bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRA versus DSA for the follow-up imaging of intracranial aneurysms treated using endovascular techniques: a meta-analysis
Authors: Ahmed Syed Uzair , Mocco J , Zhang Xiangnan , Kelly Michael , Doshi Amish , Nael Kambiz , De Leacy Reade 
Published: May 2019

BackgroundTreated aneurysms must be followed over time to ensure durable occlusion, as more than 20% of endovascularly treated aneurysms recur. While digital subtraction angiography (DSA) remains the gold standard, magnetic resonance angiography (MRA) is attractive as a non-invasive follow-up technique. Two different MRA techniques have traditionally been used: time-of-flight (TOF) and contrast-enhanced (CE) MRA. We analysed data from studies comparing MRA techniques with DSA for the follow-up of aneurysms undergoing endovascular treatment. Subgroup analysis of stent-assisted coiling (SAC) and flow diversion (FD) techniques was completed.MethodsComprehensive searches using the Embase, PubMed, and Cochrane databases were performed and updated to November 2018. Pooled sensitivity and specificity were calculated using aneurysm occlusion status as defined by the Raymond–Roy occlusion grading scale.ResultsThe literature search yielded 1579 unique titles. Forty-three studies were included. For TOF-MRA, sensitivity and specificity of all aneurysms undergoing endovascular therapy were 88% and 94%, respectively. For CE-MRA, the sensitivity and specificity were 88% and 96%, respectively. For SAC and FD techniques, sensitivity and specificity of TOF-MRA were 86% and 95%, respectively. CE-MRA had sensitivity and specificity of 90% and 92%.ConclusionMRA is a reliable modality for the follow-up of aneurysms treated using endovascular techniques. While the data are limited, MRA techniques can also be used to reliably follow patients undergoing FD and SAC. However, clinical factors must be used to optimize follow-up regimens for individual patients.
Medial branch radiofrequency ablation outcomes in patients with centralized pain
Authors: Morffi Dayaris , Larach Daniel B , Moser Stephanie E , Goesling Jenna , Hassett Afton L , Brummett Chad M 
Published: May 2019

Background and objectivesWe hypothesized that patients with characteristics of centralized pain (fibromyalgia (FM)-like phenotype) would be less likely to respond to radiofrequency ablation (RFA), which may explain some of the failures of this peripherally directed therapy.MethodsWe conducted a prospective, observational study of patients undergoing RFA using a number of validated self-report measures of pain, mood and function. The 2011 Fibromyalgia Survey Criteria were used to assess for symptoms of centralized pain and was the primary predictor of interest. We constructed multivariable linear regression models to evaluate covariates independently associated with change in pain 3 months after RFA.Results141 patients scheduled for medial branch blocks were enrolled in the study; 55 underwent RFA (51 with complete 3 months’ follow-up). Patients with higher FM scores had less improvement in overall body pain; however, this was not statistically significant (adjusted mean change in pain FM+0.41, FM−1.11, p=0.396). In a secondary analysis, the FM score was not associated with change in back pain (p=0.720), with both groups improving equally. This cohort also reported significant improvement in anxiety, physical function, catastrophizing, and sleep disturbance at 3 months after RFA.ConclusionsAlthough patients with high baseline centralized pain exhibited less improvement in overall pain, this trend was not statistically significant, possibly due to insufficient power. The same trend was not seen with change in spine pain with both groups improving equally. Centralized pain patients may have less improvement in overall pain but may have equal improvement in their site-specific pain levels after localized interventions.
Defining the Hallmarks of Metastasis
Authors: Welch Danny R. , Hurst Douglas R. 
Published: May 2019

