bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surface modification of metallic materials designed for a new generation of artificial heart valves
Authors: Major Roman , Gonsior Malgorzata , Sanak Marek , Kot Marcin , Kustosz Roman , Lackner Juergen M 
Published: August 2018

Purpose: The main goal of this work was to develop haemocompatibile thin film materials dedicated to novel flexible mechanical heart valves intended for pulsatile ventricle assist devices. Methods: The studies performed have led to the selection of a material for the surface modification of the metallic scaffold. Haemocompatible, biofunctional, ultra-elastic, thin carbon-based coatings were proposed. The surface was designed to eliminate thrombogenic and microbial construction by a reduction in turbulence and sufficient washing of the biofunctional-adapted surfaces, thus allowing for extended use for temporary heart support. The article presents the influence of the mechanical properties of coatings and their influence on the haemocompatibility. In this study, we investigated a simplified model of the whole blood shear stress based on a cone and plate rotational viscometer. Several indices of platelet activation were analysed, including platelet and granulocyte-platelet aggregates, platelet activation markers and platelet-derived microparticles. Results: The shear stress induced a platelet aggregate count in the range from 2% to 30% of the CD61 positive cells. For polyurethane (PU), the average value of platelet aggregates was on the level of 7%. The analyses have demonstrated that the cytometric methods of the direct determination of platelet-derived microparticles in plasma are reproducible and reliable. Considering the generation of microparticles on the tested coatings under hydrodynamic conditions, the best properties were observed for the coating a-C:H,N. Conclusion: The results indicate that a-C:H-based coatings with the thickness of 110 nm do not induce an immune response and do not influence the origin of platelet microparticle formation; thus, these type of coatings are the most promising for the parts which are planned to withstand blood contact under the high value of shear stress.
Recurrent seizures in cats: Diagnostic approach – when is it idiopathic epilepsy?
Authors: Hazenfratz Michal , Taylor Susan M 
Published: August 2018

Practical relevance: Seizures are one of the most common neurologic problems recognized in cats, affecting approximately 1–3% of the general population. Treatment options and prognosis are closely related to the underlying cause, so it is important that veterinarians are familiar with the diagnostic approach to cats with seizures and options for medical management. Series outline: This is the first of a two-part article series that reviews the diagnosis and treatment of seizures in cats. Part 1 outlines the classification and terminology used to describe epilepsy and epileptic seizures in cats, and discusses some of the most common and unique causes of recurrent seizures in cats. The diagnostic approach to cats with recurrent seizures is addressed, as are criteria for the diagnosis of idiopathic epilepsy. Audience: This review of recurrent seizures in cats is intended for all veterinarians who are facing the challenges of seizure diagnosis and management in the feline patient. Evidence base: Recommendations for diagnosis and management of feline seizure disorders have historically been extrapolated from the canine and human literature. The information and guidance provided in this two-part series is based on a review of the recent published literature addressing seizure disorders and antiepileptic treatment in cats, as well as the authors’ clinical experience.
Novel treatment of a totally occluded venous outflow tract of an arteriovenous graft
Authors: Farrington Crystal A , Abdel-Aal Ahmed K , Almehmi Ammar 
Published: August 2018

Introduction: Conventional guidewire techniques are not always sufficient to restore arteriovenous graft patency in patients with challenging vascular scenarios. We discuss a novel approach to the treatment of chronic total occlusion of the venous outflow tract to enable successful arteriovenous graft thrombectomy. Case presentation: A 28-year-old female with end-stage renal disease on chronic hemodialysis and recurrent arteriovenous graft thromboses presented with a clotted thigh graft. An existing ipsilateral common femoral vein stent was found to be chronically occluded, causing persistent venous outflow obstruction and rendering an initial attempt at thrombectomy unsuccessful due to wire buckling and the inability to navigate through the stent chronic total occlusion. Results: After establishing femoral vein access, a vibrational recanalization device was used to cross the occluded stent. The device was then removed, permitting routine angioplasty. Post-angioplasty angiogram revealed persistent intra-stent stenosis, so a covered stent was deployed with good angiographic results. Routine pharmaco-mechanical thrombectomy of the arteriovenous graft was then performed. Two additional stents were placed due to stenotic recoil in the venous limb of the graft. Angioplasty was also performed at the arteriovenous graft arterial anastomosis. Repeat imaging demonstrated marked improvement in the graft blood flow. Discussion: Total occlusion of the venous outflow tract prevents adequate blood flow through an arteriovenous graft and undermines successful thrombectomy. We describe the use of the Crosser vibrational recanalization device for the safe and effective treatment of a chronic total occlusion of the venous outflow tract, thus extending the life of the patient’s vascular access for hemodialysis.
Toward a low-cost, in-home, telemedicine-enabled assessment of disability in multiple sclerosis
Authors: Bove Riley , Bevan Carolyn , Crabtree Elizabeth , Zhao Chao , Gomez Refujia , Garcha Priya , Morrissey John , Dierkhising Jason , Green Ari J , Hauser Stephen L , Cree Bruce AC , Wallin Mitchell T , Gelfand Jeffrey M 
Published: August 2018

