bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of balloon guide catheter on clinical outcomes and reperfusion in Trevo thrombectomy
Authors: Nguyen Thanh N , Castonguay Alicia C , Nogueira Raul G , Haussen Diogo C , English Joey D , Satti Sudhakar R , Chen Jennifer , Farid Hamed , Borders Candace , Veznedaroglu Erol , Binning Mandy J , Puri Ajit S , Vora Nirav A , Budzik Ron F , Dabus Guilherme , Linfante Italo , Janardhan Vallabh , Alshekhlee Amer , Abraham Michael G , Edgell Randall C , Taqi M Asif , El Khoury Ramy , Mokin Maxim , Majjhoo Aniel Q , Kabbani Mouhammed R , Froehler Michael T , Finch Ira , Ansari Sameer A , Novakovic Roberta , Abdalkader Mohamad , Zaidat Osama O 
Published: February 2019

IntroductionThe Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated with a balloon guide catheter (BGC) and Solitaire stent retriever compared with a conventional guide catheter. The goal of this study was to evaluate whether use of a BGC with the Trevo stent retriever improves outcomes compared with a conventional guide catheter.MethodsThe TRACK registry recruited 23 sites to submit demographic, clinical, and site adjudicated angiographic and outcome data on consecutive patients treated with the Trevo stent retriever. BGC use was at the discretion of the physician.Results536 anterior circulation patients (of whom 279 (52.1%) had BGC placement) were included in this analysis. Baseline characteristics were notable for younger patients in the BGC group (65.4±15.3 vs 68.1±13.6, P=0.03) and lower rate of hypertension (72% vs 79%, P=0.06). Mean time from symptom onset to groin puncture was longer in the BGC group (357 vs 319 min, P=0.06).Thrombolysis in Cerebral Infarction 2b/3 scores were higher in the BGC cohort (84% vs 75.5%, P=0.01). There was no difference in reperfusion time, first pass effect, number of passes, or rescue therapy. Good clinical outcome at 3 months was superior in patients with BGC (57% vs 40%; P=0.0004) with a lower mortality rate (13% vs 23%, P=0.008). Multivariate analysis demonstrated that BGC use was an independent predictor of good clinical outcome (OR 2; 95% CI 1.3 to 3.1, P=0.001).ConclusionsIn acute stroke patients presenting with anterior circulation large vessel occlusion, use of a BGC with the Trevo stent retriever resulted in improved reperfusion, improved clinical outcome, and lower mortality.
Visual assessment of diffusion weighted imaging infarct volume lacks accuracy and reliability
Authors: Khoury Naim , Dargazanli Cyril , Guenego Adrien , Zuber Kevin , Ekmen Asya , Charbonnier Guillaume , Hebert Solène , Capron Jean , Sabben Candice , Morvan Erwan , Boisseau William , Maier Benjamin , Premat Kévin , Clarençon Frédéric , Smajda Stanislas , Redjem Hocine , Chalumeau Vanessa , Boulouis Gregoire , Chetrit Annaëlle , Lecler Augustin , Koskas Patricia , Duron Loic , Ciccio Gabriele , Ducroux Célina , Escalard Simon , Desilles Jean Philippe , Hamdani Mylène , Lapergue Bertrand , Mazighi Mikael , Ben Maacha Malek , Brikci-Nigassa Nahida , Blanc Raphael , Piotin Michel , Fahed Robert 
Published: February 2019

PurposeThe DAWN trial (Diffusion weighted imaging or CT perfusion Assessment with clinical mismatch in the triage of Wake-up and late presenting strokes undergoing Neurointervention with Trevo) has demonstrated the benefits of thrombectomy in patients with unknown or late onset strokes, using automated software (RAPID) for measurement of infarct volume. Because RAPID is not available in all centers, we aimed to assess the accuracy and repeatability of visual infarct volume estimation by clinicians and the consequences for thrombectomy decisions based on the DAWN criteria.Materials and methods18 physicians, who routinely depend on MRI for acute stroke imaging, assessed 32 MR scans selected from a prospective databaseover two independent sessions. Raters were asked to visually estimate the diffusion weighted imaging (DWI) infarct volume for each case. Sensitivity, specificity, and accuracy of the estimated volumes were compared with the available RAPID measurements for various volume cut-off points. Thrombectomy decisions based on DAWN criteria with RAPID measurements and raters’ visual estimates were compared. Inter-rater and intra-rater agreement was measured using kappa statistics.ResultsThe mean accuracy of raters was <90% for all volume cut-points. Inter-rater agreement was below substantial for each DWI infarct volume cut-off points. Intra-rater agreement was substantial for 55–83% of raters, depending on the selected cut-off points. Applying DAWN criteria with visual estimates instead of RAPID measurements led to 19% erroneous thrombectomy decisions, and showed a lack of reproducibility.ConclusionThe visual assessment of DWI infarct volume lacks accuracy and repeatability, and could lead to a significant number of erroneous decisions when applying the DAWN criteria.
Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction
Authors: Reriani Martin , Flammer Andreas J , Duhé Jessica , Li Jing , Gulati Rajiv , Rihal Charanjit S , Lennon Ryan , Tilford Jonella M , Prasad Abhiram , Lerman Lilach O , Lerman Amir 
Published: February 2019