AbstractMetastasis is the primary cause of cancer morbidity and mortality. The process involves a complex interplay between intrinsic tumor cell properties as well as interactions between cancer cells and multiple microenvironments. The outcome is the development of a nearby or distant discontiguous secondary mass. To successfully disseminate, metastatic cells acquire properties in addition to those necessary to become neoplastic. Heterogeneity in mechanisms involved, routes of dissemination, redundancy of molecular pathways that can be utilized, and the ability to piggyback on the actions of surrounding stromal cells makes defining the hallmarks of metastasis extraordinarily challenging. Nonetheless, this review identifies four distinguishing features that are required: motility and invasion, ability to modulate the secondary site or local microenvironments, plasticity, and ability to colonize secondary tissues. By defining these first principles of metastasis, we provide the means for focusing efforts on the aspects of metastasis that will improve patient outcomes.
NFATc1-E2F1-LMCD1–Mediated IL-33 Expression by Thrombin Is Required for Injury-Induced Neointima Formation
Authors: Govatati Suresh , Pichavaram Prahalathan , Janjanam Jagadeesh , Zhang Baolin , Singh Nikhlesh K. , Mani Arul M. , Traylor James G. , Orr A. Wayne , Rao Gadiparthi N. 
Published: May 2019

Objective—
IL (interleukin)-33 has been shown to play a role in endothelial dysfunction, but its role in atherosclerosis is controversial. Therefore, the purpose of this study is to examine its role in vascular wall remodeling following injury.

Approach and Results—
Thrombin induced IL-33 expression in a time-dependent manner in human aortic smooth muscle cells and inhibition of its activity by its neutralizing antibody suppressed thrombin induced human aortic smooth muscle cell migration but not DNA synthesis. In exploring the mechanisms, we found that Par1 (protease-activated receptor 1), Gαq/11 (Gα protein q/11), PLCβ3 (phospholipase Cβ3), NFATc1 (nuclear factor of activated T cells), E2F1 (E2F transcription factor 1), and LMCD1 (LIM and cysteine-rich domains protein 1) are involved in thrombin-induced IL-33 expression and migration. Furthermore, we identified an NFAT-binding site at −100 nt that mediates thrombin-induced IL-33 promoter activity. Interestingly, we observed that NFATc1, E2F1, and LMCD1 bind to NFAT site in response to thrombin and found that LMCD1, while alone has no significant effect, enhanced either NFATc1 or E2F1-dependent IL-33 promoter activity. In addition, we found that guidewire injury induces IL-33 expression in SMC and its neutralizing antibodies substantially reduce SMC migration and neointimal growth in vivo. Increased expression of IL-33 was also observed in human atherosclerotic lesions as compared to arteries without any lesions.

Conclusions—
The above findings reveal for the first time that thrombin-induced human aortic smooth muscle cell migration and injury-induced neointimal growth require IL-33 expression. In addition, thrombin-induced IL-33 expression requires LMCD1 enhanced combinatorial activation of NFATc1 and E2F1.
Risk of Brain Arteriovenous Malformation Hemorrhage Before and After Stereotactic Radiosurgery
Authors: Ding Dale , Chen Ching-Jen , Starke Robert M. , Kano Hideyuki , Lee John Y.K. , Mathieu David , Feliciano Caleb , Rodriguez-Mercado Rafael , Almodovar Luis , Grills Inga S. , Kondziolka Douglas , Barnett Gene H. , Lunsford L. Dade , Sheehan Jason P. 
Published: May 2019

Background and Purpose—
Understanding the hemorrhage risks associated with brain arteriovenous malformations (AVMs) before and after stereotactic radiosurgery (SRS) is important. The aims of this multicenter, retrospective cohort study are to evaluate and compare the rates of pre- and post-SRS AVM hemorrhage and identify risk factors.

Methods—
We pooled AVM SRS data from 8 institutions participating in the International Radiosurgery Research Foundation. Predictors of post-SRS hemorrhage were determined using a multivariate logistic regression model. Pre- and post-SRS hemorrhage rates were compared using Fisher exact test. Ruptured and unruptured AVMs were matched in a 1:1 ratio using propensity scores, and their outcomes were compared.

Results—

The study cohort comprised 2320 AVM patients who underwent SRS. Deep AVM location (odds ratio, 1.86; 95% CI, 1.19–2.92;
P
=0.007), the presence of an AVM-associated arterial aneurysm (odds ratio, 2.44; 95% CI, 1.63–3.66;
P
<0.001), and lower SRS margin dose (odds ratio, 0.93; 95% CI, 0.88–0.98;
P
=0.005) were independent predictors of post-SRS hemorrhage. The post-SRS hemorrhage rate was lower for obliterated versus patent AVMs (6.0 versus 22.3 hemorrhages/1000 person-years;
P
<0.001). The AVM hemorrhage rate decreased from 15.4 hemorrhages/1000 person-years before SRS to 11.9 after SRS (
P
=0.001). The outcomes of the matched ruptured versus unruptured AVM cohorts were similar.

