bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thrombectomy Results in Reduced Hospital Stay, More Home-Time, and More Favorable Living Situations in DEFUSE 3
Authors: Tate William J. , Polding Laura C. , Kemp Stephanie , Mlynash Michael , Heit Jeremy J. , Marks Michael P. , Albers Gregory W. , Lansberg Maarten G. 
Published: July 2019

Background and Purpose—
The DEFUSE 3 trial (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) demonstrated that endovascular thrombectomy in the 6- to 16-hour time window improves functional outcomes of patients with evidence of salvageable tissue on baseline computed tomography or magnetic resonance imaging. The purpose of this study is to assess the effect of endovascular therapy on length of hospital stay, home-time during the first 3 months poststroke, and living situation poststroke in DEFUSE 3.

Methods—
Duration of hospital stay and home-time (number of days during the 90-day poststroke period that the patient resides in their own home or in that of a relative) were compared between treatment groups using the Wilcoxon rank-sum test. Patient living situation was assessed at discharge, 30 days, and 90 days on an ordinal 4-point scale (home, acute rehabilitation unit, institutionalized care, or hospice/death) and differences between groups were analyzed using the Cochran-Armitage trend test.

Results—

Median length of hospital stay was 9.1 (interquartile range, 6.2–15.0) days in the medical group versus 6.5 (interquartile range, 3.7–9.3) days in the endovascular group (
P
<0.001). Median home-time during the first 90 days after stroke was 0 (interquartile range, 0–53) days in the medical group versus 55 (interquartile range, 0–83) days in the endovascular group (
P
<0.001). The endovascular group had more favorable living situations at time of discharge (
P
<0.001), 30 days (
P
<0.001), and 90 days (
P
<0.001) poststroke.

Conclusions—
Endovascular thrombectomy resulted in reduced hospital stay, more home-time, and more desirable living situations in the 90 days after stroke. These results provide evidence that endovascular therapy in the delayed time window can improve quality of life for stroke patients and reduce healthcare costs.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02586415.
Derivo Embolization Device for the Treatment of Intracranial Aneurysms
Authors: Trivelato Felipe Padovani , Abud Daniel Giansante , Ulhôa Alexandre Cordeiro , Waihrich Eduardo Siqueira , Abud Thiago Giansante , Castro Afonso Luis Henrique , Nakiri Guilherme Seizem , de Castro Guilherme Duarte , Parente Bruno de Sousa Mendes , dos Santos Silva Rodrigo , Manzato Luciano Bambini , Bonadio Lucas Eduardo , Viana Dinark Conceição , Vanzin José Ricardo , Baccin Carlos Eduardo , Rezende Marco Túlio Salles 
Published: July 2019

Background and Purpose—
Flow diverter technology improvements are necessary to provide safe and good results and enable the treatment of a larger variety of aneurysms. We report a nationwide experience with the Derivo Embolization Device in the treatment of intracranial aneurysms.

Methods—
BRAIDED (Brazilian Registry of Aneurysms Assigned to Intervention With the Derivo Embolization Device) is a multicenter, prospective, interventional, single-arm trial of the Derivo Embolization Device for the treatment of intracranial aneurysms. The primary effectiveness end point was total aneurysm occlusion at 6- and 12-month angiographies. The secondary safety end point was the absence of serious adverse events during follow-up. Univariable and multivariable logistic regression was performed to identify predictors of aneurysm persistence, periprocedural complications, and adverse events during follow-up.

Results—
Between December 2016 and October 2018, 146 patients harboring 183 intracranial aneurysms were treated in 151 interventions at 7 centers. Derivo Embolization Device placement was technically successful in all patients. Most aneurysms (86.9%) were located at the internal carotid artery, and the mean diameter was 6.7 mm. At 6 months, 113 of 140 (80.7%) aneurysms met the study’s primary end point, and 74 of 83 (89.2%) met the study’s primary end point at 12 months. Saccular morphology of the aneurysm (odds ratio, 5.66; 95% CI, 1.01–31.77) and the presence of a branch arising from the sac (odds ratio, 6.36; 95% CI, 2.11–22.36) predicted persistence. A long duration of follow-up (odds ratio, 0.86; 95% CI, 0.78–0.95) predicted total occlusion. Of the 146 enrolled patients, 138 (94.5%) were treated without serious adverse events during follow-up. In the multivariable analysis, aneurysms located at a sidewall were less likely to experience these events than those located at bifurcations (odds ratio, 0.07; 95% CI, 0.01–0.51).

