bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular changes with optical coherence tomography angiography during aura of migraine: A case report
Authors: Bingöl Kızıltunç Pınar , Atilla Huban 
Published: January 2020

Purpose: To demonstrate macular and optic disk vessel changes by optical coherence tomography angiography during and after a migraine attack with aura Methods: Case report Results: A 34-year-old healthy female patient was evaluated by optical coherence tomography angiography imaging during visual aura with phosphenes in the left visual field. Optical coherence tomography angiography imaging showed diffuse narrowing of the retinal vessels, decreased radial peripapillary capillary density, and decreased superficial and deep foveal vessel density in the right eye. These changes improved 3 hours after visual aura. The patient suffered from right eye pain and right-sided headache, which are typical for migraine, after the visual aura. Conclusion: These findings indicate that blood flow during migraine attack is reduced not only in the brain but also in the eye. Eye pain in migraine patients may be due to decreased blood flow in the eye. Restoring the vascular changes 3 hours after the visual aura suggests that vascular changes may be transient during a migraine attack.
MRI differences between MOG antibody disease and AQP4 NMOSD
Authors: Salama Sara , Khan Majid , Shanechi Amirali , Levy Michael , Izbudak Izlem 
Published: January 2020

Background: MOG antibody and AQP4 antibody seropositive diseases are immunologically distinct subtypes of neuromyelitis optica spectrum disorders (NMOSD) with similar clinical presentations. MRI findings can be instrumental in distinguishing MOG antibody disease from AQP4 antibody NMOSD. Objectives: The aim of this study is to characterize the neuroradiological differences between MOG antibody disease and AQP4 antibody NMOSD with the aim to distinguish between the two entities. Methods: This is a retrospective study of 26 MOG and 25 AQP4 seropositive patients in which MRI features of the brain, spinal cord, and orbit were compared. Results: The majority of the abnormal findings in the MOG cohort were located on orbital MRIs, while spinal cord magnetic resonance (MR) abnormalities were more common in the AQP4 cohort. Brain abnormalities showed some overlap, but cortical gray/juxtacortical white matter involvement was distinct to MOG patients, while area postrema involvement was a rare feature. Conclusion: Cortical gray/juxtacortical white matter lesions on brain MRI might help distinguish MOG antibody disease from AQP4-positive NMOSD. These findings could be of value in distinguishing the two entities as early as the first presentation.
Establishment of an internationally agreed minimum data set for acute telestroke
Authors: Cadilhac Dominique A , Bagot Kathleen L , Demaerschalk Bart M , Hubert Gordian , Schwamm Lee , Watkins Caroline L , Lightbody Catherine Elizabeth , Kim Joosup , Vu Michelle , Pompeani Nancy , Switzer Jeffrey , Caudill Juanita , Estrada Juan , Viswanathan Anand , Hubert Nikolai , Ohannessian Robin , Hargroves David , Roberts Nicholas , Ingall Timothy , Hess David C , Ranta Annemarei , Padma Vasantha , Bladin Christopher F 
Published: January 2020

Introduction Globally, the use of telestroke programmes for acute care is expanding. Currently, a standardised set of variables for enabling reliable international comparisons of telestroke programmes does not exist. The aim of the study was to establish a consensus-based, minimum dataset for acute telestroke to enable the reliable comparison of programmes, clinical management and patient outcomes. Methods An initial scoping review of variables was conducted, supplemented by reaching out to colleagues leading some of these programmes in different countries. An international expert panel of clinicians, researchers and managers ( n = 20) from the Australasia Pacific region, USA, UK and Europe was convened. A modified-Delphi technique was used to achieve consensus via online questionnaires, teleconferences and email. Results Overall, 533 variables were initially identified and harmonised into 159 variables for the expert panel to review. The final dataset included 110 variables covering three themes (service configuration, consultations, patient information) and 12 categories: (1) details about telestroke network/programme ( n = 12), (2) details about initiating hospital ( n = 10), (3) telestroke consultation ( n = 17), (4) patient characteristics ( n = 7), (5) presentation to hospital ( n = 5), (6) general clinical care within first 24 hours ( n = 10), (7) thrombolysis treatment ( n = 10), (8) endovascular treatment ( n = 13), (9) neurosurgery treatment ( n = 8), (10) processes of care beyond 24 hours ( n = 7), (11) discharge information ( n = 5), (12) post-discharge and follow-up data ( n = 6). Discussion The acute telestroke minimum dataset provides a recommended set of variables to systematically evaluate acute telestroke programmes in different countries. Adoption is recommended for new and existing services.
Cities, selective admission, and economic sorting
Authors: Glick Lior 
Published: January 2020

