bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between plasma imatinib levels and response to treatment of chronic myeloid leukemia in patients from Manaus, Brazil
Authors: Henriques Maíra Araújo , Júnior Frank do Carmo Guedes , Karube Lílian Minako , de Abreu Rosângela Santos , Neto José Pereira de Moura , Magalhães Igor Rafael dos Santos 
Published: May 2024

Introduction Imatinib mesylate (IM) is the drug of choice for the treatment of chronic myeloid leukemia (CML). However, despite most of the results obtained with this therapy being positive, some patients still present a suboptimal therapeutic response or still develop some type of resistance. Therefore, the aim of this study was to evaluate IM plasma levels in CML patients treated at a referral unit in Manaus and correlate them with variables that might interfere with these levels. Methods Data from 52 patients were obtained through a standardized questionnaire containing clinical, sociodemographic, lifestyle, and use of other medication information, as well as an estimate of therapeutic adherence. Additionally, blood collection was performed to measure the plasma concentration of the drug using the HPLC-UV technique. Molecular studies were done to identify the presence of polymorphism in the ABCG2 C421A membrane transporter. Results Most patients were male with a mean age of 52 ± 12.3 years (95% CI 49.0–55.9). There was a high variation in drug concentrations in the range from 0 to 4694 ng/mL, with a mean of 1558.59 ± 989.79 ng/mL (95% CI 1283.0–1834.1). Conclusion Approximately two-thirds of patients were classified in the drug-level range considered therapeutic, and there was a correlation between plasma concentration and higher molecular response. Additionally, most individuals had the normal genotype for the ABCG2 C421A polymorphism but further studies should be performed to reveal the role of this variable in the outcome of the disease in this population.
Artificial intelligence to automate assessment of ocular and periocular measurements
Authors: Rana Khizar , Beecher Mark , Caltabiano Carmelo , Macri Carmelo , Zhao Yang , Verjans Johan , Selva Dinesh 
Published: May 2024

Purpose To develop and validate a deep learning facial landmark detection network to automate the assessment of periocular anthropometric measurements. Methods Patients presenting to the ophthalmology clinic were prospectively enrolled and had their images taken using a standardised protocol. Facial landmarks were segmented on the images to enable calculation of marginal reflex distance (MRD) 1 and 2, palpebral fissure height (PFH), inner intercanthal distance (IICD), outer intercanthal distance (OICD), interpupillary distance (IPD) and horizontal palpebral aperture (HPA). These manual segmentations were used to train a machine learning algorithm to automatically detect facial landmarks and calculate these measurements. The main outcomes were the mean absolute error and intraclass correlation coefficient. Results A total of 958 eyes from 479 participants were included. The testing set consisted of 290 eyes from 145 patients. The AI algorithm demonstrated close agreement with human measurements, with mean absolute errors ranging from 0.22 mm for IPD to 0.88 mm for IICD. The intraclass correlation coefficients indicated excellent reliability (ICC > 0.90) for MRD1, MRD2, PFH, OICD, IICD, and IPD, while HPA showed good reliability (ICC 0.84). The landmark detection model was highly accurate and achieved a mean error rate of 0.51% and failure rate at 0.1 of 0%. Conclusion The automated facial landmark detection network provided accurate and reliable periocular measurements. This may help increase the objectivity of periocular measurements in the clinic and may facilitate remote assessment of patients with tele-health.
Efficacy of a novel low-cost torchlight transcorneal transillumination for diode laser transscleral cyclophotocoagulation in adult glaucoma
Authors: Thattaruthody Faisal , Chauhan Neha , Choudhary Sandeep , Raj Srishti , Pandav Surinder Singh , Kaushik Sushmita 
Published: May 2024

