bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Use of Cangrelor After Percutaneous Coronary Intervention in Patients Requiring Mechanical Circulatory Support
Authors: Katz Alyson , Lewis Tyler C. , Arnouk Serena , Altshuler Diana , Papadopoulos John , Toy Bridget , Smith Deane E. , Merchan Cristian 
Published: February 2021

Background: Patients with cardiogenic shock after percutaneous coronary intervention (PCI) may require mechanical circulatory support (MCS). The combination of dual antiplatelet therapy with cangrelor and continuous anticoagulation required for MCS may increase the risk of bleeding. Objective: The objective of the study is to describe the complications and outcomes of patients who received cangrelor during MCS following PCI. Methods: This is a single-center, retrospective, observational case series of 17 patients who received cangrelor while on MCS from June 2017 to September 2019. Results: In a case series of 17 patients, 8 patients (47%) were supported with an Impella device and 4 patients (24%) with venoarterial (VA) extracorporeal membrane oxygenation (ECMO); 5 required (29%) concomitant VA ECMO and Impella support in the setting of cardiogenic shock. All patients received triple antithrombotic therapy with aspirin, heparin, and cangrelor. Cangrelor was commonly initiated at a median dose of 0.75 (range 0.5-4) µg/kg/min. Cangrelor dose adjustments included changes in increments up to 0.25 µg/kg/min with review of P2Y12 levels. A total of 10 patients (59%) experienced a bleeding event, most commonly located at the peripheral cannulation site (40%) and in the gastrointestinal tract (30%). Seven (70%) and 3 (30%) of the bleeding complications were classified as major and minor, respectively. No patient developed in-stent thrombosis during the hospitalization; 14 (82%) patients survived their MCS course. Conclusion and Relevance: This case series suggests that cangrelor doses less than 0.75 µg/kg/min may be beneficial. Larger studies should evaluate alternative dosing regimens.
Robotic chemotherapy compounding: A multicenter productivity approach
Authors: Riestra Ana C , López-Cabezas Carmen , Jobard Marion , Campo Mertxe , Tamés María J , Marín Ana M , Brandely-Piat Marie L , Carcelero-San Martín Esther , Batista Rui , Cajaraville Gerardo 
Published: February 2021

Introduction The aim of this study is to compare productivity of the KIRO Oncology compounding robot in three hospital pharmacy departments and identify the key factors to predict and optimize automatic compounding time. Methods The study was conducted in three hospitals. Each hospital compounding workload and workflow were analyzed. Data from the robotic compounding cycles from August 2017 to July 2018 were retrospectively obtained. Nine cycle specific parameters and five productivity indicators were analysed in each site. One-to-one differences between hospitals were evaluated. Next, a correlation analysis between cycle specific factors and productivity indicators was conducted; the factors presenting a highest correlation to automatic compounding time were used to develop a multiple regression model (afterwards validated) to predict the automatic compounding time. Results A total of 2795 cycles (16367 preparations) were analysed. Automatic compounding time showed a relevant positive correlation (ǀrs|>0.40) with the number of preparations, number of vials and total volume per cycle. Therefore, these cycle specific parameters were chosen as independent variables for the mathematical model. Considering cycles lasting 40 minutes or less, predictability of the model was high for all three hospitals (R2:0.81; 0.79; 0.72). Conclusion Workflow differences have a remarkable incidence in the global productivity of the automated process. Total volume dosed for all preparations in a cycle is one of the variables with greater influence in automatic compounding time. Algorithms to predict automatic compounding time can be useful to help users in order to plan the cycles launched in KIRO Oncology.
Associations between early neutering, obesity, outdoor access, trauma and feline degenerative joint disease
Authors: Maniaki Evangelia , Murrell Jo , Langley-Hobbs Sorrel J , Blackwell Emily J 
Published: February 2021