Conclusions—
SRS appears to reduce the risk of AVM hemorrhage, although this effect is predominantly driven by obliteration. Deep-seated AVMs are more likely to rupture during the latency period after SRS. AVM-associated aneurysms should be considered for selective occlusion before SRS of the nidus to ameliorate the post-SRS hemorrhage rate of these lesions.
Balloon Guide Catheter Is Beneficial in Endovascular Treatment Regardless of Mechanical Recanalization Modality
Authors: Baek Jang-Hyun , Kim Byung Moon , Kang Dong-Hun , Heo Ji Hoe , Nam Hyo Suk , Kim Young Dae , Hwang Yang-Ha , Kim Yong-Won , Kim Yong-Sun , Kim Dong Joon , Kwak Hyo Sung , Roh Hong Gee , Lee Young-Jun , Kim Sang Heum , Baik Seung Kug , Jeon Pyoung , Yoo Joonsang , Suh Sang Hyun , Kim Byungjun , Kim Jin Woo , Suh Sangil , Jeon Hong-Jun 
Published: May 2019

Background and Purpose—
Based on its mechanism, the use of balloon guide catheters (BGCs) may be beneficial during endovascular treatment, regardless of the type of mechanical recanalization modality used—stent retriever thrombectomy or thrombaspiration. We evaluated whether the use of BGCs can be beneficial regardless of the first-line mechanical endovascular modality used.

Methods—
We retrospectively reviewed consecutive acute stroke patients who underwent stent retriever thrombectomy or thrombaspiration from the prospectively maintained registries of 17 stroke centers nationwide. Patients were assigned to the BGC or non-BGC group based on the use of BGCs during procedures. Endovascular and clinical outcomes were compared between the BGC and non-BGC groups. To adjust the influence of the type of first-line endovascular modality on successful recanalization and favorable outcome, multivariable analyses were also performed.

Results—

This study included a total of 955 patients. Stent retriever thrombectomy was used as the first-line modality in 526 patients (55.1%) and thrombaspiration in 429 (44.9%). BGC was used in 516 patients (54.0%; 61.2% of stent retriever thrombectomy patients; 45.2% of thrombaspiration patients). The successful recanalization rate was significantly higher in the BGC group compared with the non-BGC group (86.8% versus 74.7%, respectively;
P
<0.001). Furthermore, the first-pass recanalization rate was more frequent (37.0% versus 14.1%;
P
<0.001), and the number of device passes was fewer in the BGC group (2.5±1.9 versus 3.3±2.1;
P
<0.001). The procedural time was also shorter in the BGC group (54.3±27.4 versus 67.6±38.2;
P
<0.001). The use of BGC was an independent factor for successful recanalization (odds ratio, 2.18; 95% CI, 1.54–3.10;
P
<0.001) irrespective of the type of first-line endovascular modality used. The use of BGC was also an independent factor for a favorable outcome (odds ratio, 1.40; 95% CI, 1.02–1.92;
P
=0.038) irrespective of the type of first-line endovascular modality used.

Conclusions—
Regardless of the first-line mechanical endovascular modality used, the use of BGC in endovascular treatment was beneficial in terms of both recanalization success and functional outcome.
Evaluation of Convection-Permitting Precipitation Forecast Products Using WRF, NMMB, and FV3 for the 2016–17 NOAA Hydrometeorology Testbed Flash Flood and Intense Rainfall Experiments
Authors: Snook Nathan , Kong Fanyou , Brewster Keith A. , Xue Ming , Thomas Kevin W. , Supinie Timothy A. , Perfater Sarah , Albright Benjamin 
Published: May 2019

