bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of cytochrome P450 1B1 gene polymorphisms and environmental biomarkers with hypertension in Slovak midlife women
Authors: Falbová Darina , Vorobeľová Lenka , Čerňanová Veronika Candráková , Beňuš Radoslav , Wsólová Ladislava , Siváková Daniela 
Published: July 2020

Abstract

Objective:
This study investigated the association of the Leu432Val and Asn453Ser CYP1B1 polymorphisms and selected environmental biomarkers with hypertension (HT) in Slovak midlife women.

Methods:
We studied 575 women. Divided according to their blood pressure status: 255 with HT and 320 without HT. All data was obtained by using standard anthropometric, genetic methods and analyzed by regression models to adjust for HT risk factors such as age, obesity, smoking, and level of education.

Results:
Our findings revealed that CYP1B1 Leu432Val polymorphism was associated with HT, whereas no association was found between Asn453Ser polymorphism and HT. Women with at least one Val allele had significantly higher odds of HT compared to women with the Leu/Leu genotype in the total sample (Exp(B) = 1.82, CI 1.16-2.84, P = 0.009). After dividing women by menopausal status and the presence of HT environmental risk factor, the association between CYP1B1 polymorphism and HT was observed in pre/perimenopausal women (Exp(B), 2.36; 95% CI 1.13-4.92; P = 0.02), smokers (Exp(B), 3.40; 95% CI 1.48-7.82; P = 0.004), abdominal obesity (Exp(B), 2.41; 95% CI 1.23-4.75; P = 0.01) and in women with only basic education (Exp(B), 4.20, 95% CI 1.12-15.71; P = 0.03). However, general linear models did not reveal a statistically significant interactions between CYP1B1, menopausal status, and HT risk factors and their common association with HT (P > 0.05).

Conclusions:
In this pilot study, we have provided novel data that supports the significant association of CYP1B1 Leu432Val gene polymorphism with HT in Slovak midlife women.
EVALUATION OF RETINAL VESSEL DIAMETERS IN EYES WITH ACTIVE CENTRAL SEROUS CHORIORETINOPATHY
Authors: Altunel Orhan , Arifoglu Hasan Basri 
Published: July 2020

Purpose:
To compare the retinal vessel diameters of healthy eyes and active central serous chorioretinopathy (CSC) eyes, and to evaluate possible effect of retinal vessel diameter alterations on the pathogenesis of CSC.

Methods:
This retrospective study included 39 patients with CSC and 34 healthy individuals. Spectralis optical coherence tomography + HRA with an infrared reflectance image were used to evaluate structure of retinal vessels in the circular region around the optic disc. For each eye, vertical inner and outer diameters of the four major arteries and veins were measured using infrared reflectance images, and vessel wall thicknesses were also calculated based on inner and outer diameters.

Results:
The 304 vessels of the 39 active CSC eyes and 266 vessels of the 34 healthy eyes were used in the analyses. The mean venous wall thickness in active CSC eyes was significantly thicker than that in healthy eyes (40.0 ± 4.9 vs. 33.5 ± 4.1 μm, P = 0.001), whereas the mean venous inner diameter in active CSC eyes was significantly narrower (52.5 ± 9.7 vs. 61.3 ± 8.1 μm, P = 0.001). Also, the mean venous outer diameter was wider in CSC eyes, albeit not significantly (131.1 ± 7.0 vs. 128.5 ± 8.4 μm, P = 0.074).

Conclusion:
Our results suggest that the alterations of retinal venous diameters may play a potential role in the pathogenesis of CSC in addition to alterations in choroidal thickness.
Comparison of Visual, Tomographic, and Biomechanical Outcomes of 360 Degrees Intracorneal Ring Implantation With and Without Corneal Crosslinking for Progressive Keratoconus: A 5-Year Follow-up
Authors: Mohammadpour Mehrdad , Khoshtinat Narges , Khorrami-Nejad Masoud 
Published: July 2020

Purpose:
To evaluate the long-term (5 years) results of 360 degrees intracorneal ring (ICR) implantation with and without corneal crosslinking (CXL) in patients with progressive keratoconus (KCN).

Method:
This historical cohort study was performed on 35 eyes with progressive KCN, which was randomly divided into 2 groups. Fourteen patients were implanted only with ICR, and 21 patients with KCN were treated with ICR plus CXL simultaneously. Uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), and refractive components were collected from patients' medical records. The biomechanical properties of patients were measured using the Corvis ST (Oculus, Inc, Weltzar, Germany). Corneal topography and aberrometry parameters were also recorded from the Pentacam HR device (Oculus).

