bluuebunny/crossref_metadata_2025_split huggingface dataset:
VSMC-Specific Deletion of FAM3A Attenuated Ang II-Promoted Hypertension and Cardiovascular Hypertrophy
Authors: Xiang Rui , Chen Ji , Li Shuangyue , Yan Han , Meng Yuhong , Cai Jun , Cui Qinghua , Yang Yan , Xu Ming , Geng Bin , Yang Jichun 
Published: April 2020

Rationale:
Dysregulated purinergic signaling transduction plays important roles in the pathogenesis of cardiovascular diseases. However, the role and mechanism of vascular smooth muscle cell (VSMC)-released ATP in the regulation of blood pressure, and the pathogenesis of hypertension remain unknown. FAM3A (family with sequence similarity 3 member A) is a new mitochondrial protein that enhances ATP production and release. High expression of FAM3A in VSMC suggests it may play a role in regulating vascular constriction and blood pressure.

Objective:
To determine the role and mechanism of FAM3A-ATP signaling pathway in VSMCs in the regulation of blood pressure and the pathogenesis of hypertension.

Methods and Results:
In the media layer of hypertensive rat and mouse arteries, and the internal mammary artery of hypertensive patients, FAM3A expression was increased. VSMC-specific deletion of FAM3A reduced vessel contractility and blood pressure levels in mice. Moreover, deletion of FAM3A in VSMC attenuated Ang II (angiotensin II)-induced vascular constriction and remodeling, hypertension, and cardiac hypertrophy in mice. In cultured VSMCs, Ang II activated HSF1 (heat shock factor 1) to stimulate FAM3A expression, activating ATP-P2 receptor pathway to promote the change of VSMCs from contractile phenotype to proliferative phenotype. In the VSMC layer of spontaneously hypertensive rat arteries, Ang II-induced hypertensive mouse arteries and the internal mammary artery of hypertensive patients, HSF1 expression was increased. Treatment with HSF1 inhibitor reduced artery contractility and ameliorated hypertension of spontaneously hypertensive rats.

Conclusions:
FAM3A is an important regulator of vascular constriction and blood pressure. Overactivation of HSF1-FAM3A-ATP signaling cascade in VSMCs plays important roles in Ang II-induced hypertension and cardiovascular diseases. Inhibitors of HSF1 could be potentially used to treat hypertension.
Use of Tissue Plasminogen Activator in Abdominal Abscesses in Children—A Single-Center Randomized Control Trial
Authors: Gibson Craig R. , Amirabadi Afsaneh , Goman Simal , Armstrong Nicholas C. , Langer Jacob C. , Amaral Joao G. , Temple Michael J. , Parra Dimitri , John Philip R. , Connolly Bairbre L. 
Published: April 2020

Purpose: To establish the efficacy of once-per-day intracavitary tissue plasminogen activator (tPA) in the treatment of pediatric intra-abdominal abscesses. Methods: A single-center prospective, double-blinded, randomized controlled trial of the use of intracavitary tPA in abdominal abscesses in children. Patients were randomized to either tPA-treatment or saline-treatment groups. Primary outcome was drainage catheter dwell (hours). Secondary outcomes were length of hospital stay, times to discharge, clinical and sonographic resolution, and adverse events (AEs). Results: Twenty-eight children were randomized to either group (n = 14 each). Demographics between groups were not significantly different (age P = .28; weight P = .40; gender P = .44). There were significantly more abscesses in the tPA-treated group ( P = .03). Abscesses were secondary to perforated appendicitis (n = 25) or postappendectomy (n = 3). Thirty-four abscesses were drained, 4 aspirated, 3 neither drained/aspirated. There was no significant difference in number of drains ( P = .14), drain size ( P = .19), primary outcome ( P = .077), or secondary outcomes found. No procedural or intervention drug-related AEs occurred. No patient in the saline-treated group required to be switched/treated with tPA. Conclusion: No significant difference in the length of catheter dwell time, procedure time to discharge, or time to resolution was found. Intracavitary tPA was not associated with morbidity or mortality. The results neither support nor negate routine use of tPA in the drainage of intra-abdominal abscess in children. It is possible that a multicentre study with a larger number of patients may answer this question more definitively.
Loopholes in Current Infection Control and Prevention Practices Against COVID-19 in Radiology Department and Improvement Suggestions
Authors: Yu Juan , Ding Ning , Chen Huan , Liu Xia-Jing , Pu Zu-Hui , Xu Hua-Jian , Lei Yi , Zhang Han-Wen 
Published: April 2020

