bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iliac vein stenting is a safe and effective treatment for iliac vein compression syndrome: A systematic review of Chinese data
Authors: Wang Shiyue , He Yuchen , Xin Shijie , Zhang Jian 
Published: July 2020

Objectives This study was a systematic review of available data from China, and our aim was to evaluate the safety and efficacy of stenting in iliac vein compression syndrome. Methods We searched the PubMed, National Knowledge Infrastructure, Chongqing Weipu Information Company, and Cochrane Central Register for Controlled Trials databases, and key references. Results Twelve studies were included (nine retrospective analyses, two retrospective case series studies, and one prospective cohort study) involving 2292 patients and 1897 stented limbs. The overall primary patency rates ranged from 81.8% to 100%. Studies showed significant improvements in patients’ symptoms, and ulcer healing rates ranged from 71.4% to 100% in stented limbs. The incidence of severe complications ranged from 0 to 16.8%. Conclusions For Chinese patients with iliac vein compression syndrome, stenting provided significant efficacy regarding favorable patency rates, symptom relief, and complications. However, the quality of evidence to support the use of iliac vein stenting to treat iliac vein compression syndrome is currently weak, especially for Chinese patients.
A Novel Use of Topical Ketamine for the Treatment of Oral Pemphigus: A Case Report
Authors: Higgins Elizabeth A. , West Julia Arana 
Published: July 2020

Background: Paraneoplastic pemphigus (PNP) is a rare autoimmune blistering disease often associated with lymphoproliferative disorders. PNP causes hemorrhagic stomatitis of the lips, tongue, and cheeks which can be painful and difficult to treat. Case History: A 54-year-old man was referred to our hospital for treatment of Stage IV lymphoma and paraneoplastic pemphigus. Due to pain from oral stomatitis, he required a gastrostomy tube for delivery of nutritional tube feeds. He was placed on steroids and received both lidocaine mouthwash and opioids, but his pain persisted. Case Management and Outcome: A palliative care consult was obtained for management of his pain. The palliative team recommended topical ketamine for the treatment of the painful lip lesions. The patient felt immediate relief with the application of ketamine and his pain level was reduced to a 5/10. The following day, his pain was 0/10. Five days later, the opioids were discontinued and the pain relief continued. Conclusion: Painful stomatitis from PNP may be refractory to standard treatment. We found that the application of topical ketamine was very effective in this patient with hemorrhagic stomatitis from PNP.
Exploring Sex Differences in the Effectiveness of Telehealth-Based Health Coaching in Weight Management in an Employee Population
Authors: Johnson Kelly E. , Alencar Michelle K. , Miller Brian , Gutierrez Elizabeth , Dionicio Patricia 
Published: July 2020

Purpose: To explore a telehealth-based lifestyle therapeutics (THBC) program on weight loss (WL) and program satisfaction in an employer population. Design: This study was a collaboration between inHealth Lifestyle Therapeutics and a large national employer group including 685 participants (296 women [64% obese] and 389 men [62% obese]). Measures: Percent WL and subjective rating (Perceived Program Value measured by a questionnaire) were assessed. Intervention: Average number of visits was 3.1 ± 0.4; each visit ranged between 20 and 45 minutes. Analysis: This study utilized a 2 × 2 block design using analysis of variance techniques based on sex (male and female) and initial body mass index (BMI) category (overweight and obese) tested at P ≤ .05. Results: There was no statistical difference in %WL between by sex ( F1,681 = 0.398, P = .528) nor an interaction between sex and BMI ( F1,681 = 0.809, P = .369). There was a statistically significant difference in %WL from pre to post program across initial BMI category ( F1,681 = 13.707, P ≤ .001) with obese participants losing an average of 1.1% (0.5%-1.6%) more than overweight participants (overweight 2.5% [2.1%-3.0%] vs obese 3.6% [3.2%-3.9%]). Obese participants were 1.15 (1.07-1.25) times more likely to lose weight compared to overweight participants. Analysis of variance power analysis indicated sufficient power on minimum factor combination n = 106 ( Effect Size = 0.282). Conclusion: Results support the efficacy THBC in supporting WL with no reported differences between men and women, while having a high perceived value for employee participants.
Assessment of extended urine protein monitoring frequency in patients receiving bevacizumab
Authors: Schiffer Molly , Zukovic Lejla , Hall Sophia , Merl Man Yee 
Published: July 2020