Results:
Both UCVA and CDVA increased in both groups after ICR implantation; however, this improvement was more significant in the ICR plus CXL group (P = 0.002 and P = 0.001, respectively). The mean improvement of CDVA in patients with ICR implantation with and without CXL was 0.56 ± 0.67 and 0.33 ± 0.61, respectively. A comparison of the long-term postoperative Tomographic and Biomechanical Index between 2 groups showed a better result in the ICR plus CXL group (P = 0.012). Topographic findings of the anterior corneal surface (flat-K, steep-K, mean-K, and astigmatism) after surgery were significantly better than before surgery in both groups (P < 0.05).

Conclusions:
Although ICR implantation alone might halt the KCN progression with acceptable visual, topographic, and biomechanical outcomes, the combination of ICR and CXL has an adjuvant and synergistic effect, especially in long-term follow-up.
Management of Vulvar Cancer Precursors: A Survey of the International Society for the Study of Vulvovaginal Disease
Authors: Green Nicole , Adedipe Tolu , Dmytryshyn Julia , Preti Mario , Selk Amanda 
Published: July 2020

Objective
The aim of the study was to determine how experts treat vulvar high-grade squamous intraepithelial neoplasia (VHSIL) and differentiated vulvar intraepithelial neoplasia (dVIN).

Method
A 26-question survey was designed through a literature review, reviewed by the Survey Committee of the International Society for the Study of Vulvovaginal Disease (ISSVD), and distributed to all ISSVD members via e-mail in January 2019.

Results
Overall, 90 of 441 physician members consented to participate and 78 of 90 were eligible to complete the survey. Most respondents were gynecologists (77%), followed by dermatologists (12%). Forty-five percent responded that their pathology was being reported using the 2015 ISSVD terminology of vulvar squamous intraepithelial lesions. The most common first-line treatments were as follows: unifocal VHSIL—excision (65%), multifocal VHSIL—imiquimod 5% (45%), VHSIL in a hair-bearing area—excision (69%), and clitoral disease—imiquimod 5% (47%). In the recurrent VHSIL, excision was favored (28%), followed by imiquimod 5% (26%) and laser (19%). Differentiated vulvar intraepithelial neoplasia was most often first treated with excision (82%), and more patients were referred to gynecologic oncology. Most patients were seen in follow-up at 3 months (range: 1 week–6 months). Sixty-seven respondents provided 26 different ways to follow treated patients, which were most commonly every 6 months for 2 years and then yearly (25%), followed by every 6 months indefinitely (18%).

Conclusions
Treatment of VHSIL and dVIN varies among vulvar experts with excision being the most common treatment, except in multifocal VHSIL where imiquimod is commonly used. There is wide variation in how patients are followed after treatment.
High frequency of gastric cancer precursor lesions in patients with gastric xanthelasma: a prospective case-control study
Authors: Sayar Suleyman , Ayranci Gülçiçek , Kürbüz Kemal , Ak Çağatay , Tarikçi Kiliç Ebru , Kahraman Resul , Atalay Roni , Öztürk Oğuzhan , Çalişkan Zuhal , Adali Gupse , Doganay Levent , Özdil Kamil 
Published: July 2020

Objective
An association of gastric cancer and precursor lesions with gastric xanthelasma has frequently been reported. However, the incidence of both gastric xanthelasma and gastric cancer precursor lesions increases with age. The aim of this study was to evaluate the frequency and characteristics of atrophic gastritis, intestinal metaplasia and dysplasia in patients with gastric xanthelasma compared to controls.

Material and methods
Cases with gastric xanthelasma endoscopically and histopathologically were included in this prospective study. The patients included in the study were compared with age- and sex-matched controls in terms of the frequency and characteristics of atrophic gastritis, intestinal metaplasia, dysplasia and cancer.

Results
In a series of 1892 upper endoscopies, 108 patients (5.7%) were found to have gastric xanthelasma. The average age of the patients was 61.41 ± 11.43 years. Among the patients, 58 (53.7%) were male. The frequencies of atrophic gastritis, intestinal metaplasia, dysplasia and gastric cancer in the xanthelasma group (n = 108) were 31.5, 68.5, 3.7 and 2.8%, respectively. The frequencies of atrophic gastritis, intestinal metaplasia, dysplasia and gastric cancer in the control group (n = 183) were 11.5, 31.7, 0.5 and 0.5%, respectively. Compared to the control group, the frequency of these cancer precursor lesions and the prevalence of advanced stage based on operative link on gastritis intestinal metaplasia assessment were found to be higher in the xanthelasma group (P < 0.05).