Objectives: To improve the infection control and prevention practices against coronavirus disease 2019 (COVID-19) in radiology department through loophole identification and providing rectifying measurements. Methods: Retrospective analysis of 2 cases of health-care-associated COVID-19 transmission in 2 radiology departments and comparing the infection control and prevention practices against COVID-19 with the practices of our department, where no COVID-19 transmission has occurred. Results: Several loopholes have been identified in the infection control and prevention practices against COVID-19 of the 2 radiology departments. Loopholes were in large part due to our limited understanding of the highly contagious coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is characterized by features not observed in other SARS viruses. We recommend to set up an isolation zone for handling patients who do not meet the diagnostic criteria of COVID-19 but are not completely cleared of the possibility of infection. Conclusions: Loopholes in the infection control and prevention practices against COVID-19 of the 2 radiology departments are due to poor understanding of the emerging disease which can be fixed by establishing an isolation zone for patients not completely cleared of SARS-CoV-2 infection.
Patterns of gynaecological check-up and their association with body mass index within the CONSTANCES cohort
Authors: Franck Jeanna-eve , Ringa Virginie , Rigal Laurent , Sassenou Jeanne , Cœuret-Pellicer Mireille , Chauvin Pierre , Menvielle Gwenn 
Published: April 2020

Objectives To investigate the relationship between patterns of gynaecological check-up and body mass index while accounting for various determinants of health care use. Methods Sequence analysis and clustering were used to highlight patterns of gynaecological check-up, which included the regularity of breast and cervical cancer screening and visits to the gynaecologist over four years, among 6182 women aged 54–65 included in the CONSTANCES cohort between 2013 and 2015 in France. Multinomial logistic regressions were used to study the association between these patterns and women’s body mass index. Results We identified four patterns of gynaecological check-up, from (A) no or inappropriate check-up (20%) to (D) almost one visit to the gynaecologist every year, overscreening for cervical cancer and frequent use of opportunistic breast cancer screening (12%). From patterns A to D, the proportion of obese women decreased and that of women with normal body mass index increased. Obese and overweight women underwent more breast than cervical cancer screening and were less often overscreened than normal weight women. These differences were only partly explained by the lower socioeconomic situation of overweight and obese women. Beyond the financial barrier, the screening modality and the type of exam may play a role. Among women who were screened for cervical cancer, obese and overweight women were less often screened by a gynaecologist. Conclusion Further efforts should be made to enhance the take-up of screening among obese women who are deterred by the healthcare system.
Estimation of risk–benefit ratio and comparison of post-operative efficacy results between trabeculectomy and canaloplasty
Authors: Vastardis Iraklis , Fili Sofia , Perdikakis Georgios , Gatzioufas Zisis , Kohlhaas Markus 
Published: April 2020

