bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Expression of Activin Receptor-Like Kinase 1 (ACVRL1/ALK1) in Hippocampal Arterioles Declines During Progression of Alzheimer’s Disease
Authors: Anderson Kelley E , Bellio Thomas A , Aniskovich Emily , Adams Stephanie L , Blusztajn Jan Krzysztof , Delalle Ivana 
Published: July 2020

Abstract
Cerebral amyloid angiopathy (CAA) in Alzheimer’s disease (AD)—deposition of beta amyloid (Aβ) within the walls of cerebral blood vessels—typically accompanies Aβ buildup in brain parenchyma and causes abnormalities in vessel structure and function. We recently demonstrated that the immunoreactivity of activin receptor-like kinase 1 (ALK1), the type I receptor for circulating BMP9/BMP10 (bone morphogenetic protein) signaling proteins, is reduced in advanced, but not early stages of AD in CA3 pyramidal neurons. Here we characterize vascular expression of ALK1 in the context of progressive AD pathology accompanied by amyloid angiopathy in postmortem hippocampi using immunohistochemical methods. Hippocampal arteriolar wall ALK1 signal intensity was 35% lower in AD patients (Braak and Braak Stages IV and V [BBIV-V]; clinical dementia rating [CDR1-2]) as compared with subjects with early AD pathologic changes but either cognitively intact or with minimal cognitive impairment (BBIII; CDR0-0.5). The intensity of Aβ signal in arteriolar walls was similar in all analyzed cases. These data suggest that, as demonstrated previously for specific neuronal populations, ALK1 expression in blood vessels is also vulnerable to the AD pathophysiologic process, perhaps related to CAA. However, cortical arterioles may remain responsive to the ALK1 ligands, such as BMP9 and BMP10 in early and moderate AD.
Comparing children and adults with chronic nonbacterial osteomyelitis
Authors: Lenert Aleksander , Ferguson Polly J. 
Published: July 2020

Purpose of review
To describe the main clinical differences of children and adults with chronic nonbacterial osteomyelitis (CNO).

Recent findings
CNO is a severe systemic autoinflammatory syndrome characterized by multiple bone lesions because of inflammatory osteitis. Delay to diagnosis of CNO can lead to functional impairment, fractures, and chronic pain. Key clinical aspects and disease patterns differ in children and adults, including onset and time to diagnosis, symptom localization, associated comorbidities (i.e. skin, joints), bone lesion distribution pattern, and treatment approach. Novel biomarkers, such as urine N-terminal telopeptide in children and serum IgG4 in adults, are being studied for possible future use in improving diagnosis and guiding treatment. Despite recent advances in our understanding of CNO, many children and adults have a high disease burden and poor long-term outcomes. Recent findings suggest that adults with CNO tend to have a more chronic disease course and are less likely to achieve remission in follow-up.

Summary
The clinical presentation of CNO differs in children and adults, highlighting the importance of these key features for the accurate diagnosis and early treatment in CNO.
Role of Anterior Segment OCT for Descemet Membrane Stripping During Descemet Membrane Endothelial Keratoplasty in Eyes With Congenital Hereditary Endothelial Dystrophy
Authors: Fogla Rajesh 
Published: July 2020

Purpose:
To report the utility of preoperative anterior segment optical coherence tomography (ASOCT) in decision-making for stripping of the Descemet membrane (DM) during Descemet membrane endothelial keratoplasty (DMEK) in eyes with congenital hereditary endothelial dystrophy (CHED).

Methods:
ASOCT was performed in eyes with CHED undergoing DMEK. Host DM was retained if the DM appearance was normal on ASOCT. Outcomes of DMEK with or without DM stripping (non DM stripping [DMEK]) were analyzed and compared regarding graft adhesion, graft clarity, visual acuity, and complications.

Results:
Twelve eyes of 8 patients were included in the series. Of these, 6 eyes (mean age, 6 ± 2.6 years, range 3–8 years) underwent nDMEK and 6 eyes (mean age, 23.6 ± 10.2 years, range 13–39 years) underwent standard DMEK. There were no intraoperative complications in either group. During the early postoperative period, one eye in the nDMEK group had donor detachment that was successfully managed by repeat air injection. The mean preoperative and postoperative corrected visual acuities were 1.15 and 0.37 logarithm of the minimum angle of resolution (LogMAR) in the nDMEK group, and 0.95 and 0.25 LogMAR in the DMEK group (P 0.39 and 0.06). Average endothelial cell counts were 1826 ± 318 cell/mm2 in the nDMEK group (32.3% loss), and 1708 ± 271 cells/mm2 in the DMEK group (33.6% loss) at the last follow-up.

