bluuebunny/crossref_metadata_2025_split huggingface dataset:
An International, Multicenter Retrospective Observational Study to Assess Technical Success and Clinical Outcomes of Patients Treated with an Endovascular Aneurysm Sealing Device for Type III Endoleak
Authors: Zoethout Aleksandra C. , Ketting Shirley , Zeebregts Clark J. , Apostolou Dimitri , Mees Barend M.E. , Berg Patrick , Beyrouti Hazem El , De Vries Jean-Paul P.M. , Torella Francesco , Migliari Mattia , Silingardi Roberto , Reijnen Michel M.P.J. 
Published: August 2021

Introduction: Type III endoleaks post-endovascular aortic aneurysm repair (EVAR) warrant treatment because they increase pressure within the aneurysm sac leading to increased rupture risk. The treatment may be difficult with regular endovascular devices. Endovascular aneurysm sealing (EVAS) might provide a treatment option for type III endoleaks, especially if located near the flow divider. This study aims to analyze clinical outcomes of EVAS for type III endoleaks after EVAR. Methods: This is an international, retrospective, observational cohort study including data from 8 European institutions. Results: A total of 20 patients were identified of which 80% had a type IIIb endoleak and the remainder (20%) a type IIIa endoleak. The median time between EVAR and EVAS was 49.5 months (28.5–89). Mean AAA diameter prior to EVAS revision was 76.6±19.9 mm. Technical success was achieved in 95%, 1 patient had technical failure due to a postoperative myocardial infarction resulting in death. Mean follow-up was 22.8±15.2 months. During follow-up 1 patient had a type Ia endoleak, and 1 patient had a new type IIIa endoleak at an untreated location. There were 5 patients with aneurysm growth. Five patients underwent AAA-related reinterventions indications being: growth with type II endoleak (n=3), type Ia endoleak (n=1), and iliac aneurysm (n=1). At 1-year follow-up, the freedom from clinical failure was 77.5%, freedom from all-cause mortality 94.7%, freedom from aneurysm-related mortality 95%, and freedom from aneurysm-related reinterventions 93.8%. Conclusion: The EVAS relining can be safely performed to treat type III endoleaks with an acceptable technical success rate, a low 30-day mortality rate and no secondary ruptures at short-term follow-up. The relatively low clinical success rates, related to reinterventions and AAA enlargement, highlight the need for prolonged follow-up.
The Effectiveness of Lapatinib in HER2-Positive Metastatic Breast Cancer Patients Pretreated With Multiline Anti-HER2 Treatment: A Retrospective Study in China
Authors: Wang Xinzhao , Wang Lin , Yu Qian , Liu Zhaoyun , Li Chao , Wang Fukai , Yu Zhiyong 
Published: August 2021

Background: The aim of this study was to evaluate the effectiveness of lapatinib in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Methods: We retrospectively reviewed the medical records of patients who received lapatinib for salvage treatment at any line setting from January 1, 2007 to August 31, 2019 at Shandong Cancer Hospital and Institute. Results: A total of 115 (89.1%) patients were included in the study. In the overall cohort, the median disease-free survival (DFS) was 19.0 months; the median progression-free survival (PFS), 6.3 months; and median overall survival (OS), 88.0 months, with 32.2% of patients alive at 5 years. In the second line setting, the median PFS among trastuzumab, lapatinib, and trastuzumab plus lapatinib were 4.2 months, 5.2 months, and 7.3 months, respectively ( P = 0.004). No significant differences between the median PFSs and OSs of the different line salvage treatments with lapatinib was observed (all P > 0.05). For brain metastasis patients, the median PFSs in first line, second line, and more than 3 lines were 7.2 months, 4.5 months, and 6.3 months, respectively. Conclusions: Our findings suggest that patients would benefit more from trastuzumab plus lapatinib than from lapatinib or trastuzumab alone for second line treatment in the advanced stages of the disease. Lapatinib could be used as an alternative selection for HER2-positive metastasic breast cancer patients when there is disease progression after trastuzumab or pyrotinib treatment, which is used as part of China’s national health insurance.
Tendon Transection Healing Can Be Improved With Adipose-Derived Stem Cells Cultured With Growth Differentiation Factor 5 and Platelet-Derived Growth Factor
Authors: Fitzgerald Michael J. , Mustapich Taylor , Liang Haixiang , Larsen Christopher G. , Nellans Kate W. , Grande Daniel A. 
Published: August 2021