Purpose To study the outcomes of diode laser transscleral cyclophotocoagulation (TSCPC) with trans-corneal transillumination using a novel low-cost torchlight method in refractory glaucoma. Methods and analysis This prospective interventional study included patients with refractory glaucoma who underwent TSCPC with trans-corneal transillumination (TSCPC-TI) using a novel low-cost torchlight method. Patients completing a minimum 6-month follow-up were analyzed. They were compared to a historical control group of patients who underwent TSCPC without transillumination (TSCPC-No TI) at 6-month follow-up period. We analyzed the mean laser energy delivered, post-laser intraocular pressure (IOP) reduction, number of antiglaucoma medications (AGM), the requirement of retreatment and complications of the procedure in both groups. Results 32 eyes of 29 patients comprised the TSCPC-TI group and were compared with 39 eyes of 37 patients in the TSCPC-No TI group. The TSCPC-TI group required lower energy than the TSCPC-No TI group (46.15 ± 22.8 Vs 80.65 ± 56.1 J p < 0.001). At 6-month follow-up, the TSCPC-TI group required lesser AGM for IOP control (2.33 ± 1.02 vs 3.02 ± 1.32 p = 0.01). There was a significantly reduced dependence of oral acetazolamide in the TSCPC-TI group at 6 months follow-up (15.6% vs 41% p = 0.03%). The success and response rates were 71.8% Vs 23.1%; p < 0.0001 and 87.5% Vs 51.2%; p = 0.001 significantly high in the TSCPC-TI group. The TSCPC-No TI group had a significantly high failure rate (12.5% Vs 48.2% p = 0.001). Hypotony ( n = 1) and phthisis ( n = 2) were noted TSCPC-No TI group. Conclusions TSCPC with transillumination with a low-cost torchlight resulted in a more efficient and effective cycloablation than TSCPC without transillumination.
Snuffbox distal transradial access (dTRA) for arteriovenous fistuloplasty in Singapore: Going distal is safe
Authors: Lim Xuxin , Lee Naomi , Zhang Li , Hong Qiantai , Mak Malcolm , Chong Rhan Chaen , Tan Glenn Wei Leong , Pua Uei , Wu Yi-Wei , Yong Enming , Kwan Justin 
Published: May 2024

Aim: Arteriovenous fistula (AVF) dysfunction resulting from stenosis or occlusion, is a prevalent issue in end-stage renal failure patients reliant on autogenous AVFs for dialysis. Recently, a distal transradial approach (dTRA) has emerged, offering advantages such as diminished access site complications, better patient comfort and reduced risk of radial artery occlusion. Our study seeks to assess the effectiveness, outcomes and complication rates of employing dTRA for arteriovenous fistuloplasty in Singaporean patients. Methods: A retrospective review of all dTRA fistuloplasties performed on dysfunctional or slow to mature AVFs from 2017 to 2023 in our institution was performed. Patients with a distal radial artery measuring 2 mm or more with no evidence of occlusion or thrombosis were included. Patients who required central venoplasty or cutting balloon angioplasty were excluded. Outcome measures included technical success, mean procedure duration, complications and post-intervention primary patency at 1, 3 and 6 months. Patients were followed up for 12 months post-intervention. Results: A total of 37 patients were included. 97.3% of patients undergoing dTRA fistuloplasty had radiocephalic fistulas while 2.7% had brachiobasilic fistulas. There was 100% technical success (defined as success in radial artery cannulation, sheath insertion and crossing of stenotic lesions) in our study as all patients successfully underwent fistuloplasty via dTRA approach. One-month patency rate was 97.4%, 3-month patency rate was 92.1% and 6-month patency rate was 86.8%. There were no immediate complications (haematoma, infection, bleeding, pseudoaneurysm, occlusion) of the radial artery post-intervention. Conclusion: Our paper illustrates the safety and efficacy of utilising dTRA for arteriovenous fistuloplasty. This approach offers distinct benefits in addressing non-mature or dysfunctional distal forearm arteriovenous fistulas and should be taken into account in anatomically suitable cases.
Assessment of volume flow rate in arteriovenous fistulas with a novel ultrasound Doppler device (earlybird): Trend analysis, comparison of methods, and inter- and intra-rater reliability
Authors: Holst-Jæger Emilie , Barstad Marthe , Salvesen Øyvind , Torp Hans , Seternes Arne , Pettersen Erik Mulder 
Published: May 2024

