bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Biologic Drug Effects and Distal Particulate Embolization in Three Paclitaxel-Coated Balloons for Femoropopliteal Lesions in a Rabbit Model
Authors: Yoshikawa Marie , Torii Sho , Aihara Kazuki , Ito Masatoshi , Nakamura Norihito , Noda Satoshi , Yoshikawa Ayako , Utsunomiya Sayo , Nakazawa MD Gaku , Ikari Yuji 
Published: March 2023

Background: A recent meta-analysis of randomized control trials demonstrated a significantly higher risk of major amputation in patients treated with drug-coated balloons (DCBs) compared with standard treatment, especially in high-dose paclitaxel-coated DCBs. Distal particulate embolization after DCB use was considered a potential cause of the higher incidence of major amputation. The current study aimed to histologically and biologically compare biologic drug effect and distal particulate embolization in 3 DCBs (a high-dose paclitaxel-coated DCB [IN.PACT Admiral] and 2 low-dose paclitaxel-coated DCBs [Ranger and Lutonix]). Methods and Results: The DCBs were inflated in the healthy descending aortas of 18 rabbits, followed by euthanasia 28 days after the procedure. The treated descending aorta and distal skeletal muscles were histopathologically evaluated, and paclitaxel concentrations were measured. The paclitaxel concentration of the treated lesion was highest for Ranger, followed by IN.PACT and Lutonix (Ranger vs IN.PACT vs Lutonix: 1089 [745–2170] pmol/mg vs 638 [160–2075] pmol/mg vs 25 [10–304] pmol/mg, respectively; p<0.0001). In the histopathological evaluation, the angle of severe medial smooth muscle cell loss was largest for Ranger followed by IN.PACT and Lutonix (12.8 [8.0–20.4] degree vs 1.4 [1.2–5.2] degree vs 0.8 [0.5–2.5] degree, respectively), with significant differences for Ranger vs IN.PACT (p=0.007) and Ranger vs Lutonix (p=0.002). However, paclitaxel concentrations of distal skeletal muscles were lowest for Lutonix, followed by Ranger and IN.PACT (12 [1–58] pmol/mg vs 15 [13–21] pmol/mg vs 42 [19–108] pmol/mg, respectively, p<0.0001). The numbers of arteries with downstream DCB effects were highest for IN.PACT, followed by Ranger and Lutonix (Ranger vs IN.PACT vs Lutonix, 3 [3–4] vs 4 [3–7] vs 2 [1–2], respectively), which was consistent with the measured tissue paclitaxel concentrations. Conclusion: These findings suggest that Ranger demonstrates the strongest paclitaxel effect, as well as the second-best effect regarding distal particulate embolization, making it a good treatment option for patients with peripheral artery disease among the 3 DCBs evaluated in the current study. Further clinical head-to-head comparisons with larger numbers of patients are needed to explore which DCB is the most effective and safe treatment option.Clinical Impact: The findings of the current preclinical study suggests that Ranger demonstrates the strongest paclitaxel effect, as well as the second-best effect regarding distal particulate embolization making it a good treatment for patients with intermittent claudication and chronic limb-threatening ischemia.
First-in-human clinical trial of the NKT cell-stimulatory glycolipid OCH in multiple sclerosis
Authors: Sato Wakiro , Noto Daisuke , Araki Manabu , Okamoto Tomoko , Lin Youwei , Yamaguchi Hiromi , Kadowaki-Saga Ryoko , Kimura Atsuko , Kimura Yukio , Sato Noriko , Ishizuka Takami , Nakamura Harumasa , Miyake Sachiko , Yamamura Takashi 
Published: March 2023