Background: As hand surgeons, tendon injuries and lacerations are a particularly difficult problem to treat, as poor healing potential and adhesions hamper optimal recovery. Adipose-derived stem cells (ADSCs) have been shown to aid in rat Achilles tendon healing after a puncture defect, and this model can be used to study tendon healing in the upper extremity. We hypothesized that ADSCs cultured with growth differentiation factor 5 (GDF5) and platelet-derived growth factor (PDGF) would improve tendon healing after a transection injury. Methods: Rat Achilles tendons were transected and then left either unrepaired or repaired. Both groups were treated with a hydrogel alone, a hydrogel with ADSCs, or a hydrogel with ADSCs that were cultured with GDF5 and PDGF prior to implantation. Tissue harvested from the tendons was evaluated for gene expression of several genes known to play an important role in successful tendon healing. Histological examination of the tendon healing was also performed. Results: In both repaired and unrepaired tendons, those treated with ADSCs cultured with GDF5/PDGF prior to implantation showed the best tendon fiber organization, the smallest gaps, and the most organized blood vessels. Treatment with GDF5/PDGF increased expression of the protenogenesis gene SOX9, promoted cell-to-cell connections, improved cellular proliferation, and enhanced tissue remodeling. Conclusions: Adipose-derived stem cells cultured with GDF5/PDGF prior to implantation can promote tendon repair by improving cellular proliferation, tenogenesis, and vascular infiltration. This effect results in a greater degree of organized tendon healing.
Challenges and opportunities in point-of-care ultrasound: A qualitative exploration of respiratory physiotherapists’ experiences of lung ultrasound training and its adoption in critical care
Authors: Hayward Simon , Innes Sue , Smith Mike 
Published: August 2021

Introduction Diagnostic lung ultrasound (LUS) is gaining popularity among respiratory physiotherapists as an imaging modality to aid pulmonary assessments, guide intervention selection, and monitor the efficacy of chosen interventions. The ability of respiratory physiotherapists to incorporate LUS into their clinical practice is influenced by multiple factors to adoption and implementation. The aim of this study was to explore the experiences of senior respiratory physiotherapists who have attempted to adopt and implement LUS into their clinical practice in critical care. It is hoped these experiences will inform the development of educational and adoption strategies for the future implementation of LUS. Methods Following a national call out, eight senior critical care respiratory physiotherapists were purposively selected to be interviewed using semi-structured questions exploring their varied experiences of LUS adoption into clinical practice in critical care. The transcribed data were thematically analysed. Results Five main themes emerged from the participants’ responses: (i) support for physiotherapists using LUS, (ii) knowledge and understanding of LUS evidence, (iii) governance, (iv) physiotherapists’ motivation to use LUS, and (v) resources. Quotes for each of the five themes are given as exemplars. Conclusion Participants reported a range of factors that influenced their ability to adopt and implement LUS into practice several were enabling, and others were barriers to progress. Online Appendix 1 contains recommendations from the authors to help guide managers and clinicians wishing to adopt LUS into respiratory physiotherapy services and patient pathways.
Case report: Flattening of the tectal plate in obstructive hydrocephalus with auto-ventriculostomy
Authors: Städt Michael , Holtmannspötter Markus , Schwab Johannes , Eff Florian , Voit-Höhne Heinz 
Published: August 2021

Background Obstructive hydrocephalus in adulthood can be caused by stenosis in the aqueductal area. Chronic changes lead to a dilatation of the lateral ventricles and ballooning of infratentorial recesses. In rare cases a rupture of the floor of the third ventricle (so-called spontaneous ventriculostomy) has been described in the literature. Case presentation: We present two cases of chronic obstructive hydrocephalus due to aqueductal stenosis in adult patients. Magnetic resonance imaging included phase-contrast-imaging and revealed significant flow through the floor of the third ventricle in keeping with spontaneous ventriculostomy. In addition to other typical changes associated with chronic hydrocephalus, a distinct flattening of the tectal plate could be identified in one case. Conclusion We present two cases of spontaneous ventriculostomy in patients with chronic hydrocephalus. To our knowledge, flattening of the tectal plate has not yet been described in the literature and may be caused by continuous cerebrospinal fluid-pulsation.
Patient-reported utilization patterns of endometriosis medications in Europe: Real-world results from the non-interventional VIPOS study
Authors: Becker Kerstin , Heinemann Klaas , Imthurn Bruno , Marions Lena , Moehner Sabine , von Stockum Sophia , Gerlinger Christoph , Serrani Marco , Faustmann Thomas 
Published: August 2021

