bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing an Occupational Therapy Low Vision Rehabilitation Program in Singapore
Authors: Boey Debbie Shuying , Warren Mary 
Published: October 2019

Introduction: This article describes the development, implementation, and evaluation of an occupational therapy (OT) low vision rehabilitation program established in a large hospital in Singapore in 2013. Methods: A logic model was used to develop a blueprint to guide program development and evaluation of the program. The targeted short-term outcomes for the first 2 years are to demonstrate program growth through an increase in referrals and meeting of clients’ needs through expressed client satisfaction and improvement in performance of daily activities. The long-term outcomes are to expand the program’s referral base and contribute to education and research in low vision rehabilitation. The steps of the logic model are described along with program evaluation results from the first 2 years of implementation. Results: The short-term outcome for program growth was met with the increase of referrals in the first 2 years. Program evaluation, however, revealed that there was limited support from some referral sources and underutilization of OT services, which need to be addressed to ensure sustainability of the program. It was difficult to establish whether the short-term outcomes for meeting clients’ needs were met due to limited outcome measures completed. Discussion: The logic model guided the steps of developing and evaluating an outpatient low vision rehabilitation program in a hospital in Singapore to determine whether the targeted outcomes were met for the first 2 years of the program. Use of this process enabled the program providers to identify weaknesses in the program and institute steps to move the program toward achievement of its long-term goals. Implications for practitioners: This blueprint can be used to guide occupational therapists developing medically based low vision rehabilitation programs for older adults.
Association between benign prostate hyperplasia and metabolic syndrome in men under 60 years old: a meta-analysis
Authors: Wu Shuiqing , He Haiqing , Wang Yinhuai , Xu Ran , Zhu Bin , Zhao Xiaokun 
Published: October 2019

Objective To assess the potential relationship between benign prostate hyperplasia (BPH) and metabolic syndrome in men under 60 years old. Methods We searched the Medline, Embase, and Web of Science databases for studies of patients with metabolic syndrome and BPH using the key words ‘metabolic syndrome’, ‘benign prostatic hyperplasia’, and ‘BPH’. The odds ratios (ORs) and 95% confidence intervals (95%CIs) were extracted from the included studies and the role of metabolic syndrome in BPH and its characteristics (International Prostate Symptom Score (IPSS), total prostate volume (TPV), postvoid residual (PVR)) were evaluated by meta-analysis. Results Six comparative studies comprising 61,826 individuals were identified and included in this meta-analysis. There were significant correlations between metabolic syndrome and BPH (OR = 1.24, 95%CI = 1.19–1.29), clinical BPH (OR = 1.37, 95%CI = 1.03–1.70), and TPV (OR = 2.34, 95%CI = 1.25–3.42). However, there was no significant association between metabolic syndrome and IPSS (OR = 1.19, 95%CI = 0.35–2.04) or PVR (OR = 2.15, 95% CI = 0.95–3.34). Conclusions These results indicate that metabolic syndrome is significantly and positively correlated with the incidence of BPH in younger men aged <60 years. However, there was no significant relationship between metabolic syndrome and BPH-related symptoms.
Interview with Karol Modzelewski, 1991
Authors: Tymowski Andrzej W. 
Published: October 2019

This is an edited version of an interview conducted in 1991 and first published in New Politics 4, no. 2 (1993): 155–72. The editors of EEPS publish this version after the recent death of Karol Modzelewski, 1937–2019. In the 1991 interview, Modzelewski reflected on the difference between Solidarność 1980–1981 as a mass social movement and the very much changed Solidarność that in 1989 formed the first non-Communist government in the Soviet bloc. His comments have a premonitory relevance for Polish politics today.
Pediatric retinal damage due to soccer-ball-related injury: Results from the last decade
Authors: Leshno Ari , Alhalel Amir , Fogel-Levin Miri , Zloto Ofira , Moisseiev Joseph , Vidne-Hay Orit 
Published: October 2019