In the last few decades, residency in some of the world’s desired destination cities has become a privilege, as housing supply has not kept pace with population growth. This has led to a significant rise in housing prices and consequently to the exclusion of middle- and low-income populations on a large scale. These developments have received only scant attention in political theory despite their prominence in local policymaking and their contribution to processes of redrawing the boundaries of inclusion into local political communities. My focus in this article is on the question ‘is it morally permissible for cities to sort members by economic means, and grant the better-off privileged access to residency?’ I explore this question by examining the main arguments used to support the city’s right to selectively admit would-be members. This allows me to delineate the limitations of the city’s general duty to be accessible to all segments of society and to present particular cases where the city has special obligations to incorporate nonmembers.
Efficacy of extended, comprehensive outpatient cardiac rehabilitation on cardiovascular risk factors: A nationwide registry
Authors: Reich Bernhard , Benzer Werner , Harpf Hanns , Hofmann Peter , Mayr Karl , Ocenasek Helmuth , Podolsky Andrea , Pokan Rochus , Porodko Michael , Puelacher Christoph , Sareban Mahdi , Traninger Heimo , Ziegelmeyer Wolfgang , Niebauer Josef 
Published: January 2020

Aim Cardiac rehabilitation (CR) is a key component of the treatment of cardiac diseases. The Austrian outpatient CR model is unique, as it provides patients with an extended professionally supervised, multidisciplinary program of 4–6 weeks of phase II (OUT-II) and 6–12 months of phase III (OUT-III) CR. The aim of this analysis was to assess the efficacy of the Austrian outpatient CR model using a nationwide registry. Methods Data of all consecutive patients ( N = 7560) who completed OUT-II and/or OUT-III between 1 January 2005 and 31 December 2015 were entered prospectively into a registry. OUT-III patients were analyzed separately according to whether the preceding phase II was performed as outpatient (OUT-II/OUT-III, N = 2403) or in-patient (IN-II/OUT-III, N = 2789). All patients underwent assessment of anthropometry, resting blood pressure, lipid profile, fasting blood glucose, exercise capacity, quality of life, anxiety and depression. Results During OUT-II, patients significantly improved their metabolic risk factor profile and increased exercise capacity by 14.3%. OUT-II/OUT-III patients achieved an additional increase in exercise capacity by 10%, further improvement in high-density lipoprotein (HDL) and stabilization of the remaining risk factors. IN-II/OUT-III patients increased their maximal exercise capacity by 18.4% and there was improvement in blood pressure, HDL, low-density lipoprotein and glucose levels. Conclusion Extended, professionally supervised, multidisciplinary outpatient CR in a large nationwide registry of consecutive patients consistently improved maximal exercise capacity and relevant modifiable cardiovascular risk factors beyond effects seen after IN- or OUT-II alone.
Monocyte-mediated inflammation and cardiovascular risk factors in type 2 diabetes mellitus: A systematic review and meta-analysis of pre-clinical and clinical studies
Authors: Mokgalaboni Kabelo , Dludla Phiwayinkosi V , Nyambuya Tawanda M , Yakobi Sinethemba H , Mxinwa Vuyolwethu , Nkambule Bongani B 
Published: January 2020