Purpose Proteinuria monitoring is required for patients receiving bevacizumab. Nonetheless, the frequency of monitoring is not specified in the package insert. A 2014 quality improvement study performed at Yale New Haven Health System (YNHHS) found that proteinuria occurred in 15% (all grade) of the 162 patients evaluated. These results led to decreasing the frequency of proteinuria monitoring from every treatment to every other treatment. The objective of this study is to assess the safety of the extended interval for urine protein (UP) monitoring. Methods Patients receiving at least four bevacizumab treatments at YNHHS from January to June 2017 were randomly selected and retrospectively reviewed. The following data were collected: baseline patient characteristics, comorbidities, medication history, and proteinuria monitoring. The grade, prevalence and management of proteinuria were evaluated. The minimum necessary sample size was determined to be 384 treatments to achieve a 95% confidence interval. Results Fifty-five patients and 388 bevacizumab treatments were evaluated. Urine protein was assessed in 52.5% of treatments. The incidence of proteinuria among patients was 7.2% (grade 2) and 0% (grade 3). Cumulative dose and the number of total bevacizumab doses did not affect the timing for onset or severity of proteinuria. Two patients with UP ≥ 2+ were further monitored using a 24-h urine collection test with negative results. No treatments were held due to proteinuria. Conclusion Monitoring proteinuria every other treatment does not increase the frequency of adverse events. Urine protein is now monitored prior to every third bevacizumab treatment, reducing unnecessary labs and chair time.
Prognostic factors and proposed grading system for cutaneous and subcutaneous soft tissue sarcomas in cats, based on a retrospective study
Authors: Dobromylskyj Melanie J , Richards Victoria , Smith Ken C 
Published: July 2020

Objectives The objectives of this study included utilising a large database from a diagnostic laboratory to identify any breed, sex or age predilections for cutaneous and subcutaneous soft tissue sarcomas (STSs), and the most common anatomical locations. The second aim was to obtain clinical outcomes and to assess histological features of those tumours to identify any potentially useful prognostic indicators and propose a grading system. Methods Records from the laboratory were searched for feline submissions received from January 2012 to December 2013 diagnosed with STSs; the breed, age, sex and neuter status of the cat and anatomical location of the tumour were recorded. Clinical outcomes were acquired using a questionnaire to submitting practices, and histological features of tumours from patients with known outcomes were assessed. Results No sex, neuter status or breed predispositions were found. Most STSs arise in middle-aged and older cats, and the most common anatomical location was the trunk. Forty-seven cases had a known clinical outcome and archived tissues allowing for histological assessment of the tumour. Significant differences in median survival time (MST), mitotic index and histological score were detected between those cats that died of tumour-related disease and those that did not. A novel grading system applied to these tumours produced significant differences in MST between cats with low (MST = 900.5 days), intermediate (MST = 514 days) and high grade tumours (MST = 283 days). Conclusions and relevance This is the first study applying a histological grading system to these common tumours. Local recurrence is often the cause of a poor outcome, with metastatic disease apparently rare. The proposed grading system incorporates features that can be assessed on routine haematoxylin and eosin-stained sections; in this small study, the histological grade of the tumour appears to be associated with survival time.
Dimethyl fumarate treatment shifts the immune environment toward an anti-inflammatory cell profile while maintaining protective humoral immunity
Authors: Longbrake Erin E , Mao-Draayer Yang , Cascione Mark , Zielinski Tomasz , Bame Eris , Brassat David , Chen Chongshu , Kapadia Shivani , Mendoza Jason P , Miller Catherine , Parks Becky , Xing Diana , Robertson Derrick 
Published: July 2020