Objective: To outline the incidence of posterior segment injuries related to soccer-ball blunt trauma in children. Methods: Retrospective search of the computerized hospital medical database between the years 2007 and 2017. All pediatric trauma cases were reviewed and cases with blunt trauma related to direct orbital/ocular hit from a soccer-ball were included. Cases were divided into two groups (non-severe and severe) based on the presence of sight-threatening findings on presentation (e.g. retinal tear, vitreous hemorrhage, retinal detachment, and macular edema). Results: Out of 343 pediatric patients with relevant diagnoses, 14 (4.1%) were treated for injuries related to soccer-ball trauma. All patients were males at their early-to-mid teens (14.3 ± 2.1 years). The most common funduscopic finding was peripheral commotio retina (13, 93%). There was equal distribution between the two groups (seven each). Retinal injury in the severe group included retinal tear (3), vitreous hemorrhage (4), retinal detachment (1), and macular hole (1). Five patients in this group presented with visual acuity of 20/25 or better. Rate of external signs of injury were similar in both groups. Conclusion: Soccer-ball blunt trauma in children can cause significant posterior segment injuries regardless of the presence of external injury or ocular complaints. A thorough ocular exam is mandatory in all cases for the detection of vision-threatening retinal injuries.
Serum neurofilament light chain level associations with clinical and cognitive performance in multiple sclerosis: A longitudinal retrospective 5-year study
Authors: Jakimovski Dejan , Zivadinov Robert , Ramanthan Murali , Hagemeier Jesper , Weinstock-Guttman Bianca , Tomic Davorka , Kropshofer Harald , Fuchs Tom A , Barro Christian , Leppert David , Yaldizli Özgür , Kuhle Jens , Benedict Ralph HB 
Published: October 2019

Background: A limited number of studies investigated associations between serum neurofilament light chain (sNfL) and cognition in persons with multiple sclerosis (PwMS). Objective: To assess cross-sectional and longitudinal associations between sNfL levels, clinical, and cognitive performance in PwMS and age-matched healthy controls (HCs). Materials: One hundred twenty-seven PwMS (85 relapsing–remitting MS/42 progressive MS), 20 clinically isolated syndrome patients, and 52 HCs were followed for 5 years. sNfL levels were measured using the single-molecule array (Simoa) assay and quantified in picograms per milliliter. Expanded Disability Status Scale (EDSS), walking, and manual dexterity tests were obtained. At follow-up, Brief International Cognitive Assessment for MS (BICAMS) was utilized. Cognitively impaired (CI) status was derived using HC-based z-scores. Age-, sex-, and education-adjusted analysis of covariance (ANCOVA) and regression models were used. Multiple comparison–adjusted values of q < 0.05 were considered significant. Results: In PwMS, sNfL levels were cross-sectionally associated with walking speed ( r = 0.235, q = 0.036), manual dexterity ( r = 0.337, q = 0.002), and cognitive processing speed (CPS; r =−0.265, q = 0.012). Baseline sNfL levels predicted 5-year EDSS scores ( r = 0.25, q = 0.012), dexterity ( r = 0.224, q = 0.033), and CPS ( r =−0.205, q = 0.049). CI patients had higher sNfL levels (27.2 vs. 20.6, p = 0.016) and greater absolute longitudinal sNfL increase when compared with non-CI patients (4.8 vs. 0.7, p = 0.04). Conclusion: Higher sNfL levels are associated with poorer current and future clinical and cognitive performance.
Outcomes of Subacromial Balloon Spacer Implantation for Massive and Irreparable Rotator Cuff Tears: A Systematic Review
Authors: Stewart Russell K. , Kaplin Lisa , Parada Stephen A. , Graves Benjamin R. , Verma Nikhil N. , Waterman Brian R. 
Published: October 2019

Background: Selection of optimal treatment for massive to irreparable rotator cuff tears (RCTs) entails a challenging decision-making process in which surgeons must consider several factors, including duration of symptoms, tear pattern, tear size, and muscle quality, as well as patient characteristics such as age, comorbidities, shoulder dominance, and activity level. Unfortunately, no clear consensus has been reached regarding optimal management. Purpose: To systematically review the published literature assessing outcomes after subacromial balloon spacer implantation for treatment of massive and irreparable RCTs. Study Design: Systematic review; Level of evidence, 4. Methods: A comprehensive literature search was performed in September 2018 through use of MEDLINE and the Cochrane Library electronic databases. Studies were assessed for multiple outcomes of interest including Constant score, Oxford Shoulder Score (OSS), University of California Los Angeles (UCLA) Shoulder Score, complications, and patient satisfaction. Results: After applying the selection criteria, 12 clinical studies were included for data extraction and analysis. In total, 291 shoulders (in 284 patients) treated with subacromial balloon spacer implantation were pooled for evaluation, with a mean follow-up of 22.9 ± 14.9 months (range, 6-60 months). Constant scores were used as an outcome metric for 267 shoulders (91.7%; 11 studies), with improvements in mean Constant score ranging from 18.5 to 49.6 points. Patient satisfaction was assessed in 105 patients (37.0%; 5 studies), with rates of patients indicating they were satisfied or very satisfied with their treatment outcome ranging from 45.8% to 100%. A total of 6 patients (2.1%) experienced complications related to balloon spacer implantation, including transient neurapraxia of the lateral antebrachial cutaneous nerve, superficial wound infection, deep wound infection, and balloon migration. Of these, 3 patients (2 balloon migration, 1 deep wound infection) required subsequent surgeries for balloon removal. Conclusion: Placement of the subacromial balloon spacer is a minimally invasive, technically simple procedure with favorable patient-reported outcomes at limited short-term follow-up. However, inherent methodological limitations and patient heterogeneity between studies may impair our ability to fully characterize the longer term efficacy, particularly relative to other potential surgical options. Further prospective randomized or comparative studies are warranted to ascertain clinical outcomes of subacromial balloon spacer in the management of massive and irreparable RCTs.
Ocular Ischemic Syndrome With Congenital Absence of Internal Carotid Artery
Authors: Elwood Kevin F. , Taboada Jorge L. , Wong Robert W. 
Published: October 2019