Background Monocyte-mediated inflammation increases the risk of developing type 2 diabetes mellitus and cardiovascular disease. This is the first systematic review and meta-analysis of studies reporting on monocyte-mediated inflammation in type 2 diabetes mellitus. Methods This systematic review and meta-analysis was registered in the international prospective register of a systematic review: CRD42019132902. The MEDLINE, EMBASE and Google scholar electronic databases were searched, and a random-effects model was used to generate pooled standardised mean differences between patients with type 2 diabetes mellitus and healthy controls. Results The clinical studies (n = 20) comprised of 1065 patients with type 2 diabetes mellitus and 1103 healthy controls. Notably, the levels of monocyte activation were higher in patients with type 2 diabetes mellitus compared to healthy controls (standardised mean difference  = 0.47, 95% confidence interval (0.10, 0.84), p = 0.01) (χ2 = 65.72, I2 = 83%, p < 0.00001). Patients with type 2 diabetes mellitus had an increased risk of cardiovascular disease compared to healthy controls (standardised mean difference  = 0.37, 95% confidence interval (0.13, 0.61), p = 0.003) (χ2 = 958.77, I2 = 95%, p < 0.00001). All included pre-clinical studies reported on the C57BL/6 mice strain, with a majority of the studies 57% of reporting on high fat diet-induced C57BL/6 mice model. The overall quality of the studies was good with a median score and range of 16 (13–19). Conclusion Our meta-analysis suggests that there is increased monocyte activation in patients with type 2 diabetes mellitus.
Long-term results after femoral thrombendarterectomy combined with simultaneous endovascular intervention in intermittent claudication and critical ischemia
Authors: Altreuther Martin , Mattsson Erney 
Published: January 2020

Objective: This population-based retrospective cohort study investigates long-term results of femoral thrombendarterectomy combined with simultaneous endovascular intervention of the iliac or femoropopliteal vessels, or both, with focus on freedom from recurrent intervention, limb salvage and survival. Methods: All patients undergoing femoral thrombendarterectomy and simultaneous endovascular intervention between 1999 and 2013 were included. Stratification was according to clinical symptoms, intermittent claudication or critical ischemia, with subgroups for rest pain and ulcer/gangrene, and for type of endovascular intervention, iliac, femoropopliteal or both. We assessed technical success, 30-day complications, freedom from recurrent intervention, survival and amputation free survival in all patients. Limb salvage was assessed in patients with critical ischemia. Results: We identified 151 operations in 143 patients with a total of 164 limbs treated. A total of 13 patients had bilateral and 8 patients had subsequent contralateral operations. Indication was intermittent claudication in 87 (57.6%) and critical ischemia in 64 (42.4%) operations. Thirty-day mortality, only observed in critical ischemia, was 5/64 (7.8%). Freedom from recurrent intervention after 5 years was 91% in intermittent claudication and 70% in critical ischemia. In total, 84% of the patients with claudication were improved at the end of the study. Limb salvage at 5 years was 75% in critical ischemia, 93% in rest pain and 64% in patients with ulcer or gangrene. Conclusion: Femoral thrombendarterectomy combined with endovascular iliac or femoropopliteal intervention has good and durable results in intermittent claudication and critical ischemia, especially in patients with rest pain. In most cases, a single operation is sufficient.
Knowledge and practices of fundoscopy among general practitioners in Qassim Province, Saudi Arabia, for the management of diabetic retinopathy and diabetic macular edema: A cross-sectional study
Authors: Al-Rashidi Sultan H , Al-Thunayyan Faris S , Alsuhaibani Khalid A , Alharbi Abdulmajeed A , Alharbi Khalid A 
Published: January 2020

