bluuebunny/crossref_metadata_2025_split huggingface dataset:
The novel Tenzing 7 delivery catheter designed to deliver intermediate catheters to the face of embolus without crossing: clinical performance predicted in anatomically challenging model
Authors: Frölich Andreas Maximilian , Kim Warren , Stribrny Knut , Jansen Olav , Möhlenbruch Markus , Szikora Istvan , Wodarg Fritz , Fiehler Jens , Otto Kim , Chou Tony , Buhk Jan Hendrik , English Joey 
Published: September 2020

BackgroundIn large vessel occlusionstroke, navigation of aspiration catheters (AC) can be impeded by vessel tortuosity and the ophthalmic artery origin. A novel tapered delivery catheter was designed to facilitate delivery without disturbing the embolus. We assessed AC deliverability in vitro and validated the observations in a first-in-human experience.MethodsIn a vascular model with three challenging craniocervical scenarios, two commercial AC were advanced from the carotid to the middle cerebral artery by four neurointerventionalists. Catheter deliverability with standard microwire and microcatheter (MC) combinations and the Tenzing 7 (T7) Delivery Catheter (Route 92 Medical, San Mateo, CA) were compared. Operators rated aspects of catheter deliverability on a 5-point scale. Results were compared with device delivery patterns at a neurovascular center before and after clinical introduction of T7.ResultsIn vitro, success rate and speed were higher with T7 (96%; mean 30±10 s) than with MC (65%; 72±47 s, p<0.001 each), with fewer interactions with the occlusion site (T7: 54% vs MC: 77%, p=0.004). T7 received superior ratings regarding carotid artery deflection (T7: 2, IQR1-3 vs MC: 3, IQR2-3, p<0.001), guide catheter pushback (T7: 2, IQR1-3 vs MC: 3, IQR3-3, p<0.001) and ophthalmic artery passage (T7: 1.5, IQR1-2 vs MC: 4, IQR3-5, p<0.001). Before introduction of T7 at a single center, delivery of AC to a large vessel occlusion without crossing was achieved in 15/123 cases (12%). With T7, this rate was 28/31 patients (90.3%).ConclusionCompared with microcatheter and microwire combinations, T7 improves aspiration catheter delivery in vitro, minimizing the need to cross the occlusion. Initial clinical experience appears to validate the model’s observations.
Humoral Response to HPV16 Proteins in Persons with Anal High-Grade Squamous Intraepithelial Lesion or Anal Cancer
Authors: Stankiewicz Karita Helen C. , Waterboer Tim , Magaret Amalia , Doody David R. , Pawlita Michael , Brenner Nicole , Galloway Denise A. , Wald Anna , Madeleine Margaret M. 
Published: September 2020

Abstract

Background:
This study was launched to evaluate the association of early and late antibodies to human papillomavirus 16 (HPV16) detection and risk of anal high-grade squamous intraepithelial lesions (HSIL) or cancer.

Methods:
We analyzed data from persons with anal HSIL or cancer and controls from a case–control study in Seattle, Washington. Sera were evaluated for HPV16 early (E1, E2, E4, E6, and E7) and late (L1) antibodies by multiplex serology. Logistic regression models were used to assess serologic associations with risk of anal HSIL or cancer.

Results:
The study included 67 participants with anal HSIL, 116 with anal cancer, and 830 population-based controls. HPV16 seropositivity to L1 [adjusted OR (aOR), 13.8; 95% confidence interval (CI), 7.4–25.8], E4 (aOR, 2.3; 95% CI, 1.1–4.5), and E6 (aOR, 4.9; 95% CI, 1.1–21.2) was associated with HSIL; and detection of all antibodies to HPV16 late and early proteins was associated with increased risk of anal cancer ranging from aOR 1.7 to 32.5 [L1 aOR, 12.5 (95% CI, 7.3–21.7); E1 aOR, 24.9 (95% CI, 10.3–59.9); E2 aOR, 6.3 (95% CI, 3.4–11.7); E4 aOR, 2.8 (95% CI, 1.6–4.8); E6 aOR, 32.5 (95% CI, 14.2–74.4); and E7 aOR, 1.7 (95% CI, 1.0–3.0)].