Purpose: This article describes a case of ocular ischemic syndrome (OIS) in a patient with a congenitally absent left internal carotid artery (ICA). Methods: Retrospective case report with anterior-segment and fundus photography, fluorescein angiography (FA), and computerized tomography angiography (CT-A). Results: A 31-year-old-man was found to have neovascularization of the iris (NVI) and angle of the left eye. FA showed capillary nonperfusion in the temporal periphery. He required intravitreal bevacizumab and triamcinolone injections and 2 panretinal photocoagulation treatments for persistent rubeosis and cystoid macular edema. Transient right-eye vision loss prompted CT-A, revealing an absent left ICA. Three years following presentation, FA continued to show delayed arteriovenous flow suggestive of OIS. He has required intravitreal bevacizumab injections every 12 weeks for persistent NVI. Conclusion: Congenitally absent left ICA with resultant cerebrovascular insufficiency is a rare cause of OIS, underscoring the pathophysiological principles of insufficient blood supply to the ophthalmic artery.
TGF-B Inhibition Rescues Hematopoietic Defects in Fanconi Anemia
Authors: Greenberger Joel S 
Published: October 2019

Abstract
Four different combinations of double knock-out mouse strains have been created (SMAD3-/- Fancd2-/-) consisting of combinations of the individual knock-out strains on either the C57BL/6 or 129/Sv background. Sets of breeding experiments were carried out and the frequency of detection of double knock-out mice was significantly below the expected frequency of detecting DKO mice by breeding double heterozygotes (1 out of 16 or 6.25%). In fact, DKO mice were detected at a frequency ranging from 3.4% to 0.54%. Mice of all four DKO genotypes showed resistance of bone marrow hematopoietic progenitor cells to canonical TGF-β signaling, consistent with the SMAD3-/- parent. However, the predominant phenotype was that of the Fancd2-/- parent including reduced duration of hematopoiesis in long-term bone marrow cultures, reduced marrow stem cell competitive repopulation capacity, and retained mitomycin C and radiation sensitivity of bone marrow stromal cells. These mice should be a valuable resource for elucidating the bypass pathways involved in the reduced, but successful gestation of SMAD3-/- Fancd2-/- mice, and the interactions of the FA and TGF-β signaling pathways.
Supported by the NIAID/NIH U19-A168021 and the Fanconi Anemia Research Fund.

Disclosures
No relevant conflicts of interest to declare.
Dasatinib Significantly Enhances the Level of Th1 Cells While Decreases the Level of Treg Cells in Chronic Myeloid Leukemia Patients, and Th1 Can be a Potential Marker for Evaluating the Therapeutic Efficacy and Prognosis
Authors: Dai Jingying , Yang Xi , Huang Xiaobing , Zheng Hong , Wang Xiaodong 
Published: October 2019

