bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Effectiveness of TEVAR in Native Proximal Landing Zone 2 for Chronic Type B Aortic Dissection in Patients With Genetic Aortic Syndrome
Authors: Eleshra Ahmed , Panuccio Giuseppe , Spanos Konstantinos , Rohlffs Fiona , von Kodolitsch Yskert , Kölbel Tilo 
Published: December 2021

Objectives The aim of this study is to report the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) in a native proximal landing zone (PLZ) 2 for chronic type B aortic dissection (TBAD) patients with genetic aortic syndrome (GAS). Methods A retrospective review of a single center database to identify patients with GAS treated with TEVAR in native PLZ 2 for chronic TBAD and thoracic false lumen aneurysm between February 2012 and February 2018 was undertaken. Results In total, 31 patients with GAS (24 Marfan syndrome [MFS], 5 Loeys-Dietz syndrome [LDS], and 2 vascular Ehlers-Danlos syndrome [vEDS]) were treated by endovascular repair. Nineteen patients were treated by TEVAR as index procedures with 8 patients (5 females, mean age = 55, range = 36–79 years old) receiving TEVAR in native PLZ 2. Left subclavian artery (LSA) perfusion was preserved in all 8 patients: by left common carotid artery-LSA bypass in 6 patients, chimney stenting of the LSA in 1 patient, and partial coverage of LSA ostium in 1 patient. Technical success was achieved in all patients (100%). There was no 30 day mortality (0%). The 30 day morbidity (0%) was free from major complications. The median follow-up was 40 months (range = 7–79). One patient died due to non-aortic-related cause. Native PLZ 2 was free from complications in MFS patients (5/8). Two patients with LDS developed type Ia endoleak with aneurysmal progression. One patient was treated by proximal extension with a double inner branched arch stent-graft landing in the replaced ascending aorta. The other one was treated with frozen elephant trunk. Conclusion Thoracic endovascular aortic repair in native PLZ 2 was safe and effective with no early or midterm PLZ complications in patients with MFS with chronic TBAD in this limited series. Native PLZ 2 is not safe in patients with LDS and should only be used in emergencies as a bridging to open repair.
Understanding Patients’ and Living Donors’ Kidney Paired Donation Educational Experiences and Recommendations for Improvement
Authors: Pines Rachyl , Iraheta Yaquelin Arevalo , Dahmani Katia A. , Cooper Matthew , Waterman Amy D. 
Published: December 2021

Introduction Educating potential kidney patients and living donors about the risks and benefits of kidney paired donation to ensure they make informed decisions is complex. This study aimed to increase understanding of patients’ and donors’ decision-making about donation, the educational content they received, and their recommendations for educational improvements. Method We conducted a mixed methods study, including semistructured interviews and quantitative surveys, with 43 participants (25 living donors; 18 kidney recipients). Findings Participants reported that the benefits of paired donation motivated them to participate (ie, helping multiple people, receiving a transplant sooner, flexible timing of donation). Although deciding to participate in paired donation was a systematic, logical, and carefully considered process for some. For most, it was a quickly made, often emotion-based decision. Paired donation educational content on different topics varied, with recipients reporting receiving less information than donors about donor protections and processes to ameliorate the challenges faced, such as broken swaps and chains, and delays in matching. Those who faced challenges requested more information about donor protections and support during and after paired donation. Although many acknowledged their transplant coordinators’ helpfulness, participants also recommended being more proactive in learning about kidney paired donation and speaking to former donors and recipients beforehand. Discussion Standardized, health literate educational content addressing the gaps and variability in education received may help increase paired donation informed decision-making.
Chronic subdural hematoma recurrence due to contralateral neovascularization following middle meningeal artery embolization
Authors: Hubbard Zachary S , Al Kasab Sami , Porto Guilherme B , Spiotta Alejandro 
Published: December 2021