Purpose: To estimate a risk–benefit ratio by comparing the efficacy of canaloplasty to trabeculectomy exclusively in pseudophakic eyes with primary open angle glaucoma. Patients and methods: One hundred four eyes that underwent ab externo canaloplasty and 136 eyes that underwent trabeculectomy with mitomycin C 0.02% and collagen matrix implantation were retrospectively compared. The efficacy was evaluated by evaluating the absolute success rate (5 ⩽ intraocular pressure ⩽ 15 mmHg) and the qualified success rate (intraocular pressure ⩽15 mmHg) using the Kaplan–Meier survival analysis. A meta-analysis to evaluate the relative risk of both procedures in relation to post-operative interventions was performed. Results: Mean intraocular pressure was significantly lower in both groups. Intraocular pressure decreased by 32.17% in the canaloplasty group and by 55.04% in the trabeculectomy group at 12 months (analysis of variance, p < 0.001). Medication use was lower in both groups (analysis of variance, p < 0.001) by the 12th month. The absolute success rate for canaloplasty was 20.19% of eyes compared to 52.21% of eyes with trabeculectomy ( p < 0.0001). The qualified success rate was not statistically different between groups ( p = 0.15). The relative risk ratio was not statistically different between groups (relative risk of 0.01 and weight of 49.65% for group A and relative risk of 0.0005 and weight of 50.35% for group B; p = 0.5). The hospitalization length was longer in trabeculectomy-treated patients ( t-test, p < 0.0001). Conclusion: The trabeculectomy group showed better results in terms of absolute success rate. However, canaloplasty may provide a better risk–benefit ratio in terms of qualified success rate, hospitalization time, and required post-operative interventions, since canaloplasty yielded equal or superior results compared to trabeculectomy.
Loneliness and Burden Perceived by Family Caregivers of Patients With Alzheimer Disease
Authors: Bramboeck Verena , Moeller Korbinian , Marksteiner Josef , Kaufmann Liane 
Published: April 2020

Background: The present study aimed at investigating loneliness and burden experienced by family members caring for relatives diagnosed with Alzheimer disease. Methods: Participants were 40 caregivers of inpatients with Alzheimer disease. Correlation and multiple regression analyses were conducted to investigate whether caregivers’ loneliness (uni- and multidimensional) and burden are associated with and predicted by (1) specific caregiver characteristics and/or (2) patients’ dementia severity and neuropsychiatric symptoms. Results: Loneliness was significantly correlated with caregivers’ sex, age, and living circumstances, while burden was significantly correlated with caregivers’ education solely. Regression analyses revealed that caregivers’ sex and living circumstances contributed significantly to variance explanation of loneliness (but not burden), while the additional consideration of patient variables did not improve model fit. Conclusions: Loneliness reported by caregivers of relatives diagnosed with dementia is significantly modulated by caregiver (but not patient) characteristics. Notably, both uni- and multidimensional loneliness scales seem to be sensitive diagnostic tools.
Higher sensitivity for traumatic cerebral microbleeds at 7 T ultra-high field MRI: is it clinically significant for the acute state of the patients and later quality of life?
Authors: Hütter Bernd-Otto , Altmeppen Jan , Kraff Oliver , Maderwald Stefan , Theysohn Jens M. , Ringelstein Adrian , Wrede Karsten H. , Dammann Philipp , Quick Harald H. , Schlamann Marc , Moenninghoff Christoph 
Published: April 2020

Background: The present study evaluates the possible prognostic benefits of 7 T susceptibility weighted imaging (SWI) of traumatic cerebral microbleeds (TMBs) over 3 T SWI to predict the acute clinical state and subjective impairments, including health-related quality of life (HRQOL), after closed head injury (CHI). Methods: The study group comprised 10 participants with known TMBs All subjects underwent 3 T magnetic resonance imaging (MRI) and 7 T MRI, respectively. Location and count of TMBs were independently evaluated by two neuroradiologists. The initial Glasgow Coma Scale (GCS), the duration of coma and further clinical data were taken from the patients records. HRQOL was assessed by means of a questionnaire. Memory complaints and neurological symptoms were inquired at the time of the MRI examinations. Results: SWI revealed a total of 485 TMBs at 3 T, 584 TMBs at 7 T with similar spatial resolution, and 684 TMBs at 7 T with a factor of 10 higher spatial resolution. The TMBs depicted by 7 T high-resolution SWI were correlated with the duration of coma (Spearman’s rho of 0.77). The corresponding association with TMBs in 3 T MRI SWI showed a Spearman’s rho of 0.71. The initial GCS score and TMBs correlated with a Spearman’s rho of −0.35 at 3 T SWI MRI and a rho of −0.33 at 7 T high-resolution SWI, respectively. The physical aspect of HRQOL correlated substantially with the count of TMBs (rho = 0.44 for 3 T SWI and rho = 0.35 for both 7 T SWI sequences, respectively). Conclusions: The number of TMBs showed a substantial association with indicators of the acute clinical state and chronic neurobehavioral parameters after CHI, but there was no additional advantage of 7 T MRI. These preliminary findings warrant a larger prospective study for the future.
Self-Drilling Versus Self-Tapping Screws: A 3D Finite Element Analysis
Authors: Kumar Vineeth K. , Prasad Kavitha , Sansgiri Tanvy , Ranganath K. , Shwetha V. , Al-Khuteja Kubra 
Published: April 2020