Background: An accessible tool is required to analyze volume flow trends in arteriovenous fistulas for hemodialysis. Earlybird, an easy-to-place ultrasound Doppler device, has shown comparable accuracy to duplex ultrasound. In this study, we compared volume flow measurements obtained with duplex ultrasound and the dilution technique to an enhanced earlybird device, featuring a dual Doppler probe system, eliminating the requirement for a known insonation angle. Methods: Nine patients with a distal radiocephalic arteriovenous fistula were monitored for 12 months with regular volume flow measurements. Correlation and inter- and intra-class reliability analyses were conducted. Results: An overall moderate correlation was observed between earlybird and duplex ultrasound or dilution technique (intraclass correlation coefficient = 0.606 (95% confidence interval 0.064, 0.721) and 0.581 (0.039, 0.739), respectively). Duplex ultrasound compared to dilution measurements, demonstrated an overall moderate correlation (0.725 (0.219, 0.843)). Correlation between earlybird and duplex ultrasound was stronger for the arteriovenous fistula (0.778 (0.016, 0.901)) than the brachial artery (0.381 (−0.062, 0.461)). For earlybird, inter-rater reliability was excellent for the arteriovenous fistula (0.907 (0.423, 0.930)) and poor for the brachial artery (0.430 (0.241, 0.716)). Duplex ultrasound showed a good inter-rater reliability (arteriovenous fistula: 0.843 (0.610, 0.871), brachial artery: 0.819 (0.477, 0.864)). The overall intra-rater reliability was good for duplex ultrasound (rater A: 0.893 (0.727, 0.911); rater B: 0.853 (0.710, 0.891)), while excellent for earlybird (rater A: 0.905 (0.819, 0.928); rater B: 0.921 (0.632, 0.969)). Conclusion: We observed a weaker correlation in the measurements of volume flow rates in arteriovenous fistulas when obtained using earlybird compared to dilution technique, unlike the comparison between duplex ultrasound and the dilution technique. However, inter-rater reliability for the arteriovenous fistula was excellent with earlybird and good with duplex ultrasound, indicating the potential of earlybird as a tool for frequent measurements, enabling trend surveillance and predicting adverse outcomes.
Most preoperative stress tests fail to comply with practice guideline indications and do not reduce cardiac events
Authors: Ponukumati Aravind S , Columbo Jesse A , Henkin Stanislav , Beach Jocelyn M , Suckow Bjoern D , Goodney Philip P , Scali Salvatore T , Stone David H 
Published: May 2024

Background: There is wide variation in stress test utilization before major vascular surgery and adherence to practice guidelines is unclear. We defined rates of stress test compliance at our institution and led a quality improvement initiative to improve compliance with American Heart Association (ACC/AHA) guidelines. Methods: We implemented a stress testing order set in the electronic medical record at one tertiary hospital. We reviewed all patients who underwent elective, major vascular surgery in the 6 months before (Jan 1, 2022 – Jul 1, 2022) and 6 months after (Aug 1, 2022 – Jan 31, 2023) implementation. We studied stress test guideline compliance, changes in medical or surgical management, and major adverse cardiac events (MACE). Results: Before order set implementation, 37/122 patients (30%) underwent stress testing within the past year (29 specifically ordered preoperatively) with 66% (19/29) guideline compliance. After order set implementation, 50/173 patients (29%) underwent stress testing within the past year (41 specifically ordered preoperatively) with 80% (33/41) guideline compliance. In the pre- and postimplementation cohorts, stress testing led to a cardiovascular medication change or preoperative coronary revascularization in 24% (7/29) and 27% (11/41) of patients, and a staged surgery or less invasive anesthetic strategy in 14% (4/29) and 4.9% (2/41) of patients, respectively. All unindicated stress tests were surgeon-ordered and none led to a change in management. There was no change in MACE after order set implementation. Conclusions: Electronic medical record-based guidance of perioperative stress testing led to a slight decrease in overall stress testing and an increase in guideline-compliant testing. Our study highlights a need for improved preoperative cardiovascular risk assessment prior to major vascular surgery, which may eliminate unnecessary testing and more effectively guide perioperative decision-making.
Considerations for effective dissemination of evidence-based early intervention approaches
Authors: D’Agostino Sophia R , Frost Kyle M , Pickard Katherine 
Published: May 2024

Dissemination efforts play an important role in bridging the gap between research and practice. Many evidence-based early intervention programs for young autistic children have yet to be widely disseminated to the early childhood workforce. The purpose of this letter is to discuss how packaging and branding early intervention approaches may facilitate or hinder widespread dissemination to community-based early childhood settings. To disseminate early interventions more effectively, we argue that it will be important to account for factors that are known to impact the widespread uptake within community settings. Lay abstract Dissemination, or the widespread sharing of information, is important for moving research evidence into community practice. Early intervention programs for young autistic children have not yet been widely disseminated to the early childhood workforce. This letter describes factors that may support or prevent dissemination to community-based settings, such as packaging and branding early intervention approaches. We argue that an increased focus on dissemination research is needed.
Three-Dimensional Geometric Analysis of Viabahn VBX Bridging Stent Grafts in Fenestrated Endovascular Aortic Repair: A Multicenter, Retrospective Cohort Study
Authors: Fouad Fatima , Saleem Ben R. , Tielliu Ignace F. J. , Pegorer Matteo A. , Bellosta Raffaello , Esposito Davide , Fargion Aaron T. , Zeebregts Clark J. , de Vries Jean-Paul P. M. , Schuurmann Richte C. L. 
Published: May 2024

