bluuebunny/crossref_metadata_2025_split huggingface dataset:
Per-Pass Analysis of Thrombus Composition in Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy
Authors: Duffy Sharon , McCarthy Ray , Farrell Michael , Thomas Sunitha , Brennan Paul , Power Sarah , O’Hare Alan , Morris Liam , Rainsford Eleanor , MacCarthy Eugene , Thornton John , Gilvarry Michael 
Published: April 2019

Background and Purpose—
Mechanical thrombectomy may involve multiple attempts to retrieve the occluding thrombus. This study examined the composition of thrombus fragments retrieved with each pass of a device during the thrombectomy procedure. Second, the per-pass composition was compared with procedural and clinical data including angiographic outcome and stroke etiology.

Methods—
Thrombi were retrieved from 60 patients with acute ischemic stroke, where thrombus fragments retrieved in each pass were segregated as individual samples and maintained throughout the histological analysis as independent samples. All samples were stained with hematoxylin and eosin and Martius Scarlet Blue. The relative composition of red blood cells, fibrin, and white blood cells in thrombus fragments from each pass was quantified.

Results—
Over the 60 cases, thrombus material was retrieved in 106 of 138 passes. The number of passes required to complete the cases ranged from 1 to 6 passes. The analysis of thrombus fragments retrieved in each pass provided a greater insight into the thrombectomy procedure progression than the overall thrombus composition; the red blood cell content of thrombus fragments retrieved in passes 1 and 2 was significantly higher than that retrieved in passes 3 to 6. The removal of thrombus material in a total of 1, 2, or 3 passes was associated with the highest percentage of final modified Thrombolysis in Cerebral Infarction score of 2c-3. There was no association between modified Thrombolysis in Cerebral Infarction score and per-pass thrombus composition.

Conclusions—
The differentiation achieved through the per-pass analysis of acute ischemic stroke thrombi provides a greater insight into the thrombectomy procedure progression than the combined per-case thrombus analysis. Insights gained may be a useful consideration in determining the treatment strategy as a case evolves and may be useful for the development of new devices to increase rates of 1-pass recanalization.
A novel assay for triglycerides using glycerol dehydrogenase and a water-soluble formazan dye, WST-8
Authors: Kawano Miki , Hokazono Eisaku , Osawa Susumu , Sato Shouichi , Tateishi Takiko , Manabe Masahiro , Matsui Hirotaka , Kayamori Yuzo 
Published: April 2019

BackgroundThe glycerol-3-phosphate (GPO)-peroxidase (POD) chromogenic method is one of the most widely used methods to assay triglycerides. However, it is well known that peroxidase is affected by reducing agents, and recently, it has been reported that some materials affect its activity. Moreover, there is a high possibility of non-specific reaction, as the method uses many enzymes. Against this background, we developed a simpler assay method for triglycerides without using peroxidase.MethodsTriglycerides were hydrolysed to glycerol and fatty acids by lipoprotein lipase followed by the oxidation of glycerol to dihydroxyacetone with simultaneous production of NADH by glycerol dehydrogenase. To overcome incomplete conversion of glycerol to dihydroxyacetone by glycerol dehydrogenase at equilibrium, we added 2-(2-methoxy-4-nitrophenyl)-3–(4-nitrophenyl)-5–(2,4-disulfophenyl)-2 H-tetrazolium monosodium salt (WST-8) to the reaction mixture to remove NADH, allowing the reaction to complete while showing stoichiometric production of reduced WST-8.ResultsThe reaction was linear up to 6.4 mmol/L. The mean intra-assay ( n = 20) and inter-assay ( n = 20) imprecision, as determined by replicate analysis of three pooled human serum samples with different triglyceride concentrations, were 1.1–2.3% and 1.1–1.5% coefficient of variation (%CV), respectively. No interference by 2.5 g/L haemoglobin, 65  μmol/L free bilirubin and 359  μmol/L conjugated bilirubin was observed. The equation obtained in comparison with that by the GPO-POD method including endogenous glycerol-eliminating step was: y = 1.0002x + 0.0395 mmol/L; r = 0.999; Sy/x = 0.049 mmol/L; n = 97.ConclusionOur method is an accurate, yet simpler and more sensitive for the quantitative analysis of triglycerides.
Improving an Administrative Case Definition for Longitudinal Surveillance of Sickle Cell Disease
Authors: Snyder Angela B. , Zhou Mei , Theodore Rodney , Quarmyne Maa-Ohui , Eckman James , Lane Peter A. 
Published: April 2019