Background: Remote assessment of neurological disability in people with multiple sclerosis (MS) could improve access to clinical care and efficiency of clinical research. Objective: To develop and validate a telemedicine-based MS disability examination that does not require an in-home examiner. Methods: Adults with MS were recruited after a standardized in-person Expanded Disability Status Scale (EDSS) evaluation, and within 1 week underwent a blinded televideo-enabled EDSS examination with a different clinician. EDSS and tele-EDSS scores were compared. Results: Overall, 41 adults participated (mean (standard deviation (SD)) age: 47.0 years (11.6); median EDSS: 2 (range: 0–7)); 37 required no in-home assistance for the tele-EDSS evaluation (e.g. help positioning camera). Mean difference between EDSS and tele-EDSS was 0.34 (95% confidence interval (CI): 0.07–0.61). For 88% of evaluations, tele-EDSS and EDSS scores were within 1 point (similar to reported in-person inter-rater differences). Unweighted kappa for agreement within 0.5 point was 0.72. Correlation for individual functional systems (FS) ranged from modest (vision: 0.37) to high (bowel/bladder: 0.79). Overall correlation between EDSS and tele-EDSS was 0.89 ( p < 0.0001); and 0.98 ( p < 0.0001) at EDSS range: 4–7. Conclusion: In this proof of principle study, disability evaluation in mild to moderate MS is feasible using telemedicine without an aide at the patient’s location.
Moving forward toward standardizing analysis of quality of life data in randomized cancer clinical trials
Authors: Bottomley Andrew , Pe Madeline , Sloan Jeff , Basch Ethan , Bonnetain Franck , Calvert Melanie , Campbell Alicyn , Cleeland Charles , Cocks Kim , Collette Laurence , Dueck Amylou C , Devlin Nancy , Flechtner Hans-Henning , Gotay Carolyn , Greimel Eva , Griebsch Ingolf , Groenvold Mogens , Hamel Jean-Francois , King Madeleine , Kluetz Paul G , Koller Michael , Malone Daniel C , Martinelli Francesca , Mitchell Sandra A , Moinpour Carol M , Musoro Jammbe Z , O’Connor Daniel , Oliver Kathy , Piault-Louis Elisabeth , Piccart Martine , Pimentel Francisco L , Quinten Chantal , Reijneveld Jaap C , Schürmann Christoph , Smith Ashley Wilder , Soltys Katherine M , Sridhara Rajeshwari , Taphoorn Martin J B , Velikova Galina , Coens Corneel 
Published: August 2018

Background There is currently a lack of consensus on how health-related quality of life and other patient-reported outcome measures in cancer randomized clinical trials are analyzed and interpreted. This makes it difficult to compare results across randomized controlled trials (RCTs) synthesize scientific research, and use that evidence to inform product labeling, clinical guidelines, and health policy. The Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data for Cancer Clinical Trials (SISAQOL) Consortium aims to develop guidelines and recommendations to standardize analyses of patient-reported outcome data in cancer RCTs. Methods and Results Members from the SISAQOL Consortium met in January 2017 to discuss relevant issues. Data from systematic reviews of the current state of published research in patient-reported outcomes in cancer RCTs indicated a lack of clear reporting of research hypothesis and analytic strategies, and inconsistency in definitions of terms, including “missing data,”“health-related quality of life,” and “patient-reported outcome.” Based on the meeting proceedings, the Consortium will focus on three key priorities in the coming year: developing a taxonomy of research objectives, identifying appropriate statistical methods to analyze patient-reported outcome data, and determining best practices to evaluate and deal with missing data. Conclusion The quality of the Consortium guidelines and recommendations are informed and enhanced by the broad Consortium membership which includes regulators, patients, clinicians, and academics.
Upregulation of LGALS1 is associated with oral cancer metastasis
Authors: Li Ji-Min , Tseng Chien-Wei , Lin Chi-Chen , Law Ching-Hsuan , Chien Yu-An , Kuo Wen-Hung , Chou Hsiu-Chuan , Wang Wen-Ching , Chan Hong-Lin 
Published: August 2018