Conclusions:
Preoperative anterior segment OCT is useful in decision-making regarding stripping of host DM during DMEK in eyes with CHED. The outcomes of nDMEK were similar to DMEK in this small series.
Novel Microforceps Technique Developed for Endothelial Surgical Procedures
Authors: Berry J. Christian , Moore Lee E. , Riaz Kamran M. 
Published: July 2020

Purpose:
To develop a more efficient and less traumatic method of Descemet membrane removal in endothelial surgery.

Methods:
A novel, vertically oriented, reverse-grasping microforceps (named the Rabiyah Descemet Membrane Removal Microforceps) were created to facilitate grasping and extraction of a host Descemet membrane.

Results:
This new instrument has been used successfully and safely in more than 85 endothelial keratoplasty cases among 4 surgeons.

Conclusions:
The Rabiyah Descemet Membrane Removal Microforceps provides surgeons with a safe and an efficient option to remove Descemet membrane in endothelial surgical procedures.
Evaluation of Visual Acuity Outcomes and Corneal Alterations of New Generation Hybrid Contact Lenses in Patients With Advanced Keratoconus
Authors: Dikmetas Ozlem , Kocabeyoglu Sibel , Mocan Mehmet Cem 
Published: July 2020

Purpose:
To evaluate the visual and corneal outcomes of new generation hybrid contact lenses (HCL) in patients with advanced keratoconus.

Methods:
This was a retrospective study undertaken at a single academic center. The study cohort consisted of subjects with advanced keratoconus who had elected not to undergo keratoplasty and were fitted with HCLs. Patients were fitted either with EyeBrid (LCS, Cane, France) or Airflex (SwissLens, Prilly, Switzerland) HCLs. Primary outcome measures included contact lens (CL) drop-out rate, best corrected visual acuity, and corneal endothelial cell density (ECD) measurements at the end of a 6-month HCL wear. ECD was measured using in vivo confocal microscopy (ConfoScan4; Nidek, Tokyo, Japan). One eye per patient was included for statistical purposes. Paired t tests and Wilcoxon signed-rank tests were used for comparative analyses.

Results:
Thirty-two keratoconic eyes of 32 patients (14M/18F) with a mean age of 25.9 ± 11.5 years were included in the study. All patients were able to continue CL wear for a duration of 6 months. There was a significant improvement in the mean best corrected visual acuity from 0.5 ± 0.2 logarithm of minimal angle of resolution to 0.1 ± 0.1 logarithm of minimal angle of resolution after daily CL wear with HCL at the 6-month follow-up visit (P < 0.001). No vision-threatening CL-related corneal adverse effects were observed. There was no significant reduction in the ECD noted at the 6-month visit [2625.8 ± 300.3 cells/mm2 (baseline) vs. 2566.4 ± 309.8 cells/mm2 (6-month); P = 0.623].

Conclusions:
Hybrid contact lenses can provide improved visual function without inducing any short-term clinical or microscopic adverse effects on corneal endothelial cells in patients with advanced keratoconus.
Optimizing Visualization of Descemet Membrane Endothelial Keratoplasty Tissue: Assessing the Impact of Trypan Blue Exposure on Stain Duration and Corneal Endothelial Cell Function
Authors: Ling Jennifer J. , Kyrillos Ralph , Burckart Kimberlee A. , Aldrich Benjamin T. , Skeie Jessica M. , Schmidt Gregory A. , Conwell Chris , Ramirez Tiffany , Reed Cynthia R. , Zimmerman M. Bridget , Greiner Mark A. , Li Jennifer Y. 
Published: July 2020

Purpose:
To assess how trypan blue staining affects Descemet membrane endothelial keratoplasty (DMEK) graft visibility and corneal endothelial cell (CEC) mitochondrial respiration.

Methods:
DMEK grafts (n = 20) were stained with trypan blue 0.06% for 1, 3, 5, or 10 minutes. Each graft was injected into an artificial anterior chamber. Surgery was simulated with tapping and sweeping motions on the corneal surface and injections of balanced salt solution (BSS). Graft visibility was assessed at 5, 10, 20, and 30 minutes. Effects of trypan blue on mitochondrial respiration were assessed using primary CECs cultured from donor corneas (n = 43). Treatment wells exposed to trypan blue 0.06% (1, 5, or 30 minutes) and donor-matched control wells to methylene blue 1% (1 minute) or BSS (1, 5, or 30 minutes) were assayed for key respiration parameters.