Conclusions—
The Derivo Embolization Device is a safe and effective treatment for intracranial aneurysms.

Clinical Trial Registration—

URL:
http://plataformabrasil.saude.gov.br/login.jsf
. Unique identifier: CAAE 77089717.7.1001.5125.
Uncovering Neotropical treefrog diversity: integrative taxonomy reveal paraphyly in Boana atlantica (Amphibia, Anura, Hylidae)
Authors: Lima Luana Rodrigues , Dubeux Marcos Jorge Matias , do Nascimento Filipe Augusto Cavalcanti , Bruschi Daniel Pacheco , Mott Tamí 
Published: July 2019

Abstract
Boana atlantica was described based on morphological characters to acommodate populations from Bahia state, Brazil, previously referred to as B. punctata. However, its taxonomic validity is questionable due to inconsistencies in bioacoustic data. Here, we integrate molecular, cytogenetic and morphological data to re-evaluate the taxonomic status of B. atlantica. Molecular analyses provided strong support for the hypothesis that B. atlantica is a valid species, being, however, nominal populations from Bahia state paraphyletic with respect to individuals of B. atlantica collected in Alagoas and Pernambuco states. These populations shown high genetic divergence in the 16S rRNA mitochondrial fragment, and we consider populations from Alagoas and Pernambuco as a putative new candidate species of Boana punctata group. The external and internal morphology of the tadpoles of these lineages were similar, but Nucleolar Organizer Regions (NOR) was sited in different chromosomes. Our results indicate that B. atlantica is paraphyletic and may be a complex of species. Morphological of adult and/or bioacoustical data should be further assessed to find diagnostic characters to tease these lineages apart and name them properly.
Schoolchildren’s play – A tool for health education
Authors: Sjöblom Margareta , Jacobsson Lars , Öhrling Kerstin , Kostenius Catrine 
Published: July 2019

Objective: The purpose of this study was to gain more knowledge about the phenomenon of the inner child in relation to health and well-being as reflected in play experienced by schoolchildren. Design/method: Participants were 20 schoolchildren recruited from a primary school in a medium-size city in central Sweden. The children who agreed to participate were 14 girls and 6 boys aged between 9 and 10 years old in grade 3. A hermeneutic phenomenological approach was used to analyse the data consisting of the schoolchildren’s drawings and transcribed interviews. Participants’ verbal reflections on their drawings enabled deeper insight into their lived experiences of play. Results: Findings from this study demonstrate how schoolchildren are influenced by the inner child in childhood to handle conflicts, to cope, to make choices, to build relationships to connect and to dream about the future. The schoolchildren in this study developed their coping skills in conflict situations as part of friendship making. Conclusion: The value play offers for health and well-being reveals how schoolchildren are influenced by the inner child in childhood. Gaining knowledge from schoolchildren’s own voices about play makes a worthwhile contribution to research. In addition, the value play provides to schoolchildren’s health and well-being suggest that play can be an important tool as part of health education.
Cortical 5-hydroxytryptamine 1A receptor biased agonist, NLX-101, displays rapid-acting antidepressant-like properties in the rat chronic mild stress model
Authors: Depoortère Ronan , Papp Mariusz , Gruca Piotr , Lason-Tyburkiewicz Magdalena , Niemczyk Monika , Varney Mark A , Newman-Tancredi Adrian 
Published: July 2019