Objective: Several states are building infrastructure and data collection methods for longitudinal, population-based surveillance systems for selected hemoglobinopathies. The objective of our study was to improve an administrative case definition for sickle cell disease (SCD) to aid in longitudinal surveillance. Methods: We collected data from 3 administrative data sets (2004-2008) on 1998 patients aged 0-21 in Georgia who had ≥1 encounter in which an SCD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code was recorded, and we compared these data with data from a laboratory and medical record review. We assessed performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of case definitions that differed by number and type of SCD-coded encounters; addition of SCD-associated treatments, procedures, and complications; and length of surveillance (1 vs 5 years). We identified correct diagnoses for patients who were incorrectly coded as having SCD. Results: The SCD case definition of ≥3 SCD-coded encounters in 5 years simplified and substantially improved the sensitivity (96.0% vs 85.8%) and NPV (68.2% vs 38.2%) of the original administrative case definition developed for 5-year, state-based surveillance (≥2 encounters in 5 years and ≥1 encounter for an SCD-related treatment, procedure, or complication), while maintaining a similar PPV (97.4% vs 97.4%) and specificity (76.5% vs 79.0%). Conclusions: This study supports an administrative case definition that specifies ≥3 ICD-9-CM–coded encounters to identify SCD with a high degree of accuracy in pediatric patients. This case definition can be used to help establish longitudinal SCD surveillance systems.
Synergistic role of susceptibility-weighted imaging with diffusion-weighted imaging and magnetic resonance angiography in the evaluation of acute arterial stroke
Authors: Rai Santosh PV , Sanyal Pulastya , Pai Shivananda , Achappa Basavaprabhu , Madi Deepak , MR Pavan 
Published: April 2019

Objective This study was performed to investigate whether diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) are more effective than conventional imaging modalities for evaluation of stroke and selection of candidates for thrombolytic therapy. Methods Eighty patients who presented within 12 hours of onset of symptoms of brain ischemia underwent 1.5T magnetic resonance imaging. DWI and SWI were compared with conventional sequences (T1, T2, and fluid-attenuated inversion recovery [FLAIR]) and time-of-flight magnetic resonance angiography (TOF-MRA) to assess factors that affect stroke management and prognosis. Results The volume of brain tissue showing hyperintensity was significantly greater than that showing diffusion restriction in patients with a >6-hour symptom onset. The hypointensity sign (susceptibility sign) on SWI showed a sensitivity of 66.7%, specificity of 87.5%, positive predictive value of 88.9, and negative predictive value of 63.6 compared with TOF-MRA. Micro-hemorrhagic foci were significantly associated with 27-mL infarcts on DWI (sensitivity, 71.4%; specificity, 85.0%). Patients with DWI–SWI mismatch showed better responses to thrombolytics. FLAIR–DWI mismatch helped to assess the time of stroke onset. Conclusion DWI and SWI should be part of the routine imaging protocol in patients with acute stroke and serve as a decision-making tool for selection of patients for thrombolytic therapy.
CXC chemokine ligand 1 mediates adiponectin-induced angiogenesis in ovarian cancer
Authors: Ouh Yung-Taek , Cho Hyun Woong , Lee Jae Kwan , Choi Song Hee , Choi Hyun Jin , Hong Jin Hwa 
Published: April 2019