Abstract
In this study, we evaluate the T cell subtypes by flow cytometry on the chronic myeloid leukemia (CML) patients of our center who have received the treatment with dasatinib (n=10), nolotinib (n=26) or imatinib (n=44) for more than 3 months. We also analyze and correlate these data with the clinical remission situations and prognosis. Results: 1. For the anti-cancer cellular immunity associated Th1 cells: 80% of the patients in dasatinib group, 12.5% of the patients in nilotinib group, 27.5% of the patients in imatinib group have a Th1 proportion (Th1/CD4+ T) higher than the upper limit of normal. The statistical analysis shows that the Th1 proportion in dasatinib group (30.86±9.75%) is significantly higher than that in nilotinib group (17.37±9.35%, p=0.00) and in imatinib group (20.79±9.01%, p=0.00). 2. As for the CD8+ T cell proportion (CD8+ T/Lymphocyte) dasatinib group does not show the statistical difference compared with the nilotinib group and the imatinib group respectively (p=0.24; p=0.09). 3. As for the Th2 cell proportion (Th2/CD4+ T), dasatinib group does not show the statistical difference compared with nilotinib group and imatinib group (p=0.96; p=0.62). 4. The Treg proportion (Treg/CD4+ T) in dasatinib group (1.31±0.10%) is significantly lower than that in nilotinib group (2.65±0.97%, p=0.00) and in imatinib group (2.99±1.40%, p=0.00). 5. When we analyzes all the CML patients with a TKI treatment: (1) In those patients with a Th1 proportion above the upper limit of normal _ 25.8% (n=28), 84.62% of these patients obtain CCyR (complete cytogenetic response), 71.43% of these patients obtain MMR (major molecular response ), and 71.43% of these patients obtain MR4.5; (2) In those patients with a Th1 proportion in the normal range _ 11.8-25.8% (n=45), 90.7% of these patients obtain CCyR, 75.56% of these patients obtain MMR, and 75.56% of these patients obtain MR4.5; (3) In those patients with a Th1 proportion below the lower limit of normal _ 11.8% (n=21), 57.14% of these patients obtain CCyR, 47.62% of these patients obtain MMR, and 47.62% of these patients obtain MR4.5. The patients in the high Th1 level or normal Th1 level groups exhibit deeper remission level, which indicates lower risk of disease progression, higher chance for treatment-free and better prognosis. Conclusion: The data of our center indicates that during the TKI treatment for CML patients, the higher or normal level of Th1 may become a potential candidate marker to be monitored, so as to predict the better therapeutic efficacy and prognosis besides CCyR, MMR, and MR4.5. Dasatinib can significantly improve the anti-cancer immunity associated markers compared with nilotinib and imatinib, and this may be the mechanism of dasatinib to bring good therapeutic efficacy and prognosis.

Disclosures
No relevant conflicts of interest to declare.
Prevalence and Regulation of Effector CD8+ T Cell Subsets in B-Cell NHL
Authors: Wu Hongyan , Yang Zhi-Zhang , Kim Hyo Jin , Jalali Shahrzad , Price-Troska Tammy , Ansell Stephen M. 
Published: October 2019

Abstract
Effector CD8+ T cells play a crucial role in anti-tumor immunity. Two major subsets of effector CD8+ T cells have been identified based on expression of KLRG1 and CD127: KLRG1+CD127- short-lived effector cells (SLECs) and KLRG1-CD127+ memory precursor effector cells (MPECs). In B-cell non-Hodgkin lymphoma (NHL), the frequency and function of SLECs and MPECs are unknown. Furthermore, the underlying mechanism by which these two CD8+ subsets were regulated and differentiate in B-cell NHL remains poorly understood. The goal of the present study is therefore to phenotypically and functionally characterize SLECs and MPECs in B-cell NHL. Using patient biopsy specimens, we observed that the median percentage of SLECs was greater than MPECs and was 39.9% (range: 22.7%~ 54.7%) and 18% (range: 7.66%~31.6%), respectively. In controls, the median percentage of SLECs was lower than that of MPECs and was 13.71% (range: 5.26%~29.2%) and 51.63% (range: 22.5%~70.1%) in PBMC and 12.14% (range: 4.01%~26%) and 51.62% (range: 29.2%~70.3%) in tonsil, respectively. Using mass cytometry (CyTOF), we observed that SLECs have higher expression levels of TIGIT and PD-1 and lower expression of CCR7, CD26 and CD27 when compared to MPECs. SLECs were functionally superior to MPECs as the numbers of cytokine (IFN-γ and TNF-α) - and granule (granzyme B and perforin)-producing cells were higher in SLECs than MPECs. However, SLECs had a lower proliferative capacity and a higher apoptosis rate when compared to MPECs. We observed that a reciprocal differentiation pathway exists between SLECs and MPECs. Activation and cytokine stimulation (IL-2 and IL-15) promoted the development of SLECs and decreased the number of MPECs. This effect was reversed when cells were treated with neutralizing antibodies to block IL-2 or IL-15 signaling. We also found that these two subsets had a distinct transcription factor profile as SLECs had higher expression of Eomes and T-bet, and lower expression of Tcf-1than MPECs. IL-2 and IL-15 enhanced the expression of T-bet and decreased the expression of Tcf-1. Taken together, our results show that SLECs are more prevalent than MPECs in B-cell NHL when compared to normal control tissue. These two effector cell subsets have distinct phenotypical and function profiles and their development is controlled by cytokines that may be dysregulated in lymphoma. Despite the fact that SLECs produce more granzyme B and IFN-γ, they are less proliferative and more susceptible to apoptosis. This may compromise an effective anti-tumor immune response in B-cell NHL.