Results:
After 5 minutes of surgical manipulation, grafts stained for 5 minutes were significantly more visible than grafts stained for 1 or 3 minutes; there was no added benefit of staining for 10 minutes. After 10 minutes of surgical manipulation, grafts stained for 3 minutes were more visible than grafts stained for 1 minute, without additional benefits of staining ≥5 minutes. No visibility differences were observed after ≥20 minutes of surgical manipulation. CEC mitochondrial respiration did not change significantly following trypan blue exposure for all intervals tested compared to BSS.

Conclusions:
Staining DMEK grafts with trypan blue for 3 to 5 minutes optimizes visibility during surgical manipulation without mitochondrial impairment. Corneal surgeons learning DMEK will benefit from optimizing this critical step.
Measuring Student Interprofessional Skills in the Roles/Responsibilities Competency
Authors: Chappell Rachel , Goumas Amanda , Hollie Shay , Levitzky Elizabeth G. , Gunaldo Tina Patel 
Published: July 2020

Purpose
To assess students' perceptions and knowledge of interprofessional collaborative practice related to the Interprofessional Education Collaborative (IPEC) Roles/Responsibilities (RRs) competency after engagement in interprofessional education experiences.

Methods
Thirty physician assistant students were surveyed 3 times during the clinical year to assess the level of collaborative engagement with 5 professions. The level of engagement was assessed utilizing a 5-point Likert scale, and an open-ended question measured student knowledge of other professionals' roles.

Results
Student responses indicated that the level of engagement was greatest during the first clinical semester overall for all 3 levels of engagement. An increase in the level of engagement was noted for 2 professions over the one-year study period. Students also provided examples of opportunities where they relied on the expertise of another profession during the clinical rotation year.

Conclusion
Study results confirm student acquisition of 2 IPEC RR subcompetencies during clinical rotations. However, there remains a gap in correlating interprofessional education with interprofessional collaborative practice.
Role of endoscopic ultrasonography guided fiducial marker placement in gastrointestinal cancer
Authors: Kerdsirichairat Tossapol , Shin Eun Ji 
Published: July 2020

Purpose of review
Dose escalation radiation therapy such as those delivered by stereotactic body radiation therapy (SBRT) has shown to improve local disease control in multiple types of malignancies. This requires fiducial placement to improve accuracy of treatment and avoid adverse events to adjacent radiosensitive organs during respiration phases. The purpose of this review is to provide updates of recent high-quality articles related to endoscopic ultrasonography (EUS)-guided fiducial placement for gastrointestinal malignancies, particularly in pancreatic cancer, which is expected to be the second leading cause of cancer-related deaths in the USA within this decade.

Recent findings
A recent systematic review and meta-analysis has shown that EUS-guided fiducial placement for gastrointestinal malignancies has excellent technical success and safety profile. Comparative studies of most commercially available fiducial types via a 22-gauge needle system showed that a 0.035 mm diameter and 10 mm long gold fiducial with coiled configuration, hollow core and external helical design might be favoured due to its most balanced performance of visibility, artifact and migration.

Summary
A fine balance of performance characteristics of fiducials should be discussed with radiation oncologists to select a suitable and preferred type of fiducials. The comparative studies of other newly developed platinum fiducials and liquid fiducial are pending.
Insights into ADAMTS13 structure: impact on thrombotic thrombocytopenic purpura diagnosis and management
Authors: Roose Elien , Veyradier Agnès , Vanhoorelbeke Karen 
Published: July 2020

Purpose of review
Fundamental knowledge on the role of a disintegrin and metalloprotease with thrombospondin type one repeats, member 13 (ADAMTS13) has been crucial to better understand the pathophysiology of the rare and life-threatening disease thrombotic thrombocytopenic purpura (TTP).

Recent findings
ADAMTS13 works through a molecular zipper mechanism to proteolyze its substrate von Willebrand factor (VWF). Recent insights into the structure and function of ADAMTS13 led to the identification of an allosteric activation mechanism. Therefore, ADAMTS13 is roughly folded in two in which the N-terminal spacer (S) domain and C-terminal T7-CUB2 domains interact to adopt a closed conformation. Upon substrate binding, ADAMTS13 adopts an open conformation in which the S-T7-CUB2 interaction is abrogated to further position VWF towards the catalytic cleft, inducing activation of the latent metalloprotease domain and resulting in cleavage of VWF. Unravelling the structure function relationship of ADAMTS13 helped identifying open ADAMTS13 as a novel and unique biomarker for immune-mediated TTP (iTTP). This novel biomarker has potential in the diagnosis, treatment and follow-up of iTTP.