Objectives: Blindness is one of the most widespread final pathways of diabetic retinopathy and its associated diabetic macular edema. The general practitioners are the first to encounter these diabetic patients. Fundoscopy is now considered as an ideal way for the diagnosis of patients with diabetic retinopathy. Therefore, this study was undertaken to know the ability and skills of general practitioners for the diagnosis and management of patients with diabetic retinopathy and diabetic macular edema. Methods: This study was conducted in all major cities in Qassim province of Saudi Arabia during January to May 2017. A validated questionnaire was used to assess the general practitioners’ knowledge and practice for the management of diabetic retinopathy and diabetic macular edema. Questions related to referrals, diagnosis, and treatment options to diabetic retinopathy and diabetic macular edema were asked to the general practitioners. Results: Of 96 general practitioners, 76 returned the questionnaire with a response rate of 79.2%. Only 26.3% general practitioners referred patients with type 1 diabetes to ophthalmologists as per guidelines set by the American Academy of Ophthalmology, whereas 74% of general practitioners showed good knowledge for referring patients with type 2 diabetes to ophthalmology clinics. Lack of knowledge was also noticed for the treatment of diabetic retinopathy, as only 36.8% of general practitioners replied positive for dilated fundus examination option, whereas 78.9% of general practitioners chose laser photocoagulation as a treatment option. Similar response from them was observed for patients with diabetic macular edema. Furthermore, data also showed years in practice of general practitioners was well correlated with their knowledge for the management of diabetic retinopathy and diabetic macular edema. Conclusion: The general practitioners included in this study showed lack of knowledge in handling patients with diabetic retinopathy and diabetic macular edema. Therefore, refresher courses are needed that highlight the acquisition of their skills in fundoscopy.
Activation of IL-10+ B cells: A novel immunomodulatory mechanism for therapeutic bacterial suspensions
Authors: Salazar Alberto , Nieto Jane E , Velazquez-Soto Henry , Jiménez-Martínez Maria C 
Published: January 2020

Objectives: Bacterial components are used to improve immune responses in patients with respiratory infections. Pharmacological formulations of bacterial components include a mixture of bacterial antigens, some of which are complete inactivated bacteria, that is, named bacterial suspensions; while others are fragments of bacteria, which are presented as bacterial lysates. Although bacterial lysates have been broadly used as immune-stimulators, the biological support for the therapeutic effectiveness of bacterial suspension has not yet been studied. Thus, the aim of our study was to investigate the immunological activity induced by bacterial suspension. Methods: This work was an exploratory translational study. Peripheral blood mononuclear cells were obtained from healthy donors and cultured in time–dose dependent assays with a commercial bacterial suspension. Flow cytometry was used for phenotypic analysis and for determining soluble cytokines in culture supernatants. Results: We observed that bacterial suspension activates B cells in a dose-dependent manner. Peripheral blood mononuclear cells were able to secrete IL-6 and IL-10 after 24 h of bacterial suspension stimulation. TLR2 expression was observed mainly on CD19+ CD38Lo B cells after 72 h of culture; remarkably, most of the TLR2+ CD19+ cells were also IL-10+. Conclusion: Our findings suggest that bacterial suspension induces the activation of B cell subsets as well as the secretion of IL-6 and IL-10. Expression of TLR2 on CD19+ cells could act as an activation loop of IL-10+ B regulatory cells. The clinical implications of these findings are discussed at the end of this article.
Ascites in a young male: idiopathic FIP1L1-PDGFRA-negative hypereosinophilic syndrome
Authors: Kasinathan Ganesh , Sathar Jameela 
Published: January 2020

Introduction Idiopathic hypereosinophilic syndrome is defined as persistently elevated peripheral blood absolute eosinophil count of more than 1.5 × 109/L for at least six months with no obvious secondary cause. Case Presentation We report the case of a 26-year-old gentleman of Malay ethnicity who presented to the medical department with a three-week history of abdominal distension associated with dyspepsia and epigastric pain. Physical examination revealed ascites. The complete blood count portrayed peripheral leucocytosis with eosinophilia of 8.84 × 109/L. Parasitic serology was negative. Paracentesis analysis showed exudative ascites with an absolute eosinophil count of 8 × 109/L. He was referred to the haematology department. He was noticed to have bilateral tonsillitis and pruritic skin rash at the legs. There were no palpable lymph nodes or organomegaly. A peripheral blood film showed 44% eosinophils with no excess blasts. Clonal eosinophilic fusion studies did not detect FIP1L1-PDGFRA mutation. JAK2 V617F and BCR-ABL1 mutations were undetected. Serum B12 and tryptase levels were normal. A whole-body computed tomography imaging showed bowel wall thickening at the duodenum, jejunum, ileum, rectosigmoid and splenic flexure. Sections of fragments taken from the endoscopy showed features of eosinophilic gastritis and colitis on histology. Bone marrow biopsy depicted marked eosinophilia. He was started on oral imatinib mesylate 200 mg daily and oral prednisolone 0.5 mg/kg daily which was tapered based on response. He achieved complete remission and is now asymptomatic. Conclusion The diagnosis of hypereosinophilic syndrome should be considered in a patient with unexplained ascites. Secondary sinister causes such as malignancy should always be excluded.
Survival following the placement of gastrostomy tube in patients with multiple sclerosis
Authors: Grandidge Lisa , Chotiyarnwong Chayaporn , White Sean , Denning Jessica , Nair Krishnan Padmakumari Sivaraman 
Published: January 2020

