bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation and outcomes of a pharmacist-led oral chemotherapy clinic at VA Maine Healthcare System
Authors: Sargent Whitney , Whalley Adam 
Published: September 2021

Background Patients undergoing intravenous chemotherapy tend to receive more structured follow-up and closer monitoring than those taking oral chemotherapy. The management of oral chemotherapy at our facility was historically segmented and weighed heavily on veteran self-advocacy. It was hypothesized that routine check-ins with a clinical pharmacy specialist with a scope of practice would allow for a more proactive, supportive approach to care. Objective The primary purpose of this quality improvement project is to ascertain the impacts of a pharmacist-led oral chemotherapy clinic at the VA Maine Healthcare System. Methods: Starting January 7, 2019, all patients filling an oral medication(s) for cancer treatment were considered for enrollment into the pharmacist-run clinic at the time of medication approval. The pharmacist contacted each patient by phone at patient-specific intervals determined by drug-specific lab monitoring requirements, side effect prevalence, refill due date, and overall patient preference. The total number of interventions was tallied by intervention category. Medication adherence was assessed as a secondary outcome by comparing medication possession ratios preclinic and postclinic implementation. Results From January 7, 2019, to January 5, 2020, there were a total of 698 interventions made by the clinical pharmacist. These impacts are a composite of pharmacologic ( n = 141), nonpharmacologic ( n = 115), and surveillance ( n = 442) interventions. Medication possession increased from 92% to 96% ( p < 0.05). Conclusion A pharmacist-led oral chemotherapy clinic allows for a variety of clinically significant interventions and improved monitoring of patients on oral anticancer medication(s). Providing proactive follow-up with a scoped pharmacist improved medication compliance and improved the quality of care for our veterans.
A randomized controlled trial to assess the influence of a picture-based antiemetic medication calendar on medication-taking behavior in adults receiving chemotherapy
Authors: Maximos Mira , Smith Kelly , Harris Venita , McFarlane Thomas , Blay Jonathan , Hahn Karin , Chang Feng 
Published: September 2021

Objective A prospective open-label randomized controlled trial to assess the role of a picture-based medication calendar on adherence to antiemetic regimens for adult patients receiving chemotherapy and assess the effect on other medication taking behaviors as well as patient satisfaction with the tool. Methods Participants were randomly assigned 1:1 to routine care with or without calendar. Results Adherence, stratified by education (university or postgraduate, p = 0.09; grade school, high school or college p = 0.32), was non-significantly different between study arms. At least 70% of intervention arm participants moderately or completely agreed that the calendar helped with medication taking behaviors. There was no statistical difference between study arms for perceived regimen complexity ( p = 0.16). Medication Use and Self Efficacy score (adjusted for age) used to assess perceived self-efficacy with medication taking behaviors were not statistically significant between study arms ( p = 0.09). Conclusion The picture-based medication calendar did not statistically affect adherence to scheduled antiemetics among outpatients receiving chemotherapy for solid organ tumor origins. However, participants indicated that the calendar was effective for keeping track of medications, had an easy-to-understand layout, and provided help around when and how to take medications related to the oncology regimen.
Systematic Review on the Mid-Term Outcomes of Elective Endovascular Aneurysm Sealing in Comparison to Endovascular Aneurysm Repair
Authors: Zoethout Aleksandra C , Hochstenbach Iris , van der Laan Maarten J , de Vries Jean-Paul P.M , Reijnen Michel M.P.J. , Zeebregts Clark J 
Published: September 2021