Objectives The aim of this case-control study was to identify early-life risk factors associated with the occurrence of owner-reported mobility changes in 6-year-old cats by examining prospective data from a longitudinal cohort study of pet cats, the Bristol Cats study. Methods Data on potential risk factors were obtained from seven sequential questionnaires completed between the ages of 2–4 months and 5 years. Mobility-related questions from the study questionnaire distributed at the age of 6 years were used to calculate each cat’s mobility score. Cats with mobility scores of ⩾2 and 0 were allocated to the case and control groups, respectively, and the cat’s status was the outcome variable. Results Of the 799 cats included for analysis, 238 (29.8%) had owner-reported mobility changes. Binomial logistic regression using backwards elimination identified four risk factors for owner-reported mobility changes at 6 years of age: entire neuter status at 6 months of age (odds ratio [OR] 1.97; 95% confidence interval [CI] 1.26–3.07), sustained trauma before 6 years of age (OR 1.85; 95% CI 1.30–2.60), outdoor access at 6 years of age (OR 1.67; 95% CI 0.96–2.90) and overweight/obese status at 6 years of age (OR 1.62; 95% CI 1.13–2.33). Conclusions and relevance Risk factor analysis demonstrated that obesity, outdoor access and a history of trauma may predispose cats to developing owner-reported mobility changes associated with degenerative joint disease, whereas neutering before 6 months of age appears to decrease that risk.
Trans-scleral plugs scleral fixation IOL and penetrating keratoplasty to restore vision in vitrectomized eyes
Authors: de Angelis Lorenzo , Barca Francesco , Rizzo Stanislao , Di Leo Laura , Oliverio Leandro , Caporossi Tomaso 
Published: February 2021

Purpose: To report the surgical outcomes of penetrating keratoplasty (PKP) and sutureless scleral fixation (SSF) using Carlevale Lens (Soleko) combined procedure to solve corneal failure and aphakia in vitrectomized eyes and discuss eventual advantages of this new approach. Methods: Two patients underwent primary wound repair and pars plana vitrectomy after a penetrating ocular trauma and were referred to the author’s clinic. The PKP and SSF-Carlevale lens implantation were performed under retrobulbar anesthesia. Intraoperative and postoperative complications were recorded, intraocular lens positioning was evaluated using anterior segment optical coherence tomography (AS-OCT) and endothelial cell density was determined using an endothelial microscope. Both patients completed 12 months follow-up. Results: The surgery was performed without intraoperative complications. After 1 month, the lens was fixed well, and the graft showed no sign of rejection. At the last visit after 12 months, the corneal graft remained transparent with good endothelial cell density in both cases; conjunctival scarring or inflammation and plugs externalization did not occur during follow-ups. Best-corrected visual acuity was 4/10 Snellen in the first case, while in the second case, we witnessed a limited visual recovery of 1/20 Snellen due to retinal issues. Conclusion: We report the feasibility of secondary IOL implantation using Carlevale with penetrating keratoplasty. The relative of ease of Carlevale lens implantation through the transscleral plugs reduces the open globe length resulting in a safer procedure, especially for vitrectomized eyes.
Effect of smoking on the macula and optic nerve integrity using optical coherence tomography angiography
Authors: Aboud Safaa Awad-Allah , Hammouda Layla Mohamed , Saif Mohamed Yasser Said , Ahmed Samar Said 
Published: February 2021

Objective: To investigate the effect of chronic smoking on the macula and optic nerve integrity using optical coherence tomography angiography (OCTA). Methods: This prospective, comparative study involved the right eyes of 160 healthy subjects (80 smokers group, and 80 control group). OCTA scanning was performed for all subjects. All macular subfields thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, superficial and deep macular vessel density, foveal avascular zone (FAZ) area, and the macular outer retina flow area, were measured and analyzed. Results: The thickness of some macular subfields, inferior GCC, and RNFL was statistically significantly lower in the smokers’ group ( p  < 0.05). The FAZ area was 0.409  ± 0.048 mm2 in the smokers' group and 0.327  ± 0.055 mm2 in the control group ( p  < 0.001). The superficial foveal VD was 31.35  ± 5.79% in the smokers’ group and 33.63  ± 4.78% in the control group ( p  = 0.06). The deep foveal VD was 39.38  ± 4.56% in the smokers’ group and 34.15  ± 6.57% in the control group ( p  ≤ 0.001). The superficial and deep parafoveal VD was 52.09  ± 4.56% and 59.99  ± 2.25% respectively in the smokers’ group, and 54.75  ± 2.30% and 55.58  ± 4.69% respectively in the control group ( p  < 0.05). The macular outer retina flow area was 1.29  ± 0.12 mm2 in the smokers’ group and 1.16  ± 0.11 mm2 in the control group ( p  < 0.001). Conclusion: Chronic smoking affected the integrity of the macula and optic nerve. It decreased the macular VD, enlarged the FAZ, and increased outer retinal flow area.
Peripherally inserted central catheter versus totally implanted venous port for delivering medium- to long-term chemotherapy: A cost-effectiveness analysis based on propensity score matching
Authors: Wang Kairong , Zhou Yingfeng , Huang Na , Lu Zhenqi , Zhang Xiaoju 
Published: February 2021