Conclusion
Gastric xanthelasma is associated with an increased frequency of gastric precancerous lesions and should be considered an important marker.
Impact of a Follow-up Telephone Call Program on 30-Day Readmissions (FUTR-30)
Authors: Yiadom Maame Yaa A.B. , Domenico Henry J. , Byrne Daniel W. , Hasselblad Michele , Kripalani Sunil , Choma Neesha , Tucker-Marlow Sarah , Gatto Cheryl L. , Wang Li , Bhatia Monisha C. , Morrison Johnston , Harrell Frank E. , Hartert Tina V. , Lindsell Christopher J. , Bernard Gordon R. 
Published: July 2020

Background:
Telephone call programs are a common intervention used to improve patients’ transition to outpatient care after hospital discharge.

Objective:
To examine the impact of a follow-up telephone call program as a readmission reduction initiative.

Research Design:
Pragmatic randomized controlled real-world effectiveness trial.

Subjects:
We enrolled and randomized all patients discharged home from a hospital general medicine service to a follow-up telephone call program or usual care discharge. Patients discharged against medical advice were excluded. The intervention was a hospital program, delivering a semistructured follow-up telephone call from a nurse within 3–7 days of discharge, designed to assess understanding and provide education, and assistance to support discharge plan implementation.

Measures:
Our primary endpoint was hospital inpatient readmission within 30 days identified by the electronic health record. Secondary endpoints included observation readmission, emergency department revisit, and mortality within 30 days, and patient experience ratings.

Results:
All 3054 patients discharged home were enrolled and randomized to the telephone call program (n=1534) or usual care discharge (n=1520). Using a prespecified intention-to-treat analysis, we found no evidence supporting differences in 30-day inpatient readmissions [14.9% vs. 15.3%; difference −0.4 (95% confidence interval, 95% CI), −2.9 to 2.1; P=0.76], observation readmissions [3.8% vs. 3.6%; difference 0.2 (95% CI, −1.1 to 1.6); P=0.74], emergency department revisits [6.1% vs. 5.4%; difference 0.7 (95% CI, −1.0 to 2.3); P=0.43], or mortality [4.4% vs. 4.9%; difference −0.5 (95% CI, −2.0 to 1.0); P=0.51] between telephone call and usual care groups.

Conclusions:
We found no evidence of an impact on 30-day readmissions or mortality due to the postdischarge telephone call program.
Direct oral anticoagulants in chronic kidney disease: an update
Authors: Mavrakanas Thomas A. , Charytan David M. , Winkelmayer Wolfgang C. 
Published: July 2020

Purpose of review
Direct oral anticoagulants (DOACs) are variably eliminated by the kidneys rendering their use potentially problematic in patients with chronic kidney disease (CKD) or necessitating appropriate dose adjustment.

Recent findings
Both observational and limited randomized trial data for DOACs compared with no treatment or with warfarin for patients with atrial fibrillation on maintenance dialysis were recently published. In a randomized trial in patients on hemodialysis, there was no significant difference in vascular calcification between patients who received rivaroxaban with or without vitamin K2 or vitamin K antagonists. A randomized trial of apixaban versus warfarin was terminated owing to poor enrollment and preliminary results identified no difference in clinical outcomes between groups. However, valuable pharmacodynamic data will be forthcoming from that trial. In observational research, among patients newly diagnosed with atrial fibrillation, there were opposing trends in the associations of apixaban initiation versus no oral anticoagulation with ischemic versus hemorrhagic stroke and no association was present with the overall risk of stroke or embolism. In another study comparing apixaban with warfarin initiation, apixaban was associated with less bleeding. Regular-dose apixaban (5 mg twice daily) associated with reduced rates of ischemic stroke or systemic embolism, whereas no such association was present for those prescribed the reduced dose (2.5 mg twice daily).

Summary
DOACs may be used after appropriate dose adjustment for an established clinical indication in patients with advanced CKD. Quality evidence for oral anticoagulation, with any specific agent or dose, for stroke prevention in hemodialysis continues to be lacking.
Weight loss as primary indication for FDG-PET/CT
Authors: Maliha Peter George , Singerman Julia , Probst Stephan 
Published: July 2020

Purpose
Some consider fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) clinically useful in patients presenting with nonspecific symptoms of malignancy, weight loss most commonly encountered. However, the appropriateness of such FDG-PET/CT studies remains to be clarified. This study evaluated the clinical value of FDG-PET/CT in patients referred primarily for weight loss.

