bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preferred and actual place of death in haematological malignancies: a report from the UK haematological malignancy research network
Authors: Sheridan Rebecca , Roman Eve , Smith Alex G , Turner Andrew , Garry Anne C , Patmore Russell , Howard Martin R , Howell Debra A 
Published: May 2020

ObjectivesHospital death is comparatively common in people with haematological cancers, but little is known about patient preferences. This study investigated actual and preferred place of death, concurrence between these and characteristics of preferred place discussions.MethodsSet within a population-based haematological malignancy patient cohort, adults (≥18 years) diagnosed 2004–2012 who died 2011–2012 were included (n=963). Data were obtained via routine linkages (date, place and cause of death) and abstraction of hospital records (diagnosis, demographics, preferred place discussions). Logistic regression investigated associations between patient and clinical factors and place of death, and factors associated with the likelihood of having a preferred place discussion.ResultsOf 892 patients (92.6%) alive 2 weeks after diagnosis, 58.0% subsequently died in hospital (home, 20.0%; care home, 11.9%; hospice, 10.2%). A preferred place discussion was documented for 453 patients (50.8%). Discussions were more likely in women (p=0.003), those referred to specialist palliative care (p<0.001), and where cause of death was haematological cancer (p<0.001); and less likely in those living in deprived areas (p=0.005). Patients with a discussion were significantly (p<0.05) less likely to die in hospital. Last recorded preferences were: home (40.6%), hospice (18.1%), hospital (17.7%) and care home (14.1%); two-thirds died in their final preferred place. Multiple discussions occurred for 58.3% of the 453, with preferences varying by proximity to death and participants in the discussion.ConclusionChallenges remain in ensuring that patients are supported to have meaningful end-of-life discussions, with healthcare services that are able to respond to changing decisions over time.
Strengthening effects of bone marrow mononuclear cells with intensive atorvastatin in acute myocardial infarction
Authors: Yang Yue-Jin , Qian Hai-Yan , Song Lei , Geng Yong-Jian , Gao Run-lin , Li Na , Wang Hong , Tian Xia-Qiu , Huang Ji , Huang Pei-Sen , Xu Jun , Shen Rui , Lu Min-Jie , Zhao Shi-Hua , Wu Wei-Chun , Wu Yuan , Zhang Jun , Qian Jie , Xu Jun-Yan , Xiong Yu-Yan 
Published: May 2020

ObjectiveTo test whether intensive atorvastatin (ATV) increases the efficacy of transplantation with autologous bone marrow mononuclear cells (MNCs) in patients suffering from anterior ST-elevated myocardial infarction (STEMI).MethodsThis clinical trial was under a 2×2 factorial design, enrolling 100 STEMI patients, randomly into four groups of regular (RA) or intensive ATV (IA) with MNCs or placebo. The primary endpoint was the change of left ventricular ejection fraction (LVEF) at 1-year follow-up from baseline, primarily assessed by MRI. The secondary endpoints included other parameters of cardiac function, remodelling and regeneration determined by MRI, echocardiography, positron emission tomography (PET) and biomarkers.ResultsAll the STEMI patients with transplantation of MNCs showed significantly increased LVEF change values than those with placebo (p=0.01) with only in the IA+MNCs patients group demonstrating significantly elevation of LVEF than in the IA+placebo group (+12.6% (95%CI 10.4 to 19.3) vs +5.0% (95%CI 4.0 to 10.0), p=0.001), pointing to a better synergy between ATV and MNCs (p=0.019). PET analysis revealed significantly increased viable areas of myocardium (p=0.015), while the scar sizes (p=0.026) and blood aminoterminal pro-B-type natriuretic peptide (p<0.034) reduced. All these above benefits of MNCs were also attributed to IA+MNCs instead of RA+MNCs group of patients with STEMI.ConclusionsIntensive ATV treatment augments the therapeutic efficacy of MNCs in patients with anterior STEMI at the convalescent stage. The treatment with the protocol of intensive ATV and MNC combination offers a clinically essential approach for myocardial infarction.Trial registration numberNCT00979758.
Hospital meal intake in acute heart failure patients and its association with long-term outcomes
Authors: Yoshida Taizo , Shoji Satoshi , Shiraishi Yasuyuki , Kawana Masataka , Kohno Takashi , Inoue Kenji , Fukuda Keiichi , Heidenreich Paul A , Kohsaka Shun 
Published: May 2020