Introduction: Women with endometriosis require individualized, long-term treatment. Analyzing prescription choices, medication switches, discontinuations, and breaks can describe real-world treatment patterns and optimize pathways for women. To our knowledge, the Visanne Post-approval Observational Study (VIPOS) is the largest real-world, non-interventional study examining the safety of hormonal treatments for the routine clinical management of endometriosis. We present data from VIPOS on endometriosis drug utilization patterns, including treatment discontinuation due to treatment failure. Methods: VIPOS was a prospective, long-term, controlled, non-interventional cohort study in six European countries (Germany, Switzerland, Russia, Poland, Ukraine, and Hungary) conducted between 2010 and 2018. Women self-reported medical and gynecological history and symptoms and treatment information via comprehensive questionnaires. Results: Overall, 27,840 women were enrolled via gynecologists or specialized centers. Inter-country variance in treatment prescription patterns suggests the influence of differential management strategies and guidelines on prescribing behavior and diagnostic methods. Most enrolled women were receiving combined hormonal contraceptives. Women receiving dienogest 2 mg or gonadotropin-releasing hormone agonists more often had a surgical diagnosis of endometriosis compared to other treatments, while most women receiving combined hormonal contraceptives, other progestins or danazol had a symptom-based diagnosis. Although treatment changes during follow-up were common, only 4733 discontinuations out of 42,342 treatment starts were reported due to side effects or treatment ineffectiveness. Conclusion: VIPOS provides valuable insights into the considerable inter-country variance in endometriosis treatment prescription and potential role of differing management guidelines and practices strategies. Findings presented here suggest the need greater alignment of clinical practice to optimize patient management.
Multilayer sheets for thermoforming non thermoformable polymers
Authors: Wittmann Lisa-Maria , Drummer Dietmar 
Published: August 2021

Multilayer sheets were used for thermoforming non thermoformable polymers in order to face the challenge of semi-crystalline polymers like low melt-stiffness. Mono- and 2-layer sheets consisting of different polypropylene (PP) homopolymers were extruded on a twin screw extruder. The PP viscosity as was measured by melt flow rate (MFR) 3 g/10 min., 12 g/10 min., 22 g/10 min. and 50 g/10 min. The layer ratio was varied between the equal layer ratio (A50/B50) of the individual layers and the low (A30/B70) or high viscosity ratio (A70/B30). The extrusion results show that for extreme viscosity differences (MFR3 and MFR50), the critical layer ratios known from the literature are only valid to a limited extent. The critical viscosity ratio < 4, which is known from the literature, is much lower here and should be less than 3. The investigation of thermoformability on laboratory scale of the extruded PP sheets with different viscosities showed that the low viscous layer position has only a marginal influence on the general thermoformability. Thermoforming of materials that are not thermoformable, with a storage modulus of less than 10³ Pa and a ratio between storage and loss modulus (tan δ) greater than 1, becomes possible using a multilayer sheet independant of the layer ratio. If the layer with higher viscosity acts as a stabilizing layer, thermoforming is possible.
Novel NPM1 exon 5 mutations and gene fusions leading to aberrant cytoplasmic nucleophosmin in AML
Authors: Martelli Maria Paola , Rossi Roberta , Venanzi Alessandra , Meggendorfer Manja , Perriello Vincenzo Maria , Martino Giovanni , Spinelli Orietta , Ciurnelli Raffaella , Varasano Emanuela , Brunetti Lorenzo , Ascani Stefano , Quadalti Corinne , Cardinali Valeria , Mezzasoma Federica , Gionfriddo Ilaria , Milano Francesca , Pacini Roberta , Tabarrini Alessia , Bigerna Barbara , Albano Francesco , Specchia Giorgina , Vetro Calogero , Di Raimondo Francesco , Annibali Ombretta , Avvisati Giuseppe , Rambaldi Alessandro , Falzetti Franca , Tiacci Enrico , Sportoletti Paolo , Haferlach Torsten , Haferlach Claudia , Falini Brunangelo 
Published: August 2021