Methods
From 2010 to 2017 in one academic center, 252 subjects underwent 254 FDG-PET/CT studies for weight loss as primary indication and retrospectively studied. Eighteen subjects were excluded due to ongoing active malignancy, weight loss not ultimately being the main indication for the FDG-PET/CT, technically inadequate FDG-PET/CT and insufficient follow-up. The FDG-PET/CT scans were considered clinically beneficial when true positive for the cause of weight loss that other investigations missed or would have missed, clinically neutral when true negative and clinically detrimental when false positive leading to additional investigations or false negative.

Results
Ultimately 234 unique subjects (236 FDG-PET/CT studies) were included. The average subject weight loss prior to the PET was 12 kg and average follow-up time post FDG-PET/CT scan was 3.4 years. The FDG-PET/CT scans were true positive in 24 studies (10%) with 8 studies (3%) clinically beneficial; false positive in 38 studies (16%) of which 26 led to 35 additional procedures and false negative in 13 studies (6%). In total, 39 (17%) FDG-PET/CT studies were clinically detrimental. The other 149 (63%) studies were true negative, clinically neutral.

Conclusion
FDG-PET/CT appears to have limited value in assessing subjects with weight loss as the leading clinical indication, proving to be five times more often detrimental than beneficial.
99mTc-sestamibi SPECT/CT and 18F-FDG-PET/CT have similar performance but different imaging patterns in newly diagnosed multiple myeloma
Authors: Mosci Camila , Pericole Fernando V. , Oliveira Gislaine B. , Delamain Marcia T. , Takahashi Maria E.S. , Carvalheira José Barreto C. , Etchebehere Elba C.S.C. , Santos Allan O. , Miranda Eliana C. M. , Lima Mariana C.L. , Amorim Barbara J. , de Souza Carmino A. , Lorand-Metze Irene , Ramos Celso D. 
Published: July 2020

Purpose

18F-fluorodeoxiglucose (18F-FDG)-PET/CT has been widely used to evaluate multiple myeloma. 99mTc-sestamibi (MIBI) scintigraphy has also been proposed for assessing multiple myeloma, but its use with state-of-the-art single-photon emission computed tomography/computed tomography (SPECT/CT) technology has not been fully evaluated.This study aimed to compare these two imaging modalities in multiple myeloma staging.

Materials and methods
Sixty-two patients with recently diagnosed multiple myeloma were submitted to whole-body 18F-FDG-PET/CT and whole-body MIBI scans plus SPECT/CT of the chest and abdomen/pelvis. Number of focal lesions, contiguous soft tissue involvement (CSTI), extramedullary lesions (EMLs) and diffuse bone marrow (BM) involvement were recorded.

Results
PET/CT was positive in 59 patients (95%) and MIBI SPECT/CT in 58 (93%) (P = 0.69). MIBI detected more diffuse bone marrow involvement than PET/CT (respectively 78 vs. 58% of the patients), while PET/CT demonstrated more focal lesions than MIBI SPECT/CT (81 vs. 54% of the patients) (P = 0.002). PET/CT detected EMLs in four subjects and MIBI in one subject. CSTI was found in 28 (45%) and 23 (37%) patients on PET/CT and MIBI images, respectively (P = 0.36). Three patients with lytic lesions and no FDG uptake were MIBI positive, and two subjects with lytic lesions without MIBI uptake were FDG positive.

Conclusion
MIBI SPECT/CT performs similarly to 18F-FDG-PET/CT in identifying sites of active disease in multiple myeloma staging. MIBI is more efficient than FDG for detecting the diffuse involvement of bone marrow but less efficient for detecting focal lesions. Some patients presented a ‘mismatch’ pattern of FDG/MIBI uptake.
Fatal Direct Current Electrocution in a Welder
Authors: Hans Anmol , Key Phillip , Prahlow Joseph A. 
Published: July 2020

Abstract
Direct current (DC) electrocution is exceedingly rare, especially in the context of workplace accidents and exposure, where electrical fatality is almost exclusively associated with alternating current (AC). The DC electrocution requires a much higher voltage to cause significant injury and death, and therefore is generally considered safer than AC. Here, we present a case of DC electrocution where a welder accidentally electrocuted himself while repairing a metal plate inside a silo. The decedent had complained of feeling shocks in his arm while welding twice before being electrocuted. Autopsy revealed minimal trauma, along with a classic targetoid electrical burn and punctate lesions likely to be electrical burns. Correlation of the history obtained at the scene and the examination performed at autopsy aided the identification of this rare cause of death.
Artificial Intelligence and Machine Learning in Radiology
Authors: Wichmann Julian L. , Willemink Martin J. , De Cecco Carlo N. 
Published: July 2020