BackgroundRisk prediction for hospitalised heart failure (HF, HHF) patients remains suboptimal. We aimed to determine the prognostic value of hospital food intake (FI) immediately before discharge among HHF patients.MethodWe analysed the data of 255 HHF patients extracted from the records of a single university hospital. The FI percentage of the three meals the day before hospital discharge was averaged. Patients were stratified into adequate FI (100% consumption) and inadequate FI (less than 100% consumption) groups. The primary outcome was the composite of all-cause mortality and/or HF readmission within 1 year.ResultsOnly 49.3% of HHF patients consumed 100% of their meals. Patients with inadequate FI were older; predominantly women; and had a lower body mass index, higher brain natriuretic peptide levels and Clinical Frailty Scale scores at discharge than those with adequate FI. Inadequate FI was significantly associated with adverse outcomes after adjustments (HR 2.00; 95% CI 1.09 to 3.67; p=0.026). The effect of interaction by ejection fraction (EF) was highly significant: HF with preserved EF (≥40%) was significantly associated with inadequate FI with adverse outcomes (HR 4.95; 95% CI 1.71 to 14.36; p=0.003) but HF with reduced EF (<40%) was not (HR 0.77; 95% CI 0.31 to 1.95; p=0.590).ConclusionsThe hospital FI assessment might be a simple, useful tool for predicting and stratifying risk for HHF patients.
Therapeutic Targeting of the Secreted Lysophospholipase D Autotaxin Suppresses Tuberous Sclerosis Complex-Associated Tumorigenesis
Authors: Feng You , Mischler William J. , Gurung Ashish C. , Kavanagh Taylor R. , Androsov Grigoriy , Sadow Peter M. , Herbert Zachary T. , Priolo Carmen 
Published: May 2020

Abstract

Tuberous sclerosis complex (TSC) is an autosomal dominant disease characterized by multiorgan hamartomas, including renal angiomyolipomas and pulmonary lymphangioleiomyomatosis (LAM). TSC2 deficiency leads to hyperactivation of mTOR Complex 1 (mTORC1), a master regulator of cell growth and metabolism. Phospholipid metabolism is dysregulated upon TSC2 loss, causing enhanced production of lysophosphatidylcholine (LPC) species by TSC2-deficient tumor cells. LPC is the major substrate of the secreted lysophospholipase D autotaxin (ATX), which generates two bioactive lipids, lysophosphatidic acid (LPA) and sphingosine-1-phosphate (S1P). We report here that ATX expression is upregulated in human renal angiomyolipoma-derived TSC2-deficient cells compared with TSC2 add-back cells. Inhibition of ATX via the clinically developed compound GLPG1690 suppressed TSC2-loss associated oncogenicity in vitro and in vivo and induced apoptosis in TSC2-deficient cells. GLPG1690 suppressed AKT and ERK1/2 signaling and profoundly impacted the transcriptome of these cells while inducing minor gene expression changes in TSC2 add-back cells. RNA-sequencing studies revealed transcriptomic signatures of LPA and S1P, suggesting an LPA/S1P-mediated reprogramming of the TSC lipidome. In addition, supplementation of LPA or S1P rescued proliferation and viability, neutral lipid content, and AKT or ERK1/2 signaling in human TSC2-deficient cells treated with GLPG1690. Importantly, TSC-associated renal angiomyolipomas have higher expression of LPA receptor 1 and S1P receptor 3 compared with normal kidney. These studies increase our understanding of TSC2-deficient cell metabolism, leading to novel potential therapeutic opportunities for TSC and LAM.

Significance:
This study identifies activation of the ATX–LPA/S1P pathway as a novel mode of metabolic dysregulation upon TSC2 loss, highlighting critical roles for ATX in TSC2-deficient cell fitness and in TSC tumorigenesis.
Fibroblasts from Distinct Pancreatic Pathologies Exhibit Disease-Specific Properties
Authors: Barrera Lawrence N. , Evans Anthony , Lane Brian , Brumskill Sarah , Oldfield Frances E. , Campbell Fiona , Andrews Timothy , Lu Zipeng , Perez-Mancera Pedro A. , Liloglou Triantafillos , Ashworth Milton , Jalali Mehdi , Dawson Rebecca , Nunes Quentin , Phillips Phoebe A. , Timms John F. , Halloran Christopher , Greenhalf William , Neoptolemos John P. , Costello Eithne 
Published: May 2020

