bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravascular Lithotripsy for Treatment of Calcified Infrapopliteal Lesions: Results from the Disrupt PAD III Observational Study
Authors: Adams George , Soukas Peter A. , Mehrle Anderson , Bertolet Barry , Armstrong Ehrin J. 
Published: August 2021

Purpose: To evaluate the safety and effectiveness of the Shockwave S4 intravascular lithotripsy (IVL) catheter in an “all-comers” cohort of patients with calcified infrapopliteal lesions. Materials and Methods: The Disrupt PAD III Observational Study (NCT02923193) is a prospective, nonrandomized, multicenter single-arm study designed to assess the “real-world” acute safety and effectiveness of the Shockwave Peripheral IVL System for the treatment of de novo calcified, stenotic peripheral arteries. Patients were eligible for enrollment if they had claudication or critical limb ischemia (CLI) and at least moderate calcification as assessed by angiography. This subanalysis includes consecutive patients enrolled with angiographic core lab-assessed treatment of infrapopliteal arteries using the Shockwave S4 IVL catheter. Results From July 2018 to August 2020, 101 patients with 114 calcified infrapopliteal arteries treated with the S4 IVL catheter were enrolled at 15 sites in 3 countries. CLI was present in 69.3% of patients. The anterior tibial and tiboperoneal trunk were the most commonly treated vessels with an overall mean reference vessel diameter (RVD) of 3.1±0.8 mm, minimum lumen diameter (MLD) of 0.5±0.6 mm, and a corresponding diameter stenosis of 83.4%±15.8% by core lab assessment. Mean lesion length was 64.7±54.7 mm with moderate to severe calcification in 69.3% of lesions by the Peripheral Academic Research Consortium (PARC) criteria. Adjunctive calcium-modifying technology, defined as scoring or cutting balloon and/or atherectomy, was used in 22.7% of procedures. The average acute gain at the end of the procedure was 2.0±0.7 mm with a residual stenosis <50% achieved in 99.0% of lesions and a mean residual stenosis of 23.3±12.5%. There were no flow-limiting dissection, embolization, slow flow/no-reflow, or abrupt closure events at the end of the procedure. Conclusion This subanalysis of the PAD III Observational Study represents the largest report to-date of IVL treatment of heavily calcified below-the-knee (BTK) lesions in a “real-world” patient cohort. The use of S4 IVL demonstrated consistent acute safety and effectiveness outcomes consistent with prior IVL peripheral studies. These consistent outcomes were achieved with the initial use of the S4 IVL catheter for treatment of complex BTK lesions.
A Novel Nomogram for Predicting Cancer-Specific Survival in Patients With Spinal Chordoma: A Population-Based Analysis
Authors: Huang Zhangheng , Fan Zhiyi , Zhao Chengliang , Sun He 
Published: August 2021

Background: Chordoma is a rare malignant bone tumor, and the survival prediction for patients with chordoma is difficult. The objective of this study was to construct and validate a nomogram for predicting cancer-specific survival (CSS) in patients with spinal chordoma. Methods: A total of 316 patients with spinal chordoma were identified from the SEER database between 1998 and 2015. The independent prognostic factors for patients with spinal chordoma were determined by univariate and multivariate Cox analyses. The prognostic nomogram was established for patients with spinal chordoma based on independent prognostic factors. Furthermore, we performed internal and external validations for this nomogram. Results: Primary site, disease stage, histological type, surgery, and age were identified as independent prognostic factors for patients with spinal chordoma. A nomogram for predicting CSS in patients with spinal chordoma was constructed based on the above 5 variables. In the training cohort, the area under the curve for predicting 1-, 3-, and 5-year CSS were 0.821, 0.856, and 0.920, respectively. The corresponding area under the curve in the validation cohort were 0.728, 0.804, and 0.839, respectively. The calibration curves of the nomogram showed a high degree of agreement between the predicted and the actual results, and the decision curve analysis further demonstrated the satisfactory clinical utility of the nomogram. Conclusions: The prognostic nomogram provides a considerably more accurate prediction of prognosis for patients with spinal chordoma. Clinicians can use it to categorize patients into different risk groups and make personalized treatment methods.
Does body mass index have an effect on clinical and pain after endovenous therapy? A retrospective study
Authors: Donbaloğlu Mehmet O 
Published: August 2021