Abstract
During the summers of 2016 and 2017, the Center for Analysis and Prediction of Storms (CAPS) ran real-time storm-scale ensemble forecasts (SSEFs) in support of the Hydrometeorology Testbed (HMT) Flash Flood and Intense Rainfall (FFaIR) experiment. These forecasts, using WRF-ARW and Nonhydrostatic Mesoscale Model on the B-grid (NMMB) in 2016, and WRF-ARW and GFDL Finite Volume Cubed-Sphere Dynamical Core (FV3) in 2017, covered the contiguous United States at 3-km horizontal grid spacing, and supported the generation and evaluation of precipitation forecast products, including ensemble probabilistic products. Forecasts of 3-h precipitation accumulation are evaluated. Overall, the SSEF produces skillful 3-h accumulated precipitation forecasts, with ARW members generally outperforming NMMB members and the single FV3 member run in 2017 outperforming ARW members; these differences are significant at some forecast hours. Statistically significant differences exist in the performance, in terms of bias and ETS, among subensembles of members sharing common microphysics and PBL schemes. Year-to-year consistency is higher for PBL subensembles than for microphysical subensembles. Probability-matched (PM) ensemble mean forecasts outperform individual members, while the simple ensemble mean exhibits substantial bias. A newly developed localized probability-matched (LPM) ensemble mean product was produced in 2017; compared to the simple ensemble mean and the conventional PM mean, the LPM mean exhibits improved retention of small-scale structures, evident in both 2D forecast fields and variance spectra. Probabilistic forecasts of precipitation exceeding flash flood guidance (FFG) or thresholds associated with recurrence intervals (RI) ranging from 10 to 100 years show utility in predicting regions of flooding threat, but generally overpredict the occurrence of such events; however, they may still be useful in subjective flash flood risk assessment.
Self-perceived attention deficit and hyperactivity symptom levels and risk of non-migraine and migraine headaches among university students: A cross-sectional study
Authors: Carpenet Claire , Guichard Elie , Tzourio Christophe , Kurth Tobias 
Published: May 2019

Objectives The aim was to evaluate the association of self-perceived levels of attention deficit and hyperactivity symptoms with non-migraine and migraine headaches among university students. We also evaluated their association with migraine aura. Methods Study subjects were all participants in the internet-based Students Health Research Enterprise. Scores were built to evaluate global attention and hyperactivity symptom levels, self-perceived attention deficit levels and self-perceived hyperactivity symptom levels based on the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale (ASRS v1.1.). We used standardised questions to classify headache and group participants into “no headache,” “non-migraine headache,” “migraine without aura” or “migraine with aura”. Results A total of 4816 students were included (mean age 20.3 ± 2.8 years; 75.5% women). Compared with participants without headache, we found significant associations between global ADHD scores and migraine. Students in the highest quintile of global ASRS scores had adjusted odds ratio (aOR) of 1.95 (95% CI 1.56–2.45) when compared to the lowest. This association was mainly driven by an association between self-perceived hyperactivity and migraine with aura. The aOR for migraine with aura was 2.83 (95% CI 2.23–3.61) for students in the highest quintile of hyperactivity. No significant association was found for any attention and hyperactivity symptom level measure and non-migraine headache and between self-perceived levels of attention deficit and migraine. Conclusions Among students in higher education in France, self-perceived levels of attention deficit and hyperactivity symptoms were selectively associated with migraine. The association was strongest for the hyperactivity domain and migraine with aura.
The Natural History of Progression in Adult Spinal Deformity: A Radiographic Analysis
Authors: Faraj Sayf S. A. , Hennepe Niek te , van Hooff Miranda L. , Pouw Martin , de Kleuver Marinus , Spruit Maarten 
Published: May 2019

Study Design: Historical cohort study. Objective: To evaluate progression in the coronal and sagittal planes in nonsurgical patients with adult spinal deformity (ASD). Methods: A retrospective analysis of nonsurgical ASD patients between 2005 and 2017 was performed. Magnitude of the coronal and sagittal planes were compared on the day of presentation and at most recent follow-up. Previous reported prognostic factors for progression in the coronal plane, including the direction of scoliosis, curve magnitude, and the position of the intercrest line (passing through L4 or L5 vertebra), were studied. Results: Fifty-eight patients were included with a mean follow-up of 59.8 ± 34.5 months. Progression in the coronal plane was seen in 72% of patients. Mean Cobb angle on the day of presentation and most recent follow-up was 37.2 ± 14.6° and 40.8° ± 16.5°, respectively. No significant differences were found in curve progression in left- versus right-sided scoliosis (3.3 ± 7.1 vs 3.7 ± 5.4, P = .81), Cobb angle <30° versus ≥30° (2.6 ± 5.0 vs 4.3 ± 6.5, P = .30), or when the intercrest line passed through L4 rather than L5 vertebra (3.4 ± 5.0° vs 3.8 ± 7.1°, P = .79). No significant differences were found in the sagittal plane between presentation and most recent follow-up. Conclusions: This is the first study that describes progression in the coronal and sagittal planes in nonsurgical patients with ASD. Previous reported prognostic factors were not confirmed as truly relevant. Although progression appears to occur, large variation exists and these results may not be directly applicable to the individual patient.
Evaluation of Heterotopic Ossification After Using Recombinant Human Bone Morphogenetic Protein–2 in Transforaminal Lumbar Interbody Fusion: A Computed Tomography Review of 996 Disc Levels
Authors: Niu Shuo , Anastasio Albert T. , Faraj Razan R. , Rhee John M. 
Published: May 2019