Conclusions:
HPV serologic markers proved to be specific for identifying anal cancer. HPV16 E6 seropositivity is relatively uncommon in persons without anal cancer.

Impact:
This large study comprehensively describes the distinct antibody responses to the HPV16 proteins in persons with anal HSIL or anal cancer. Antibodies to HPV16 E6 should be further evaluated as a potential biomarker for anal cancer prevention.
Comprehensive Genomic Profiling of Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NENs)
Authors: Puccini Alberto , Poorman Kelsey , Salem Mohamed E. , Soldato Davide , Seeber Andreas , Goldberg Richard M. , Shields Anthony F. , Xiu Joanne , Battaglin Francesca , Berger Martin D. , Tokunaga Ryuma , Naseem Madiha , Barzi Afsaneh , Iqbal Syma , Zhang Wu , Soni Shivani , Hwang Jimmy J. , Philip Philip A. , Sciallero Stefania , Korn W. Michael , Marshall John L. , Lenz Heinz-Josef 
Published: September 2020

AbstractPurpose:GEP-NENs are rare malignancies with increasing incidence. Their molecular characteristics are still undefined. We explored the underlying biology of GEP-NENs and the differences between gastrointestinal (GI) and pancreatic (PNEN), high-grade (HG), and low-grade (LG) tumors.Experimental Design:GEP-NENs were analyzed using next-generation sequencing (NGS; MiSeq on 47 genes, NextSeq on 592 genes), IHC, and in situ hybridization. Tumor mutational burden (TMB) was calculated on the basis of somatic nonsynonymous missense mutations, and microsatellite instability (MSI) was evaluated by NGS of known MSI loci.Results:In total, 724 GEP-NENs were examined: GI (N = 469), PNEN (N = 255), HG (N = 135), and LG (N = 335). Forty-nine percent were female, and median age was 59. Among LG tumors, the most frequently mutated genes were ATRX (13%), ARID1A (10%), and MEN1 (10%). HG tumors showed TP53 (51%), KRAS (30%), APC (27%), and ARID1A (23%). Immune-related biomarkers yielded a lower prevalence in LG tumors compared with HG [MSI-H 0% vs. 4% (P = 0.04), PD-L1 overexpression 1% vs. 6% (P = 0.03), TMB-high 1% vs. 7% (P = 0.05)]. Compared with LG, HG NENs showed a higher mutation rate in BRAF (5.4% vs. 0%, P &lt; 0.0001), KRAS (29.4% vs. 2.6%, P &lt; 0.0001), and PI3KCA (7% vs. 0.3%, P &lt; 0.0001). When compared with GI, PNEN carried higher frequency of MEN1 (25.9% vs. 0.0%, P &lt; 0.0001), FOXO3 (8.6% vs. 0.8%, P = 0.005), ATRX (20.6% vs. 2.0%, P = 0.007), and TSC2 (6.3% vs. 0.0%, P = 0.007), but lower frequency of mutations in APC (1.0% vs. 13.8%, P &lt; 0.0001).Conclusions:Significant molecular differences were observed in GEP-NENs by tumor location and grade, indicating differences in carcinogenic pathways and biology.
CYLD Alterations in the Tumorigenesis and Progression of Human Papillomavirus–Associated Head and Neck Cancers
Authors: Cui Zhibin , Kang Hyunseok , Grandis Jennifer R. , Johnson Daniel E. 
Published: September 2020

