respond to HMA chemotherapy were independently associated with a higher IFI risk. In subgroup analysis, posaconazole appeared to be more beneficial for patients with good Eastern Cooperative Oncology Group performance score or liver function at HMA initiation. Conclusion: Thus, in AML and MDS patients receiving HMAs, IFI risk may be high during the early cycles, especially when the underlying disease is not controlled. Posaconazole could represent antifungal prophylaxis in these patients; further studies are needed for its appropriate indications.
Does the Presence of Chondral Lesions Negatively Affect Patient-Determined Outcomes After Arthroscopic Rotator Cuff Repair?
Authors: Baumgarten Keith M. , Chang Peter S. , Schweinle Will E. 
Published: October 2020

Background: There are limited data available to guide patients to their prognosis when glenohumeral chondral lesions are found during arthroscopic rotator cuff repair. Hypothesis: The primary hypothesis was that patients with glenohumeral chondral lesions will have inferior outcomes after arthroscopic rotator cuff repair compared with patients without chondral lesions. The secondary hypothesis was that patients with concomitant chondral lesions will have more severe preoperative symptoms compared with those without chondral lesions. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis was performed of patients who underwent arthroscopic rotator cuff repair between 2008 and 2012. We examined the effects of chondral lesions on patient-determined outcomes, which included the Western Ontario Rotator Cuff Index (WORC), American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), Single Assessment Numeric Evaluation (SANE), and the Shoulder Activity Level (SAL). Shoulders without chondral lesions were compared with shoulders with chondral lesions to determine whether differences in severity of preoperative symptoms as well as postoperative improvements were statistically significant. Results: A total of 281 shoulders were included from 273 patients, with a mean follow-up of 3.7 years. In total, 90 shoulders (32%) had concomitant chondral lesions in the glenohumeral joint. The presence and degree of chondral damage were not associated with the severity of preoperative symptoms or the amount of improvement after arthroscopic rotator cuff repair, as determined by patient outcome scores. Shoulders with bipolar chondral lesions had less postoperative improvement in their outcome scores compared with shoulders with unipolar lesions, with significant differences found in the SST ( P = .0005), the SANE ( P = .005), and the SAL ( P = .04). Regardless of this, the majority of shoulders with bipolar chondral lesions (80%-92%) had postoperative improvements that superseded the minimal clinically important difference of the ASES, WORC, and SANE. Conclusion: At a mean 3.7-year follow-up, the presence of chondral damage did not appear to negatively affect the improvement in patient-determined outcomes after arthroscopic rotator cuff repair. However, improvement in outcomes was negatively affected by the presence of bipolar chondral lesions.
Upper Extremity Pain and Overuse Injuries in Fly-Fishing: A North American Cross-Sectional Survey and Implications for Injury Prevention
Authors: Kuhn Andrew W. , Kuhn John E. 
Published: October 2020

Background: Fly-fishing requires rhythmic, coordinated movements to successfully cast a fly line. Previous studies have shown that the biomechanical demands of fly-casting may cause some individuals to develop upper extremity pain or injuries. Purpose: To report the rates, trends, and contributing factors of upper extremity pain and overuse injuries in a sample of North American recreational fly-fishers. Study Design: Descriptive epidemiology study. Methods: Participants were reached via 3 popular online fly-fishing forums in April 2019. Each consenting North American participant over 18 years of age was given a link to a unique survey that recorded his or her demographic and orthopaedic histories, fly-fishing experience, equipment, casting techniques, upper extremity pain after fly-fishing, and chronic outcomes. Results: The 162 fly-fishers included were 63.3 (± 11.5) years of age, and 95.1% were men. In total, 59 (36.4%) reported experiencing upper extremity pain immediately after fly-fishing. Pain was rated a 4.0 (interquartile range, 3.0-6.0) on a 10-point Likert scale, commonly lasting less than 1 day (45.0%) or between 1 day and 1 week (45.0%). The majority (62.7%) reported not needing to see a medical provider for their pain/soreness. Those who did most commonly received diagnoses of elbow or rotator cuff tendinitis. Pain/soreness was associated with casting in an elliptical/sidearm fashion, compared with overhead or 2-handed casting ( P = .006) using a weighted line or added weight (split-shot, weighted heads, etc) ( P = .034) and with grip styles where the hand was pronated compared with being in a more neutral position ( P = .046). The mean shortened version of the Disabilities of the Arm, Shoulder and Hand score was 10.8 (± 11.5). Higher scores were associated with a history of self-reported upper extremity orthopaedic injuries (B = 6.059 [95% CI, 2.476-9.642]; SE, 1.814; P = .001) and having had surgery for these injuries (B = 8.484 [95% CI, 4.454-12.513]; SE, 0.314; P < .001). Conclusion: In this sample of recreational fly-fishers, no aspects of fly-fishing were associated with long-term upper extremity disability, and only a little more than a third reported having transient pain immediately after fishing. Casting style, using weighted lines or added weight, and grip style were all associated with pain. These are modifiable risk factors that can be adjusted to reduce the risk of upper extremity pain immediately after fly-fishing.
Impacts of child welfare worker and clientele characteristics on attitudes toward trauma informed-care
Authors: Collin-Vézina Delphine , Brend Denise , Black Karen , Beeman Irene , Brown Steve 
Published: October 2020