Study Design: Self-tapping and self-drilling screws are two modalities available for plate fixation. When compared to self-drilling, self-tapping screws have a few drawbacks like screw loosening, thermal osteolysis, equipment dependent, and time-consuming. Aim: The aim of this study was to compare the efficacy of self-tapping and self-drilling screws with relation to plate retention and stability in internal fixation of mandibular fractures using 3D finite element analysis (FEA). Objectives: The objective of this study was to determine the influence of screw placement technique on stress concentration and deformation occurring at the screw–bone interface in self-drilling and self-tapping screws. Materials and Methods: A 3D computer-aided design modeling system was used to build a trilaminate mandibular bone, self-tapping screw and self-drilling screw, and a 2-holed miniplate with gap that were converted into finite element models using Hypermesh 13.0 software. Material properties and boundary conditions were assigned to these models. Pullout, torque, and torsional forces were applied to evaluate the stress concentration and deformation at the screw–bone interface. Results: The comparison of stress concentration and deformation values between the two types of screws was interpreted using ANSYS software version 14.5. Results of torque test, pullout test, and torsional test showed maximum Von Mises stress, and deformation around the screw–bone interface was higher in self-tapping screw than in self-drilling screw. Conclusion: Within the limitations of the 3D FEA, the findings provided significant evidence to suggest that self-tapping screws have a greater incidence of fatigue when compared to self-drilling screws as there was more stress distribution and deformation at their screw–bone interface.
Low-Intensity Pulsed Ultrasound Alleviates Osteoarthritis Condition Through Focal Adhesion Kinase–Mediated Chondrocyte Proliferation and Differentiation
Authors: Sang Fei , Xu Jin , Chen Zheng , Liu Qingbai , Jiang Wenchao 
Published: April 2020

Objective Osteoarthritis (OA) is a prevalent chronic multifactorial degenerative disease characterized by joint tissue inflammation, osteophyte formation, subchondral bone sclerosis, and articular cartilage degradation. Low-intensity pulsed ultrasound (LIPUS), a noninvasive ultrasound technique, is widely used to attenuate diseases. The aim of this study was to investigate whether LIPUS can ameliorate OA, and to explore its underlying molecular mechanism. Design The OA model was established in a C57BL/6 mouse by the anterior cruciate ligament transaction method. OA was assessed using arthritis scoring and weightbearing parameters. Chondrocyte proliferation was detected by a CCK-8 assay. The levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α (TNF-α) in synovial fluid of the mice were measured by enzyme-linked immunosorbent assay. Results In OA mice, the arthritis score and weightbearing abilities were dramatically improved by LIPUS treatment. LIPUS also remarkably declined the levels of inflammatory cytokines IL-6, IL-8, and TNF-α in synovial fluid of OA mice. Moreover, LIPUS promoted chondrocyte proliferation and differentiation by activating focal adhesion kinase (FAK) signaling. Inhibition of FAK significantly blocked LIPUS-mediated cell proliferation and differentiation in vitro, as well as inflammation condition in OA mice. Conclusion LIPUS alleviates OA through promoting chondrocytes proliferation and differentiation by activating FAK, which could act as an intervening target for OA treatment.
Single-stage minimally invasive nephroureterectomy for upper tract urothelial carcinoma: Perioperative and early oncological outcomes
Authors: Ryan PC , Haroon UM , Keenan RA , O’Donoghue PJ , Hegazy M , McGuire BB 
Published: April 2020