Background: Oral cancer metastasis is a devastating process that contributes to poor prognosis and high mortality, yet its detailed underlying mechanisms remain unclear. Here, we aimed to evaluate metastasis-specific markers in oral cancer and to provide comprehensive recognition concerning functional roles of the specific target in oral cancer metastasis. Methods: Lectin, galactoside-binding, soluble, 1 (LGALS1) was identified by secretomic analysis. LGALS1 expression of patient samples with oral cancer on the tissue microarray were examined by immunochemical (IHC) staining. Small interfering RNA (siRNA)-mediated knockdown of LGALS1 revealed the role of LGALS1 in oral cancer metastasis in vitro and in vivo. Results: LGALS1 was observed to be upregulated in highly invasive oral cancer cells, and elevated LGALS1 expression was correlated with cancer progression and lymph node metastasis in oral cancer tissue specimens. Functionally, silencing LGALS1 resulted in suppressed cell growth, wound healing, cell migration, and cell invasion in oral cancer cells in vitro. Knockdown of LGALS1 in highly invasive oral cancer cells dramatically inhibited lung metastasis in an in vivo mouse model. Mechanistic studies suggested p38 mitogen-activated protein kinase (MAPK) phosphorylation, upregulated MMP-9, and mesenchymal phenotypes of epithelial-mesenchymal transition (EMT) in highly invasive oral cancer cells, whereas siRNA against LGALS1 resulted in the inactivation of p38 MAPK pathway, downregulated MMP-9, and EMT inhibition. Conclusions: These findings demonstrate that elevated LGALS1 is strongly correlated with oral cancer progression and metastasis, and that it could potentially serve as a prognostic biomarker and an innovative target for oral cancer therapy.
Comparison of Electrophysiological Properties and Gene Expression between Human Chondrocytes and Chondroprogenitors Derived from Normal and Osteoarthritic Cartilage
Authors: Kachroo Upasana , Livingston Abel , Vinod Elizabeth , Sathishkumar Solomon , Boopalan P. R. J. V. C. 
Published: August 2018

Objectives Bone-marrow mesenchymal stem cells (MSCs) and chondrocytes are currently used for cell-based therapy in cartilage repair. Chondroprogenitors (CPs), resident cells of articular cartilage, demonstrate likeness to stem cells. Reports suggest that chondrocytes phenotype is altered in culture, thus making differentiation between the two cell populations difficult. Our objectives were to electrophysiologically assess chondrocytes and CPs, compare their mRNA expression with that of ionic channels already reported in MSCs, and to observe the effect of time in culture and osteoarthritic damage on cells. Design and Results Chondrocytes and CPs at passages 0 (p0) and 5 (p5) derived from normal and osteoarthritic (OA) knee joints were used. Ionic currents were recorded by subjecting cells to depolarizing voltage pulses, and reverse transcriptase-polymerase chain reaction (RT-PCR) was used for studying ion channel expression. Our results demonstrated that both chondrocytes and CPs showed the presence of similar currents belonging to voltage-gated potassium channel subfamily, with RT-PCR confirming high mRNA expression of Maxi K, HKv1.1, HKv1.4, HKv4.2, and hEAG1 channels. Our finding also suggested that CPs were comparatively more sensitive to increased time in culture and inflammatory processes as observed in OA, as was evidenced by the significant decrease in mean current density (p0 normal CP: 183.171 ± 50.80 pA/pF; p5 normal CP: 50.225 ± 17.63 pA/pF; P = 0.0280) and significant increase in cellular size (p0 normal CP: 21.564 ± 2.98 pF; p0 OA CP: 37.939 ± 3.55 pF; P = 0.0057). Conclusion Both cell types appear to be optimal candidates for cell-based therapy although initial seeding density, cell source (normal vs. OA), and time in culture are matters of concern, prior to cell-type selection.
Clinical and genetic associations with prostacyclin response in pulmonary arterial hypertension
Authors: Halliday Stephen J. , Xu Meng , Thayer Timothy E. , Mosley Jonathan D. , Sheng Quanhu , Ye Fei , Farber‐Eger Eric H. , Pugh Meredith E. , Robbins Ivan R. , Assad Tufik R. , West James D. , Brittain Evan L. , Hemnes Anna R. 
Published: August 2018