Background: Peripherally inserted central catheters (PICCs) and totally implanted vascular access ports (PORTs) have been widely used for medium- to long-term chemotherapy. PICCs are associated with lower insertion cost, but higher complication rates than PORTs. However, there is a paucity of cost-effectiveness comparisons between the devices. We aimed to compare the cost-effectiveness of PICCs and PORTs for medium- to long-term chemotherapy from catheter insertion to removal. Methods: A cost-effectiveness analysis was conducted based on propensity score matching (PSM) from the hospital perspective. Data were collected from a retrospective cohort study. The total cost outcome comprised insertion, maintenance, removal and complication costs. The effectiveness outcome was the complication-free rate. The primary and supplemental outcomes were cost-effectiveness ratios (CERs) and incremental cost-effectiveness ratios (ICERs). Results: A total of 1050 patients (after PSM for 417 patients) were included. The average total cost for 3–6 month ($603.55 ± 78.68 vs $1270.21 ± 128.84), 6–9 month ($731.40 ± 42.97 vs $1414.48 ± 155.43), and 9–12 month ($966.83 ± 53.78 vs $1587.76 ± 160.56) dwell times were all significantly lower for PICCs than for PORTs ( p < 0.001). PICCs were associated with significantly lower complication-free rates than PORTs during the 3–6 month (65.22% vs 90.58%, p < 0.001), 6–9 month (53.33% vs 91.80%, p < 0.001), and 9–12 month (44.44% vs 88.46%, p = 0.015) dwell times. Ultimately, PICCs were associated with lower CERs than PORTs for the 3–6 month (928.54 vs 1395.84) and 6–9 month (1380.00 vs 1537.48) but higher CER for the 9–12 month (2197.34 vs 1804.27) dwell times. ICERs were 2564.08 and 1751.49 with dwell times of 3–6 months and 6–9 months, respectively. Conclusion: This study provided economic evidence that informs vascular access device choice for medium- to long-term chemotherapy. For 3–9 month dwell times, PICCs were more cost-effective than PORTs. Furthermore, ICERs were applied and the choice was determined by willingness-to-pay. For 9–12 month dwell times, PORTs might be more cost-effective than PICCs, and studies with larger sample size would be needed to verify this finding in the future.
The Oncolytic Activity of Myxoma Virus against Soft Tissue Sarcoma Is Mediated by the Overexpression of Ribonucleotide Reductase
Authors: Woo Yanghee , Warner Susanne G , Geha Rula , Stanford Marianne M , Decarolis Penelope , Rahman Masmudur M , Singer Samuel , McFadden Grant , Fong Yuman 
Published: February 2021

Background: Myxoma virus (MYXV) is an oncolytic poxvirus that lacks the gene for 1 of the subunits of ribonucleotide reductase (RR), a crucial DNA synthesis and repair enzyme. The overexpression of RR has been implicated in the invasiveness of several cancers, including soft tissue sarcomas (STS). The purpose of the study was to investigate the oncolytic efficacy of MYXV in STS with different levels of RR expression. Methods: The oncolytic effect of recombinant MYXV was evaluated in 4 human STS cell lines, LS141 (a dedifferentiated liposarcoma), DDLS8817 (a dedifferentiated liposarcoma), RDD2213 (recurrent dedifferentiated liposarcoma), and HSSYII (a synovial sarcoma) using infectivity and cytotoxicity assays. Following the overexpression of RRM2 by cDNA transfection and silencing of RRM2 by siRRM2 in these STS cell lines, the RRM2 expression levels were analyzed by Western blot. Results: We observed a direct correlation between viral oncolysis and RRM2 mRNA levels ( R = 0.96) in STS. Higher RRM2 expression was associated with a more robust cell kill. Silencing the RRM2 gene led to significantly greater cell survival (80%) compared with the control group ( P = .003), whereas overexpression of the RRM2 increased viral oncolysis by 33% ( P < .001). Conclusions: Our results show that the oncolytic effects of MYXV correlate directly with RR expression levels and are enhanced in STS cell lines with naturally occurring or artificially induced high expression levels of RR. Myxoma virus holds promise in the treatment of advanced soft tissue cancer, especially in tumors overexpressing RR.
Prognostic Value of Pretreatment D-Dimer Level in Small-Cell Lung Cancer: A Meta-Analysis
Authors: Li Jialong , Wang Yan , Li Jue , Che Guowei 
Published: February 2021