Introduction Chronic subdural hematoma (CSDH) is one of the most commonly encountered neurosurgical diseases. Middle meningeal artery embolization (MMAE) is a technique for the management of CSDH that has elicited promising results. Despite the encouraging results of MMAE, recurrence does occur. One uncommon mechanism for recurrence of CSDH is by means of neovascularization of the contralateral middle meningeal artery (MMA). We describe two cases of CSDH recurrence by means of contralateral middle meningeal artery neovascularization treated with contralateral MMAE. Methods We identified two cases of recurrent subdural hematoma secondary to neovascularization following treatment with contralateral MMAE. Results Two patients initially treated with MMAE were identified with CSDH recurrence secondary to contralateral MMA neovascularization. There was no traumatic or coagulopathic contribution to CSDH recurrence. In both cases, patients underwent contralateral MMAE. Both patients were neurologically intact with radiographic improvement of CSDH at follow up. Conclusions Re-accumulation of SDH following MMAE by means of contralateral MMA neovascularization is a rare subtype of subdural hematoma (SDH) recurrence following MMAE. Within the context of re-accumulation of SDH following MMAE, catheter angiography is an important diagnostic investigation to elucidate the etiology of the recurrence. Furthermore, when angiography reveals neovascularization of the contralateral MMA, embolization of the contralateral MMA achieves good clinical and radiographic result.
Results of a study of remote reporting over virtual applications and using visually calibrated monitors
Authors: Lai Yusheng Keefe , Kuo Benjamin Jyhhan , Lim Kheng Choon , Lim Chee Yeong , Low Albert Su Chong , Png Meng Ai 
Published: December 2021

Background and Objectives The purpose of this study is to examine differences in image quality, discrepancy rates, productivity and user experience between remote reporting over Virtual Application (VA) using visually calibrated monitors, and reporting using diagnostic grade workstations in hospital premises. Methods Three specialist accredited radiologists examined and provisionally reported outpatient CT and MR studies over PACS delivered as a VA, using visually calibrated monitors from their homes. They then proceeded to view the same studies within hospital premises and issue a final report. Surveys were filled out for each imaging study. Discrepancies were reviewed and assigned RADPEER scores. Results A total of 51 outpatient CT and MRIs were read. Relative to hospital premise reporting, on a Likert scale of 5 (the higher the better), average image quality was 3.9, speed of loading and image manipulation was 4.4 and productivity was 4.1. Remote reporting user experience did not differ significantly between CT versus MRI studies. Complete concordance rate was 80.4% (41/51) and only one of the studies had a significant discrepancy, which may have been due to extra time given to interpretation. All three radiologists reported factors influencing image display and quality as the top factor impacting remote reporting throughput. Conclusions Remote reporting over VA with visually calibrated monitors for CT and MR can be useful in periods of staffing difficulty to augment on-site radiologists, though attention must be paid to its limitations and policies defined by local leadership with reference to relevant national position
Prevalence and Factors Associated With Oral Cavity and Pharyngeal Cancer Screening in a Rural Population
Authors: Matos Sophia , Boakye Eric Adjei , Crosby Dana , Sharma Arun 
Published: December 2021

Objective(1) To quantify the prevalence of provider recommendation and receipt of oral cavity and pharyngeal cancer (OCPC) screening and (2) to examine the factors associated with OCPC screening recommendation and receipt among adults.Study DesignCross‐sectional.SettingRural counties in central Illinois.MethodsThis study among adults (N = 145) was conducted between January 1 and June 30, 2017. The outcomes of interest were provider recommendation and receipt of OCPC screening. Multivariable logistic regression models were used to examine the association between (1) sociodemographic, health care access and utilization, and OCPC risk factors and (2) provider recommendation and receipt of OCPC screening.ResultsThe prevalence of provider recommendation and receipt of OCPC screening was 12.4% and 28.3%, respectively. Approximately 15% of current smokers, 13% of participants who consume alcohol, and 10% of participants with ≥5 lifetime sexual partners had received an OCPC screening recommendation. OCPC screening rates were 19% for current smokers, 30% for those who consume alcohol, and 32% for those with ≥5 lifetime sexual partners. In the adjusted analyses, respondents with ≥5 partners (adjusted odds ratio, 3.10 [95% CI, 1.25‐7.66]) had a higher odds of receiving OCPC screening than those with <5. There were no significant associations between other OCPC risk factors and provider recommendation and receipt of OCPC screening.ConclusionOCPC screening recommendation and receipt were low; only number of lifetime sexual partners was associated with OCPC screening receipt. Our findings suggest that rural populations may be vulnerable to late‐stage diagnosis of OCPC, and interventions to help improve screening rates are warranted.
Providing diabetes education to patients with chronic kidney disease: A survey of diabetes educators in Ontario, Canada
Authors: Clemens Kristin K , Ouédraogo Alexandra M , Liu Selina L , Bleah Paulina , Mikalachki Amanda , Spaic Tamara 
Published: December 2021