Background: Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system that causes the damage to the myelin sheath as well as axonal degeneration. Individuals with MS appear to have changes in the numbers and functions of T-cell subsets, leading to an immunological imbalance accompanied by enhanced autoreactivity. In previous preclinical studies, (2 S,3 S,4R)-1-O-(α-D-Galactopyranosyl)-N-tetracosanoyl-2-amino-1,3,4-nonanetriol (OCH), a synthetic analog of α-galactosylceramide stimulatory for invariant NKT (iNKT) cells, has shown therapeutic or disease-preventive immunoregulatory effects in autoimmune disease models such as experimental autoimmune encephalomyelitis (EAE). Objectives: This study is the first-in-human study of oral OCH to evaluate the pharmacokinetics and to examine the effects on immune cells as well as related gene expression profiles. Methods: Fifteen healthy volunteers and 13 MS patients who met the study criteria were enrolled. They were divided into five cohorts and received oral administration of various doses of granulated powder of OCH (0.3–30 mg), once per week for 4 or 13 weeks. Plasma OCH concentrations were measured by high-performance liquid chromatography. Frequencies of lymphocyte subsets in peripheral blood were evaluated by flow cytometry, and microarray analysis was performed to determine OCH-induced changes in gene expression. Results: Oral OCH was well tolerated, and its bioavailability was found to be sufficient. Six hours after a single dose of OCH, increased frequencies of Foxp3+ regulatory T-cells were observed in some cohorts of healthy subjects and MS patients. Furthermore, gene expression analysis demonstrated an upregulation of several immunoregulatory genes and downregulation of pro-inflammatory genes following OCH administration. Conclusion: This study has demonstrated immunomodulatory effects of the iNKT cell-stimulatory drug OCH in human. Safety profiles together with the presumed anti-inflammatory effects of oral OCH encouraged us to conduct a phase II trial.
Therapeutic efficacy and safety of plasmapheresis in elderly patients with neuromyelitis optica spectrum disorder: a single-center observational study
Authors: Zhang Weihe , Jiao Yujuan , Cui Lei , Zhang Yeqiong , Jiao Jinsong , Jin Ming , Yuan Wei , You Yang , Wang Renbin , Peng Dantao 
Published: March 2023

Background: Neuromyelitis optica spectrum disorder (NMOSD) is a devastating autoimmune disorder with cycles of escalating relapse. Rates of diagnosis in the elderly are increasing. Therapeutic decision-making is more challenging in elderly patients due to multiple comorbidities and high risk of drug-induced side effects. Objective: This retrospective study assessed the efficacy and safety of standard plasma exchange (PLEX) treatment in an elderly population with NMOSD. Design: Seventy-six patients with NMOSD who received PLEX were apportioned to two groups as either elderly (⩾60 years, n = 26) or young (<60 years) at the time of the first procedure. Methods: Therapeutic response was judged according to functional recovery at 6 months, as reflected by Expanded Disability Status Scale (EDSS) and visual outcome scale (VOS) scores. Results: The mean age of the 26 elderly patients was 67.7 ± 7.9 years (range 60–87 years); the population was predominantly female (88.5%). PLEX sessions were generally well tolerated among the elderly. Compared with the young patients, the elderly had significantly more comorbidities and concomitant medications. Twenty-four (96.0%) elderly patients showed functional improvement at 6 months after PLEX, of which 15 (60.0%) experienced moderate-to-marked improvement. Six months after the initial PLEX treatment, the patients overall experienced a significant improvement in EDSS and VOS scores. Logistic regression showed that severe optic neuritis attack was a significant independent prognostic factor associated with poor PLEX response. The groups were comparable regarding overall or serious adverse events. The rate of transient hypotension was significantly higher in the elderly compared with the young. Conclusion: PLEX is an effective and safe therapy for elderly patients with NMOSD and should be considered a treatment option during NMOSD attacks. In the elderly, preventive measures against hypotension are recommended before PLEX.
The cruel optimism of educational technology teacher ambassador spaces
Authors: Thompson Kali 
Published: March 2023

In the last 20 years, neoliberal ideology has heavily influenced the U.S. education system, opening public education up to private corporations as a profitable business endeavor. In this paper, I inquire ( Pierre, 2018 , 2021 ) into educational technology (edtech) teacher ambassador programs through a blog post I wrote as a former second-grade teacher and ambassador for a prominent K-12 edtech company. I argue one way these exploitative spaces operate is through educators’ attachment ( Berlant, 2011 ) to the idea of being a good enough woman teacher ( Pittard, 2015 ) fueled by neoliberal discourses of “keeping up” ( Walkerdine, 2003 ). In other words, the material-discursive apparatus of these program spaces produces a “cruel optimism” for what we could be, rather than what we are, which in turn produces further profit for edtech companies. Overall, this paper grapples with how these programs may appear or feel mutually beneficial for educators, yet are often only monetarily beneficial for edtech companies and their investors.
Strength after the arthroscopic Latarjet procedure: Are shoulder internal rotation, elbow flexion & supination strength decreased?
Authors: Alnusif Naser , Lari Ali , AlQahtani Saad , Athwal George S 
Published: March 2023