Introduction The Nellix endovascular aneurysm sealing (EVAS) system has been a topic of discussion. Early results were promising but did not deliver on the long-term and the device has been recalled from the market. This study compares literature for EVAS and conventional endovascular aneurysm repair (EVAR). Methods A systematic review and analysis was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane Library were searched and identified the eligible studies. Proportion rates for the outcomes of interest were extracted. Subgroup analyses were performed for EVAS and EVAR. Results A total of 12 studies were included (EVAS n = 4, EVAR n = 8) including 10,255 patients (EVAS n = 784, EVAR n = 9441). The longest duration of follow-up was 3.4 years for EVAS and 5.0 years for EVAR studies. Throughout follow-up the overall all-cause mortality rates were 6% for EVAS and 13% for EVAR, and endoleak of any type was described in 10% of EVAS and 17% of EVAR patients. The migration rate >10 mm was 8% for EVAS and 0% for EVAR and aneurysm growth >5 mm was found in 11% of EVAS and 3% of EVAR cases. Total reintervention rate was 13% for EVAS and 7% for EVAR patients. For all analyzed outcome parameters heterogeneity was >50%. Conclusion There is a tendency toward lower mortality and overall endoleak rates for EVAS compared to EVAR but with a higher rate of migration, aneurysm growth, and reintervention. Despite lower overall endoleak rates there was a tendency toward less type II and more type I endoleaks after EVAS compared to EVAR. Substantial heterogeneity however limits robust statistical analyses, and is probably caused by significant instructions for use breach in EVAS-treated patients. We call for more high-quality and long-term follow-up studies on both EVAS and EVAR in order to confirm the trends found in this study.
Motor Cortical Network Flexibility is Associated With Biomechanical Walking Impairment in Chronic Stroke
Authors: Palmer Jacqueline A. , Kesar Trisha M. , Wolf Steven L. , Borich Michael R. 
Published: September 2021

Background: The inability to flexibly modulate motor behavior with changes in task demand or environmental context is a pervasive feature of motor impairment and dysfunctional mobility after stroke. Objective: The purpose of this study was to test the reactive and modulatory capacity of lower-limb primary motor cortical (M1) networks using electroencephalography (EEG) measures of cortical activity evoked by transcranial magnetic stimulation (TMS) and to evaluate their associations with clinical and biomechanical measures of walking function in chronic stroke. Methods: TMS assessments of motor cortex excitability were performed during rest and active ipsilateral plantarflexion in chronic stroke and age-matched controls. TMS-evoked motor cortical network interactions were quantified with simultaneous EEG as the post-TMS (0–300 ms) beta (15–30 Hz) coherence between electrodes overlying M1 bilaterally. We compared TMS-evoked coherence between groups during rest and active conditions and tested associations with poststroke motor impairment, paretic propulsive gait deficits, and the presence of paretic leg motor evoked potentials (MEPs). Results: Stroke ( n = 14, 66 ± 9 years, F = 4) showed lower TMS-evoked cortical coherence and activity-dependent modulation compared to controls ( n = 9, 68 ± 6 years, F = 3). Blunted reactivity and atypical modulation of TMS-evoked coherence were associated with lower paretic ankle moments for propulsive force generation during walking and absent paretic MEPs. Conclusions: Impaired flexibility of motor cortical networks to react to TMS and modulate during motor activity is distinctly associated with paretic limb biomechanical walking impairment, and may provide useful insight into the neuromechanistic underpinnings of chronic post-stroke mobility deficits.
The coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume
Authors: Haider Stefan P , Qureshi Adnan I , Jain Abhi , Tharmaseelan Hishan , Berson Elisa R , Majidi Shahram , Filippi Christopher G , Mak Adrian , Werring David J , Acosta Julian N , Malhotra Ajay , Kim Jennifer A , Sansing Lauren H , Falcone Guido J , Sheth Kevin N , Payabvash Seyedmehdi 
Published: September 2021