Summary
In this review, the most recent findings on the structure and working mechanism of ADAMTS13 are addressed. In addition, how those findings led to the identification of a novel biomarker, and how this novel biomarker could have an impact on the diagnosis, management and follow-up of iTTP patients are discussed.
PET imaging in testicular tumours
Authors: Calabrò Diletta , Telo Silvi , Ambrosini Valentina 
Published: July 2020

Purpose of review
Testicular cancer is rare, but its incidence is expected to rise. [18F] fluorodeoxyglucose ([18F]FDG) PET/computed tomography (CT) added role in testicular cancer management has been defined in a set of specific clinical settings. The current review focuses on recent advances in the employment of PET/CT in testicular cancer patients.

Recent findings
[18F]FDG PET/CT is not recommended for initial staging or for suspected testicular tumours. PET/CT role in testicular cancer management is mainly for the assessment of seminoma residual masses after therapy (>3 cm). Although [18F]FDG PET/CT has a very high negative predictive value, its positive predictive value varies across studies: appropriate PET/CT scheduling after therapy and a careful history are mandatory for accurate interpretation. Interim PET/CT could prove valuable to spare subsequent chemotherapy cycles in patients already in remission, reducing related toxicity. The role of [18F]FDG in nonseminoma tumours is hampered by the low sensitivity in teratoma.

Summary
[18F]FDG PET/CT is currently used for the assessment of seminoma residual masses (>3 cm) after therapy. A negative PET could also spare unnecessary further chemotherapy cycles in responding patients, reducing toxicity. Although rare, testicular secondary lesions can be detected with non[18F]FDG tracers when PET/CT is performed for other primary tumours.
Impact of hospital and surgeon volumes on short-term and long-term outcomes of radical cystectomy
Authors: Sari Motlagh Reza , Mori Keiichiro , Aydh Abdulmajeed , Karakiewicz Pierre I. , Trinh Quoc-Dien , Shariat Shahrokh F. 
Published: July 2020

Purpose of review
There is heightened awareness and trends towards centralizing high-risk, complex surgeries such as radical cystectomy to minimize complications and improve survival. However, after nearly a decade of mandated and/or passive centralization of care, debate regarding its benefits and harms continues.

Recent findings
During the past decade, mandated and passive centralization has led to an increase in radical cystectomies performed in high-volume hospitals (HVHs) and, perhaps by high-volume surgeons (HVS), in addition to efforts to increase the uptake of multidisciplinary strategies in the management of radical cystectomy patients. Consequently, 30 and 90-day mortality rates and overall survival have improved, and major complications and transfusion rates have decreased. Factors impacting surgical quality, such as negative surgical margin(s), pelvic lymphadenectomy and/or lymph node yield rates have increased. However, current studies have not demonstrated a coadditive impact of centralization on oncological outcomes (i.e. cancer-specific and recurrence-free survival). The benefits of centralization on oncologic survival of radical cystectomy remain unclear given the varied definitions of HVHs and HVSs across studies. In fact, centralization of radical cystectomy could lead to an increase in patient load in HVHs and for HVSs, thereby leading to longer surgery waiting times, a factor that is important in the management of muscle-invasive bladder cancer.

Summary
The benefits of centralization of radical cystectomy with multidisciplinary management are shown increasingly and convincingly. More studies are necessary to prospectively test the benefits, risks and harms of centralization.
Unexpected Bone Resorption in Mentum Induced by the Soft-Tissue Filler Hyaluronic Acid: A Preliminary Retrospective Cohort Study of Asian Patients
Authors: Guo Xiaoshuang , Zhao Jingyi , Song Guodong , Zong Xianlei , Zhang Dong , Lai Chenzhi , Jin Xiaolei 
Published: July 2020

Background:
As one of the most commonly used soft-tissue fillers, hyaluronic acid is generally considered safe and efficacious. However, evident bone resorption in mentum was observed. In this study, the authors analyzed the impact of hyaluronic acid on bone resorption in mentum and the influencing factors.