Abstract

Although fibrotic stroma forms an integral component of pancreatic diseases, whether fibroblasts programmed by different types of pancreatic diseases are phenotypically distinct remains unknown. Here, we show that fibroblasts isolated from patients with pancreatic ductal adenocarcinoma (PDAC), chronic pancreatitis (CP), periampullary tumors, and adjacent normal (NA) tissue (N = 34) have distinct mRNA and miRNA profiles. Compared with NA fibroblasts, PDAC-associated fibroblasts were generally less sensitive to an antifibrotic stimulus (NPPB) and more responsive to positive regulators of activation such as TGFβ1 and WNT. Of the disease-associated fibroblasts examined, PDAC- and CP-derived fibroblasts shared greatest similarity, yet PDAC-associated fibroblasts expressed higher levels of tenascin C (TNC), a finding attributable to miR-137, a novel regulator of TNC. TNC protein and transcript levels were higher in PDAC tissue versus CP tissue and were associated with greater levels of stromal activation, and conditioned media from TNC-depleted PDAC-associated fibroblasts modestly increased both PDAC cell proliferation and PDAC cell migration, indicating that stromal TNC may have inhibitory effects on PDAC cells. Finally, circulating TNC levels were higher in patients with PDAC compared with CP. Our characterization of pancreatic fibroblast programming as disease-specific has consequences for therapeutic targeting and for the manner in which fibroblasts are used in research.

Significance:
Primary fibroblasts derived from various types of pancreatic diseases possess and retain distinct molecular and functional characteristics in culture, providing a series of cellular models for treatment development and disease-specific research.
Reducing Aortic Barotrauma and Vascular Extracellular Matrix Degradation by Pacemaker‐Mediated QRS Widening
Authors: Sezer Murat , Atici Adem , Coskun Isa , Cizgici Yaşar , Ozcan Alp , Umman Berrin , Bugra Zehra , Ozcan Ilke , Hasdemir Hakan , Kocaaga Mehmet , Davies Justin E. , Umman Sabahattin 
Published: May 2020

Background

The extent of pressure‐related damage might be related to acceleration rate of the applied pressure (peak
dP
/dt) in the vascular system. In this study, we sought to determine whether
dP
/dt applied to the aortic wall (aortic
dP
/dt) and in turn vascular extracellular matrix degradation can be mitigated via modulation of left ventricular (
LV
) contractility (
LV dP
/dt) by pacemaker‐mediated desynchronization.

Methods and Results

First, in 34 patients, changes in aortic
dP
/dt values in 3 aortic segments in response to pacemaker‐mediated stepwise
QRS
widening leading to gradual desynchronization of the
LV
contraction by means of steadily changed atrioventricular delay (
AVD
) with temporary dual‐chamber pacing was examined before and after beta‐blocker (15 mg
IV
metoprolol) administration. Second, serum matrix metalloproteinase‐9 levels were measured in the 20 patients with permanent pacemaker while they were on sinus rhythm with normal
QRS
width and 3 weeks after wide
QRS
rhythm ensured by dual pacing, dual sensing, and dual response to sensing with short
AVD
.
LV dP
/dt substantially correlated with
dP
/dt measured in ascending (
r
=0.83), descending (
r
=0.89), and abdominal aorta (
r
=0.96).
QRS
width strongly correlated with
dP
/dt measured in ascending (
r
=−0.95), descending (
r
=−0.92), and abdominal (
r
=−0.96) aortic segments as well. In patients with permanent pacemaker, wide
QRS
rhythm led to a significant reduction in serum matrix metalloproteinase‐9 levels (from 142.5±32.9 pg/mL to 87.5±32.4 pg/mL [
P
<0.001]) at the end of 3 weeks follow‐up.

Conclusions

QRS
prolongation by short
AVD
dual pacing, dual sensing, and dual response to sensing results in concomitant decreases in peak
dP
/dt values in the
LV
and in all aortic segments with or without background beta‐blocker administration, which in turn led to a significant reduction in circulating matrix metalloproteinase‐9 levels.

Registration

URL
:
https://www.clini​caltr​ials.gov
; Unique identifier:
NCT
03665558.
Red Blood Cell Transfusion After Stage I Palliation Is Associated With Worse Clinical Outcomes
Authors: Mille Felina K. , Badheka Aditya , Yu Priscilla , Zhang Xuemei , Friedman David F. , Kheir John , van den Bosch Sarah , Cabrera Antonio G. , Lasa Javier J. , Katcoff Hannah , Hu Paula , Borasino Santiago , Hock Krissie , Huskey Jordan , Weller Jamie , Kothari Harsh , Blinder Joshua 
Published: May 2020

Background
Packed red blood cell transfusion may improve oxygen content in single‐ventricle neonates, but its effect on clinical outcomes after Stage 1 palliation is unknown.