Background Among prognostic imaging variables, the hematoma volume on admission computed tomography (CT) has long been considered the strongest predictor of outcome and mortality in intracerebral hemorrhage. Aims To examine whether different features of hematoma shape are associated with functional outcome in deep intracerebral hemorrhage. Methods We analyzed 790 patients from the ATACH-2 trial, and 14 shape features were quantified. We calculated Spearman’s Rho to assess the correlation between shape features and three-month modified Rankin scale (mRS) score, and the area under the receiver operating characteristic curve (AUC) to quantify the association between shape features and poor outcome defined as mRS>2 as well as mRS > 3. Results Among 14 shape features, the maximum intracerebral hemorrhage diameter in the coronal plane was the strongest predictor of functional outcome, with a maximum coronal diameter >∼3.5 cm indicating higher three-month mRS scores. The maximum coronal diameter versus hematoma volume yielded a Rho of 0.40 versus 0.35 ( p = 0.006), an AUC[mRS>2] of 0.71 versus 0.68 ( p = 0.004), and an AUC[mRS>3] of 0.71 versus 0.69 ( p = 0.029). In multiple regression analysis adjusted for known outcome predictors, the maximum coronal diameter was independently associated with three-month mRS (p < 0.001). Conclusions A coronal-plane maximum diameter measurement offers greater prognostic value in deep intracerebral hemorrhage than hematoma volume. This simple shape metric may expedite assessment of admission head CTs, offer a potential biomarker for hematoma size eligibility criteria in clinical trials, and may substitute volume in prognostic intracerebral hemorrhage scoring systems.
Cardiovascular risk factors and cervical carotid plaque features on CT angiography
Authors: Benson John C , Nardi Valentina , Hunt Christopher H , Lerman Amir , Lanzino Giuseppe , Brinjikji Waleed 
Published: September 2021

Background Little is known about the impact that cardiovascular (CV) risk factors have on the formation of various carotid atherosclerotic plaque features. This study set out to assess the association between CV risk factors and plaque characteristics on computed tomography (CT) angiography (CTA). Materials and methods A retrospective review was completed of consecutive patients that underwent a carotid endarterectomy and had CTA imaging of the head and neck vasculature. Atherosclerotic plaques of both carotid arteries were evaluated for calcification(s), low-density plaque (LDP) components, ulceration(s), and degree of stenosis. Various clinical CV risk factors were assessed using medical records. Last recorded laboratory levels were dichotomized into categories: total cholesterol <200 or ≥200 mg/dL, low-density lipoprotein (LDL) <130 or ≥130 mg/dL, high-density lipoprotein <35 or ≥35 mg/dL, and triglyceride <200 or ≥200 mg/dL. Results Of 97 included patients, 62 were male (63.9%); the average age was 72.7 (standard deviation = 9.5). Calcifications were in 95/97 (97.9%) of patients (one or both carotid plaques); LDP components were in 73/97 (75.3%), and ulcerations were in 21/97 (21.6%). Elevated total cholesterol and elevated LDL levels were both associated with a higher likelihood of LDP components ( p = 0.004 and p = 0.02, respectively). There were no other statistically significant associations between individual plaque features or severity of arterial stenosis and CV risk factors. Conclusion In carotid atherosclerotic plaques, LDP components are more frequently present in one or both carotid arteries in patients with elevated total cholesterol and/or LDL levels. Such findings raise the possibility that cholesterol levels may be directly related to the formation of specific high-risk plaque features.
Cleavage of talin by calpain promotes platelet-mediated fibrin clot contraction
Authors: Fong Karen P. , Molnar Kathleen S. , Agard Nicholas , Litvinov Rustem I. , Kim Oleg V. , Wells James A. , Weisel John W. , DeGrado William F. , Bennett Joel S. 
Published: September 2021