AbstractGenetic alterations of CYLD lysine 63 deubiquitinase (CYLD), a tumor-suppressor gene encoding a deubiquitinase (DUB) enzyme, are associated with the formation of tumors in CYLD cutaneous syndrome. Genome sequencing efforts have revealed somatic CYLD alterations in multiple human cancers. Moreover, in cancers commonly associated with human papillomavirus (HPV) infection (e.g., head and neck squamous cell carcinoma), CYLD alterations are preferentially observed in the HPV-positive versus HPV-negative form of the disease. The CYLD enzyme cleaves K63-linked polyubiquitin from substrate proteins, resulting in the disassembly of key protein complexes and the inactivation of growth-promoting signaling pathways, including pathways mediated by NF-κB, Wnt/β-catenin, and c-Jun N-terminal kinases. Loss-of-function CYLD alterations lead to aberrant activation of these signaling pathways, promoting tumorigenesis and malignant transformation. This review summarizes the association and potential role of CYLD somatic mutations in HPV-positive cancers, with particular emphasis on the role of these alterations in tumorigenesis, invasion, and metastasis. Potential therapeutic strategies for patients whose tumors harbor CYLD alterations are also discussed.Implications:Alterations in CYLD gene are associated with HPV-associated cancers, contribute to NF-κB activation, and are implicated in invasion and metastasis.
Lifestyle Moderates Genetic Risk of Venous Thromboembolism
Authors: Evans Christina R. , Hong Ching-Ping , Folsom Aaron R. , Heckbert Susan R. , Smith Nicholas L. , Wiggins Kerri , Lutsey Pamela L. , Cushman Mary 
Published: September 2020

Objective:
Venous thromboembolism (VTE) is a common disease that has a genetic basis. Lifestyle factors contribute to risk, but it is unknown whether healthy lifestyle can mitigate the genetic risk. We studied whether greater adherence to the American Heart Association’s cardiovascular health metric, Life’s Simple 7 (LS7), is associated with lower incidence of VTE in individuals across categories of a genetic risk score (GRS) for VTE.

Approach AND RESULTS:
We followed 9026 White participants from the ARIC (Atherosclerosis Risk in Communities) Study, a prospective cohort enrolled in 1987 to 1989 until 2015. We tested the joint associations with VTE of a validated VTE GRS comprising 5 well-known gene variants and baseline LS7 categories. There were 466 incident VTE events over 22.8 years. Participants with an optimal LS7 score had a lower incidence of VTE (3.9%) than those with inadequate LS7 (5.7%). Compared with the high GRS and inadequate LS7 group (hazard ratio=1), those with high GRS and optimal LS7 indeed had a reduced hazard ratio of VTE: 0.65 (95% CI, 0.48–0.89). The group with low GRS and optimal LS7 had the lowest hazard ratio of VTE (0.39 [95% CI, 0.25–0.61]). Of the LS7 components, in all GRS groups, the factor most strongly protective for VTE was normal weight.

Conclusions:
Among people at low or high genetic risk for VTE, healthier lifestyle factors, particularly normal weight, were associated with a lower incidence of VTE. Further studies should determine the impact of lifestyle changes among patients at high genetic risk of VTE, such as in thrombophilic families.
Do Parents Know Best?
Authors: Eekelaar John 
Published: September 2020

Abstract
While Article 5 of the UN Convention on the Rights of the Child requires states to respect parents’ responsibilities to provide ‘appropriate’ direction and guidance to their children, Article 18 also proclaims that ‘the best interests of the child will be [the parents’] basic concern’. But how can this be done if, as is widely accepted, the “best interests” standard is too indeterminate safely to allow courts to substitute their assessment of children’s interests for those of a child’s parents? This reason for privatising such decisions has been reinforced by concerns over the extent of public expenditure on court involvement in and legal aid for such issues, with the possible result of withdrawal of the law from this process. This article argues that there are inherent risks in leaving the arrangements for children of separating parents entirely in the hands of the parents, and considers various ways in which such risks might be reduced.
The Enigma of Article 5 of the United Nations Convention on the Rights of The Child
Authors: Sutherland Elaine E. 
Published: September 2020