AimAngina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD.Methods and resultsFollow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function.ConclusionAmong patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.
Potential use of PCSK9 inhibitors as a secondary preventative measure for cardiovascular disease following acute coronary syndrome: a UK real-world study
Authors: Elamin Ahmed Farouk Mohamed , Grafton-Clarke Ciaran , Wen Chen Kai , Obafemi Toba , Luvai Ahai , Katira Ravish , Davis Gershan 
Published: February 2019

AbstractBackgroundProprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a major development in the prevention of cardiovascular disease (CVD) and is one of the most significant discoveries since the development of statin therapy. Administration of two human monoclonal antibodies to PCSK9 (alirocumab and evolocumab) can significantly reduce low-density lipoprotein cholesterol (LDL-c) concentrations, thus improving lipid management. Accordingly, guidelines on the specific indications for alirocumab and evolocumab usage have been released. This multicentre study aimed to estimate the proportion of patients treated for an acute myocardial infarction (MI) who could be considered for PCSK9 inhibitors under the current National Institute for Health and Care Excellence (NICE) lipid targets criteria.MethodsThe records of 596 patients in two large hospitals in Liverpool, UK were analysed. Information was collected on lipid profiles during and after admission, lipid-lowering therapy and previous CVD.ResultsAt least 2.2% of patients were eligible for PCSK9 inhibitors post-MI under the current NICE guidance. Additionally, 29% of patients failed to achieve LDL-c concentrations &lt;2.0 mmol/L despite maximum statin therapy and failed to meet eligibility for PCSK9 inhibitors as per the NICE criteria. This cohort represents a group of patients ‘in limbo’, in which statin therapy alone is not sufficient to reduce LDL-c.ConclusionsPCSK9 inhibitors are expensive and so their use must be highly selective. At present, in a real-world setting with ezetimibe underprescribing, ~2% of patients are eligible and a further 30% are deprived of benefit and improved outcomes by lack of optimisation and/or potential use of PCSK9 inhibitors.
Limb sparing achieved by ray amputation for osteosarcoma of the left third metacarpal bone in a labrador
Authors: Hall Jon L , Mason Sarah L 
Published: February 2019

A seven‐year‐old male neutered labrador weighing 35 kg with a two‐week history of left forelimb lameness was diagnosed with osteosarcoma of the third metacarpal bone. No pulmonary metastases were detected and ray amputation (removal of the left third metacarpal bone and third phalanx en bloc) was performed. Circumferential sutures were placed around metacarpals II and IV to realign the adjacent bones and digits during the healing period. The dog received six cycles of single‐agent carboplatin (300 mg/m2) postoperatively. Restaging nine months postoperatively revealed no evidence of metastasis or recurrence. Two years postoperatively, the dog has no evidence of complications or lameness. Thoracic limb amputation and postoperative adjunctive therapy are considered the gold standard treatment for appendicular osteosarcoma; however, an oncological compartment excision of this bone tumour was performed with similar outcome for the patient while preserving the limb.
Multiple season-long sprays of ethephon or NAA combined with calcium chloride on ‘Honeycrisp’ apples: I. Effect on bloom and fruit quality attributes
Authors: Cline John A. 
Published: February 2019