Objectives: Adiponectin is a cytokine secreted from adipose tissue that regulates energy homeostasis, inflammation, and cell proliferation. Obesity is associated with increased risk of various cancers, including ovarian cancer. Adipokines, including adiponectin, have been implicated as a factor linking obesity and carcinogenesis. The oncogenic role of adiponectin is not known with regard to various cancer types. We sought to determine the role of adiponectin in angiogenesis in ovarian cancer in vitro. Methods: We transfected SKOV3 cells with vascular endothelial growth factor small interfering RNA in order to identify the independent angiogenic role of adiponectin in ovarian cancer. The vascular endothelial growth factor knockdown SKOV3 cell lines were treated with adiponectin for 48 h. The cytokines involved in adiponectin-mediated angiogenesis were explored using the human angiogenesis cytokine array and were verified with the enzyme-linked immunosorbent assay. The angiogenic effect of adiponectin was evaluated using the human umbilical vein endothelial cell tube formation assay. We also investigated the effects of adiponectin treatment on the migration and invasion of SKOV3 cells. Results: The number of tubes formed by human umbilical vein endothelial cell decreased significantly after knockdown of vascular endothelial growth factor (via transfection of vascular endothelial growth factor small interfering RNA into SKOV3 cells). When these vascular endothelial growth factor knockdown SKOV3 cells were treated with adiponectin, there was an increase in the number of tubes in a tube formation assay. Following adiponectin treatment, the CXC chemokine ligand 1 secretion increased in a cytokine array. This was confirmed by both enzyme-linked immunosorbent assay and Western blot. The increased secretion of CXC chemokine ligand 1 by adiponectin occurred regardless of vascular endothelial growth factor knockdown. In addition, the induction of migration and invasion of SKOV3 cells were significantly stronger with adiponectin treatment than they were without. Conclusion: Adiponectin treatment of ovarian cancer cells induces angiogenesis via CXC chemokine ligand 1 independently of vascular endothelial growth factor. These findings suggest that adiponectin may serve as a novel therapeutic target for ovarian cancer.
Forefoot Reconstruction Following Metatarsal Head Resection Arthroplasty With a Plantar Approach—A 20-Year Follow-Up
Authors: Simon Maciej J. K. , Strahl André , Mussawy Haider , Rolvien Tim , Schumacher Robert F. , Seller Marcel , Rüther Wolfgang 
Published: April 2019

Background: Rheumatoid arthritis (RA) can cause significant forefoot disorders. If forefoot deformity and pain are severe, surgical treatment can be considered. The aim of this study was to analyze the long-term outcomes of surgical forefoot correction per Tillmann, which involves resection of the metatarsal heads through a transverse plantar approach for the lesser toes and a dorsomedial approach to the great toe. Methods: This retrospective study used patient-based questionnaires to analyze the revision rate, pain, use of orthoses, walking ability, forefoot function, and patient satisfaction of patients with RA who had undergone a complete forefoot correction of metatarsophalangeal (MTP) I to V. The study only included participants with RA before the era of biological agents and who were at least 20 years postoperatively. A total of 60 patients who had undergone 100 complete forefoot operations according to Tillmann 24.6 ± 3.5 years ago were included in this study. Results: The data collected showed that 35 reoperations were performed on 26 of the patients. Deformity relapses were often documented for the hallux valgus. More than 60% of the patients were able to wear conventional shoes. The distances the participants were able to walk were significantly increased by wearing shoes when compared with walking barefoot ( P < .01). Conclusion: While forefoot function remained difficult to assess, the majority of patients were able to use conventional shoes. This long-term follow-up study of patient-reported questionnaires completed more than 20 years after the Tillmann procedure showed that more than 80% of the patients remained satisfied with the outcome. Level of Evidence: Level IV, retrospective cohort study.
Efficacy of tranexamic acid in traumatic brain injury: Updated systematic review and meta-analysis
Authors: Alhelaly Mohamed Magdy , Soliman Ahmed Magdy , Khaled Anas , Ellotf Hamed , Attia Mahmoud Mohamed , Elmaraezy Ahmed 
Published: April 2019