Disclosures
Ansell: Celldex: Research Funding; Takeda: Research Funding; Merck & Co: Research Funding; Affimed: Research Funding; Bristol-Myers Squibb: Research Funding; Trillium: Research Funding; Regeneron: Research Funding; LAM Therapeutics: Research Funding; Pfizer: Research Funding; Seattle Genetics: Research Funding.
Study of Treatment-Free Remission Evaluation in Real-World Chronic Myeloid Leukemia; Cost-Effectiveness Analysis
Authors: Nam Bora , Kim Soktae , Lee Jae Hoon , Yoo Kwai Han , Ahn Jeong-Yeal , Kim Hawk 
Published: October 2019

Abstract
Chronic myeloid leukemia (CML) needs taking life-long tyrosine kinase inhibitor (TKI) which arises serious toxicities such as peripheral occlusive disease and pulmonary hypertension as well as low-grade toxicities. Treatment-free remission (TFR) can make almost half CML patients achieving deep molecular response (DMR) free from TKIs. We investigated total costs of each TKI considering TFR in Korea.
Total numbers of annual newly-diagnosed CML patients were adopted from national cancer registration database. TFR was defined as achieving MR4.5 and lasting for 3 years. The proportion of MR4.5 was adopted from phase III studies of imatinib (IM), nilotinib (NIL) and dasatinib (DAS). TKI management followed life-long Markov model (Fig 1). Willingness to pay (WTP)was calculated for beneficial effects of patients who have achieved TFR and taking no TKIs as 2 times of gross domestic product per capita. Cost of progression was calculated based on the study by Jabbour et al. Patients older than 79y was not included in this study because TFR benefit is not considered in this age group. Duration of treatment and TFR was calculated separately according to age groups. We assumed that taking KTI lasted life-long until median life expectancy in Korea (80.87 years).
Newly diagnosed annual CML patients were 443; 9 in age 0-14, 96 in age 15-34, 125 in age 35-49, 124 in age 50-64 and 89 in age 65-79. The theoretical number of patients who have sustainable TFR was 73 in IM, 93 in DAS and 119 in NIL. TFR as person-year in IM, DAS and NIL were 1940, 2521 and 3247, respectively. TFR (person-year) was very different according to age groups because of different incidence rates; 99.9 in age 0-14, 788.7 in age 15-34, 666.1 in age 35-49, 353.8 in age 50-64 and 33.7 in age 65-79 when IM was applied. TFR (person-year) were 128.2 in age 0-14, 1014.5 in age 15-34, 861.6 in age 35-49, 464.1 in age 50-64 and 52.8 in age 65-79 when DAS was applied. TFR (person-year) were 164.9 in age 0-14, 1305.6 in age 15-34, 1109.4 in age 35-49, 598.3 in age 50-64 and 69.0 in age 65-79 when NIL was applied. WTP according to TFR was 121.3 in IM, 157.5 in DAS and 202.8 billion KW in NIL. Costs by progression were 32.8 in IM, 26.8 in DAS and 22.3 billion KW in NIL. Life-long maintenance costs for patients who did not achieved sustainable TFR without progression were 128.7 in IM, 294.2 in DAS and 327.1 billion KW in NIL. Net costs considering TFR and progression were 40.2 in IM, 163.5 in DAS and 146.6 billion KW in NIL.
Nilotinib was superior to other TKIs in terms of TFR benefit and progression cost according to our life-time Markov model. However, the net cost was lowest in IM. This analysis is limited by our assumption that MR4.5 is achieved by first 5 year and there is no further additional achievement of MR4.5 because of limitation of MR4.5 rates in each TKI trial.
Figure. Figure.

Disclosures
No relevant conflicts of interest to declare.