Abstract
Although artificial intelligence (AI) has been a focus of medical research for decades, in the last decade, the field of radiology has seen tremendous innovation and also public focus due to development and application of machine-learning techniques to develop new algorithms. Interestingly, this innovation is driven simultaneously by academia, existing global medical device vendors, and—fueled by venture capital—recently founded startups. Radiologists find themselves once again in the position to lead this innovation to improve clinical workflows and ultimately patient outcome. However, although the end of today's radiologists' profession has been proclaimed multiple times, routine clinical application of such AI algorithms in 2020 remains rare. The goal of this review article is to describe in detail the relevance of appropriate imaging data as a bottleneck for innovation, provide insights into the many obstacles for technical implementation, and give additional perspectives to radiologists who often view AI solely from their clinical role. As regulatory approval processes for such medical devices are currently under public discussion and the relevance of imaging data is transforming, radiologists need to establish themselves as the leading gatekeepers for evolution of their field and be aware of the many stakeholders and sometimes conflicting interests.
Solving nonlinear non-local problems using positive square-root operators
Authors: Montagu E. L. , Norbury John 
Published: July 2020

A non-constructive existence theory for certain operator equations

L
u
=
D
u
,

using the substitution

u
=

B

1
2

ξ

with
B
=
L
−1
, is developed, where
L
is a linear operator (in a suitable Banach space) and
D
is a homogeneous nonlinear operator such that
Dλu
=
λ

α

D u
for all
λ
≥ 0 and some

α
∈

R

,

α
≠ ~1. This theory is based on the positive-operator approach of Krasnosel’skii. The method has the advantage of being able to tackle the nonlinear right-hand side
D
in cases where conventional operator techniques fail. By placing the requirement that the operator
B
must have a positive square root, it is possible to avoid the usual regularity condition on either the mapping
D
or its Fréchet derivative. The technique can be applied in the case of elliptic PDE problems, and we show the existence of solitary waves for a generalization of Benjamin’s fluid dynamics problem.
“PLEXIT - Therapeutic plasma exchange (TPE) for Covid-19 cytokine release storm (CRS), a retrospective propensity matched control study”
Authors: Kamran Sultan Mehmood , Mirza Zill-e-Humayun , Naseem Arshad , Liaqat Jahanzeb , Fazal Imran , Alamgir Wasim , Saeed Farrukh , Azam Rizwan , Hussain Maryam , Yousaf Muhammad Ali , Ashraf Nadeem , Nisar Shazia , Zafar Ali Muhammad , Saleem Salman , Sajjad Kaswar , Zaman Asad , Azam Malik Nadeem , Hussain Mehmood , Iftikhar Raheel 
Published: July 2020

AbstractPurposeTo evaluate the outcome of patients with COVID-19 triggered CRS treated with Therapeutic Plasma Exchange (TPE) as compared to propensity score matched (PSM)-controls not receiving TPE.Material and methodsUsing PS 1:1 matching, 90 patients were assigned 2 groups (45 receiving TPE and 45 controls). Forced matching and covariate matching was done to overcome bias between two groups.ResultsMedian age was 60 years (range 32-73 in TPE and 37-75 in non-TPE group), p= 0.325. Median duration of symptoms 7 days (range 3-22 days in TPE and 3-20 days in non-TPE), p=0.266. Disease severity in both groups was 6.6% moderate, 44.4% severe and 49% critical. Twenty-eight-day survival was significantly superior in TPE group (91.1%) as compared to PS-matched controls (61.5%), HR 0.21, 95% CI for HR 0.09-0.53, log rank 0.002. Median duration of hospitalization was significantly reduced in TPE treated group as compared to non-TPE controls 10 days and 15 days respectively (p< 0.01). CRS resolution time was also significantly reduced in TPE treated group (6 days vs. 12 days) (p< 0.001).ConclusionUse of TPE is associated with superior overall survival, early resolution of CRS and time to discharge as compared to standard therapy for COVID-19 triggered CRS.Highlights□Cytokine release syndrome (CRS) plays a pivotal role in pathophysiology and progression to severe and critical disease in patients with COVID-19.□Beyond supportive care, there are currently no proven effective treatment options (including Tocilizumab) for coronavirus disease (COVID-19)□Therapeutic plasma exchange (TPE) may dampen CRS of COVID-19 by removing circulating cytokines and toxins□TPE is the cheapest of all novel treatments available so far to treat severe to critical COVID-19□By intervening early with TPE, mortality and morbidity associated with COVID-19 triggered CRS can be reduced