Background The Latarjet procedure is an effective shoulder stabilizing surgery, however, the procedure results in an alteration of anatomy that may result in shoulder and elbow weakness. Thus, the purpose of this study was to assess post-operative shoulder and elbow strength after the Latarjet procedure. We hypothesized that shoulder and elbow strength are not affected after the procedure. Methods The study group consisted of patients that had undergone the arthroscopic Latarjet procedure. An isokinetic dynamometer was used to evaluate the strength of bilateral shoulder internal rotation, elbow flexion, forearm supination using peak torque (N/m), as well as grip strength (kilograms). Shoulder range of motion and the potential effects of hand dominance were further analysed. Results Nineteen patients with a mean age of 29 years and an average follow up of 47 months were included. Shoulder internal rotation strength, elbow flexion and forearm supination strength and grip strength were not significantly different when compared to the non-operative side ( p > 0.13). The range of shoulder external rotation was significantly reduced ( p < 0.001) on the Latarjet side. Conclusion The results from this study demonstrate no statistically significant differences in the strength of shoulder internal rotation, elbow flexion, forearm supination or grip strength despite the surgical alterations to the subscapularis and conjoint tendon.
Variation in the Current Use of Technology to Support Diabetes Management in UK Hospitals: Results of a Survey of Health Care Professionals
Authors: Lumb Alistair , Misra Shivani , Rayman Gerry , Avari Parizad , Flanagan Daniel , Choudhary Pratik , Dhatariya Ketan 
Published: March 2023

Background: There has been a significant increase in the use of wearable diabetes technologies in the outpatient setting over recent years, but this has not consistently translated into inpatient use. Methods: An online survey was undertaken to understand the current use of technology to support inpatient diabetes care in the United Kingdom. Results: Responses were received from 42 different organizations representing 104 hospitals across the United Kingdom. Significant variation was found between organizations in the use of technology to support safe, effective inpatient diabetes care. Benefits of the use of technology were reported, and areas of good practice identified. Conclusion: Technology supports good inpatient diabetes care, but there is currently variation in its use. Guidance has been developed which should drive improvements in the use of technology and hence improvements in the safety and effectiveness of inpatient diabetes care. Key recommendations include implementation of this guidance (especially for continuous glucose monitoring), ensuring specialist support is available for the use of wearable diabetes technology in hospital, optimizing information sharing across the health care system, and making full use of data from networked glucose and ketone meters.
Assessing operative delay and complications in hip fracture patients on anticoagulants and antiplatelets
Authors: Elete Asheesh R , Panwar Yash , Dannaway Jasan , Chen Jacqueline , Thomas Bijoy 
Published: March 2023

Objectives: Hip fractures represent a prevalent geriatric cause of morbidity and mortality. The presence of multiple comorbidities requiring the use of an anticoagulant or antiplatelet medication adds complexity to management and influences outcomes. International guidelines suggest expedited surgery within 48 h; however, anticoagulant and antiplatelet medications commonly cause delays. Research exploring health outcomes in this group is unclear. Therefore, we aimed to determine the impact of anticoagulant and antiplatelet medications on operative delay and overall complications in hip fracture patients. Methods: A retrospective cohort study of hip fractures was performed at a tertiary hospital over a 3-year period from 1st January 2018 to 31st December 2020. Data collected included demographics, time to surgery, length of stay, postoperative blood transfusion, venous thromboembolism, acute coronary syndrome, stroke, infections in hospital and 120-day mortality. Patients were categorised based on the use of direct oral anticoagulants, warfarin and antiplatelet medications. Results: In total, 474 patients were included and 43.5% were on an anticoagulant or antiplatelet medication. Patients on these medications had more than twice the rate of operative delay (41.7% versus 17.2%, p < 0.001) with the greatest in the direct oral anticoagulant group (92.7% delay). After controlling for age and gender, this was still significant for direct oral anticoagulant ( p < 0.001) and antiplatelet group patients ( p = 0.02). These patients also had a 20% increased overall complication rate ( p < 0.001). On subgroup logistic regression, the increased complication rate was noted in the direct oral anticoagulant group ( p = 0.006) and the antiplatelet group ( p < 0.001) but not in the warfarin group ( p = 0.25). Time to surgery beyond 48 h was associated with a double increase in the odds of a postoperative complication ( p = 0.005). Conclusion: There is a significantly greater delay to surgery in hip fracture patients on anticoagulant or antiplatelet medications as well as a higher incidence of complications. Guidelines to expedite early safe surgery in this high-risk patient group are required.
Anterior Cruciate Ligament Reconstruction With Transtibial Medial Meniscus Root Repair
Authors: LaPrade Robert F. , Parvaresh Kevin C. , Vadhera Amar S. , Singh Harsh , Gursoy Safa , Verma Nikhil N. , Chahla Jorge 
Published: March 2023