Background: There is increasing recognition of the need to integrate trauma-informed care (TIC) into child welfare practices, given the high rates of trauma experiences among children and youth across these settings. The implementation of TIC is facilitated by various elements, including worker attitudes, yet further research is needed to illuminate the factors that influence child welfare workers’ positive regard for TIC. Objectives: This study aims to explore the relationship between child welfare worker attitudes regarding TIC with workers’ and clients’ individual characteristics. Methods: N = 418 child welfare workers from 11 agencies completed two measures: a demographic questionnaire as well as the French translated version of the ARTIC-35 questionnaire comprised of five subscales. Linear mixed effects models were run for each ARTIC subscale, examining how child and worker factors affect attitudes toward TIC. Results: Participants indicated relatively positive attitudes toward TIC. Managerial staff in offender units scored higher on the subscale regarding their beliefs about the causes underlying child behaviors and on the subscale regarding beliefs about the secondary effects of trauma, than their counterparts in protection units serving boys. Managers scored higher than frontline staff on worker self-efficacy, response to problem behavior, and on-the-job behavior subscales. Workers with a community college degree—and not a university degree–indicated greater sense of self-efficacy. Conclusions: This study points to the importance of paying attention to the characteristics of both workers and clients that may influence inclination toward TIC principles, as a means to build effective integration of this approach in child-serving settings.
Low serum free light chain is associated with risk of COPD exacerbation
Authors: Tanimura Kazuya , Sato Susumu , Sato Atsuyasu , Tanabe Naoya , Hasegawa Koichi , Uemasu Kiyoshi , Hamakawa Yoko , Hirai Toyohiro , Muro Shigeo 
Published: October 2020

BackgroundMost exacerbations of chronic obstructive pulmonary disease (COPD) are triggered by respiratory tract infections. Adaptive immunityviaantibody production is important in preventing infections. Impaired antibody production is reported to be associated with an increased risk of exacerbations of COPD. In the present study, we elucidated whether reduced free light chains (FLCs), which are excessive amounts of light chains produced during antibody synthesis and can be used to estimate systemic antibody production, may be a promising biomarker to predict the risk of exacerbations of COPD.MethodsWe enrolled stable male patients with COPD and prospectively observed them for 2 years. At baseline, serum combined FLC (cFLC; sum of kappa and lambda values) and pulmonary function were evaluated. Exacerbation was defined as a worsening of symptoms requiring treatments with antibiotics, corticosteroids or both.Results63 patients with stable COPD were enrolled (72.8±8.1 years, GOLD A/B/C/D=24/28/6/5), and 51 patients completed the 2-year follow-up. Serum cFLC was 31.1 mg·L−1on average and ranged widely (1.4 to 89.9 mg·L−1). The patients with low cFLC (below the mean−sd, n=6) experienced a significantly shorter time to the first exacerbation of COPD (p<0.0001 by the log-rank test). A multivariate Cox proportional hazard model, including the COPD assessment test score, % predicted forced expiratory volume in 1 s (FEV1% pred), and number of previous exacerbations demonstrated that low cFLC and low FEV1% pred were independently and significantly correlated with the risk for exacerbations of COPD.ConclusionLow cFLC may be a B-cell-associated novel biomarker associated with risk of COPD exacerbation.
Influence of wood anatomy on fiber orientation measurement obtained by laser scanning on five European species
Authors: Besseau Benoît , Pot Guillaume , Collet Robert , Viguier Joffrey 
Published: October 2020