Study Design: Retrospective cohort study. Objectives: Reported incidences and complications of heterotopic ossification (HO) after using recombinant human bone morphogenetic protein–2 (rhBMP-2) in transforaminal lumbar interbody fusion (TLIF) have been inconclusive. This study was designed to evaluate both incidences of radiologic and symptomatic HO in a large series of TLIFs using rhBMP-2. Methods: A total of 996 disc levels in 927 consecutive TLIF patients were retrospectively evaluated at 6-month postoperative follow-up in a single surgical practice. Subjects were separated into the BMP group and the control group. Operative reports, pre- and postoperative medical records were reviewed. Computed tomography (CT) scans were analyzed and graded independently for ossification at each disc level of TLIF. Results: A total of 933 disc levels were in the BMP group, and 63 were in the control group. Six-month fusion rate of interbody was 92.5% in the BMP group, which was significantly higher in contrast to 71.4% in the control group ( P < .001). The incidence of radiologic HO in the BMP group was 13.5%, which was significantly higher than 1.6% in the control group ( P = .006). After controlling for basic demographics and comorbidities, the presence of radiologic HO was significantly associated with the use of rhBMP-2 ( P = .026). However, only one case in the BMP group (0.11%) developed a symptomatic HO (mild-medium left buttock pain, treated nonsurgically) involving left foramen of L5-S1. Conclusions: rhBMP-2 can be safely used in TLIF with regard to HO. There was a low rate of radiologic HO and minimal symptomatic HO, with high fusion rates at 6 months postoperative.
Which Factors Increase the Risk of Reoperation After Meniscal Surgery in Children?
Authors: Patel Neeraj M. , Mundluru Surya N. , Beck Nicholas A. , Ganley Theodore J. 
Published: May 2019

Background: Meniscal injuries in children can pose treatment challenges, as the meniscus must maintain its biomechanical function over a long lifetime while withstanding a high activity level. While the adult literature contains a plethora of studies regarding risk factors for failure of meniscal surgery, such reports are scarcer in children. Purpose: To determine the rate at which children undergoing meniscal surgery require subsequent reoperation as well as to define risk factors for reoperation in this population. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective institutional database of 907 first-time meniscal surgical procedures performed between 2000 and 2015 was reviewed. All patients were <18 years old. Demographic and intraoperative information was recorded, as were concurrent injuries or operations and subsequent procedures. Univariate analysis consisted of chi-square and independent-samples t tests. Multivariate logistic regression with purposeful selection was then performed to adjust for confounding factors. Results: The mean ± SD patient age was 13.2 ± 2.1 years, and 567 (63%) were male. The mean postoperative follow-up duration was 20.1 ± 10.1 months. Overall, 83 patients (9%) required repeat surgery at a mean of 23.2 months after the index operation. After adjustment for confounders in a multivariate model, meniscal repair resulted in 3.1-times higher odds of reoperation when compared with meniscectomy (95% CI, 1.2-8.3; P = .02), while white-white zone tears had 2.8-times lower odds of reoperation (95% CI, 1.01-7.7; P = .04) versus red-red and red-white zone tears. Conclusion: Approximately 9% of children undergoing meniscal surgery will require reoperation at a mean 23.2 months after the index operation. Repair carried approximately 3-times higher odds of reoperation than meniscectomy, while white-white zone tears had nearly 3-times lower odds of requiring repeat surgery when compared with tears in other zones.