Purpose: The primary aim of this study was to assess the 3-dimensional flare geometry of the Gore Viabahn VBX balloon-expandable covered stent (BECS) after fenestrated endovascular aortic repair (FEVAR) and to determine and visualize BECS-associated complications. Methods: This multicenter retrospective study included patients who underwent FEVAR between 2018 and 2022 in 3 vascular centers participating in the VBX Expand Registry. Patients with at least one visceral artery treated with the VBX and with availability of 2 post-FEVAR computed tomography angiography (CTA) scans (follow-up [FU] 1: 0–6 months; FU2: 9–24 months) were included. The flare geometry of the VBX, including flare-to-fenestration distance, flare-to-fenestration diameter ratio, flare angle, and apposition with the target artery were assessed using a vascular workstation and dedicated CTA applied software. Results: In total, 90 VBX BECS were analyzed in 43 FEVAR patients. The median CTA FU for FU1 and FU2 was 35 days (interquartile range [IQR], 29–51 days) and 14 months (IQR, 13–15 months), respectively. The mean flare-to-fenestration distance was 5.6±2.0 mm on FU1 and remained unchanged at 5.7±2.0 mm on FU2 (p=.417). The flare-to-fenestration diameter ratio was 1.19±0.17 on FU1 and remained unchanged at 1.21±0.19 (p=.206). The mean apposition length was 18.6±5.3 mm on FU1 and remained 18.6±5.3 mm (p=.550). The flare angle was 31°±15° on FU1 and changed to 33°±16° (p=.009). On FU1, the BECS-associated complication rate was 1%, and the BECS-associated reintervention rate was 0%. On FU2, the BECS-associated complication rate was 3%, and the BECS-associated reintervention rate was 1%. Conclusions: The flare geometry of the VBX bridging stent did not change significantly during 14 months follow-up in this study. Three-dimensional geometric analysis of the flare may contribute to identify the origin of endoleaks and occlusions, but this should be confirmed in a larger study including enough patients and BECS to compare complicated and uncomplicated cases. Clinical Impact The three-dimensional flare geometry of the Gore Viabahn VBX BECS was assessed on the first and second postoperative CTA scans, and geometrical changes during this period were identified. For BECS that were diagnosed with a type 3c endoleak or occlusion, the BECS geometry was analyzed to detect geometrical components that were related to the complication. Geometric analysis of the flare may help to better detect and identify the cause of such complications.
piR-1919609 Is an Ideal Potential Target for Reversing Platinum Resistance in Ovarian Cancer
Authors: Yan Ying , Tian Dan , Zhao Bingbing , Li Zhuang , Huang Zhijiong , Li Kuina , Chen Xiaoqi , Zhou Lu , Feng Yanying , Yang Zhijun 
Published: May 2024

Purpose PIWI-interacting RNAs (piRNAs) are a type of noncoding small RNA that can interact with PIWI-like RNA-mediated gene silencing (PIWIL) proteins to affect biological processes such as transposon silencing through epigenetic effects. Recent studies have found that piRNAs are widely dysregulated in tumors and associated with tumor progression and a poor prognosis. Therefore, this study aimed to investigate the effect of piR-1919609 on the proliferation, apoptosis, and drug resistance of ovarian cancer cells. Methods In this study, we used small RNA sequencing to screen and identify differentially expressed piRNAs in primary ovarian cancer, recurrent ovarian cancer, and normal ovaries. A large-scale verification study was performed to verify the expression of piR-1919609 in different types of ovarian tissue, including ovarian cancer tissue and normal ovaries, by RT–PCR and to analyze its association with the clinical prognosis of ovarian cancer. The expression of PIWILs in ovarian cancer was verified by RT–PCR, Western blotting and immunofluorescence. The effects of piR-1919609 on ovarian cancer cell proliferation, apoptosis and drug resistance were studied through in vitro and in vivo models. Results (1) piR-1919609 was highly expressed in platinum-resistant ovarian cancer tissues (p < 0.05), and this upregulation was significantly associated with a poor prognosis and a shorter recurrence time in ovarian cancer patients (p < 0.05). (2) PIWIL2 was strongly expressed in ovarian cancer tissues (p < 0.05). It was expressed both in the cytoplasm and nucleus of ovarian cancer cells. (3) Overexpression of piR-1919609 promoted ovarian cancer cell proliferation, inhibited apoptosis, and promoted tumor growth in nude mice. (4) Inhibition of piR-1919609 effectively reversed ovarian cancer drug resistance. Conclusion In summary, we showed that piR-1919609 is involved in the regulation of drug resistance in ovarian cancer cells and might be an ideal potential target for reversing platinum resistance in ovarian cancer.
Treatment of intracranial aneurysms with large-diameter (≥5.5 mm) Derivo Embolization Devices, with particular focus on 7 and 8 mm diameter devices
Authors: Goertz Lukas , Zopfs David , Kottlors Jonathan , Pennig Lenhard , Schob Stefan , Schlamann Marc , Kabbasch Christoph 
Published: May 2024