Abstract
The United Nations Convention on the Rights of the Child sets the gold standard for the rights of children and young people, placing the obligation on States parties to ensure their realisation. Since most children live in families, recognising their rights has implications for other family members, particularly their parents.
Article 5 creates a framework for balancing the rights and obligations of the parties – the child, the parents and the state – in this triangular relationship, requiring States parties to respect the right of parents to direct and guide the child in the exercise of Convention rights. Yet other Convention provisions address the parties’ roles, calling into question the need for Article 5.
This article sets the scene for those that follow in this issue, exploring what the drafters of the Convention were seeking to achieve in Article 5 and highlighting issues that proved controversial, before focussing on the work of the United Nations Committee on the Rights of the Child to drill down into its content and address its place in the Convention.
Locations and Mechanisms of Ocean Ventilation in the High-Latitude North Atlantic in an Eddy-Permitting Ocean Model
Authors: MacGilchrist Graeme A. , Johnson Helen L. , Marshall David P. , Lique Camille , Thomas Matthew , Jackson Laura C. , Wood Richard A. 
Published: September 2020

AbstractA substantial fraction of the deep ocean is ventilated in the high-latitude North Atlantic. Consequently, the region plays a crucial role in transient climate change through the uptake of carbon dioxide and heat. However, owing to the Lagrangian nature of the process, many aspects of deep Atlantic Ocean ventilation and its representation in climate simulations remain obscure. We investigate the nature of ventilation in the high-latitude North Atlantic in an eddy-permitting numerical ocean circulation model using a comprehensive set of Lagrangian trajectory experiments. Backward-in-time trajectories from a model-defined North Atlantic Deep Water (NADW) reveal the locations of subduction from the surface mixed layer at high spatial resolution. The major fraction of NADW ventilation results from subduction in the Labrador Sea, predominantly within the boundary current (~60% of ventilated NADW volume) and a smaller fraction arising from open ocean deep convection (~25%). Subsurface transformations—due in part to the model’s parameterization of bottom-intensified mixing—facilitate NADW ventilation, such that water subducted in the boundary current ventilates all of NADW, not just the lighter density classes. There is a notable absence of ventilation arising from subduction in the Greenland–Iceland–Norwegian Seas, due to the re-entrainment of those waters as they move southward. Taken together, our results emphasize an important distinction between ventilation and dense water formation in terms of the location where each takes place, and their concurrent sensitivities. These features of NADW ventilation are explored to understand how the representation of high-latitude processes impacts properties of the deep ocean in a state-of-the-science numerical simulation.
Anterior wall resection plus radiofrequency ablation versus simple aspiration in the treatment of auricular pseudocyst: a retrospective study
Authors: Liu Liangliang , Gao Tianxi , Wang Zhenghui 
Published: September 2020

Objective To compare the efficacy of two different treatment approaches for auricular pseudocyst. Methods This retrospective study reviewed data from patients with auricular pseudocyst that were treated with either anterior wall resection plus radiofrequency ablation compression (surgical group) or simple aspiration and compression suturing (control group). The following outcomes were compared between the two groups: therapeutic response (cure, good or none), duration of postoperative medication (antibiotics) use, duration of postoperative pain, duration of recovery of appearance and rate of complications (infection, auricular thickening, incision swelling and recurrence). Results A total of 386 patients were enrolled in the study: 218 in the surgical group and 168 in the control group. Duration of postoperative medication use, duration of postoperative pain, duration of recovery of appearance and rate of postoperative complications were significantly lower in the surgical group compared with the control group. The overall therapeutic response (cure and good response) was significantly greater in the surgical group than in the control group. Conclusion Auricular pseudocyst can be effectively treated by both of these methods, but anterior wall resection plus radiofrequency ablation compression might be more effective.
Soluble guanylyl cyclase stimulation and phosphodiesterase‐5 inhibition improve portal hypertension and reduce liver fibrosis in bile duct–ligated rats
Authors: Brusilovskaya Ksenia , Königshofer Philipp , Lampach Daniel , Szodl Adrian , Supper Paul , Bauer David , Beer Andrea , Stift Judith , Timelthaler Gerald , Oberhuber Georg , Podesser Bruno Karl , Seif Martha , Zinober Kerstin , Rohr‐Udilova Nataliya , Trauner Michael , Reiberger Thomas , Schwabl Philipp 
Published: September 2020