Objectives: The study aims to investigate the change in postoperative clinic, pain, and general quality of life of patients who were operated on due to chronic venous disease (CVD), according to their body mass index (BMI). Materials and methods: 150 patients (30–45 years) who were treated with cyanoacrylate embolization for CVD between January 2017 and February 2020 were analyzed retrospectively. The clinical (C) category of clinical, etiology, anatomy, and pathophysiology (CEAP) classification venous clinical severity score (VCSS) and visual analog scale (VAS) questionnaires were applied to the patients before and after the operation periodically. The patients were surveyed preoperatively and postoperatively at 1st, 6th, 12th, and 24th months. Results: The patients were divided into three groups according to their BMI. In the comparison between normal and overweight participants, venous reflux, CEAP C categories, and VAS scores were not statistically significantly different in preoperative and postoperative periods. In the comparison between normal and obese participants, CEAP C categories, VCSS, and VAS scores were statistically significantly different in postoperative periods. There was no statistically significant difference in terms of venous reflux preoperatively and postoperatively in all three groups. Conclusions: The study showed that the increase in BMI had negative effects on the CEAP C categories, pain, and quality of life independently of the venous reflux of CVD.
Damage control surgery (DCS) in the management of maxillofacial bomb blast patients during the Yemen civil conflict. Neighboring Level 1 trauma hospital experience
Authors: Daniels John Spencer , Albakry Ibrahim , Braimah Ramat Oyebunmi , Samara Mohammed Ismail , Albalasi Rabea Arafa , Al Rayshan Saleh Mana Mohammed 
Published: August 2021

Study design: Application of Damage Control Surgery (DCS) in Oral and maxillofacial surgery is still evolving, therefore, the current study hopes to share our experience in the management of bomb blast patients. Objectives: The objectives of the current study is to share our experience in the management of maxillofacial bomb blast injuries emphasizing on DCS. Methods: This was a retrospective study of combatant Yemeni war patients who were transported across the border from Yemen and treated in Najran, Kingdom of Saudi Arabia from December 2015 to December 2019. Information such as etiology of injury, age, zone of injury and mechanisms of bomb blast associated injuries, treatment protocol and complications. The treatment protocols adopted include; DCS in which exploration to control soft tissue bleeding was done and when bone bleeding could not be controlled, immediate reduction and osteosynthesis of bone fractures was carried out. Early Definitive Surgery (EDS) was done in patients that were hemodynamically stable with open reduction and internal fixation (ORIF) of all facial bone fractures. Closed reduction and fixation were done with the use of arch bars while in conservative approach, patients were placed only on soft diet. Data was stored and analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp). Results: A total of 235 (57.6%) patients sustained bomb blast injuries from the 408 war casualties. Other patients (42.4%) sustained other types of injuries. All the patients were males. Their ages ranged from 21 to 53 years with mean (SD) at 27.3 (5.6) years. DCS was carried out in a large proportion of the patients totaling 78 (33.2%) patients, while EDS was carried out in 58 (24.7%) hemodynamically stable patients. ORIF was the main treatment modality for the fractures in 136 (57.9%) of the patients. Conclusion: The result of the study showed a large proportion of the patients were managed with DCS. DCS should be seen as a strategy in stabilizing the patients before definitive surgery is performed.
Mass spectrometry-based proteomics in basic and translational research of SARS-CoV-2 coronavirus and its emerging mutants
Authors: Rais Yasmine , Fu Zhiqiang , Drabovich Andrei P. 
Published: August 2021