Abstract
Nucleophosmin (NPM1) mutations in acute myeloid leukemia (AML) affect exon 12, but also sporadically affect exons 9 and 11, causing changes at the protein C-terminal end (tryptophan loss, nuclear export signal [NES] motif creation) that lead to aberrant cytoplasmic NPM1 (NPM1c+), detectable by immunohistochemistry. Combining immunohistochemistry and molecular analyses in 929 patients with AML, we found non–exon 12 NPM1 mutations in 5 (1.3%) of 387 NPM1c+ cases. Besides mutations in exons 9 (n = 1) and 11 (n = 1), novel exon 5 mutations were discovered (n = 3). Another exon 5 mutation was identified in an additional 141 patients with AML selected for wild-type NPM1 exon 12. Three NPM1 rearrangements (NPM1/RPP30, NPM1/SETBP1, NPM1/CCDC28A) were detected and characterized among 13 979 AML samples screened by cytogenetic/fluorescence in situ hybridization and RNA sequencing. Functional studies demonstrated that in AML cases, new NPM1 proteins harbored an efficient extra NES, either newly created or already present in the fusion partner, ensuring its cytoplasmic accumulation. Our findings support NPM1 cytoplasmic relocation as critical for leukemogenesis and reinforce the role of immunohistochemistry in predicting AML-associated NPM1 genetic lesions. This study highlights the need to develop new assays for molecular diagnosis and monitoring of NPM1-mutated AML.
Bleeding diathesis in mice lacking JAK2 in platelets
Authors: Eaton Nathan , Subramaniam Saravanan , Schulte Marie L. , Drew Caleb , Jakab David , Haberichter Sandra L. , Weiler Hartmut , Falet Hervé 
Published: August 2021

AbstractThe tyrosine kinase JAK2 is a critical component of intracellular JAK/STAT cytokine signaling cascades that is prevalent in hematopoietic cells, such as hematopoietic stem cells and megakaryocytes (MKs). Individuals expressing the somatic JAK2 V617F mutation commonly develop myeloproliferative neoplasms (MPNs) associated with venous and arterial thrombosis, a leading cause of mortality. The role of JAK2 in hemostasis remains unclear. We investigated the role of JAK2 in platelet hemostatic function using Jak2fl/fl Pf4-Cre (Jak2Plt−/−) mice lacking JAK2 in platelets and MKs. Jak2Plt−/− mice developed MK hyperplasia and splenomegaly associated with severe thrombocytosis and bleeding. This notion was supported by failure to occlude in a ferric chloride carotid artery injury model and by a cremaster muscle laser-induced injury assay, in which Jak2Plt−/− platelets failed to form stable thrombi. Jak2Plt−/− platelets formed thrombi poorly after adhesion to type 1 collagen under arterial shear rates. Jak2Plt−/− platelets spread poorly on collagen under static conditions or on fibrinogen in response to the collagen receptor GPVI-specific agonist, collagen-related peptide (CRP). After activation with collagen, CRP, or the CLEC-2 agonist rhodocytin, Jak2Plt−/− platelets displayed decreased α-granule secretion and integrin αIIbβ3 activation or aggregation, but showed normal responses to thrombin. Jak2Plt−/− platelets had impaired intracellular signaling when activated via GPVI, as assessed by tyrosine phosphorylation. Together, the results show that JAK2 deletion impairs platelet immunoreceptor tyrosine-based activation motif signaling and hemostatic function in mice and suggest that aberrant JAK2 signaling in patients with MPNs affects GPVI signaling, leading to hemostatic platelet function.
A future without drivers? Comparing users', urban planners' and developers' assumptions, hopes, and concerns about autonomous vehicles
Authors: Strömberg Helena , Ramos Érika Martins Silva , Karlsson MariAnne , Johansson Mikael , Ekman Fredrick , Bligård Lars-Ola , Bergstad Cecilia Jakobsson 
Published: August 2021

Abstract
Aim
This study identifies and compares perceptions of autonomous vehicle (AV) implementation among three Swedish stakeholder groups: Future Users, Urban Planners, and Developers.