‘Honeycrisp’ apple trees are highly prone to biennial bearing and predisposed to bitter pit. The hypothesis that tank mix sprays of ethephon (ETH), naphthaleneacetic acid (NAA), and 1-aminocyclopropane carboxylic acid (ACC) combined with calcium chloride (CaCl2) can mitigate these production problems was tested in a 3-yr study. Mature ‘Honeycrisp’ trees were treated with either three or six summer applications of 150 mg L−1ETH or 5 mg L−1NAA, all tank-mixed with and without CaCl2, or two or five applications of 150 mg L−1ACC (without CaCl2). Treatments were applied at 10-d intervals and initiated between 21 and 26 June. All treatments had little effect on enhancing return bloom of ‘Honeycrisp’. NAA, ETH, and CaCl2all influenced fruit maturity and quality at harvest to varying degrees and across years. Fruit treated with NAA were firmer compared with untreated fruit in 2 out of 3 yr, whereas overall, fruit treated with six sprays of ETH had lower fruit firmness and were more mature. NAA had less influence on fruit quality attributes at harvest than did ETH, and decreased pre-harvest fruit drop (PFD). PFD increased with ETH in 1 out of 2 yr, whereas ACC and NAA both decreased PFD in 1 out of 2 yr. Overall, ETH and NAA, with or without CaCl2, had significant but inconsistent effects on fruit quality and maturity, all dependent on the year and number of applications. Adding CaCl2decreased fruit firmness in 2 out of 3 yr.
The effects of childhood trauma on adolescent hippocampal subfields
Authors: Malhi Gin S , Das Pritha , Outhred Tim , Irwin Lauren , Gessler Danielle , Bwabi Zina , Bryant Richard , Mannie Zola 
Published: February 2019

Objective: Mood disorders are more common among girls and typically emerge during adolescence. The precise reasons for this are unknown, but among the many mechanisms implicated are stress-induced hippocampal structural changes during this developmental stage. The hippocampus is a complex structure comprised of subfields that develop differentially and respond variably to stress and childhood adversity, both of which are risk factors for mood disorders. To better understand vulnerability to mood disorders, we investigated a cohort of adolescent girls and determined volumetric changes in their hippocampal subfields to elucidate the potential effects of childhood trauma. Methods: Of the 229 participants, 201 girls (aged 12–17 years) fulfilled our analysis inclusion criteria. Of these, 76 had been exposed to higher emotional trauma (emotional abuse or neglect). The girls underwent high-resolution structural magnetic resonance imaging scans, and hippocampal subfield volumes were measured using FreeSurfer. We compared hippocampal subfield volumes in those exposed to higher emotional trauma and those exposed to minimal emotional trauma, at three time-points of adolescent development: early (12–13 years), mid (14–15 years) and late (16–17 years). Results: Mid-adolescent girls exposed to higher emotional trauma had significantly smaller left CA3 volumes than minimal emotional trauma girls ( p = 0.028). Within the minimal emotional trauma group, mid-adolescents had significantly larger left CA3 volumes than early ( p = 0.034) and late ( p = 0.036) adolescents. Within the higher emotional trauma group, early adolescents had significantly larger left CA3 volumes than late adolescents ( p = 0.036). Conclusion: In our exploratory study, we observed higher emotional trauma–induced volume changes in the left CA3 hippocampal subfield, which varied depending on age, and may ultimately produce deficits in behavioural, cognitive and emotional processes. We propose that these changes (1) may provide a mechanism through which vulnerability to mood disorders may be increased in adolescent girls, and (2) may signal the best times to implement targeted prevention interventions.
Systemic lupus erythematosus is a risk factor for cancer: a nationwide population-based study in Korea
Authors: Bae E.H. , Lim S.Y. , Han K.-D. , Jung J.-Hy. , Choi H.S. , Kim C.S. , Ma S.K. , Kim SW 
Published: February 2019