Background: NLX-101 (also known as F15599) is a highly selective and efficacious ‘biased’ agonist at cortical 5-hydroxytryptamine 1A (5-HT1A) heteroreceptors. In rodents, it possesses marked antidepressant-like activity, potently and completely abolishing immobility in the forced swim test (FST) with extended duration of action. Methods: We investigated the antidepressant-like activity of NLX-101 using the rat chronic mild stress (CMS) model of depression, considered to have a higher translational potential than the FST, as it possesses construct, face and predictive validity. The effects of CMS and repeated NLX-101 treatment were tested using sucrose consumption (a measure of anhedonia), novel object recognition (NOR; a measure of working memory) and elevated plus maze (EPM; a measure of anxiety) tests. Results: NLX-101 reversed the CMS-induced decrease of sucrose intake on day 1 of testing, with full reversal observed at the dose of 0.16 mg/kg and a less pronounced but still significant effect at 0.04 mg/kg, both given twice a day intraperitoneally. The effects of NLX-101 were maintained over the 2 week treatment period and persisted for four weeks following cessation of treatment. In the NOR test, both doses of NLX-101 rescued the deficit in discrimination index caused by CMS, without any effect on locomotor activity. However, NLX-101 had no effect on the reduction of open-arms entries produced by CMS in the EPM model. In control, non-stressed rats, NLX-101 produced non-significant effects in all three models. Conclusions: NLX-101 displayed efficacious activity in the CMS test, with more rapid (1 day) antidepressant-like effects than pharmacological compounds tested previously under the same experimental conditions. These observations suggest that biased agonist targeting of cortical 5-HT1A receptors constitutes a promising strategy to achieve rapid-acting and sustained antidepressant effects.
Demonstrating the value of the oncology pharmacist within the healthcare team
Authors: M Segal Eve , Bates Jill , Fleszar Sara L , Holle Lisa M , Kennerly-Shah Julie , Rockey Michelle , Jeffers Kate D 
Published: July 2019

Introduction Although many oncology pharmacists are embedded members within the healthcare team, data documenting their contributions to optimal patient outcomes are growing. The purpose of this paper is to demonstrate the value of the oncology pharmacist within the healthcare team and describe the knowledge, skills, and functions of the oncology pharmacist. Methods A systematic literature review of articles that were published on PubMed between January 1951 and October 2018 was completed. Identified abstracts were reviewed and included if they focused on measuring the value or impact of the oncology pharmacist on provider/patient satisfaction, improvement of medication safety, improvement of quality/clinical care outcomes, economics, and intervention acceptance. Review articles, meta-analysis, and studies not evaluating oncology pharmacist activities were excluded. Studies were thematically coded into four themes (clinical care, patient education, informatics, and cost savings) by 10 oncology pharmacists. Results Four-hundred twenty-two articles were identified, in which 66 articles met inclusion criteria for this review. The selected literature included 27 interventional and 38 descriptive studies. The value of the oncology pharmacist was demonstrated by published articles in four key themes: clinical care, patient education, informatics, and cost savings. Conclusion With an expected shortage of oncology physicians and the ongoing development of complex oncology therapies, the board-certified oncology pharmacist is well suited to serve as a physician extender alongside nurse practitioners and/or physician assistants as the medication expert on the oncology care team. The demonstrated value of the oncology pharmacist supports their role as frontline providers of patient care.
The Influence of Cervical Spondylolisthesis on Clinical Presentation and Surgical Outcome in Patients With DCM: Analysis of a Multicenter Global Cohort of 458 Patients
Authors: Nouri Aria , Kato So , Badhiwala Jetan H. , Robinson Michael , Mejia Munne Juan , Yang George , Jeong William , Nasser Rani , Gimbel David A. , Cheng Joseph S. , Fehlings Michael G. 
Published: July 2019

Study Design: Ambispective study with propensity matching. Objective: To assess the impact of cervical spondylolisthesis (CS) on clinical presentation and surgical outcome in patients with degenerative cervical myelopathy (DCM). Methods: A total of 458 magnetic resonance images (MRIs) from the AOSpine CSM-NA and CSM-I studies were reviewed and CS was identified. Patients with DCM were divided into 2 cohorts, those with CS and those without, and propensity matching was performed. Patient demographics, neurological and functional status at baseline and 2-year follow-up were compared. Results: Compared with nonspondylolisthesis (n = 404), CS patients (n = 54) were 8.8 years older ( P < .0001), presented with worse baseline neurological and functional status (mJOA [modified Japanese Orthopaedic Association Assessment Scale], P = .008; Nurick, P = .008; SF-36-PCS [Short Form–36 Physical Component Score], P = .01), more commonly presented with ligamentum flavum enlargement (81.5% vs 53.5%, P < .0001), and were less commonly from Asia ( P = .0002). Surgical approach varied between cohorts ( P = .0002), with posterior approaches favored in CS (61.1% vs 37.4%). CS patients had more operated levels (4.3 ± 1.4 vs 3.6 ± 1.2, P = .0002) and tended to undergo longer operations (196.6 ± 89.2 vs 177.2 ± 75.6 minutes, P = .087). Neurological functional recovery was lower with CS (mJOA [1.5 ± 3.6 vs 2.8 ± 2.7, P = .003]; Nurick [−0.8 ± 1.4 vs −1.5 ± 1.5, P = .002]), and CS was an independent predictor of worse mJOA recovery ratio at 2 years (B = −0.190, P < .0001). After propensity matching, improvement of neurological function was still lower in CS patients (mJOA [1.5 ± 3.6 vs 3.2 ± 2.8, P < .01]; Nurick [−0.8 ± 1.4 vs −1.4 ± 1.6, P = .02]). Conclusions: CS patients are older, present with worse neurological/functional impairment, and receive surgery on more levels and more commonly from the posterior. CS may indicate a more advanced state of DCM pathology and is more likely to result in a suboptimal surgical outcome.
Dhat Syndrome: Study of Clinical Presentations in a Teaching Institute of Eastern Nepal
Authors: Shakya Dhana Ratna 
Published: July 2019