Abstract
Blood clot contraction is driven by traction forces generated by the platelet cytoskeleton that are transmitted to fibrin fibers via the integrin αIIbβ3. Here we show that clot contraction is impaired by inhibitors of the platelet cytosolic protease calpain. We used subtiligase-mediated labeling of amino termini and mass spectrometry to identify proteolytically cleaved platelet proteins involved in clot contraction. Of 32 calpain-cleaved proteins after TRAP stimulation, 14 were cytoskeletal, most prominently talin and vinculin. A complex of talin and vinculin constitutes a mechanosensitive clutch connecting integrins bound to the extracellular matrix with the actin cytoskeleton. Accordingly, we focused on talin and vinculin. Talin is composed of an N-terminal head domain and a C-terminal rod domain organized into a series of 4- and 5-helix bundles. The bundles contain 11 vinculin binding sites (VBSs), each of which is an α-helix packed into a bundle interior and requiring structural rearrangement to initiate vinculin binding. We detected 8 calpain-mediated cleavages in talin, 2 previously identified in unstructured regions and 6 in α-helical regions in proximity to a VBS. There is evidence in vitro that applying mechanical force across talin enables vinculin binding to the talin rod. However, we found that inhibiting platelet cytoskeletal contraction had no effect on talin cleavage, indicating that talin cleavage by calpain in platelets does not require cytoskeleton-generated tensile force. Therefore, it is likely that calpain acts in the later stages of clot retraction through focal adhesion disassembly.
CD158k and PD-1 expressions define heterogeneous subtypes of Sezary syndrome
Authors: Vergnolle Inès , Douat-Beyries Claudia , Boulinguez Serge , Rieu Jean-Baptiste , Vial Jean-Philippe , Baracou Rolande , Boudot Sylvie , Cazeneuve Aurore , Chaugne Sophie , Durand Martine , Estival Sylvie , Lablanche Nicolas , Nicolau-Travers Marie-Laure , Tournier Emilie , Lamant Laurence , Vergez François 
Published: September 2021

Abstract
Sezary syndrome (SS) is a rare leukemic form of cutaneous T-cell lymphoma. Diagnosis mainly depends on flow cytometry, but results are not specific enough to be unequivocal. The difficulty in defining a single marker that could characterize Sezary cells may be the consequence of different pathological subtypes. In this study, we used multivariate flow cytometry analyses. We chose to investigate the expression of classical CD3, CD4, CD7, and CD26 and the new association of 2 markers CD158k and PD-1. We performed lymphocyte computational phenotypic analyses during diagnosis and follow-up of patients with SS to define new SS classes and improve the sensitivity of the diagnosis and the follow-up flow cytometry method. Three classes of SS, defined by different immunophenotypic profiles, CD158k+ SS, CD158k−PD-1+ SS, CD158k and PD-1 double-negative SS, showed different CD8+ and B-cell environments. Such a study could help to diagnose and define biological markers of susceptibility/resistance to treatment, including immunotherapy.
Genomic stability among O3:K6 V. parahaemolyticus pandemic strains isolated between 1996 to 2012 in American countries
Authors: Guerrero Abraham , Gomez-Gil Bruno , Lizarraga-Partida Marcial Leonardo 
Published: September 2021

Abstract
Background
The V. parahaemolyticus pandemic clone, results in the development of gastrointestinal illness in humans. Toxigenic strains of this species are frequently isolated from aquatic habitats and organisms such as mollusks and crustaceans. Reports on the isolation of the pandemic clone started in 1996, when a new O3:K6 clone was identified in Asia, that rapidly spread worldwide, becoming the predominant clone isolated from clinical cases. In this study whole genome sequencing was accomplished with an Illumina MiniSeq platform, upon six novel V. parahaemolyticus strains, that have been isolated in Mexico since 1998 and three representative genomes of strains that were isolated from reported outbreaks in other American countries, and were deposited in the GenBank. These nine genomes were compared against the reference sequence of the O3:K6 pandemic strain (RIMD 2210633), which was isolated in 1996, to determine sequence differences within American isolates and between years of isolation.

Results
The results indicated that strains that were isolated at different times and from different countries, were highly genetically similar, among them as well as to the reference strain RIMD 2210633, indicating a high level of genetic stability among the strains from American countries between 1996 to 2012, without significant genetic changes relative to the reference strain RIMD 2210633, which was isolated in 1996 and was considered to be representative of a novel O3:K6 pandemic strain.