Objective: The purpose of this article is to present our minimally-invasive techniques for upper tract urothelial carcinoma and review the perioperative and early oncological outcomes at our centre. Materials and methods: A retrospective review of all patients undergoing minimally-invasive surgery for upper tract urothelial carcinoma over a 3-year period following institutional approval was performed. Perioperative and early oncological outcomes were assessed. Results: Twenty-three cases of minimally-invasive single-stage nephroureterectomy were performed with a mean patient age of 69.45 years. Twelve (52%) of these cases were for high-grade disease and six (27%) had received neo-adjuvant chemotherapy. There were no intraoperative complications, no positive surgical margins and four (17.4%) of patients had a post-operative complication. Mean length of stay was 5.5 days and there was one readmission within 30 days of surgery. Seven patients (30%) experienced either local or distant recurrences with a median time to recurrence of 6 months. Recurrence free survival was 69.6%. Two patients died during the follow-up period. Conclusion: Our minimally-invasive techniques provides a safe and reproducible approach for upper tract urothelial carcinoma. Our perioperative outcomes and oncological are comparable to similar studies, but more long-term follow-up and larger patient numbers are required to validate oncological efficacy. Level of evidence: 4.
A Comparative Analysis of Patients Undergoing Fusion for Adult Cervical Deformity by Approach Type
Authors: Varshneya Kunal , Medress Zachary A. , Stienen Martin N. , Nathan Jay , Ho Allen , Pendharkar Arjun V. , Loo Sheri , Aikin Jessica , Li Gordon , Desai Atman , Ratliff John K. , Veeravagu Anand 
Published: April 2020

Study Design: Retrospective cohort study. Objective: To provide insight into postoperative complications, short-term quality outcomes, and costs of the surgical approaches of adult cervical deformity (ACD). Methods: A national database was queried from 2007 to 2016 to identify patients who underwent cervical fusion for ACD. Patients were stratified by approach type—anterior, posterior, or circumferential. Patients undergoing anterior and posterior approach surgeries were additionally compared using propensity score matching. Results: A total of 6575 patients underwent multilevel cervical fusion for ACD correction. Circumferential fusion had the highest postoperative complication rate (46.9% vs posterior: 36.7% vs anterior: 18.5%, P < .0001). Anterior fusion patients more commonly required reoperation compared with posterior fusion patients ( P < .0001), and 90-day readmission rate was highest for patients undergoing circumferential fusion ( P < .0001). After propensity score matching, the complication rate remained higher in the posterior, as compared to the anterior fusion group ( P < .0001). Readmission rate also remained higher in the posterior fusion group; however, anterior fusion patients were more likely to require reoperation. At index hospitalization, posterior fusion led to 1.5× higher costs, and total payments at 90 days were 1.6× higher than their anterior fusion counterparts. Conclusion: Patients who undergo posterior fusion for ACD have higher complication rates, readmission rates, and higher cost burden than patients who undergo anterior fusion; however, posterior correction of ACD is associated with a lower rate of reoperation.
Critically Low Confidence in the Results Produced by Spine Surgery Systematic Reviews: An AMSTAR-2 Evaluation From 4 Spine Journals
Authors: Dettori Joseph R. , Skelly Andrea C. , Brodt Erika D. 
Published: April 2020

Study Design: A systematic cross-sectional survey of systematic reviews (SRs). Objective: To evaluate the methodological quality of spine surgery SRs published in 2018 using the updated AMSTAR 2 critical appraisal instrument. Methods: We identified the PubMed indexed journals devoted to spine surgery research in 2018. All SRs of spine surgical interventions from those journals were critically appraised for quality independently by 2 reviewers using the AMSTAR 2 instrument. We calculated the percentage of SRs achieving a positive response for each AMSTAR 2 domain item and assessed the levels of confidence in the results of each SR. Results: We identified 28 SRs from 4 journals that met our criteria for inclusion. Only 49.5% of the AMSTAR 2 domain items satisfied the AMSTAR 2 criteria. Critical domain items were satisfied less often (39.1%) compared with noncritical domain items (57.3%). Domain items most poorly reported include accounting for individual study risk of bias when interpreting results (14%), list and justification of excluded articles (18%), and an a priori establishment of methods prior to the review or registered protocol (18%). The overall confidence in the results was rated “low” in 2 SRs and “critically low” in 26. Conclusions: The credibility of a SR and its value to clinicians and policy makers are dependent on its methodological quality. This appraisal found significant methodological limitations in several critical domains, such that the confidence in the findings of these reviews is “critically low.”