Background: “Dhat syndrome” is described as a culture-bound syndrome, common mainly in the Southeast Asian region, including Nepal. We have limited data on this problem from Nepal. Objective: To study clinico-demographic profile of “Dhat syndrome” cases, with the focus on its clinical presentations seen in psychiatry out-patient clinic of B. P. Koirala Institute of Health Sciences (BPKIHS). Methodology: All consecutive out-patients with the diagnosis of “Dhat syndrome” coming into contact of the investigator in psychiatry OPD were enrolled during 12 months of study period. A pretested short questionnaire, including their view about “semen loss” and “masturbation,” was used. Psychiatric diagnoses were made according the International Classification of Diseases, Tenth Revision (ICD-10). Results: Majority of the subjects were of productive ages; average age was 25 years. More of them were of Terai origin and from villages, though there were people also from other ethnic groups and urban settings. Most of them were educated but up to a middle/secondary level only. Most of the cases presented with depressive and anxiety symptoms, and semen loss, and were worried because they had heard or read that semen loss or masturbation was bad for health. They viewed semen as precious, something to be preserved, and masturbation a bad practice. Beside Dhat syndrome, two-thirds of the subjects (68%) had other ICD-10 psychiatric disorders, the most common being depression. Conclusion: Psychiatric diagnoses are common among patients with “Dhat syndrome.” Most of these people view semen loss as a bad sign and masturbation a bad habit. Sex education is warranted for better health.
Contributions of T cell dysfunction to the resistance against anti-PD-1 therapy in oral carcinogenesis
Authors: Wen Liling , Lu Huanzi , Li Qiusheng , Li Qunxing , Wen Shuqiong , Wang Dikan , Wang Xi , Fang Juan , Cui Jun , Cheng Bin , Wang Zhi 
Published: July 2019

Abstract
Background
Programmed death 1 (PD-1) blockade has great effect in the prevention of oral precancerous lesions, but the drug resistance has also been observed. The determinants of immune resistance during the malignant transformation are poorly understood.

Methods
Anti-PD-1 antibody was administered in the 4NQO-induced carcinogenesis mouse models. The mice were then subdivided into PD-1 resistance(PD-1R) group and PD-1 sensitive(PD-1S) group according to the efficacy. The expression of PD-1 and PD-L1, and the abundance of CD3+ T cells in tumor microenvironment between the two groups was tested by immunohistochemistry. In addition, the activation and effector functions, as well as the accumulation of immunosuppressive cells and expression of immune checkpoints of T cells in the draining lymph nodes and spleen between PD-1R and PD-1S group were analyzed by flow cytometry.

Results
Our results showed that T cell infiltration in tumor microenvironment, effector T cell cytokine secretion and central memory T cell accumulation in peripheral lymphoid organs were all inhibited in the anti-PD-1 resistance group. Furthermore, we found that an increase of regulatory T cell (Treg) population contributed to the resistance of the anti-PD-1 therapy. Notably, TIM-3 was found to be the only immunosuppressive molecule that mediated the resistance to anti-PD-1 therapy in the oral malignant transformation model.