Methods and Results

Retrospective multicenter analysis of packed red blood cell transfusion exposures in neonates after Stage 1 palliation, excluding those with intraoperative mortality or need for extracorporeal membrane oxygenation. Transfusion practice variability was assessed, and multivariable regression used to identify transfusion risk factors. After propensity score adjustment for severity of illness, clinical outcomes were compared between transfused and nontransfused subjects. Of 396 subjects, 323 (82%) received 930 postoperative red blood cell transfusions. Packed red blood cell volume (median 9–42 mL/kg [
P
<0.0001]), donor exposures (1–2 [
P
<0.0001]), transfusion number (1–3 [
P
<0.0001]), and pretransfusion hemoglobin (12.1–13 g/dL,
P
=0.0049) varied between sites. Cyanosis (
P
=0.02), chest tube output (
P
=0.0003), and delayed sternal closure (
P
=0.0033) increased transfusion risk. Transfusion was associated with prolonged mechanical ventilation (6 [interquartile range 4, 12] versus 3 [1, 5] days,
P
=0.02) and intensive care unit stay (19 [12, 33] versus 9 [6, 19] days,
P
=0.016). When stratified by number of transfusions (0, 1, or >1), duration of mechanical ventilation (3 [1, 5] versus 4 [3, 6] versus 9 [5, 16] days [
P
<0.0001]) and intensive care unit stay (9 [6, 19] versus 13 [8, 25] versus 21 [13, 38] days [
P
<0.0001]) increased for those transfused more than once. Most subjects who died were transfused, though the association with mortality was not significant.

Conclusions
Packed red blood cell transfusion after Stage 1 palliation is common, and transfusion practice is variable. Transfusion is a significant predictor of longer intensive care unit stay and mechanical ventilation. Further studies to define evidence‐based transfusion thresholds are warranted.
Trends in Active Cigarette Smoking Among Stroke Survivors in the United States, 1999 to 2018
Authors: Parikh Neal S. , Chatterjee Abhinaba , Díaz Iván , Merkler Alexander E. , Murthy Santosh B. , Iadecola Costantino , Navi Babak B. , Kamel Hooman 
Published: May 2020

Background and Purpose—
Patients who continue to smoke after a stroke face a higher risk of recurrent stroke. While several effective drugs for smoking cessation became available over the past 2 decades, whether active smoking has decreased among stroke survivors is unknown. We, therefore, evaluated trends in active smoking among stroke survivors during this period.

Methods—
We performed trends analyses using cross-sectional data collected every 1 to 2 years from 2 US health surveys spanning 1999 to 2018. In the National Health and Nutrition Examination Survey (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS) survey, participants were asked about prior stroke and active tobacco smoking. In NHANES, serum cotinine levels were available as a secondary measure of active smoking. We used multivariable logistic regression models for survey data to assess trends in active smoking among participants with and without prior stroke.

Results—
Among 49 375 participants in NHANES during 1999 to 2016 and 3 621 741 participants in BRFSS during 2011 to 2018, the prevalence of stroke was ≈3%. The overall prevalence of active smoking among stroke survivors was 24% in NHANES and 23% in BRFSS. Among individuals without prior stroke, the odds of smoking decreased over time in both NHANES (odds ratio, 0.95 per 2 years [95% CI, 0.93–0.96]) and BRFSS (odds ratio, 0.96 per year [95% CI, 0.96–0.96]). In contrast, there was no decrease in smoking among stroke survivors in NHANES (odds ratio, 1.00 [95% CI, 0.93–1.07]) or BRFSS (odds ratio, 0.99 [95% CI, 0.98–1.004]). Results were consistent in secondary analysis using biochemical ascertainment of active smoking in NHANES and in sensitivity analyses accounting for potential demographic changes in stroke epidemiology.

Conclusions—
In contrast to the general population, the prevalence of active smoking among stroke survivors has not decreased during the past 2 decades.
Hemifacial Spasm as a Rare Clinical Presentation of Idiopathic Intracranial Hypertension: Case Report and Literature Review
Authors: Poff Charles B. , Lipschitz Noga , Kohlberg Gavriel D. , Breen Joseph T. , Samy Ravi N. 
Published: May 2020