Background and objectives There is weak evidence for the efficacy of tranexamic acid in decreasing traumatic brain injury complications or improving clinical and radiological outcomes. We conducted a systematic review and meta-analysis to update the current evidence and to assess the efficacy of tranexamic acid in different outcomes. Methods A computer literature search of Medline, Web of Science, Scopus, and Cochrane central register of controlled trials was performed to identify relevant articles including only randomized-controlled trials. RevMan 5.3 software was used for data analysis. Results Four randomized-controlled trials were included. All studies were included in the quantitative and qualitative analysis. The analysis showed significant reduction of intracranial hemorrhage growth (progression) events (risk ratio = 0.77; 95% confidence interval 0.61 to 0.98), with no significant difference in reduction of total (volumetric) hemorrhage growth (mean difference = −2.46; 95% confidence interval −6.53 to 1.60; p = 0.23). There was no difference in risk between tranexamic acid and placebo for mortality (risk ratio = 0.64; 95% confidence interval 0.41 to 1), need for neurosurgical intervention (risk ratio = 0.96; 95% confidence interval 0.61 to 1.51), re-bleed (new hemorrhage) (risk ratio = 0.90; 95% confidence interval 0.57 to 1.41), hemorrhagic mass pressure effect on brain tissue (risk ratio = 0.81; 95% confidence interval 0.65 to 1.01), or unfavorable functional status at discharge (risk ratio = 0.78; 95% confidence interval 0.57 to 1.06). Conclusions Tranexamic acid significantly reduced intracranial hemorrhage growth events. There were non-significant results for all other included radiological and clinical outcomes. Large trials are needed for further exploration of the efficacy and proper dosing.
Hypoxic Preconditioning Enhances Bone Marrow–Derived Mesenchymal Stem Cell Survival in a Low Oxygen and Nutrient-Limited 3D Microenvironment
Authors: Peck Sun H. , Bendigo Justin R. , Tobias John W. , Dodge George R. , Malhotra Neil R. , Mauck Robert L. , Smith Lachlan J. 
Published: April 2019

Objective Skeletal tissues such as intervertebral disc and articular cartilage possess limited innate potential to regenerate, in part due to their avascularity and low cell density. Despite recent advances in mesenchymal stem cell (MSC)–based disc and cartilage regeneration, key challenges remain, including the sensitivity of these cells to in vivo microenvironmental stress such as low oxygen and limited nutrition. The objective of this study was to investigate whether preconditioning with hypoxia and/or transforming growth factor–β 3 (TGF-β3) can enhance MSC survival and extracellular matrix production in a low oxygen and nutrient-limited microenvironment. Design MSCs from multiple bovine donors were preconditioned in monolayer in normoxia or hypoxia, with or without TGF-β3, and the global effects on gene expression were examined using microarrays. Subsequently, the effects of preconditioning on MSC survival and extracellular matrix production were examined using low oxygen and nutrient-limited pellet culture experiments. Results Hypoxic preconditioning resulted in upregulation of genes associated with growth, cell-cell signaling, metabolism, and cell stress response pathways, and significantly enhanced MSC survival for all donors in low oxygen and nutrient-limited pellet culture. In contrast, TGF-β3 preconditioning diminished survival. The nature and magnitude of the effects of preconditioning with either hypoxia or TGF-β3 on glycosaminoglycan production were donor dependent. Conclusions These results strongly support the use of hypoxic preconditioning to improve postimplantation MSC survival in avascular tissues such as disc and cartilage.
Geographical variations in the prevalence of hypertension in France: Cross-sectional analysis of the CONSTANCES cohort
Authors: Neufcourt Lola , Deguen Séverine , Bayat Sahar , Paillard François , Zins Marie , Grimaud Olivier 
Published: April 2019

Aims While international variations in the prevalence of hypertension are well described, less is known about intra-national disparities and their determinants. We wanted to describe the variations in hypertension prevalence within France and to determine how much lifestyle and socioeconomic factors contributed to explain these regional variations. Methods Participants (62,247 French adults aged 18 to 69 years) were recruited in the 16 centres of the CONSTANCES study between 2012 and 2015. Hypertension was defined as blood pressure higher than 140/90 mmHg and/or taking antihypertensive medications. The contribution of lifestyle and socioeconomic factors to hypertension prevalence variations among centres was examined using sequential hierarchical logistic models. Results Hypertension prevalence was 37.3% (95% confidence interval (CI) = 36.6–38.0) in men and 23.2% (95% CI = 22.7–23.8) in women. Hypertension prevalence rates varied by almost two-fold among centres (1.9 in men, 1.6 in women) with the highest prevalence in the north and the east of France. Body mass index was strongly associated with hypertension in women (odds ratio (OR)1-unit increase = 1.11 (95% CI = 1.11–1.12)) and was the highest contributor to between-centre variations (27% in women), followed by socioeconomic characteristics (e.g. ORhigh versus low education = 0.85 (95% CI = 0.83–0.87), contributing to 14% of variations in women). Together, family history of hypertension, body mass index, education, occupation and residential area socioeconomic level explained about 30% and 40% of between-centre variations in men and women, respectively. Conclusion Hypertension prevalence greatly varies among French regions and this is partly explained by known lifestyle and socioeconomic factors. Nevertheless, these variations and all the hypertension determinants have not been fully deciphered yet.
‘It’s about willpower in the end. You’ve got to keep going’: a qualitative study exploring the experience of pain in inflammatory bowel disease
Authors: Sweeney Louise , Moss-Morris Rona , Czuber-Dochan Wladyslawa , Belotti Laure , Kabeli Zoe , Norton Christine 
Published: April 2019