Background: Delayed-release dimethyl fumarate (DMF) demonstrates sustained efficacy and safety for relapsing forms of MS. Absolute lymphocyte count (ALC) is reduced initially, then stabilizes on treatment. Objective: PROCLAIM, a 96-week, prospective, open-label, phase 3b study, assessed lymphocyte subsets and immunoglobulin (Ig) levels during 48 and 96 weeks (W) of DMF treatment. Methods: Patients received 240 mg DMF BID. Endpoints: lymphocyte subset count changes (primary); Ig isotypes and ALC changes (secondary); adverse events and relationship between ALC changes and ARR/EDSS (exploratory); and neurofilament assessment (ad hoc). Results: Of 218 patients enrolled, 158 (72%) completed the study. Median ALC decreased 39% from baseline to W96 (BL–W96), stabilizing above the lower limit of normal (baseline: 1.82 × 109/L; W48: 1.06 × 109/L; W96: 1.05 × 109/L). CD4 + and CD8 + T cells correlated highly with ALC from BL–W96 ( p < 0.001). Relative to total T cells, naive CD4 + and CD8 + T cells increased, whereas CD4 + and CD8 + central and effector memory T cells decreased. Total IgA, IgG, IgM, and IgG1–4 subclass levels remained stable. Adverse event rates were similar across ALC subgroups. ARR, EDSS, and neurofilament were not correlated with ALCs. Conclusion: Lymphocyte decreases with DMF were maintained over treatment, yet immunoglobulins remained stable. No increase in infection incidence was observed in patients with or without lymphopenia. Support: Biogen
NRF2 mediates γ-globin gene regulation through epigenetic modifications in a β-YAC transgenic mouse model
Authors: Zhu Xingguo , Xi Caixia , Ward Alexander , Takezaki Mayuko , Shi Huidong , Peterson Kenneth R , Pace Betty S 
Published: July 2020

NRF2 is the master regulator for the cellular oxidative stress response and regulates γ-globin gene expression in human erythroid progenitors and sickle cell disease mice. To explore NRF2 function, we established a human β-globin locus yeast artificial chromosome transgenic/NRF2 knockout (β-YAC/NRF2−/−) mouse model. NRF2 loss reduced γ-globin gene expression during erythropoiesis and abolished the ability of dimethyl fumarate, an NRF2 activator, to enhance γ-globin transcription. We observed decreased H3K4Me1 and H3K4Me3 chromatin marks and association of TATA-binding protein and RNA polymerase II at the β-locus control region (LCR) and γ-globin gene promoters in β-YAC/NRF2−/− mice. As a result, long-range chromatin interaction between the LCR DNase I hypersensitive sites and γ-globin gene was decreased, while interaction with the β-globin was not affected. Further, NRF2 loss silenced the expression of DNA methylcytosine dioxygenases TET1, TET2, and TET3 and inhibited γ-globin gene DNA hydroxymethylation. Subsequently, protein-protein interaction between NRF2 and TET3 was demonstrated. These data support the ability of NRF2 to mediate γ-globin gene regulation through epigenetic DNA and histone modifications. Impact statement Sickle cell disease is an inherited hemoglobin disorder that affects over 100,000 people in the United States causing high morbidity and early mortality. Although new treatments were recently approved by the FDA, only one drug Hydroxyurea induces fetal hemoglobin expression to inhibit sickle hemoglobin polymerization in red blood cells. Our laboratory previously demonstrated the ability of the NRF2 activator, dimethyl fumarate to induce fetal hemoglobin in the sickle cell mouse model. In this study, we investigated molecular mechanisms of γ-globin gene activation by NRF2. We observed the ability of NRF2 to modulate chromatin structure in the human β-like globin gene locus of β-YAC transgenic mice during development. Furthermore, an NRF2/TET3 interaction regulates γ-globin gene DNA methylation. These findings provide potential new molecular targets for small molecule drug developed for treating sickle cell disease.
Assisting patients experiencing family violence: A survey of training levels, perceived knowledge, and confidence of clinical staff in a large metropolitan hospital
Authors: Fisher Caroline A. , Rudkin Nadine , Withiel Toni D , May Amanda , Barson Elizabeth , Allen Beverley , O’Brien Emma , Willis Karen 
Published: July 2020