Objectives: To report a rare case of idiopathic intracranial hypertension (IIH) presenting with hemifacial spasm (HFS) and review the current literature. Methods: Case report and literature review. The patient’s medical record was reviewed for demographic and clinical data. For literature review, all case reports or other publications published in English literature were identified using PUBMED. Results: A 43-year-old obese female presented with a 2-year history of left HFS. Electroencephalography and head computed tomography were unremarkable. Magnetic resonance imaging demonstrated bilateral anterior inferior cerebellar artery vascular loops involving the internal auditory canals as well as IIH-associated findings. A lumbar puncture was performed and revealed an elevated opening pressure of 26 cm H20 cerebrospinal fluid. Acetazolamide treatment was then initiated, resulting in complete resolution of the HFS. Conclusion: HFS may be a rare presenting manifestation of IIH, and treatment of IIH may result in improvement of HFS symptoms. This is the first report of IIH presenting with HFS in the absence of headache or visual change. As a result, this is the first report of HFS as a presenting manifestation of IIH in Otolaryngology literature.
The problematic use of social networking sites associates with elevated symptoms in patients with major depressive disorder
Authors: Aydin Orkun , Çökmüş Fikret Poyraz , Balikçi Kuzeymen , Sücüllüoğlu-Dikici Didem , Ünal-Aydin Pınar 
Published: May 2020

Background: Although excessive use of social networking site (SNS) is related to undesired effects on healthy individual’s psychological well-being, there is a huge gap in studies performed with individuals who suffer from various mental disorders. Aim: The main goal of this study is to examine the association between problematic utilization of SNSs and depressive symptoms across patients diagnosed with major depressive disorder (MDD). Methods: 111 patients diagnosed with MDD (diagnoses confirmed via the Structured Clinical Interview for DSM-5–Clinician Version (SCID-5/CV)) and 108 healthy controls (HCs) were recruited for the study. Montgomery–Asberg Depression Rating Scale (MADRS) and Bergen Social Media Addiction Scale (BSMAS) were administered by both MDD and HC groups. Group comparisons were estimated with multivariate analysis of covariance (MANCOVA) analyses. To identify the relationship between SNS addiction and depressive symptoms, the Pearson correlations were performed, and finally, we computed the multiple linear regression analyses to determine whether SNS addiction predicts depressive symptoms. Results: The results revealed that MDD group is more addicted to SNS relative to HC. In addition, depressive symptoms were significantly predicted by ‘relapse’ subdimension and the overall score of SNS addiction in the MDD group. Conclusion: Our study illustrated the detrimental effects of excessive SNSs usage on depressive symptoms in MDD particularly for the individuals in ‘relapse’ state of SNS addiction. The mental health workers should consider the usage patterns of SNSs in patients diagnosed with MDD during their clinical observation and management.
Long-term Results of Arthroscopic Rotator Cuff Repair: A Follow-up Study Comparing Single-Row Versus Double-Row Fixation Techniques
Authors: Plachel Fabian , Siegert Paul , Rüttershoff Katja , Thiele Kathi , Akgün Doruk , Moroder Philipp , Scheibel Markus , Gerhardt Christian 
Published: May 2020

Background: Arthroscopic rotator cuff repair (RCR) with suture anchor–based fixation techniques has replaced former open and mini-open approaches. Nevertheless, long-term studies are scarce, and lack of knowledge exists about whether single-row (SR) or double-row (DR) methods are superior in clinical and anatomic results. Purpose: To analyze long-term results after arthroscopic RCR in patients with symptomatic rotator cuff tears and to compare functional and radiographic outcomes between SR and DR repair techniques at least 10 years after surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Between 2005 and 2006, 40 patients with a symptomatic full-thickness rotator cuff tear (supraspinatus tendon tear with or without a tear of the infraspinatus tendon) underwent arthroscopic RCR with either an SR repair with a modified Mason-Allen suture–grasping technique (n = 20) or a DR repair with a suture bridge fixation technique (n = 20). All patients were enrolled in a long-term clinical evaluation, with the Constant score (CS) as the primary outcome measure. Furthermore, an ultrasound examination was performed to assess tendon integrity and conventional radiographs to evaluate secondary glenohumeral osteoarthritis. Results: A total of 27 patients, of whom 16 were treated with an SR repair and 11 with a DR repair, were followed up after a mean ± SD period of 12 ± 1 years (range, 11-14 years). Five patients underwent revision surgery on the affected shoulder during follow-up period, which led to 22 patients being included. The overall CS remained stable at final follow-up when compared with short-term follow-up (81 ± 8 vs 83 ± 19 points; P = .600). An increasing number of full-thickness retears were found: 6 of 22 (27%) at 2 years and 9 of 20 (45%) at 12 years after surgery. While repair failure negatively affected clinical results as shown by the CS ( P < .05), no significant difference was found between the fixation techniques ( P = .456). In general, progressive osteoarthritic changes were observed, with tendon integrity as a key determinant. Conclusion: Arthroscopic RCR with either an SR or a DR fixation technique provided good clinical long-term results. Repair failure was high, with negative effects on clinical results and the progression of secondary glenohumeral osteoarthritis. While DR repair slightly enhanced tendon integrity at long-term follow-up, no clinical superiority to SR repair was found.