BackgroundIn cirrhosis, the nitric oxide‐soluble guanylyl cyclase (sGC)‐cyclic guanosine monophosphate (cGMP) pathway is impaired, which contributes to increased intrahepatic vascular resistance (IHVR) and fibrogenesis. We investigated if sGC stimulation (riociguat (RIO)), sGC activation (cinaciguat (CINA)) or phosphodiesterase (PDE)‐5 inhibition (tadalafil (TADA)) improves portal hypertension (PHT) and liver fibrosis.MethodsFifty male Sprague–Dawley rats underwent bile‐duct ligation (BDL) or sham operation. RIO (0.5 mg/kg), CINA (1 mg/kg), TADA (1.5 mg/kg) or vehicle (VEH) was administered from weeks 2 to 4 after BDL. At week 4, invasive haemodynamic measurements were performed, and liver fibrosis was assessed by histology (chromotrope‐aniline blue (CAB), Picro‐Sirius red (PSR)) and hepatic hydroxyproline content.ResultsCirrhotic bile duct–ligated rats presented with PHT (13.1 ± 1.0 mmHg) and increased IHVR (4.9 ± 0.5 mmHg⋅min/mL). Both RIO (10.0 ± 0.7 mmHg, p  = 0.021) and TADA (10.3 ± 0.9 mmHg, p  = 0.050) decreased portal pressure by reducing IHVR (RIO: –41%, p  = 0.005; TADA: –21%, p  = 0.199) while not impacting heart rate, mean arterial pressure and portosystemic shunting. Hepatic cGMP levels increased upon RIO (+239%, p  = 0.006) and TADA (+32%, p  = 0.073) therapy. In contrast, CINA dosed at 1 mg/kg caused weight loss, arterial hypotension and hyperlactataemia in bile duct–ligated rats. Liver fibrosis area was significantly decreased by RIO (CAB: –48%, p  = 0.011; PSR: –27%, p  = 0.121) and TADA (CAB: –21%, p  = 0.342; PSR: –52%, p  = 0.013) compared to VEH‐treated bile duct–ligated rats. Hepatic hydroxyproline content was reduced by RIO (from 503 ± 20 to 350 ± 30 µg/g, p  = 0.003) and TADA (282 ± 50 µg/g, p = 0.003), in line with a reduction of the hepatic stellate cell activation markers smooth‐muscle actin and phosphorylated moesin. Liver transaminases decreased under RIO (AST: –36%; ALT: –32%) and TADA (AST: –24%; ALT: –27%) treatment. Hepatic interleukin 6 gene expression was reduced in the RIO group (–56%, p  = 0.053).ConclusionIn a rodent model of biliary cirrhosis, the sGC stimulator RIO and the PDE‐5 inhibitor TADA improved PHT. The decrease of sinusoidal vascular resistance was paralleled by a reduction in liver fibrosis and hepatic inflammation, while systemic haemodynamics were not affected.
The “invisible” wiring technique for displaced fracture patella
Authors: Wong Andrew LY , Wong Kevin KH , Wong Kam Kwong , Wong Wing Cheung 
Published: September 2020

Background: Operative treatment of displaced patella fracture dates back to Lister in 1877. Nowadays, steel wires remain the material of choice in tension band technique despite complications such as wire breakage, suboptimal placement, or skin impingement. We propose using a high-tensile strength braided tape-shaped polyblend suture (FiberTape®, Arthrex, Naples, Florida, USA) as an alternative that could minimize complications related to steel wires. Method: Between February 2014 and April 2018, 15 patients with displaced patella fractures (three distal pole, five transverse, and seven comminuted fractures) underwent our proposed method. Open fracture reduction was performed to optimize anatomy before figure-of-eight fixation with FiberTape®. An Ethibond-2 suture was also added as cerclage for stability. Postoperatively, an extension brace was given for wound resting, before progressing to mobilization exercises with a hinge-knee brace. At follow-ups, the knee’s range-of-motion (ROM), along with bone healing status from radiographs, was assessed. Results: The mean operation time was 84.5 min, and all surgeries were performed or supervised by the same senior surgeon. Eight patients were discharged from follow-up (mean follow-up of 9.9 months) after achieving good ROM and fracture healing. One patient defaulted, and the remaining is still being followed-up. There was no wound complication or knot impingement in all cases. One patient required manipulation under anesthesia due to stiffness, and one experienced malunion due to poor compliance to rehabilitation protocol. Conclusion: Fixation using a high-tensile strength braided suture may be an equally effective method in the management of displaced patella fracture. However, larger sample size is useful to provide a more definitive conclusion.
Long-term prognosis after intracerebral haemorrhage
Authors: van Nieuwenhuizen Koen M , Vaartjes Ilonca , Verhoeven Jamie I , Rinkel Gabriel JE , Kappelle L Jaap , Schreuder Floris HBM , Klijn Catharina JM 
Published: September 2020