Objectives: Family violence is a public health issue. It occurs in many forms, is most commonly directed at woman and children, and contributes significantly to death, disability, and illness. This study was conducted in the clinical staff in a large metropolitan hospital and aimed to determine levels of family violence training, self-perceived knowledge and confidence, specific clinical skills, and barriers to working effectively in the area. Methods: A short, targeted online survey was designed to capture the required information. Descriptive statistics were calculated, and free-text responses were analyzed using qualitative content analysis. Results: Survey responses were received from 534 staff (242 nurses, 225 allied health, 67 medical). Sixty-five percent had received some form of family violence training, mostly of short duration (1–3 h); 72% reported having little or no confidence working in the area, while 76% indicated that they had little or no knowledge in the area. Longer duration training was associated with an increase in knowledge and confidence ratings. Family violence screening rates and knowledge of several specific family violence clinical skills (how to appropriately ask clients about family violence and family violence risk factors) were also low. Thirty-four percent indicated that they did not know what to do, when a patient disclosed experiencing family violence. The most commonly indicated barriers to working effectively in this area were suspected perpetrators being present, perceived reluctance of patients/clients to disclose when asked, and time limitations. Conclusion: This research provides a useful snapshot of clinical staff perceptions of their family violence skill levels in a large metropolitan Australian tertiary hospital. It highlights the need for further in-depth training in clinical health professionals in family violence. The research will allow for family violence training to be tailored to the needs of the professional discipline and clinical area.
The influence of skin tears following collagenase treatment of Dupuytren’s disease on treatment outcomes
Authors: Phan Robert , Rozen Warren M. , Dela Cruz Giselle , Tobin Vicky , Hunter-Smith David J. 
Published: July 2020

This study investigated influence of skin tears on patient-reported outcomes of injection of collagenase clostridium histolyticum for Dupuytren’s disease and association between extension deficit of digits before injection and skin tear after the injection. From 2016 to 2018, 391 Dupuytren’s cords were treated in 184 patients in a prospective cohort study and the patients were evaluated before injection and six months after injection. Skin tears occurred in 50% of these patients. We found no significant differences in the patient-reported outcomes between patients with or without skin tears. A higher extension deficit before treatment was associated with significantly increased frequency of skin tears. We conclude that the incidence of skin tears after injection does not affect patient reported outcomes six months after collagenase injection, but the incidence of skin tears is significantly associated with the severity of pre-treatment finger extension deficits. Level of evidence: II
A bibliometric analysis of 23,492 publications on rectal cancer by machine learning: basic medical research is needed
Authors: Wang Kangtao , Feng Chenzhe , Li Ming , Pei Qian , Li Yuqiang , Zhu Hong , Song Xiangping , Pei Haiping , Tan Fengbo 
Published: July 2020

Background and Aims: The aim of this study was to analyse the landscape of publications on rectal cancer (RC) over the past 25 years by machine learning and semantic analysis. Methods: Publications indexed in PubMed under the Medical Subject Headings (MeSH) term ‘Rectal Neoplasms’ from 1994 to 2018 were downloaded in September 2019. R and Python were used to extract publication date, MeSH terms and abstract from the metadata of each publication for bibliometric assessment. Latent Dirichlet allocation was applied to analyse the text from the articles’ abstracts to identify more specific research topics. Louvain algorithm was used to establish a topic network resulting in identifying the relationship between the topics. Results: A total of 23,492 papers published were identified and analysed in this study. The changes of research focus were analysed by the changing of MeSH terms. Studied contents extracted from the publications were divided into five areas, including surgical intervention, radiotherapy and chemotherapy intervention, clinical case management, epidemiology and cancer risk as well as prognosis studies. Conclusions: The number of publications indexed on RC has expanded rapidly over the past 25 years. Studies on RC have mainly focused on five areas. However, studies on basic research, postoperative quality of life and cost-effective research were relatively lacking. It is predicted that basic research, inflammation and some other research fields might become the potential hotspots in the future.
Concussion Epidemiology in Youth Sports: Sports Study of a Statewide High School Sports Program
Authors: Chun Benjamin J. , Furutani Troy , Oshiro Ross , Young Casey , Prentiss Gale , Murata Nathan 
Published: July 2020