Method
Semi-structured comparative focus groups were conducted separately with each of the three groups of stakeholders and the transcripts were analysed in broad themes using thematic analysis.

Results
Assumptions, hopes, concerns, and direction of development were the main themes that emerged from the analysis. Assumptions included electrification of vehicles, changes in travel demand, and the need for regulations; Hopes included the idea that AVs will contribute to a more accessible and safer transport system; Concerns included overtrust in AV technology, a possible detrimental impact on the city in the form of congestion and higher demand for investments in infrastructure that could outcompete other modes of transport; and Direction of development and their own role, where the need for collaboration between stakeholders and implementation of AVs in connection with society’s needs were emphasised.

Conclusions
AVs were seen to lead to both positive and negative consequences depending on implementation and the development of society. The study shows that dialogue between different stakeholders is lacking but it is desired for the inclusive implementation of AVs.
Step-free railway station access in the UK: the value of inclusive design
Authors: Swift Antony , Cheng Long , Loo Becky P. Y. , Cao Mengqiu , Witlox Frank 
Published: August 2021

Abstract
Background
Despite substantial investment in step-free access at UK railway stations, persons with reduced mobility (PRMs) continue to travel less than their able-bodied counterparts and little is known about the value of step-free access. This research examines the benefits of step-free access and its relationship with rail usage among PRMs, and the wider benefits of railway station accessibility.

Methods
These issues are explored through a mixed methods approach. Semi-structured interviews with ten key organisations were undertaken, as was an analysis of Senior/Disabled Persons Railcard data from 17 railway stations in Buckinghamshire, each with varying levels of step-free accessibility.

Results
The results show that the benefits of step-free access extend beyond benefits at the individual level typically associated with those limited to PRMs, and demonstrate the potential to positively affect the society at large economically, environmentally, and socially. The findings also show a positive correlation between the level of step-free accessibility at a railway station and the percentage of PRMs using it.

Conclusions
This research argues that government and interested stakeholders should commit to expanding the number and coverage of step-free stations throughout the UK. They should ensure that the appraisal process for investment in step-free accessibility appropriately captures both user and non-user benefits.
Generalist camouflage can be more successful than microhabitat specialisation in natural environments
Authors: Briolat Emmanuelle Sophie , Arenas Lina María , Hughes Anna E. , Liggins Eric , Stevens Martin 
Published: August 2021

Abstract
Background
Crypsis by background-matching is a critical form of anti-predator defence for animals exposed to visual predators, but achieving effective camouflage in patchy and variable natural environments is not straightforward. To cope with heterogeneous backgrounds, animals could either specialise on particular microhabitat patches, appearing cryptic in some areas but mismatching others, or adopt a compromise strategy, providing partial matching across different patch types. Existing studies have tested the effectiveness of compromise strategies in only a limited set of circumstances, primarily with small targets varying in pattern, and usually in screen-based tasks. Here, we measured the detection risk associated with different background-matching strategies for relatively large targets, with human observers searching for them in natural scenes, and focusing on colour. Model prey were designed to either ‘specialise’ on the colour of common microhabitat patches, or ‘generalise’ by matching the average colour of the whole visual scenes.

Results
In both the field and an equivalent online computer-based search task, targets adopting the generalist strategy were more successful in evading detection than those matching microhabitat patches. This advantage occurred because, across all possible locations in these experiments, targets were typically viewed against a patchwork of different microhabitat areas; the putatively generalist targets were thus more similar on average to their various immediate surroundings than were the specialists.

Conclusions
Demonstrating close agreement between the results of field and online search experiments provides useful validation of online citizen science methods commonly used to test principles of camouflage, at least for human observers. In finding a survival benefit to matching the average colour of the visual scenes in our chosen environment, our results highlight the importance of relative scales in determining optimal camouflage strategies, and suggest how compromise coloration can succeed in nature.