Background: Pain is a widely experienced symptom of inflammatory bowel disease (IBD), which has significant psychological and functional impacts on patients. Understanding the aetiology and management of chronic pain is a poorly understood area of IBD research. This qualitative study aimed to explore the experiences of individuals with IBD and pain, the pain management strategies they use and any needs for future pain management interventions. Methods: In all, 14 individuals with IBD were purposively recruited and interviewed (face-to-face or telephone) using a topic guide. Interviews were transcribed and analysed using inductive thematic analysis. Results: Themes identified were ‘vicious cycles’, ‘findings solutions’ and ‘attitudes’. The experience and impact of pain were rarely viewed in isolation, but rather within the context of a cycle of IBD symptoms. Other ‘vicious cycles’ identified included anxiety, avoidance and inactivity, and poor understanding and communication. Pain management included short- and long-term strategies. Searching for a solution for pain had an emotional impact on individuals. There were contrasting attitudes from participants, including defeat, tolerance and acceptance. Conclusion: This study provides an understanding of the experience of pain in IBD. The interaction of pain with accompanying IBD symptoms has an emotional and physical impact on individuals, and creates a barrier to adequate assessment, understanding and treatment of pain. Patients rely on their own experiences, and a trial and error approach to apply helpful strategies. Adjuvant behavioural therapies may be beneficial for patients experiencing pain and psychological distress, and to facilitate self-management.
Impact of Routine Gastrocnemius Stretching on Ankle Dorsiflexion Flexibility and Injury Rates in High School Basketball Athletes
Authors: Knapik Derrick M. , LaTulip Scott , Salata Michael J. , Voos James E. , Liu Raymond W. 
Published: April 2019

Background: Achilles tightness exacerbates a variety of foot and ankle conditions while increasing the risk of lower extremity injuries. The correlation between Achilles tightness and lower extremity injury rates in a young, athletic population is unknown. Purpose: To evaluate the impact of routine gastrocnemius stretching on ankle flexibility and lower extremity injury rates in youth basketball athletes. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective cohort study enrolling 8 high school basketball teams (4 male teams, 4 female teams) was conducted over a 3-month sporting season. Two schools (2 male teams, 2 female teams) were assigned to a daily gastrocnemius stretching protocol. Two control schools (2 male teams, 2 female teams) followed no protocol. Passive ankle dorsiflexion was measured bilaterally in both groups at 4 time points: preseason, 1 month and 2 months after the start of the season, and postseason (3 months from the start of the season). The number of injuries sustained during the season and the number of games missed because of a lower extremity injury were recorded. Differences in dorsiflexion flexibility measurements and injury rates were analyzed between the protocol and control groups. Results: A total of 106 athletes (46 male, 60 female) were included in the study. The protocol group included 51 athletes (mean age, 15.7 ± 1.2 years) versus 55 athletes (mean age, 16.2 ± 1.0 years) in the control group. Athletes undergoing routine gastrocnemius stretching had significantly higher ankle dorsiflexion flexibility measurements compared with control athletes at all time points ( P < .05 for each time point) while also demonstrating a significant increase in dorsiflexion between the preseason and postseason time points ( P = .04). No significant difference in injury rates was appreciated between the protocol and control groups, and no difference in dorsiflexion flexibility measurements was appreciated between injured and uninjured athletes. Conclusion: The implementation of a gastrocnemius stretching protocol in youth basketball athletes increased ankle dorsiflexion over a single season without decreasing the injury incidence relative to controls in our study. Because the size of our study limited statistical power, a confirmation of the results in a larger study is required.