AbstractMolecular diagnostics of the coronavirus disease of 2019 (COVID-19) now mainly relies on the measurements of viral RNA by RT-PCR, or detection of anti-viral antibodies by immunoassays. In this review, we discussed the perspectives of mass spectrometry-based proteomics as an analytical technique to identify and quantify proteins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and to enable basic research and clinical studies on COVID-19. While RT-PCR and RNA sequencing are indisputably powerful techniques for the detection of SARS-CoV-2 and identification of the emerging mutations, proteomics may provide confirmatory diagnostic information and complimentary biological knowledge on protein abundance, post-translational modifications, protein–protein interactions, and the functional impact of the emerging mutations. Pending advances in sensitivity and throughput of mass spectrometry and liquid chromatography, shotgun and targeted proteomic assays may find their niche for the differential quantification of viral proteins in clinical and environmental samples. Targeted proteomic assays in combination with immunoaffinity enrichments also provide orthogonal tools to evaluate cross-reactivity of serology tests and facilitate development of tests with the nearly perfect diagnostic specificity, this enabling reliable testing of broader populations for the acquired immunity. The coronavirus pandemic of 2019–2021 is another reminder that the future global pandemics may be inevitable, but their impact could be mitigated with the novel tools and assays, such as mass spectrometry-based proteomics, to enable continuous monitoring of emerging viruses, and to facilitate rapid response to novel infectious diseases.
Sustainability in quality improvement (SusQI): a case-study in undergraduate medical education
Authors: Clery Philippa , d’Arch Smith Stuart , Marsden Oliver , Leedham-Green Kathleen 
Published: August 2021

Abstract
Background
There is a pressing need for more sustainable healthcare. UK medical graduates are required to apply social, economic, and environmental principles of sustainability to their practice. The Centre for Sustainable Healthcare has developed a sustainability in quality improvement (SusQI) framework and educator’s toolkit to address these challenges. We aimed to develop and evaluate SusQI teaching using this toolkit at Bristol Medical School.

Methods
We facilitated a SusQI workshop for all third-year Bristol Medical School students. We used mixed methods including questionnaires, exit interviews and follow-up focus groups to evaluate the outcomes and processes of learning.

Results
Students reported: improvements in knowledge, confidence, and attitudes in both sustainable healthcare and quality improvement; increased self-rated likelihood to engage in SusQI projects; and willingness to change practices to reduce environmental impact in their healthcare roles. Factors for successful teaching included: interactivity; collaboration and participation; and real-life, relevant and tangible examples of projects delivered by credible role models.

Conclusions
Students reported that SusQI education supported by the toolkit was effective at building knowledge and skills, and reframed their thinking on sustainability in quality improvement. Combining the two topics provided enhanced motivation for and engagement in both. Further research is needed on the clinical impacts of SusQI learning.
Human papillomavirus vaccination in adults: impact, opportunities and challenges – a meeting report
Authors: Waheed Dur-e-Nayab , Schiller John , Stanley Margaret , Franco Eduardo L. , Poljak Mario , Kjaer Susanne K. , del Pino Marta , van der Klis Fiona , Schim van der Loeff Maarten F. , Baay Marc , Van Damme Pierre , Vorsters Alex 
Published: August 2021

AbstractFor more than a decade human papillomavirus (HPV) vaccine have been implemented in most high-income countries, and more recently also in several low- and middle-income countries. The vaccines are safe and their impact and effectiveness in preventing HPV vaccine type infection and associated diseases has been thoroughly established. Currently, the primary recommended cohorts for immunisation are adolescents, 9–15 years of age but HPV is an ubiquitous infection that is mainly (but not exclusively) sexually transmitted. Sexually active adults remain susceptible to infection and continued transmission of the virus, representing a reservoir of infection in the population. A recent meeting, conducted by the HPV Prevention and Control Board (HPV-PCB), reviewed the current status of HPV vaccination of adults, discussed limitations, challenges and benefits of HPV vaccination of adults, evaluated the effectiveness of HPV vaccination after treatment of post cervical cancer and precancerous lesions, and discussed the potential impact of adult vaccination on cervical cancer elimination strategies in light of the current and future HPV vaccine shortage. HPV-PCB is an independent multidisciplinary board of international experts that disseminates relevant information on HPV to a broad array of stakeholders and provides guidance on strategic, technical and policy issues in the implementation of HPV prevention and control programs. The HPV-PCB concluded that, given the current data available on adult HPV vaccination and the ongoing vaccine supply constraints, it is too early to implement routine vaccination of adults. Many research gaps need to be filled before we have a better understanding of the efficacy and broader public health impact of HPV vaccination in adult women.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with major trauma and uncontrolled haemorrhagic shock: a systematic review with meta-analysis
Authors: Castellini Greta , Gianola Silvia , Biffi Annalisa , Porcu Gloria , Fabbri Andrea , Ruggieri Maria Pia , Coniglio Carlo , Napoletano Antonello , Coclite Daniela , D’Angelo Daniela , Fauci Alice Josephine , Iacorossi Laura , Latina Roberto , Salomone Katia , Gupta Shailvi , Iannone Primiano , Chiara Osvaldo ,   the Italian National Institute of Health guideline working group on Major Trauma, Stocchetti Nino , De Blasio Elvio , Flego Gaddo , Geraci Massimo , Maccauro Giulio , Rampoldi Antonio , Santolini Federico , Tacconi Claudio , Tugnoli Gregorio 
Published: August 2021

AbstractBackgroundMultiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in patients with non-compressible torso injuries and uncontrolled haemorrhagic shock were recently published. To date, the clinical evidence of the efficacy of REBOA is still debated. We aimed to conduct a systematic review assessing the clinical efficacy and safety of REBOA in patients with major trauma and uncontrolled haemorrhagic shock.MethodsWe systematically searched MEDLINE (PubMed), EMBASE and CENTRAL up to June 2020. All randomized controlled trials and observational studies that investigated the use of REBOA compared to resuscitative thoracotomy (RT) with/without REBOA or no-REBOA were eligible.We followed the PRISMA and MOOSE guidelines. Two authors independently extracted data and appraised the risk of bias of included studies. Effect sizes were pooled in a meta-analysis using random-effects models. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Primary outcomes were mortality, volume of infused blood components, health-related quality of life, time to haemorrhage control and any adverse effects. Secondary outcomes were improvement in haemodynamic status and failure/success of REBOA technique.ResultsWe included 11 studies (5866 participants) ranging from fair to good quality. REBOA was associated with lower mortality when compared to RT (aOR 0.38; 95% CI 0.20–0.74), whereas no difference was observed when REBOA was compared to no-REBOA (aOR 1.40; 95% CI 0.79–2.46). No significant difference in health-related quality of life between REBOA and RT (p= 0.766). The most commonly reported complications were amputation, haematoma and pseudoaneurysm. Sparse data and heterogeneity of reporting for all other outcomes prevented any estimate.ConclusionsOur findings on overall mortality suggest a positive effect of REBOA among non-compressible torso injuries when compared to RT but no differences compared to no-REBOA. Variability in indications and patient characteristics prevents any conclusion deserving further investigation. REBOA should be promoted in specific training programs in an experimental setting in order to test its effectiveness and a randomized trial should be planned.
Preoperative characteristics and intraoperative factors do not correlate with accomplishments of active straight-leg raising, standing up, and walking after primary total knee arthroplasty
Authors: Ishii Yoshinori , Noguchi Hideo , Sato Junko , Takahashi Ikuko , Ishii Hana , Ishii Ryo , Ishii Kei , Toyabe Shin-Ichi 
Published: August 2021

Abstract
Background
The correlations between patient characteristics and early postoperative functional performances after total knee arthroplasty have not been adequately studied. The purpose of this study was to clarify the effects of preoperative characteristics (sex, age, body mass index, American Society of Anesthesiologists grade, hospital for special surgery score) and intraoperative factors (duration of surgery and tourniquet use) on the time required to accomplish active straight-leg-raising, standing up, and walking as the objective performances for the initiation of early postoperative rehabilitation.

Methods
This cross-sectional retrospective study included 307 patients (384 primary total knee arthroplasties). Postoperative times required until each activity was accomplished were measured. Various preoperative characteristics and intraoperative factors that might affect three objective performances were evaluated.

Results
The postoperative times required before each activity was accomplished were 1.5 ± 0.5 days for active straight-leg-raising, 1.2 ± 0.5 days for standing up, and 1.4 ± 0.7 days for walking. There were no significant correlations between any factor (age, body mass index, hospital for special surgery score, duration of surgery, and tourniquet use) and the three objective performances using Spearman’s correlation coefficient. There were no differences in sex or American Society of Anesthesiologists grade for three objective functional assessments by Wilcoxon rank sum test.