AbstractIn order to obtain high production rates of sawn timber, the sawmilling industry can use laser scanning, allowing knot detection and machine strength grading. In particular, laser scanners measure grain angle using the so-called tracheid effect on wood surface where an elliptic scattering of the laser light can be observed. This paper aims to describe the light scattering obtained by a laser beam projection on wood surface and to assess the accuracy of such fiber orientation measurement on five European species. Firstly, fiber orientation measurement error was assessed by rotating samples. Secondly, the description of the scattering effect was done considering ellipse axis ratios and areas. This was studied according to several parameters such as wood surface machining, moisture content, and orthotropic planes of symmetry. Fiber orientation measurement was successfully performed on all the tested species. The measurement error was below 1.6°, except for oak longitudinal–radial (LR) plane showing an error up to 3.1°. For most of the species, the error was higher in LR plane because of the influence of medullary rays. Despite the observation of major variabilities in laser light scattering, it was possible to measure the grain angles with a good accuracy for all investigated species.
A method for estimating coherence of molecular mechanisms in major human disease and traits
Authors: Dozmorov Mikhail G. , Cresswell Kellen G. , Bacanu Silviu-Alin , Craver Carl , Reimers Mark , Kendler Kenneth S. 
Published: October 2020

Abstract
Background
Phenotypes such as height and intelligence, are thought to be a product of the collective effects of multiple phenotype-associated genes and interactions among their protein products. High/low degree of interactions is suggestive of coherent/random molecular mechanisms, respectively. Comparing the degree of interactions may help to better understand the coherence of phenotype-specific molecular mechanisms and the potential for therapeutic intervention.
However, direct comparison of the degree of interactions is difficult due to different sizes and configurations of phenotype-associated gene networks.

Methods
We introduce a metric for measuring coherence of molecular-interaction networks as a slope of internal versus external distributions of the degree of interactions. The internal degree distribution is defined by interaction counts within a phenotype-specific gene network, while the external degree distribution counts interactions with other genes in the whole protein–protein interaction (PPI) network. We present a novel method for normalizing the coherence estimates, making them directly comparable.

Results
Using STRING and BioGrid PPI databases, we compared the coherence of 116 phenotype-associated gene sets from GWAScatalog against size-matched KEGG pathways (the reference for high coherence) and random networks (the lower limit of coherence). We observed a range of coherence estimates for each category of phenotypes. Metabolic traits and diseases were the most coherent, while psychiatric disorders and intelligence-related traits were the least coherent. We demonstrate that coherence and modularity measures capture distinct network properties.

Conclusions
We present a general-purpose method for estimating and comparing the coherence of molecular-interaction gene networks that accounts for the network size and shape differences. Our results highlight gaps in our current knowledge of genetics and molecular mechanisms of complex phenotypes and suggest priorities for future GWASs.
Interleukin 4 gene polymorphism (−589C/T) and the risk of asthma: a meta-analysis and met-regression based on 55 studies
Authors: Kousha Ahmad , Mahdavi Gorabi Armita , Forouzesh Mehdi , Hosseini Mojgan , Alexander Markov , Imani Danyal , Razi Bahman , Mousavi Mohammad Javad , Aslani Saeed , Mikaeili Haleh 
Published: October 2020

Abstract
Background
Numerous investigations have previously evaluated the association of interleukin (IL) 4 gene polymorphisms and the risk of asthma, conferring inconsistent results. To resolve the incongruent outcomes yielded from different single studies, we conducted the most up-to-date meta-analysis of IL4 gene −589C/T (rs2243250) polymorphism and susceptibility to asthma.

Methods
A systematic literature search was performed in ISI web of science, Scopus, Medline/PubMed databases prior to September 2020, and the pooled odds ratio (OR) and their corresponding 95% CI were calculated to determine the association strength.

Results
Literature search led to retrieving of 49 publications (55 case-control studies) containing 9572 cases and 9881 controls. It was revealed that IL4 gene −589C/T polymorphism increased the risk of asthma across all genetic models, including dominant model (OR = 1.22), recessive model (OR = 1.17), allelic model (OR = 1.21), and TT vs. CC model (OR = 1.34), but not the CT vs. TT model. The subgroup analysis by age indicated that IL4 gene -589C/T polymorphism was significantly associated with asthma risk in both pediatrics and adults. Additionally, the subgroup analysis by ethnicity revealed significant association in Asian, American, and Europeans. Finally, subgroup analysis by East Asian and non-East Asian populations indicated significant associations.

Conclusions
The current meta-analysis revealed that IL4 gene -589C/T polymorphism was a susceptibility risk in both pediatrics and adults in the whole and different ethnic groups.