Background Around a third of people with multiple sclerosis (MS) experience dysphagia. There is a need for disease-specific information on survival following placement of gastrostomy tube in people with MS. Objective We aimed to study survival following gastrostomy in patients with MS. Methods We reviewed medical records, home enteral feeding database and death certificates of people with MS who had gastrostomy from 2005 to 2017. Cox regression analysis was performed to identify independent predictors associated with mortality after gastrostomy. Results Median survival of 53 patients with MS after gastrostomy was 21.73 months. Median duration of hospital stay after gastrostomy was 14 days (IQR 5.25, 51.5). Survival at 30 days, 3 months, 1, 2, 5 and 10 years were 100% (53/53), 98.1% (52/53), 81.1% (43/53), 54.7% (29/53), 22.4% (11/49) and 6.8% (3/44), respectively. Of 53 patients, 24 died due to respiratory tract infection. Patients who had gastrostomy tube before 50 years of age survived longer (median 28.48 months) compared with those who had the gastrostomy after age 50 years (median 17.51 months) ( p = 0.040). Conclusion Around 54% of patients with MS survived two or more years following gastrostomy. Younger patients had better survival. The most frequent cause of death was respiratory infection.
Mothers for Others: An Interpretative Phenomenological Analysis of Gestational Surrogates’ Child Relinquishment Experiences
Authors: Ferolino Austin P , Camposo Mia Angelica D , Estaño Karla Christianne L , Tacbobo Jessa Marie R 
Published: January 2020

Background: Previous studies have shown that surrogates reported high satisfaction with the surrogacy process and no psychological difficulties as a result of child relinquishment. However, the experiential dimension of child relinquishment is an understudied area. Objective: This study sought to provide a more detailed portrait of gestational surrogates’ child relinquishment experiences and the meanings they give to this experience. Method: Semistructured interviews were conducted with 3 women who experienced commercial gestational surrogacy for the first time. Interview transcripts were transcribed and analyzed using interpretative phenomenological analysis. Results: Three superordinate themes were generated from the transcripts: (1) undertaking an act of altruism, (2) going through a different kind of motherhood, and (3) promoting a positive body image. Conclusion: Such insights can provide essential knowledge for mental health professionals who are interested in the development of psychological support tailored to promote a smooth emotional transfer of the baby from the surrogate to the intended couple.
Primary immunodeficiencies reveal the molecular requirements for effective host defense against EBV infection
Authors: Tangye Stuart G. , Latour Sylvain 
Published: January 2020

Abstract
Epstein-Barr virus (EBV) is an enigma; on one hand, it infects and persists in latent form in the vast majority of the global population, causing relatively benign disease in otherwise healthy individuals. On the other hand, EBV represents the first identified oncogenic virus, capable of causing ≥7 different types of malignancies, usually in immunocompromised individuals. Furthermore, some individuals with defined inborn errors of immunity exhibit extreme susceptibility to EBV-induced disease, developing severe and often fatal infectious mononucleosis, hemophagocytic lymphohistiocytosis, lymphoproliferative disease, and/or EBV+ B-cell lymphoma. Thus, host and pathogen have coevolved to enable viral persistence and survival with minimal collateral damage to the healthy host. However, acquired or genetic disruptions to host defense that tip the balance in favor of EBV can have catastrophic effects. The study of primary immunodeficiencies has provided opportunities to define nonredundant requirements for host defense against EBV infection. This has not only revealed mechanisms underlying EBV-induced disease in these primary immunodeficiencies but also identified molecules and pathways that could be targeted to enhance the efficacy of an EBV-specific vaccine or treat severe EBV infection and pathological consequences in immunodeficient hosts.