Introduction The aim of this study was to determine the risk of recurrent intracerebral haemorrhage (ICH), ischaemic stroke, all stroke, any vascular event and all-cause mortality in 30-day survivors of ICH, according to age and sex. Patients and methods We linked national hospital discharge, population and cause of death registers to obtain a cohort of Dutch 30-day survivors of ICH from 1998 to 2010. We calculated cumulative incidences of recurrent ICH, ischaemic stroke, all stroke and composite vascular outcome, adjusted for competing risk of death and all-cause mortality. Additionally, we compared survival with the general population. Results We included 19,444 ICH-survivors (52% male; median age 72 years, interquartile range 61–79; 78,654 patient-years of follow-up). First-year cumulative incidence of recurrent ICH ranged from 1.5% (95% confidence interval 0.9–2.3; men 35–54 years) to 2.4% (2.0–2.9; women 75–94 years). Depending on age and sex, 10-year risk of recurrent ICH ranged from 3.7% (2.6–5.1; men 35–54 years) to 8.1% (6.9–9.4; women 55–74 years); ischaemic stroke 2.6% to 7.0%, of all stroke 9.9% to 26.2% and of any vascular event 15.0% to 40.4%. Ten-year mortality ranged from 16.7% (35–54 years) to 90.0% (75–94 years). Relative survival was lower in all age-groups of both sexes, ranging from 0.83 (0.80–0.87) in 35- to 54-year-old men to 0.28 (0.24–0.32) in 75- to 94-year-old women. Discussion ICH-survivors are at high risk of recurrent ICH, of ischaemic stroke and other vascular events, and have a sustained reduced survival rate compared to the general population. Conclusion The high risk of recurrent ICH, other vascular events and prolonged reduced survival-rates warrant clinical trials to determine optimal secondary prevention treatment after ICH.
Influence of assemble patterns on bonding strength of glued bamboo
Authors: Zheng Yu , Yi Bao-long , Tong Ya-qi , Peng Zhen-zhen 
Published: September 2020

AbstractAs a kind of natural composite material, the outer side of bamboo was quite different from its inner side in microscopic structure and mechanical properties. In order to research the effect of these differences on bonding strength of glued bamboo, bamboo strips were bonded by three different forms: outer side to outer side, outer side to inner side and inner side to inner side. Shear strength results indicated that the bamboo sample glued by inner side to inner side has the greatest shear strength value, which is 18.35 MPa, and the other two types have similar shear strength values (approximately 14 MPa). In particular, for the sample glued by outer side to inner side, the broken part is always the outer side. The scanning electron microscope (SEM) images indicated that bamboo fiber cells and parenchyma cells have different failure patterns in compression shear test. For bamboo fiber cells, dominant destruction occurred at the interface between the fibers. And for parenchyma cell, fracture occurred on cell wall and broken the parenchyma cell itself. The interface between bamboo fiber cells was very weak, thus parenchyma cell was the major contributor to shear strength of bamboo. The inner side had higher shear strength because it had higher content of parenchyma cells. The SEM image and shear strength curve also indicated that in the early period of shearing process, the deformed parenchyma cells are in a relax status, and until the later period of shearing process, the parenchyma cells begin to contribute to shear strength.