Parenteral prostacyclin therapy is the most efficacious pharmacologic treatment for pulmonary arterial hypertension (PAH), but clinical response is variable. We sought to identify clinical, hemodynamic, and genetic associations with response to prostacyclin therapy. We performed a retrospective analysis of patients within a de‐identified electronic health record and associated DNA biobank. Patients with PAH and a right heart catheterization (RHC) in the six months before initiation of a parenteral prostacyclin were included. Responders were defined a priori by attainment of World Health Organization (WHO) functional class (FC) 2 or better at the time of repeat RHC within two years. We performed exploratory analyses to identify genomic associations with prostacyclin response. Of 129 patients identified, 54 met our criteria for “responders.” These patients were younger, more likely to be male, and were less likely to have connective tissue disease‐related PAH. At follow‐up, responders had improved hemodynamics, 6‐min walk distance, and long‐term survival. Baseline PA oxygen saturation (hazard ratio [HR] 0.568 [0.34–0.95]) and follow‐up FC (HR = 2.57 [1.22–5.43]) were associated with survival. Prostacyclin responders were enriched in alleles related to cell development and circulatory system development and pathways related to aldosterone metabolism, cAMP signaling, and vascular smooth muscle contraction (P < 0.001). Age at treatment initiation, WHO FC at short‐term follow‐up, and PA O2% are associated with survival in patients with PAH exposed to parenteral prostacyclins. Exploratory genetic analysis yielded associations in biologically relevant pathways in the pathogenesis of PAH.
Cannabinoid Hyperemesis Syndrome Masquerading as Uremia: An Educational Case Report
Authors: Klassen Judith , Wilson Gail 
Published: August 2018

Rationale: With marijuana legalization, clinicians need to be aware of Cannabinoid Hyperemesis Syndrome (CHS), which may masquerade as other disease states such as uremia. Presenting concerns of the patient: A 37-year-old man with bipolar affective disease treated with lithium had progressive renal insufficiency presumably on the basis of interstitial fibrosis. He developed persistent and severe nausea and vomiting which was assumed to be on the basis of uremia. Predating the nausea and vomiting was a history of daily marijuana use. Diagnoses: Renal insufficiency, bipolar affective disease, and intractable nausea and vomiting. Interventions: Dialysis was initiated but did not improve his symptoms and multiple investigations revealed no other cause. Abstinence from marijuana use resulted in complete resolution of symptoms. Outcomes: The patient elected to discontinue dialysis and was still alive 7 months later. We concluded the nausea and vomiting were not on a uremic basis but more likely due to CHS. Lessons learned: With more widespread use of marijuana, it is important to be aware of CHS, which may be confused with uremia in patients with concomitant renal insufficiency.
Non-cardioembolic stroke/transient ischaemic attack in Asians and non-Asians: A post-hoc analysis of the PERFORM study
Authors: Hoshino Takao , Sissani Leila , Labreuche Julien , Bousser Marie-Germaine , Chamorro Angel , Fisher Marc , Ford Ian , Fox Kim M , Hennerici Michael G , Mattle Heinrich P , Rothwell Peter M , Gabriel Steg Philippe , Vicaut Eric , Amarenco Pierre 
Published: August 2018