Background Patients with diabetes and chronic kidney disease (CKD) have complex diabetes care needs. Diabetes educators can play an important role in their clinical care. Aim To understand diabetes educators’ experience providing diabetes support to patients with CKD and elicit their view on the additional care needs of this population. Methods We conducted a quantitative online survey of diabetes educators between May 2019 and May 2020. We surveyed English-speaking educators actively practicing in Ontario, Canada for at least 1 year. We recruited them through provincial Diabetes Education Programs and Diabetes Education Section Chairs of Diabetes Canada. Results We made email contact with 219/233 (94%) Diabetes Education Programs and 11/12 (92%) provincial Diabetes Canada Section Chairs. 122 unique diabetes educators submitted complete surveys (survey participation rate ∼79%). Most worked in community education programs (91%). Almost half were registered nurses (48%), and 39% had practiced for more than 15 years. Respondents noted difficulty helping patients balance complex medical conditions (19%), faced socioeconomic barriers (17%), and struggled to provide dietary advice (16%). One-third were uncertain of how to support those receiving dialysis. Eighty-five percent felt they needed more training and education to care for this high-risk group. When asked about the care needs of patients with CKD, almost all (90%) felt that patients needed more diabetes support in general. Improvement in care coordination was most commonly suggested (38%). Conclusions In this study of the diabetes educators’ experience treating patients with diabetes and CKD, respondents noted numerous challenges. There may be opportunities to better support both diabetes care professionals, and patients who live with multiple medical comorbidities.
The influence of microscale lithological layering and fluid availability on the metamorphic development of garnet and zircon: insights into dissolution–reprecipitation processes
Authors: McElhinney Tara R. , Dempster Tim J. , Chung Peter 
Published: December 2021

AbstractThe response of garnet and zircon to prograde amphibolite-facies metamorphism in late Proterozoic mica schists from the Scottish Highlands has been investigated. Spatial analysis of zircon populations using scanning electron microscopy was undertaken in Dalradian Schists that have undergone a sequence of prograde garnet growth and localised breakdown reactions involving coupled dissolution–reprecipitation. Fluid availability and matrix permeability strongly control this metamorphic response and different generations of garnet contain radically different populations of metamorphic micro-zircon and associated changes in the detrital zircon population. Micro-zircon abundance increases during garnet growth, whereas that of detrital zircon decreases. The mineralogy of the matrix influences zircon abundance in porphyroblast phases, where garnet overgrows a micaceous matrix zircon-rich garnet forms and where it overgrows a quartzofeldspathic matrix the result is zircon-poor garnet. Following garnet growth, micro-zircon abundance decreases at each stage of the prograde reaction history, with sillimanite-zone schists containing the lowest abundance, suggesting micro-zircons are texturally less stable at staurolite- and sillimanite-grade metamorphism. Micro-zircons are distributed evenly across host minerals in the matrix, with the exception of retrograde chlorite where micro-zircons are absent due to fluids removing Zr before new zircon can precipitate. There is an overall decrease in the mode of zircon at each stage of the reaction history, indicating that zircon is a highly reactive phase during amphibolite-facies metamorphism and is very sensitive to individual prograde and retrograde reactions.
The prognostic and clinical significance of IFI44L aberrant downregulation in patients with oral squamous cell carcinoma
Authors: Ou Deming , Wu Ying 
Published: December 2021

Abstract
Background
It is a basic task in high-throughput gene expression profiling studies to identify differentially expressed genes (DEGs) between two phenotypes. RankComp, an algorithm, could analyze the highly stable within-sample relative expression orderings (REOs) of gene pairs in a particular type of human normal tissue that are widely reversed in the cancer condition, thereby detecting DEGs for individual disease samples measured by a particular platform.