Methods:
The authors retrospectively compared the computed tomographic scans of patients with or without mentum augmentation using hyaluronic acid. The body mass index– and sex-matched control group was selected randomly. Semimandibular bone resorption index was calculated as the ratio of bone thickness in the incisive fossa to that in the mandibular symphysis. Injection volume, injection interval, the number of injections, product, complication were also recorded.

Results:
From January of 2014 to June of 2019, 80 patients (160 cases) and 80 controls were recruited. The bone resorption index in the hyaluronic acid injection cohort was significantly lower than in the controls (75.25 ± 10.02 versus 82.86 ± 6.38; p = 0.000). Patients injected with greater than or equal to 1 ml per time were more susceptible to bone erosion compared with patients injected with less (68.89 ± 10.84 versus 76.49 ± 9.42; p = 0.000). There was no significant difference between one- versus multiple-injection groups and short-injection-interval versus long-injection-interval (≥6 months) groups. Furthermore, no reduced aesthetics were realized.

Conclusions:
Hyaluronic acid injection could induce bone resorption in the mentum; nevertheless, the aesthetics were not impaired. The severity of the bone loss was positively correlated with the injection volume per time; therefore, large-volume injection of hyaluronic acid should be performed with caution. The patients should be fully informed about this complication preoperatively.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
The Effect of Hyperbaric Oxygen Therapy on Human Adipose-Derived Stem Cells
Authors: Yoshinoya Yuriko , Böcker Arne H. , Ruhl Tim , Siekmann Ullrich , Pallua Norbert , Beier Justus P. , Kim Bong-Sung 
Published: July 2020

Background:
Adipose-derived stem cells are considered as candidate cells for regenerative plastic surgery. Measures to influence cellular properties and thereby direct their regenerative potential remain elusive. Hyperbaric oxygen therapy—the exposure to 100% oxygen at an increased atmospheric pressure—has been propagated as a noninvasive treatment for a multitude of indications and presents a potential option to condition cells for tissue-engineering purposes. The present study evaluates the effect of hyperbaric oxygen therapy on human adipose-derived stem cells.

Methods:
Human adipose-derived stem cells from healthy donors were treated with hyperbaric oxygen therapy at 2 and 3 atm. Viability before and after each hyperbaric oxygen therapy, proliferation, expression of surface markers and protein contents of transforming growth factor (TGF)-β, tumor necrosis factor-α, hepatocyte growth factor, and epithelial growth factor in the supernatants of treated adipose-derived stem cells were measured. Lastly, adipogenic, osteogenic, and chondrogenic differentiation with and without use of differentiation-inducing media (i.e., autodifferentiation) was examined.

Results:
Hyperbaric oxygen therapy with 3 atm increased viability, proliferation, and CD34 expression and reduced the CD31−/CD34+/CD45− adipose-derived stem cell subset and endothelial progenitor cell population. TGF-β levels were significantly decreased after two hyperbaric oxygen therapy sessions in the 2-atm group and decreased after three hyperbaric oxygen therapy sessions in the 3-atm group. Hepatocyte growth factor secretion remained unaltered in all groups. Although the osteogenic and chondrogenic differentiation were not influenced, adipogenic differentiation and autodifferentiation were significantly enhanced, with osteogenic autodifferentiation significantly alleviated by hyperbaric oxygen therapy with 3 atm.

Conclusion:
Hyperbaric oxygen therapy with 3 atm increases viability and proliferation of adipose-derived stem cells, alters marker expression and subpopulations, decreases TGF-β secretion, and skews adipose-derived stem cells toward adipogenic differentiation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Capping Mobility to Control COVID-19: A Collision-based Infectious Disease Transmission Model
Authors: Shi Yunfeng , Ban Xuegang 
Published: July 2020

AbstractWe developed a mobility-informed disease-transmission model for COVID-19, inspired by collision theory in gas-phase chemistry. This simple kinetic model leads to a closed-form infectious population as a function of time and cumulative mobility. This model uses fatality data from Johns Hopkins to infer the infectious population in the past, and mobility data from Google, without social-distancing policy, geological or demographic inputs. It was found that the model appears to be valid for twenty hardest hit counties in the United States. Based on this model, the number of infected people grows (shrinks) exponentially once the relative mobility exceeds (falls below) a critical value (∼30% for New York City and ∼60% for all other counties, relative to a median mobility from January 3 to February 6, 2020). A simple mobility cap can be used by government at different levels to control COVID-19 transmission in reopening or imposing another shutdown.