Background: The incidence of anterior cruciate ligament (ACL) injuries has rapidly increased. Patients with ACL injuries frequently present with concomitant meniscal pathologies. Posterior medial meniscal root tears (PMMR) are less commonly seen with acute ACL injuries as compared with lateral tears and are often degenerative in nature or more rarely in an acute setting. Clinical studies have demonstrated medial meniscal deficiency to be a significant risk factor for graft failure and poor postoperative clinical outcomes. As such, given its demonstrated efficacy, there has been growing interest in transtibial meniscal repair mechanisms in combination with an ACL reconstruction as a potential solution to this challenging pathology. Indication: Patients are indicated for surgery when presenting with symptomatic ACL deficiency verified on provocative testing and advanced imaging and objective insufficiency of the medial meniscal root. Contraindications for this procedure include advanced osteoarthritis (Kellgren–Lawrence grade ≥3) on weight-bearing x-rays, age <50 years, and body mass index (BMI) > 30 as well as poor-quality meniscal tissue and unrepairable chondral defects. Technique Description: The ACL stump is debrided and a burr hole is created. A femoral aiming guide is used to drill the femoral tunnel. Following medial collateral ligament (MCL) release, a healing bony bed is prepared with a curette and shaver at the anatomic tibial footprint. An aiming device is then used through the anterior medial portal to create 2 transosseous tibial tunnels. A vertical mattress suture and simple suture are placed through the meniscal root, shuttled through the posterior and anterior transosseous tunnels, respectively. The tibial ACL tunnel is placed using a standard guide to avoid tunnel convergence with the root tunnels and prevent graft tunnel mismatch. After graft passage, interference screws are inserted while maintaining graft tension. The sutures are then tied over a cortical button over the tibia. Results: Within 2 years postoperatively, patients are expected to have improved overall knee-specific quality of life, reduced pain, and a successful return to activities with low rates of graft failure. Discussion/Conclusion: Recent advancements in our understanding of the relationship between the medial meniscus and the ACL should prompt surgeons to continue considering such combined treatments in indicated patients. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Characterization of the human platelet N- and O-glycome upon storage using tandem mass spectrometry
Authors: Rosenbalm Katelyn E. , Lee-Sundlov Melissa M. , Ashline David J. , Grozovsky Renata , Aoki Kazuhiro , Hanneman Andrew J. S. , Hoffmeister Karin M. 
Published: March 2023

Abstract
Changes in surface glycan determinants, specifically sialic acid loss, determine platelet life span. The gradual loss of stored platelet quality is a complex process that fundamentally involves carbohydrate structures. Here, we applied lipophilic extraction and glycan release protocols to sequentially profile N- and O-linked glycans in freshly isolated and 7-day room temperature–stored platelet concentrates. Analytical methods including matrix assisted laser desorption/ionization time-of-flight mass spectrometry, tandem mass spectrometry, and liquid chromatography were used to obtain structural details of selected glycans and terminal epitopes. The fresh platelet repertoire of surface structures revealed diverse N-glycans, including high mannose structures, complex glycans with polylactosamine repeats, and glycans presenting blood group epitopes. The O-glycan repertoire largely comprised sialylated and fucosylated core-1 and core-2 structures. For both N- and O-linked glycans, we observed a loss in sialylated epitopes with a reciprocal increase in neutral structures as well as increased neuraminidase activity after platelet storage at room temperature. The data indicate that loss of sialylated glycans is associated with diminished platelet quality and untimely removal of platelets after storage.
Ethnic variation in asthma healthcare utilisation and exacerbation: systematic review and meta-analysis
Authors: Akin-Imran AbdulQadr , Bajpai Achint , McCartan Dáire , Heaney Liam G. , Kee Frank , Redmond Charlene , Busby John 
Published: March 2023