Methods
In the present study, Gene Expression Omnibus (GEO) Series (GSE) GSE75540, GSE138206 were downloaded from GEO, by analyzing DEGs in oral squamous cell carcinoma based on online datasets using the RankComp algorithm, using the Kaplan-Meier survival analysis and Cox regression analysis to survival analysis, Gene Set Enrichment Analysis (GSEA) to explore the potential molecular mechanisms underlying.

Results
We identified 6 reverse gene pairs with stable REOs. All the 12 genes in these 6 reverse gene pairs have been reported to be associated with cancers. Notably, lower Interferon Induced Protein 44 Like (IFI44L) expression was associated with poorer overall survival (OS) and Disease-free survival (DFS) in oral squamous cell carcinoma patients, and IFI44L expression showed satisfactory predictive efficiency by receiver operating characteristic (ROC) curve. Moreover, low IFI44L expression was identified as risk factors for oral squamous cell carcinoma patients’ OS. IFI44L downregulation would lead to the activation of the FRS-mediated FGFR1, FGFR3, and downstream signaling pathways, and might play a role in the PI3K-FGFR cascades.

Conclusions
Collectively, we identified 6 reverse gene pairs with stable REOs in oral squamous cell carcinoma, which might serve as gene signatures playing a role in the diagnosis in oral squamous cell carcinoma. Moreover, high expression of IFI44L, one of the DEGs in the 6 reverse gene pairs, might be associated with favorable prognosis in oral squamous cell carcinoma patients and serve as a tumor suppressor by acting on the FRS-mediated FGFR signaling.
Factors influencing online orthopedic doctor–patient consultations
Authors: Lei Ping , Zheng Jianjun , Li Yun , Li Zhongjiang , Gao Fei , Li Xuesong 
Published: December 2021

AbstractBackgroundOnline doctor–patient consultation is a new option for orthopedic patients in China to obtain a diagnosis and treatment advice. This study explores the factors associated with online consultation to formulate operational guidelines for managing online consultations in an online medical community (OMC).MethodsAn empirical model was developed to identify the factors that influence online orthopedic doctor–patient consultations in an OMC while focusing on the perceived value of and perceived trust in online consultations. The moderating effects of different risk categories of orthopedic diseases were also considered. Data from 339 feedback surveys from orthopedic patients who used online consultation services and Stata software version 14.0 were used to estimate the model parameters and test the robustness of the empirical model.ResultsOf those who completed the feedback surveys, 53.42% were female patients, 82.27% were between 18 and 60 years old, and 61.98% sought consultations online more than 2 times per year. Model analysis demonstrated that the regression coefficients of the perceived value of and perceived trust in online consultations are 0.489 (p < 0.01) and 0.505 (p < 0.01), respectively. The interaction coefficient between disease risk and perceived value is 0.336 (p < 0.01), and the interaction coefficient between disease risk and perceived trust is − 0.389 (p < 0.01).ConclusionsOrthopedic patients’ perceived value of and perceived trust in online consultations in an OMC can significantly influence their intention to seek online disease diagnosis and treatment consultations. The effects of perceived value and perceived trust on patients' intention to consult vary significantly across different disease risk categories. Therefore, enhancing the perceived value and perceived trust of orthopedic patients is an important component of OMC operation and management.
A comprehensive gene-centric pleiotropic association analysis for 14 psychiatric disorders with GWAS summary statistics
Authors: Lu Haojie , Qiao Jiahao , Shao Zhonghe , Wang Ting , Huang Shuiping , Zeng Ping 
Published: December 2021

Abstract
Background
Recent genome-wide association studies (GWASs) have revealed the polygenic nature of psychiatric disorders and discovered a few of single-nucleotide polymorphisms (SNPs) associated with multiple psychiatric disorders. However, the extent and pattern of pleiotropy among distinct psychiatric disorders remain not completely clear.