Purpose: Pretreatment plasma d-dimer has been reported to be a potential prognostic indicator of lung cancer. To determine the prognostic significance of pretreatment d-dimer level in predicting clinical outcomes, such as the overall survival (OS) and progression-free survival (PFS), of patients with small cell lung cancer (SCLC). Methods: A systematic search in PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, SinoMed, Wanfang and VIP databases was performed to identify available studies. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were applied to assess the association of pretreatment d-dimer level with prognosis of SCLC patients. All statistical analyses were conducted via the STATA 12.0 version software. Results: A total of 7 studies involving 964 patients were included in this meta-analysis and all patients were from China. The results showed that elevated pretreatment d-dimer level was significantly correlated with worse OS (HR = 1.90, 95% CI: 1.55-2.34, P < 0.001) and PFS (HR = 1.52, 95% CI: 1.24-1.85, P<0.001). Subgroup analyses based on the treatment, d-dimer cut-off, detection method and source of HR were also performed to further verify the prognostic value of pretreatment d-dimer level in SCLC. Conclusions: Pretreatment blood concentration of d-dimer may deserve as a reliable factor to predict prognosis of Chinese patients with SCLC. More well-designed prospective studies with large samples are still needed to verify our findings.
Evidence for a Window of Enhanced Plasticity in the Human Motor Cortex Following Ischemic Stroke
Authors: Hordacre Brenton , Austin Duncan , Brown Katlyn E. , Graetz Lynton , Pareés Isabel , De Trane Stefania , Vallence Ann-Maree , Koblar Simon , Kleinig Timothy , McDonnell Michelle N. , Greenwood Richard , Ridding Michael C. , Rothwell John C. 
Published: February 2021

Background In preclinical models, behavioral training early after stroke produces larger gains compared with delayed training. The effects are thought to be mediated by increased and widespread reorganization of synaptic connections in the brain. It is viewed as a period of spontaneous biological recovery during which synaptic plasticity is increased. Objective To look for evidence of a similar change in synaptic plasticity in the human brain in the weeks and months after ischemic stroke. Methods We used continuous theta burst stimulation (cTBS) to activate synapses repeatedly in the motor cortex. This initiates early stages of synaptic plasticity that temporarily reduces cortical excitability and motor-evoked potential amplitude. Thus, the greater the effect of cTBS on the motor-evoked potential, the greater the inferred level of synaptic plasticity. Data were collected from separate cohorts (Australia and UK). In each cohort, serial measurements were made in the weeks to months following stroke. Data were obtained for the ipsilesional motor cortex in 31 stroke survivors (Australia, 66.6 ± 17.8 years) over 12 months and the contralesional motor cortex in 29 stroke survivors (UK, 68.2 ± 9.8 years) over 6 months. Results Depression of cortical excitability by cTBS was most prominent shortly after stroke in the contralesional hemisphere and diminished over subsequent sessions ( P = .030). cTBS response did not differ across the 12-month follow-up period in the ipsilesional hemisphere ( P = .903). Conclusions Our results provide the first neurophysiological evidence consistent with a period of enhanced synaptic plasticity in the human brain after stroke. Behavioral training given during this period may be especially effective in supporting poststroke recovery.
Investigating Therapies for Freezing of Gait Targeting the Cognitive, Limbic, and Sensorimotor Domains
Authors: Chow Rebecca , Tripp Bryan P. , Rzondzinski Daniel , Almeida Quincy J 
Published: February 2021