Background: Current research on concussion incidence in youth athletes (age <18 years) is small and limited by variability in injury reporting and diagnostic methodology. Hypothesis: Concussion injuries commonly occur in high school sports programs. The likelihood of concussion among student-athletes (aged 13-18 years) depends on the sport they are participating in as well as the sex of the athlete. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: A retrospective analysis of all Hawaii high school athletes aged 13 to 18 years participating in 14 sports from 2011 through 2017 was performed as part of a statewide standardized concussion assessment and management program. Results: A total of 5993 concussions were identified among 92,966 athletes. The overall concussion rate was 0.96 (95% CI, 0.94-0.99). Girls’ judo had the highest concussion rate (1.92; 95% CI, 1.68-2.17) followed by football (1.60; 95% CI, 1.53-1.66). The concussion rate for boys (1.0; 95% CI, 0.97-1.03) was higher than that for girls (0.91; 95% CI, 0.87-0.95); however, in 4 of the 5 sports in which both girls and boys participated, girls had a higher rate of concussion injury. Conclusion: The likelihood of concussion among student-athletes aged 13 to 18 years may be higher than previously thought and varies depending on sport and sex. Clinical Relevance: Epidemiologic data on concussion injury in children and adolescents are useful in accurately determining the relative risks of high school sports participation and may be valuable in determining the appropriate allocation of health care and scholastic resources for student-athletes, as well as the impact of rule and training modifications designed to improve participant safety.
When to Abandon the Arthroscopic Bankart Repair: A Systematic Review
Authors: Levy Benjamin J. , Grimm Nathan L. , Arciero Robert A. 
Published: July 2020

Context: Bone loss is a major factor in determining surgical choice in patients with anterior glenohumeral instability. Although bone loss has been described, there is no consensus on glenoid, humeral head, and bipolar bone loss limits for which arthroscopic-only management with Bankart repair can be performed. Objective: To provide guidelines for selecting a more complex repair or reconstruction (in lieu of arthroscopic-only Bankart repair) in the setting of glenohumeral instability based on available literature. Data Sources: An electronic search of the literature for the period from 2000 to 2019 was performed using PubMed (MEDLINE). Study Selection: Studies were included if they quantified bone loss (humeral head or glenoid) in the setting of anterior instability treated with arthroscopic Bankart repair. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Study design, level of evidence, patient demographics, follow-up, recurrence rates, and measures of bone loss (glenoid, humeral head, bipolar). Results: A total of 14 studies met the inclusion criteria. Of these, 10 measured glenoid bone loss, 5 measured humeral head bone loss, and 2 measured “tracking” without explicit measurement of humeral head bone loss. Measurement techniques for glenoid and humeral head bone loss varied widely. Recommendations for maximum glenoid bone loss for arthroscopic repair were largely <15% of glenoid width in recent studies. Recommendations regarding humeral head loss were more variable (many authors providing only qualitative descriptions) with increasing attention on glenohumeral tracking. Conclusion: It is essential that a standardized method of glenoid and humeral head bone loss measurements be performed preoperatively to assess which patients will have successful stabilization after arthroscopic Bankart repair. Glenoid bone loss should be <15%, and humeral head lesions should be “on track” if an arthroscopic-only Bankart is planned. If there is greater bone loss, adjunct or open procedures should be performed.
Supply-and-demand projections for the health workforce at a provincial level from 2015 to 2025 in Ilam, Iran
Authors: Bazyar Mohammad , Noori Hekmat Somayeh , Rafiei Sima , Mirzaei Amin , Otaghi Masoomeh , Khorshidi Ali , Mohammadnejad Sara , Tahmasebi Samane , Amarloei Ali , Jalilian Mohsen 
Published: July 2020

Background: Human resources are the key component of health systems. It is critical to have the right number of human resources at anytime and anywhere in the health system. This article aims to help local health decision makers to identify potential gaps between the future supply and demand of human resources and to make necessary changes in medical training processes to fill the gap. Methods: An eight-stage process was applied to project the supply and demand of health workers in Ilam province in 2025 for the following fields: public health, environmental health, general medicine, dentistry, pharmacy, nursing and midwifery. To estimate the demand for human resources, a mainly population-based model (manpower-to-population ratio) was applied. A modified version of the Australian dynamic stock and flow model was used to predict the supply of new recruits in 2025. The potential surplus or shortfall in the health workforce was calculated by comparing the supply and demand in 2025. Results: The demand and supply projections for the chosen fields were estimated respectively as: general medicine 457, 709; pharmacy 131, 86; dentistry 86, 251; nursing 949, 1657; midwifery 24, 247; public health 182, 211; and environmental health 92, 225. Conclusions: The current trend of medical graduates will meet the need for human resources in 2025, and there is no need to increase medical student admission. The Education Deputy of Ilam Medical University should take into account the health needs of its catchment area in medical educational processes and training new health-care staff.