Methods
We analyzed 14 psychiatric disorders using summary statistics available from the largest GWASs by far. We first applied the cross-trait linkage disequilibrium score regression (LDSC) to estimate genetic correlation between disorders. Then, we performed a gene-based pleiotropy analysis by first aggregating a set of SNP-level associations into a single gene-level association signal using MAGMA. From a methodological perspective, we viewed the identification of pleiotropic associations across the entire genome as a high-dimensional problem of composite null hypothesis testing and utilized a novel method called PLACO for pleiotropy mapping. We ultimately implemented functional analysis for identified pleiotropic genes and used Mendelian randomization for detecting causal association between these disorders.

Results
We confirmed extensive genetic correlation among psychiatric disorders, based on which these disorders can be grouped into three diverse categories. We detected a large number of pleiotropic genes including 5884 associations and 2424 unique genes and found that differentially expressed pleiotropic genes were significantly enriched in pancreas, liver, heart, and brain, and that the biological process of these genes was remarkably enriched in regulating neurodevelopment, neurogenesis, and neuron differentiation, offering substantial evidence supporting the validity of identified pleiotropic loci. We further demonstrated that among all the identified pleiotropic genes there were 342 unique ones linked with 6353 drugs with drug-gene interaction which can be classified into distinct types including inhibitor, agonist, blocker, antagonist, and modulator. We also revealed causal associations among psychiatric disorders, indicating that genetic overlap and causality commonly drove the observed co-existence of these disorders.

Conclusions
Our study is among the first large-scale effort to characterize gene-level pleiotropy among a greatly expanded set of psychiatric disorders and provides important insight into shared genetic etiology underlying these disorders. The findings would inform psychiatric nosology, identify potential neurobiological mechanisms predisposing to specific clinical presentations, and pave the way to effective drug targets for clinical treatment.
Biodegradable reduce expenditure bioreactor for augmented sonodynamic therapy via regulating tumor hypoxia and inducing pro-death autophagy
Authors: Zou Weijuan , Hao Junnian , Wu Jianrong , Cai Xiaojun , Hu Bing , Wang Zhigang , Zheng Yuanyi 
Published: December 2021

Abstract
Backgrounds
Sonodynamic therapy (SDT) as an emerging reactive oxygen species (ROS)-mediated antitumor strategy is challenged by the rapid depletion of oxygen, as well as the hypoxic tumor microenvironment. Instead of the presently available coping strategies that amplify the endogenous O2 level, we have proposed a biodegradable O2 economizer to reduce expenditure for augmenting SDT efficacy in the present study.

Results
We successfully fabricated the O2 economizer (HMME@HMONs-3BP-PEG, HHBP) via conjugation of respiration inhibitor 3-bromopyruvate (3BP) with hollow mesoporous organosilica nanoparticles (HMONs), followed by the loading of organic sonosensitizers (hematoporphyrin monomethyl ether; HMME) and further surface modification of poly(ethylene glycol) (PEG). The engineered HHBP features controllable pH/GSH/US-sensitive drug release. The exposed 3BP could effectively inhibit cell respiration for restraining the oxygen consumption, which could alleviate the tumor hypoxia conditions. More interestingly, it could exorbitantly elevate the autophagy level, which in turn induced excessive activation of autophagy for promoting the therapeutic efficacy. As a result, when accompanied with suppressing O2-consumption and triggering pro-death autophagy strategy, the HHBP could achieve the remarkable antitumor activity, which was systematically validated both in vivo and in vitro assays.

Conclusions
This work not only provides a reduce expenditure means for enduring SDT, but also represents an inquisitive strategy for tumor treatments by inducing pro-death autophagy.

Graphical Abstract