Introduction We aimed to compare the characteristics and vascular outcomes between Asian and non-Asian patients with non-cardioembolic stroke/transient ischaemic attack receiving antiplatelet monotherapy and to identify population-specific predictors for recurrent events. Patients and methods We conducted a post-hoc analysis of data from the PERFORM study, in which 19,100 patients (mean age, 67.2 years; male, 63%; 2178 Asian and 16,922 non-Asian patients) with non-cardioembolic ischaemic stroke/transient ischaemic attack were randomised to aspirin or terutroban and followed for two years. The primary outcome was a composite of major adverse cardiovascular events (non-fatal myocardial infarction, non-fatal stroke and cardiovascular death). Results There was no difference in major adverse cardiovascular events risk between Asian and non-Asian populations (11.1% vs. 10.5%; p = 0.39). However, Asian patients were at significantly higher risk of intracranial haemorrhage (2.4% vs. 1.3%; hazard ratio (HR) 1.87; 95% confidence interval (CI) 1.34–2.60; p < 0.001) and major bleeding (5.4% vs. 4.1%; HR 1.30; 95% CI 1.04–1.61; p = 0.02). Stroke risk was significantly higher in Asian than in non-Asian populations among patients with lacunar stroke (7.4% vs. 4.5%; p = 0.02). In multivariable analysis, diastolic blood pressure (HR per 5 mm Hg 1.08; 95% CI 1.01–1.16; p = 0.03) and diabetes (HR 1.36; 95% CI 1.22–1.52; p < 0.001) were independent predictors of major adverse cardiovascular events for Asian and non-Asian patients, respectively. Conclusion: Compared with non-Asian patients, Asian patients had significantly higher risk of haemorrhagic events when given antiplatelet monotherapy for secondary prevention after non-cardioembolic stroke/transient ischaemic attack. Lacunar stroke and elevated diastolic blood pressure were more associated with recurrence risk in Asian patients.
Minimally Invasive Surgery Using the Circular External Fixator to Correct Neglected Severe Stiff Equinocavus Foot Deformities
Authors: Ferreira Ricardo Cardenuto , Costa Marco Túlio , Lotti Cleber , Pistorello Lysie 
Published: August 2018

Background: Stiff equinocavus deformities of the foot are challenging to treat, often requiring extensive soft tissue dissection and bone removal. These procedures frequently yield suboptimal results and not infrequently amputation. Minimally invasive surgery using a circular external fixator potentially avoids the trauma to the soft tissue and may lead to improvement in outcomes and a lower amputation rate. The objective of this study was to evaluate the efficacy of minimally invasive surgery using a circular external fixator and limited soft tissue release to correct stiff equinocavus deformities. Methods: The treatment outcome of 29 patients (31 feet) with stiff equinocavus deformities of the foot and ankle treated with minimally invasive surgery and circular external fixation were reviewed after a mean follow-up period of 63 months. Patients’ demographics and cause of the deformities were recorded. Weight bearing radiographs of the foot were compared pre and postoperatively. Results: Outcome was satisfactory (plantigrade foot with improvement/resolution of pain) in 21 of 31 extremities, fair in 6 of 31 extremities, and poor in 4 of 31 extremities. In the majority of patients, a significant improvement in the equinocavus deformities was achieved with a statistically significant improvement in calcaneus and navicular height. Two patients with Charcot-Marie-Tooth and severely insensate feet had a poor outcome, resulting in transtibial amputation. Conclusion: Minimally invasive surgery with gradual correction of neglected stiff equinocavus deformities using a modular circular external fixator is a reliable initial limb salvage strategy. Minimally invasive surgery and gradual correction of neglected severe stiff equinocavus deformities using the modular circular external fixator to gradually correct neglected severe stiff equinocavus deformities, is a safe initial limb salvage strategy which may simplify secondary procedures such as arthrodesis. Level of evidence: IV.
Psychotherapeutic leadership and containment in psychiatry
Authors: Gibson Russell , Till Alex , Adshead Gwen 
Published: August 2018

SUMMARYLeadership is a key role for psychiatrists, with many models that can be adopted depending in part on the nature of the individual and their training, the primary task of the team and the nature of the organisation. In this article we suggest a new concept and model of leadership, ‘psychotherapeutic leadership’. We discuss the theoretical background to this model, its benefits and the implications for training and professional development.LEARNING OBJECTIVES•Understand the concept and role of the psychiatrist in providing psychotherapeutic leadership at an individual patient, team and organisational level•Explore how applying an understanding of psychodynamic principles in practice can provide containment in psychiatry and aid clinical leadership•Understand the role of psychotherapeutically informed approaches in recognising factors influencing staff morale and burnoutDECLARATION OF INTERESTNone.