Objective Specific differences in cancer risk have been observed between systemic lupus erythematosus patients and the general population. Although meta-analyses have estimated cancer incidence in systemic lupus erythematosus patients, results have been inconclusive. Hence, we aimed to assess malignancy risk in systemic lupus erythematosus patients, compared to the risk in the general population. Methods Systemic lupus erythematosus patients ( n = 21,016; mean age 41.67 ± 13.14 years; female 90.22%) were selected from the Korean National Health Insurance Service database between 2008 and 2014. Age- and sex-matched controls were randomly sampled in a 5:1 ratio ( n = 105,080). Results During the 7 years of follow up, malignancy was detected in 763 (3.63%) systemic lupus erythematosus patients and 2667 (2.54%) controls. Systemic lupus erythematosus patients had a higher risk of malignancy than controls (odds ratio 1.44; 95% confidence interval 1.327–1.559), after multivariate adjustment. Systemic lupus erythematosus patients had a higher odds ratio for developing cervical, thyroid, ovarian, and oral cancer, as well as lymphoma, leukemia, and multiple myeloma than controls. Based on subgroup analysis, male systemic lupus erythematosus patients and patients younger than 40 years showed the highest lymphoma risk. Conclusions Systemic lupus erythematosus might be an independent risk factor for cancer. Therefore, the importance of cancer screening programs should be emphasized in systemic lupus erythematosus patients. Our study is the first large nationwide cohort study for evaluating the risk of cancer in systemic lupus erythematosus patients.
Etiology and Treatment Outcomes for Sural Neuroma
Authors: Lans Jonathan , Gamo Linda , DiGiovanni Christopher W. , Chen Neal C. , Eberlin Kyle R. 
Published: February 2019

Background: Neuroma results from disorganized regeneration following nerve injury and may be symptomatic. The aim of this study was to investigate the causes, treatment, and outcomes of operatively treated sural neuromas, and to describe the factors associated with persistent or unchanged postoperative pain symptoms. Methods: Consecutive patients with surgically treated sural neuromas in a 14-year period were identified using Current Procedural Terminology (CPT) codes ( n = 49), followed by a chart review to collect patient and treatment characteristics. Postoperative pain symptoms were categorized as complete resolution of pain, improvement of pain, no change in pain, or worse pain. The median patient age was 46.5 years (interquartile range [IQR], 39.1-51.3), and median follow-up was 4.0 years (IQR, 1.9-9.2). Results: Ninety percent of symptomatic sural neuromas developed as a result of previous lower extremity surgery. Initial surgery of sural neuroma led to improvement in pain in 63% of patients, and an additional 8.2% of the patients had improvement after secondary neuroma surgery. Pain relief after diagnostic injection showed a trend toward an association with postoperative pain improvement. Neuroma excision and implantation in muscle was the most common surgical technique used (67%). Four of the 7 patients that underwent a second neuroma operation reported symptom improvement. Conclusion: Sural neuromas may arise from prior surgery or trauma to the lower extremity. Surgical intervention resulted in either improvement or complete resolution of pain symptoms in 71% of patients, although occasionally more than one procedure was required to obtain symptomatic relief. Preoperative anesthetic injection may help identify patients that benefit from neuroma surgery. Level of Evidence: Level IV, retrospective case series.
TYRO3: A potential therapeutic target in cancer
Authors: Hsu Pei-Ling , Jou Jonathan , Tsai Shaw-Jenq 
Published: February 2019

TYRO3 belongs to the TAM (TYRO3, AXL, and MER) receptor family, a unique subfamily of the receptor tyrosine kinases. Members of TAM family share the same ligand, growth arrest-specific 6, and protein S. Although the signal transduction pathways of TYRO3 have not been evaluated in detail, overexpression and activation of TYRO3 receptor tyrosine kinase have been reported to promote cell proliferation, survival, tumorigenesis, migration, invasion, epithelial-mesenchymal transition, or chemoresistance in several human cancers. Targeting TYRO3 could break the kinase signaling, stimulate antitumor immunity, reduce tumor cell survival, and regain drug sensitivity. To date, there is no specific TYRO3-targeted drug, the effectiveness of targeting TYRO3 in cancer is worthy of further investigations. In this review, we present an update on molecular biology of TYRO3, summarize the development of potential inhibitors of TAM family members, and provide new insights in TYRO3-targeted treatment.Impact statementCancer is among the leading causes of death worldwide. In 2016, 8.9 million people are estimated to have died from various forms of cancer. The current treatments, including surgery with chemotherapy and/or radiation therapy, are not effective enough to provide full protection from cancer, which highlights the need for developing novel therapy strategies. In this review, we summarize the molecular biology of a unique member of a subfamily of receptor tyrosine kinase, TYRO3 and discuss the new insights in TYRO3-targeted treatment for cancer therapy.
Mutual promotion of FGF21 and PPARγ attenuates hypoxia-induced pulmonary hypertension
Authors: Cai Gexiang , Liu Jingjing , Wang Meibin , Su Lihuang , Cai Mengsi , Huang Kate , Li Xiuchun , Li Manxiang , Wang Liangxing , Huang Xiaoying 
Published: February 2019