Conclusions
The genomes of V. parahaemolyticus strains isolated from clinical and environmental sources in Mexico and other American countries, presented common characteristics that have been reported for RIMD 2210633 O3:K6 pandemic strain. The major variations that were registered in this study corresponded to genes non associated to virulence factors, which could be the result of adaptations to different environmental conditions. Nevertheless, results do not show a clear pattern with the year or locality where the strains were isolated, which is an indication of a genomic stability of the studied strains.
Spatial variation in gene expression of Tasmanian devil facial tumors despite minimal host transcriptomic response to infection
Authors: Kozakiewicz Christopher P. , Fraik Alexandra K. , Patton Austin H. , Ruiz-Aravena Manuel , Hamilton David G. , Hamede Rodrigo , McCallum Hamish , Hohenlohe Paul A. , Margres Mark J. , Jones Menna E. , Storfer Andrew 
Published: September 2021

Abstract
Background
Transmissible cancers lie at the intersection of oncology and infectious disease, two traditionally divergent fields for which gene expression studies are particularly useful for identifying the molecular basis of phenotypic variation. In oncology, transcriptomics studies, which characterize the expression of thousands of genes, have identified processes leading to heterogeneity in cancer phenotypes and individual prognoses. More generally, transcriptomics studies of infectious diseases characterize interactions between host, pathogen, and environment to better predict population-level outcomes. Tasmanian devils have been impacted dramatically by a transmissible cancer (devil facial tumor disease; DFTD) that has led to widespread population declines. Despite initial predictions of extinction, populations have persisted at low levels, due in part to heterogeneity in host responses, particularly between sexes. However, the processes underlying this variation remain unknown.

Results
We sequenced transcriptomes from healthy and DFTD-infected devils, as well as DFTD tumors, to characterize host responses to DFTD infection, identify differing host-tumor molecular interactions between sexes, and investigate the extent to which tumor gene expression varies among host populations. We found minimal variation in gene expression of devil lip tissues, either with respect to DFTD infection status or sex. However, 4088 genes were differentially expressed in tumors among our sampling localities. Pathways that were up- or downregulated in DFTD tumors relative to normal tissues exhibited the same patterns of expression with greater intensity in tumors from localities that experienced DFTD for longer. No mRNA sequence variants were associated with expression variation.

Conclusions
Expression variation among localities may reflect morphological differences in tumors that alter ratios of normal-to-tumor cells within biopsies. Phenotypic variation in tumors may arise from environmental variation or differences in host immune response that were undetectable in lip biopsies, potentially reflecting variation in host-tumor coevolutionary relationships among sites that differ in the time since DFTD arrival.
Helicobacter pylori infection in Iran: demographic, endoscopic and pathological factors
Authors: Hojati Seyedeh Amineh , Kokabpeyk Sara , Yaghoubi Salma , Joukar Farahnaz , Asgharnezhad Mehrnaz , Mansour-Ghanaei Fariborz 
Published: September 2021

AbstractBackgroundHelicobacter pylori(H. pylori) infection is the most important risk factor for gastritis and peptic ulcer. However, factors other thanH. pyloriare involved in its pathogenesis. In the current study, we aimed to compare the clinical manifestations and endoscopic and histopathological findings of patients with and withoutH. pyloriinfection.MethodsIn this cross-sectional study, 233 patients with dyspepsia, referred for endoscopy, were examined regarding the presence ofH. pyloriinfection. During anendoscopic exam,5 biopsyspecimenswere takenfrom thestomach. The criteria for the presence ofH. pyloriinfection was the presence and identification of bacteria in pathology. Two groups ofH. pylori-positive andH. pylori-negative patients were compared regarding their demographic, endoscopic, and pathological findings.ResultsOf 233 patients, 154 (66.1%) were non-smokers, 201 (86.3%) were not alcohol users, and 153 (65.7%) used tap water. The most common symptom, reported in 157 (67.4%) patients, was epigastric pain. There was a significant difference between patients with and withoutH. pyloriinfection in terms of the educational status, occupational status, family history of gastrointestinal cancer, and some gastrointestinal symptoms. Also, there was a significant relationship between the endoscopic and pathological findings of patients withH. pylori.ConclusionsThe results of the present study revealed thatH. pyloriinfection was not associated with sex, alcohol consumption, or non-steroidal anti-inflammatory drug use. The role ofH. pyloriin the pathophysiology of peptic ulcer was clarified. Also, there was a significant difference in the endoscopic and pathological findings of patients withH. pylori.