Objective There are few studies on flow diverters with diameters >5 mm. We present our preliminary experience with the 5.5–8 mm Derivo Embolization Device (DED) implants for the treatment of cerebral aneurysms. Methods A consecutive series of 26 patients (median age: 60 years) treated for 32 aneurysms in 26 procedures was retrospectively analyzed for procedural characteristics, complications, and mid-term angiographic results. Results The median aneurysm size was 10.5 mm, 2 of 30 (6%) aneurysms were ruptured and 9 (28%) had a fusiform or dissecting morphology. DED implantation was performed in the internal carotid artery in 18 of 26 (69%) procedures and in the vertebrobasilar artery in 8 (31%). Device deployment failed in 1 (4%) procedure. The 7 and 8 mm implants were successfully deployed in 5 cases. Additional balloon angioplasty or stent implantation was performed in 3 (12%) cases to improve wall apposition. Complications included 1 (4%) major stroke and 2 (8%) minor strokes. Angiographic follow up at a mean of 6 months showed complete occlusion in 8 of30 (27%) aneurysms and favorable occlusion in 14 (47%). Conclusions The use of large diameter DEDs was safe and feasible. The mid-term occlusion rates are acceptable considering the complex subset of aneurysms studied. Further studies are warranted to define the indications for large-diameter DEDs and to evaluate their long-term efficacy.
The study of anti-idiotype antibody and antinuclear antibodies (ANA) in people receiving three doses of the COVID-19 vaccine
Authors: Chegni Hamid , Babaii Hadise , Pouran Fatemeh 
Published: May 2024

Introduction: The anti-idiotype network was introduced in 1974 by Niels Jerne. One of the factors that reduces the effectiveness of the vaccines is the anti-idiotype network. It should be noted that the Anti-idiotype of the antibody has the ability to bind to the receptors of the body cells to which the antigen of the first antibody binds; this causes pathological complications, especially after a longer period of time. In this study, we aim to be the first to study the presence of Anti-idiotype antibodies and ANA in people who have received three doses of the COVID-19 vaccine and check that at least 4 months have passed since the injection of their third dose. Materials and Methods: This study was conducted on 180 people and measuring amount of Anti-RBD Anti-idiotype, Anti-Nuclear Antibody (IgG antibodies against RNP, sm RNP, smSSB/La, SSA/Ro, scl 70, centromere B, Jo1, and dsDNA antigens) and SARS-COV-Anti IgG RBD in serum by ELISA methods. Results: In the measurement of Anti-RBD Anti-idiotype, it was found that 14 people (7.7%) of the studied subjects had Anti-idiotype antibodies and 166 (92.3%) lacked this antibody. It was found that five of the studied subjects (2.7%) had positive values for ANA (above 50 RU/ML; in 175 people (97.3), the ANA value was negative (less than 50 RU/ML). In the examination of the results related to the measurement of the quantitative amount of SARS-COV-Anti IgG RBD, it was found that all 180 people included in the study (100%) had a detectable titer of Anti-RBD antibody. Conclusion: Many studies have shown an association between autoimmune diseases and SARS-COV-2 and MERS-CoV. Nevertheless, no studies have investigated autoantibodies in people who have injected three doses of the COVID-19 vaccine. further studies are warranted to confirm and find the causes of this difference.