Background Freezing of gait (FOG) is arguably the most disabling motor symptom experienced with Parkinson’s disease (PD), but treatments are extremely limited due to our poor understanding of the underlying mechanisms. Three cortical domains are postulated in recent research (ie, the cognitive, limbic, and sensorimotor domains), thus, treatments targeting these mechanisms of FOG may potentially be effective. Cognitive training, cognitive behavioral therapy (CBT, a well-known anxiety intervention), and proprioceptive training may address the cognitive, limbic, and sensorimotor domains, respectively. Objective To investigate whether these 3 treatments could improve functional outcomes of FOG. Methods In a single-blind, randomized crossover design, 15 individuals with PD and FOG were randomized into different, counterbalanced orders of receiving the interventions. Each consisted of eight 1-hour sessions, twice weekly for 4 weeks. FOG severity was assessed as the primary outcome using a novel gait paradigm that was aimed at evoking FOG when the cognitive, limbic, or sensorimotor domains were independently challenged. Results FOG severity significantly improved after the cognitive intervention, with strong trends toward improvement specifically in the baseline and cognitive-challenge assessment conditions. CBT, as the anxiety intervention, resulted in significantly worse FOG severity. In contrast, proprioceptive training significantly improved FOG severity, with consistent trends across all conditions. Conclusions The cognitive and proprioceptive treatments appeared to improve different aspects of FOG. Thus, either of these interventions could potentially be a viable treatment for FOG. However, although the results were statistically significant, they could be sensitive to the relatively small number of participants in the study. Considering the significant results together with nonsignificant trends in both FOG and gait measures, and given equal time for each intervention, proprioceptive training produced the most consistent indications of benefits in this study. (clinicaltrials.gov NCT03065127).
Effect of the use of an iPad on the attention span of a child with Smith Magenis Syndrome: A single case study
Authors: Rikken-Evers MT , Smith KD , Sterkenburg PS 
Published: February 2021

Aims: To assess the effectiveness of iPad use on the attention span of a child with Smith Magenis Syndrome (n = 1), compared to attention span while working on the same tasks manually. Methods: An AB design with a baseline and an intervention phase was used. Three manual tasks were chosen for the baseline, which matched the participant’s intellectual age by the Early Intervention Method: a jigsaw puzzle (six pieces), a shape sorter, and matching pictures. These same tasks were performed on an iPad during the intervention phase. Six baseline and nine intervention phase films were included in the analysis. The 15 films were independently scored twice by two observers: once to observe the types of distractions that occurred (such as standing up from the chair, calling the teacher, or turning around on the chair), and a second time to measure the effective working time. Results: iPad use led to a 45% decrease in the number of total distractions. The effective working time improved by 8% and showed a more consistent range compared to working on tasksbmanually. While task enjoyment was not directly measured, the observers and teachers agreed that working on the iPad appeared to be more enjoyable. Conclusions: In this single case study the participant showed that in his case iPad use can be effective in decreasing his distractions and therefore can improve his attention span. Enjoyment was higher while working with the iPad than performing tasks manually. This technology could therefore create more learning engagement for the participant, which could positively impact his behavior. Further research into iPad implementation for children with intellectual disabilities, poor fine motor skills, and/or attention deficits is needed.
To HIIT or not to HIIT? The question pregnant women may be searching for online: a descriptive observational study
Authors: Nagpal TS , Everest C , Goudreau AD , Manicks M , Adamo KB 
Published: February 2021

Aims: An increasingly popular exercise modality for women is high-intensity interval training (HIIT). Limited research has assessed HIIT during pregnancy, and as a result, pregnant women may inquire about HIIT on their own through online searches. The purpose of this study was to systematically search and critically evaluate online resources that women may access when inquiring about performing HIIT during pregnancy. Methods: Following previously published methodology, we systematically examined the online search engine Google with the terms ‘HIIT’ and ‘pregnancy’. Using the 2019 Canadian Guideline for Physical Activity throughout Pregnancy as a reference, we identified evidence-based safety recommendations that apply to all prenatal exercise regimes. All selected links were assessed for whether or not they included evidence-based exercise and pregnancy safety recommendations. Descriptive analyses were performed to report the frequency of each construct. Results: Seventy-six links were retrieved, and 33 relevant links were selected for inclusion. The majority of the retrieved links recommended that women should consult a healthcare provider before beginning any exercise programme (67%), and modify the intensity and types of exercises in the active HIIT bout based on general pregnancy-related changes (73%) and individual comfort level (55%). Just under half of the links recommended modifying intensity based on prepregnancy activity level (46%), offered trimester-specific recommendations (42%), and only 12% mentioned contraindications to exercise. Conclusion: Publicly accessible information online on HIIT during pregnancy does not routinely adhere to evidence-based safety recommendations for prenatal exercise. Further research on HIIT during pregnancy and public dissemination of findings is required.