Conclusions
Differences in patient preoperative characteristics and intraoperative factors are unlikely to affect three objective functional performances in the early postoperative period. Therefore, there is no need to consider differences between patients when initiating early postoperative rehabilitation.
MicroRNAs involve in bicuspid aortic aneurysm: pathogenesis and biomarkers
Authors: Jia Hao , Kang Le , Ma Zhen , Lu Shuyang , Huang Ben , Wang Chunsheng , Zou Yunzeng , Sun Yongxin 
Published: August 2021

AbstractThe incidence of bicuspid aortic valves (BAV) is high in the whole population, BAV-related thoracic aortic aneurysm (TAA) is accompanied by many adverse vascular events. So far, there are two key points in dealing with BAV-related TAA. First is fully understanding on its pathogenesis. Second is optimizing surgical intervention time. This review aims to illustrate the potential role of miRNAs in both aspects, that is, how miRNAs are involved in the occurrence and progression of BAV-related TAA, and the feasibilities of miRNAs as biomarkers.
Altered hippocampal transcriptome dynamics following sleep deprivation
Authors: Gaine Marie E. , Bahl Ethan , Chatterjee Snehajyoti , Michaelson Jacob J. , Abel Ted , Lyons Lisa C. 
Published: August 2021

AbstractWidespread sleep deprivation is a continuing public health problem in the United States and worldwide affecting adolescents and adults. Acute sleep deprivation results in decrements in spatial memory and cognitive impairments. The hippocampus is vulnerable to acute sleep deprivation with changes in gene expression, cell signaling, and protein synthesis. Sleep deprivation also has long lasting effects on memory and performance that persist after recovery sleep, as seen in behavioral studies from invertebrates to humans. Although previous research has shown that acute sleep deprivation impacts gene expression, the extent to which sleep deprivation affects gene regulation remains unknown. Using an unbiased deep RNA sequencing approach, we investigated the effects of acute sleep deprivation on gene expression in the hippocampus. We identified 1,146 genes that were significantly dysregulated following sleep deprivation with 507 genes upregulated and 639 genes downregulated, including protein coding genes and long non-coding RNAs not previously identified as impacted by sleep deprivation. Notably, genes significantly upregulated after sleep deprivation were associated with RNA splicing and the nucleus. In contrast, downregulated genes were associated with cell adhesion, dendritic localization, the synapse, and postsynaptic membrane. Furthermore, we found through independent experiments analyzing a subset of genes that three hours of recovery sleep following acute sleep deprivation was sufficient to normalize mRNA abundance for most genes, although exceptions occurred for some genes that may affect RNA splicing or transcription. These results clearly demonstrate that sleep deprivation differentially regulates gene expression on multiple transcriptomic levels to impact hippocampal function.
Kidney cancer biomarkers and targets for therapeutics: survivin (BIRC5), XIAP, MCL-1, HIF1α, HIF2α, NRF2, MDM2, MDM4, p53, KRAS and AKT in renal cell carcinoma
Authors: Li Fengzhi , Aljahdali Ieman A. M. , Zhang Renyuan , Nastiuk Kent L. , Krolewski John J. , Ling Xiang 
Published: August 2021

AbstractThe incidence of renal cell carcinoma (RCC) is increasing worldwide with an approximate 20% mortality rate. The challenge in RCC is the therapy-resistance. Cancer resistance to treatment employs multiple mechanisms due to cancer heterogeneity with multiple genetic and epigenetic alterations. These changes include aberrant overexpression of (1) anticancer cell death proteins (e.g., survivin/BIRC5), (2) DNA repair regulators (e.g., ERCC6) and (3) efflux pump proteins (e.g., ABCG2/BCRP); mutations and/or deregulation of key (4) oncogenes (e.g., MDM2, KRAS) and/or (5) tumor suppressor genes (e.g., TP5/p53); and (6) deregulation of redox-sensitive regulators (e.g., HIF, NRF2). Foci of tumor cells that have these genetic alterations and/or deregulation possess survival advantages and are selected for survival during treatment. We will review the significance of survivin (BIRC5), XIAP, MCL-1, HIF1α, HIF2α, NRF2, MDM2, MDM4, TP5/p53, KRAS and AKT in treatment resistance as the potential therapeutic biomarkers and/or targets in RCC in parallel with our analized RCC-relevant TCGA genetic results from each of these gene/protein molecules. We then present our data to show the anticancer drug FL118 modulation of these protein targets and RCC cell/tumor growth. Finally, we include additional data to show a promising FL118 analogue (FL496) for treating the specialized type 2 papillary RCC.