Conclusions
Our findings identified a novel mechanism that T cell dysfunction contributes to the immune resistance during the malignant transformation of the oral mucosa. This study provides new targets for improving the efficacy of immunotherapy for early stage of tumorigenesis.
Micro differential scanning calorimetry and micro hot table method for quantifying deterioration of historical leather
Authors: Carsote Cristina , Badea Elena 
Published: July 2019

Abstract
The aim of this study was to advance the current understanding on the mechanism of deterioration of historical vegetable tanned leathers and establish new criteria for quantifying their deterioration using micro differential scanning calorimetry (micro DSC) and micro hot table (MHT) method. Ten historical leather objects were investigated to this purpose. The calorimetric indices of macromolecular change identified for fibrous collagen provided quantitative results on the bulk material and deconvolution of DSC denaturation peaks revealed the dynamics of deterioration in historical leather. The results brought clear evidence that long-term natural ageing of leather induces the destabilization of chemically modified collagen thereby promoting its partial de-tanning and allowing micro-unfolding of chemically unmodified collagen. As deterioration continues toward the extreme, collagen molecules become highly unstable allowing for gelatinisation and irreversible denaturation. It is thus explained the coexistence of collagen populations with distinct thermal stability in historical leather. They are grouped in three main structural domains, namely “leather-like”, “parchment-like” and “gelatine-like”, whose mass percentages determines leather stability against further natural ageing and deterioration. As a result of the MHT and micro DSC parameters correlation, a more comprehensive set of criteria, including T
f and T
l values, as well ∆C and ∆T intervals’ lengths, was introduced for better interpreting the shrinking activity of collagen in historical vegetable-tanned leathers and open thus the way for the highly sought in situ evaluation of leather artefacts.
Metastatic Breast Cancer in Kenya: Presentation, Pathologic Characteristics, and Patterns—Findings From a Tertiary Cancer Center
Authors: Ekpe Etoroabasi , Shaikh Asim Jamal , Shah Jasmit , Jacobson Judith S. , Sayed Shahin 
Published: July 2019

PURPOSE The purpose of this research was to describe the sociodemographic and clinical characteristics of Kenyan women with metastatic breast cancer diagnosed and treated at Aga Khan University Hospital in Nairobi, Kenya from 2012 to 2018. PATIENTS AND METHODS We reviewed charts of Kenyan women with metastatic breast cancer and analyzed sociodemographic data, breast cancer risk factors, and tumor characteristics associated with stage at diagnosis, receptor status (ie, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 [HER2]), and site of metastasis using χ2, analysis of variance, two-sample t tests, and logistic regressions. RESULTS A total of 125 cases with complete medical records were included in the analysis. Forty women (32%) had metastases at diagnosis. Of the others, those diagnosed in stage III developed metastases sooner than those diagnosed in stage II ( P < .001). Fifty-eight percent of patients had metastases to bone, 14% to brain, 57% to lungs, and 50% to liver. Seventy-four percent of patients presented with more than one metastatic site. Metastases to bone were associated with greater age at diagnosis ( P = .02) and higher parity ( P = .04), and metastases to the brain were associated with early menopause ( P = .04), lower parity ( P = .04), and lack of breastfeeding ( P = .01). Patients whose tumors were triple negative (estrogen receptor-negative, progesterone receptor-negative, and HER2 negative) were more likely to develop brain metastases ( P = .01), and those whose tumors were HER2 positive were more likely to develop liver metastases ( P = .04). CONCLUSION Although our data on patterns of metastases and pathologic subtypes are similar to those in published literature, some unique findings concerning hormonal risk factors of women with metastatic breast cancer and specific metastatic sites need additional exploration in larger patient populations.
Estrogen Signaling Drives Ciliogenesis in Human Endometrial Organoids
Authors: Haider Sandra , Gamperl Magdalena , Burkard Thomas R , Kunihs Victoria , Kaindl Ulrich , Junttila Sini , Fiala Christian , Schmidt Katy , Mendjan Sasha , Knöfler Martin , Latos Paulina A 
Published: July 2019

Abstract
The human endometrium is the inner lining of the uterus consisting of stromal and epithelial (secretory and ciliated) cells. It undergoes a hormonally regulated monthly cycle of growth, differentiation, and desquamation. However, how these cyclic changes control the balance between secretory and ciliated cells remains unclear. Here, we established endometrial organoids to investigate the estrogen (E2)-driven control of cell fate decisions in human endometrial epithelium. We demonstrate that they preserve the structure, expression patterns, secretory properties, and E2 responsiveness of their tissue of origin. Next, we show that the induction of ciliated cells is orchestrated by the coordinated action of E2 and NOTCH signaling. Although E2 is the primary driver, inhibition of NOTCH signaling provides a permissive environment. However, inhibition of NOTCH alone is not sufficient to trigger ciliogenesis. Overall, we provide insights into endometrial biology and propose endometrial organoids as a robust and powerful model for studying ciliogenesis in vitro.