BackgroundPatients from ethnic minority groups (EMGs) frequently report poorer asthma outcomes; however, a broad synthesis summarising ethnic disparities is yet to be undertaken. What is the magnitude of ethnic disparities in asthma healthcare utilisation, exacerbations and mortality?MethodsMEDLINE, Embase and Web of Science databases were searched for studies reporting ethnic variation in asthma healthcare outcomes (primary care attendance, exacerbation, emergency department (ED) visits, hospitalisation, hospital readmission, ventilation/intubation and mortality) between White patients and those from EMGs. Estimates were displayed using forest plots and random-effects models were used to calculate pooled estimates. We conducted subgroup analyses to explore heterogeneity, including by specific ethnicity (Black, Hispanic, Asian and other).Results65 studies, comprising 699 882 patients, were included. Most studies (92.3%) were conducted in the United States of America (USA). Patients from EMGs had evidence suggestive of lower levels of primary care attendance (OR 0.72, 95% CI 0.48–1.09), but substantially higher ED visits (OR 1.74, 95% CI 1.53–1.98), hospitalisations (OR 1.63, 95% CI 1.48–1.79) and ventilation/intubation (OR 2.67, 95% CI 1.65–4.31) when compared to White patients. In addition, we found evidence suggestive of increased hospital readmissions (OR 1.19, 95% CI 0.90–1.57) and exacerbation rates (OR 1.10, 95% CI 0.94–1.28) among EMGs. No eligible studies explored disparities in mortality. ED visits were much higher among Black and Hispanic patients, while Asian and other ethnicities had similar rates to White patients.ConclusionsEMGs had higher secondary care utilisation and exacerbations. Despite the global importance of this issue, the majority of studies were performed in the USA. Further research into the causes of these disparities, including whether these vary by specific ethnicity, is required to aid the design of effective interventions.
The detection, assessment and clinical evolution of interstitial lung abnormalities identified through lung cancer screening
Authors: Balata Haval , Punjabi Anshu , Chaudhuri Nazia , Greaves Melanie , Yorke Janelle , Booton Richard , Crosbie Phil , Hayton Conal 
Published: March 2023

IntroductionInterstitial lung abnormalities (ILAs) are common incidental findings in lung cancer screening; however, their clinical evolution and longer-term outcomes are less clear. The aim of this cohort study was to report 5-year outcomes of individuals with ILAs identified through a lung cancer screening programme. In addition, we compared patient-reported outcome measures (PROMs) in patients with screen-detected ILAs to newly diagnosed interstitial lung disease (ILD) to assess symptoms and health-related quality of life (HRQoL).MethodsIndividuals with screen-detected ILAs were identified, and 5-year outcomes, including ILD diagnoses, progression-free survival and mortality, were recorded. Risk factors associated with ILD diagnosis were assessed using logistic regression and survival using Cox proportional hazard analysis. PROMs were compared between a subset of patients with ILAs and a group of ILD patients.Results1384 individuals underwent baseline low-dose computed tomography screening, with 54 (3.9%) identified as having ILAs. 22 (40.7%) were subsequently diagnosed with ILD. 14 (25.9%) individuals died, and 28 (53.8%) suffered disease progression within 5 years. Fibrotic ILA was an independent risk factor for ILD diagnosis, mortality and reduced progression-free survival. Patients with ILAs had lower symptom burden and better HRQoL in comparison to the ILD group. Breathlessness visual analogue scale (VAS) score was associated with mortality on multivariate analysis.ConclusionsFibrotic ILA was a significant risk factor for adverse outcomes including subsequent ILD diagnosis. While screen-detected ILA patients were less symptomatic, breathlessness VAS score was associated with adverse outcomes. These results could inform risk stratification in ILA.