Fibroblast growth factor 21 (FGF21), a primarily liver-derived endocrine factor, has the beneficial effect of protecting blood vessels. Peroxisome proliferator-activated receptor γ (PPARγ), a ligand-activated nuclear transcription factor, has been reported to effectively inhibit pulmonary hypertension (PH). The purpose of this study is to investigate the role of FGF21 in hypoxia-induced PH (HPH) and explore the relationship between FGF21 and PPARγ in this disorder. Adult C57BL/6 mice were subjected to four weeks of hypoxia to establish a PH model. The effects of FGF21 and PPARγ agonists and antagonists were investigated in HPH mice, as well as the relationship between FGF21 and PPARγ in this model. Moreover, we investigated the underlying mechanisms of this relationship between FGF21 and PPARγ in vivo and in vitro. In vivo, we found that hypoxia resulted in pulmonary hypertension, right ventricular hypertrophy, pulmonary arterial remodeling, and pulmonary arterial collagen deposition. Furthermore, hypoxia decreased FGF21 and PPARγ levels. These changes were reversed by exogenous FGF21 and a PPARγ agonist and were further enhanced by a PPARγ antagonist. The hypoxia-induced decrease in β-klotho (KLB) expression was improved by the PPARγ agonist and further reduced by the PPARγ antagonist. Exogenous FGF21 increased adenosine monophosphate-activated protein kinase (AMPK) phosphorylation (Thr172) and PPARγ coactivator-1α (PGC-1α) expression in PH mouse lung homogenates. In vitro, we found that knockdown of AMPK or using an AMPK antagonist inhibited the FGF21-mediated up-regulation of PPARγ expression, and the PPARγ-mediated up-regulation of FGF21 expression was inhibited by knockdown of KLB. These results indicated that FGF21 exerts protective effects in inhibiting HPH. FGF21 and PPARγ mutually promote each other’s expression in HPH via the AMPK/PGC-1α pathway and KLB protein. Impact statement In this study, we reported for the first time that FGF21 alleviated hypoxia-induced pulmonary hypertension through attenuation of increased pulmonary arterial pressure, pulmonary arterial remodeling and collagen deposition in vivo, and we confirmed the mutual promotion of FGF21 and PPARγ in hypoxia-induced pulmonary hypertension. Additionally, we found that FGF21 and PPARγ mutually promote each other’s expression via the AMPK/PGC-1α pathway and KLB protein in vitro and in vivo. Pulmonary hypertension is a progressive and serious pathological phenomenon with a poor prognosis, and current therapies are highly limited. Our results provide novel insight into potential clinical therapies for pulmonary hypertension and establish the possibility of using this drug combination and potential dosage reductions in clinical settings.
Brain natriuretic peptide in pregnant women with heart disease
Authors: Singh Karanvir , Sikka Pooja , Suri Vanita , Prasad Rishikesh , Khullar Madhu , Vijayvergiya Rajesh 
Published: February 2019

Background Plasma brain natriuretic peptide levels were prospectively studied in pregnant women with heart disease. Methods Fifty pregnant women with heart disease and 25 controls were evaluated at 24 weeks or under, 30–32 weeks, 34 weeks or more of gestation, and 6 weeks postpartum. Adverse maternal cardiac events were hospitalization for worsening heart failure, stroke, and death. Results Thirty-eight (76%) women had rheumatic heart disease. Plasma brain natriuretic peptide levels were (in cases and controls) 118.3 ± 46.5 pg/ml and 66.3 ± 15.9 pg/ml (at 24 weeks or under), 124.8 ± 30.4 pg/ml and 68.4 ± 16.5 pg/ml (30–32 weeks), 135.8 ± 34.9 pg/ml and 68.6 ± 15.6 pg/ml (34 weeks or more), and 110.1 ± 21.9 pg/ml and 65.0 ± 16.1 pg/ml (6 weeks postpartum) (p = .0001). Eighteen women had adverse events. Of these, only 1 had a level less than 100 pg/ml, 12 were between 100 and 200 pg/ml, and 5 more than 200 pg/ml. Conclusions Plasma brain natriuretic peptide levels were higher in women with heart disease at all periods of gestation as well as six weeks postpartum. No woman with a plasma brain natriuretic peptide levels of 98 pg/ml or less had an adverse event.