LLukas22/scidocs huggingface dataset:
Combination therapy with azelastine hydrochloride nasal spray and fluticasone propionate nasal spray in the treatment of patients with seasonal allergic rhinitis.

BACKGROUND
To our knowledge, there are no published studies that evaluated the efficacy of azelastine hydrochloride nasal spray in combination with an intranasal corticosteroid, although anecdotal reports of the use of these agents in combination are common.


OBJECTIVE
To determine if greater efficacy could be achieved with the intranasal antihistamine azelastine and the intranasal corticosteroid fluticasone propionate used concurrently compared with the efficacy of each agent alone.


METHODS
This randomized, 2-week, multicenter, double-blind trial was conducted during the Texas mountain cedar season. After a 5-day placebo lead-in period, 151 patients with moderate to severe nasal symptoms were randomized to treatment with the following: (1) azelastine nasal spray, 2 sprays per nostril twice daily; (2) fluticasone nasal spray, 2 sprays per nostril once daily; or (3) azelastine nasal spray, 2 sprays per nostril twice daily, plus fluticasone nasal spray, 2 sprays per nostril once daily. The primary efficacy variable was the change from baseline in the total nasal symptom score (TNSS), consisting of sneezing, itchy nose, runny nose, and nasal congestion.


RESULTS
All 3 groups had statistically significant (P < .001) improvements from their baseline TNSS after 2 weeks of treatment. The TNSS improved 27.1% with fluticasone nasal spray, 24.8% with azelastine nasal spray, and 37.9% with the 2 agents in combination (P < .05 vs either agent alone). All 3 treatments were well tolerated.


CONCLUSIONS
The significant improvement in the TNSS with combination therapy relative to the individual agents alone is in contrast to previously published studies that found no advantage with an oral antihistamine and an intranasal corticosteroid in combination. Azelastine nasal spray and fluticasone nasal spray in combination may provide a substantial therapeutic benefit for patients with seasonal allergic rhinitis compared with therapy with either agent alone.
Sphenopalatine ganglion radiofrequency ablation for the management of chronic cluster headache.

OBJECTIVES
Chronic cluster headache patients are often resistant to pharmacological management. Percutaneous radiofrequency ablation (RFA) of the sphenopalatine ganglion (SPG) was shown before to improve episodic cluster headache but not chronic cluster headache. We were interested to examine the effect of such intervention in patients with intractable chronic cluster headache who failed pharmacological management.


METHODS
Fifteen patients with chronic cluster headache, who experienced temporary pain relief following SPG block, underwent percutaneous RFA via the infrazygomatic approach under fluoroscopic guidance. Collected data include demographic variables, onset and duration of the headache, mean attack intensity (MAI), mean attack frequency (MAF), and pain disability index (PDI) before and up to 18 months after procedure.


RESULTS
At 1-, 3-, 6-, 12-, 18-month follow-up, the MAI was 2.6, 3.2, 3.2, 3.4, 4.2, respectively (P < .0001, P < .0001, P < .0001, P < .0005, P < .003, respectively). The PDI improved from 55 (baseline) to 17.2 and 25.6 at 6 and 12 months respectively (P < .001). The MAF improved from 17 attacks/week to 5.4, 6.4, 7.8, 8.6, 8.3 at 1-, 3-, 6-, 12-, 18-month follow-up visits (P < .0001, P < .0001, P < .0001, P < .002, P < .004, respectively).


CONCLUSION
Our data showed that percutaneous RFA of the SPG is an effective modality of treatment for patients with intractable chronic cluster headaches. Precise needle placement with the use of real-time fluoroscopy and electrical stimulation prior to attempting radiofrequency lesioning may reduce the incidence of adverse events.
The lesser and third occipital nerves and migraine headaches.

BACKGROUND
Reports of a correlation between relief of migraine headaches and resection of corrugator muscles or injection of botulinum A toxin have renewed interest in finding the cause of migraine headaches and identifying the trigger sites. Four trigger sites have been described. One of these is along the course of the greater occipital nerve. Recent anatomical studies of this nerve have defined its location with respect to external landmarks, leading to new studies with gratifying results. There is a subset of patients who undergo chemodenervation or surgical release of the greater occipital nerve and note improvement or elimination of the symptoms along the greater occipital nerve course but who experience an emergence of migraine headache symptoms laterally. The authors propose the lesser occipital nerve as the source of pain in those who experience headaches laterally and involvement of the third occipital nerve in those who notice residual symptoms in the midportion of the occipital region.


METHODS
To test this hypothesis anatomically, 20 cadaver heads were dissected to trace the course of the lesser occipital nerve and third occipital nerve and define the location of these nerves with respect to external landmarks. The midline and a line drawn between the inferiormost points of the external auditory canals were used to obtain standardized measurements of these nerves.


RESULTS
The location of emergence of the lesser occipital nerve was determined to be an area centered 65.4 +/- 11.6 mm from midline and 53.3 +/- 15.6 mm below the line between the external auditory canals. The third occipital nerve was found 13.2 +/- 5.3 mm from midline and 62.0 +/- 20.0 mm down from the line between the two external auditory canals.


CONCLUSIONS
This information can be used to conduct clinical trials of chemodenervation of these nerves in an attempt to eliminate migraine symptoms in the subset of patients who continue to experience residual symptoms after surgical release of the greater occipital nerve.
Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy?

Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. Moreover, periodontal treatment during pregnancy can cause bacteremia, which itself may initiate the pathway leading to the adverse pregnancy outcomes. Finally, the periodontal treatments provided during pregnancy are not always effective in preventing the progression of periodontal disease during pregnancy. Pregnancy may not be an appropriate period for periodontal intervention(s). We hypothesize that periodontal treatment before pregnancy may reduce the rates of adverse pregnancy outcomes. Future randomized controlled trials are needed to test if treating periodontal disease in the prepregnancy period reduces the rate of adverse pregnancy outcomes.
Teaching subjects with type 2 diabetes how to incorporate sugar choices into their daily meal plan promotes dietary compliance and does not deteriorate metabolic profile.

OBJECTIVE
To determine whether teaching free-living subjects with type 2 diabetes how to incorporate added sugars or sweets into their daily meal plan results in a greater consumption of calories (fat or sugar) and deteriorates their glycemic or lipid profiles but improves their perceived quality of life.


RESEARCH DESIGN AND METHODS
In an 8-month randomized controlled trial, 48 free-living subjects with type 2 diabetes were taught either a conventional (C) meal plan (no concentrated sweets) or one permitting as much as 10% of total energy as added sugars or sweets (S). Mean individual nutrient intake was determined using the average of six 24-h telephone recalls per 4 months. Metabolic control and quality of life were evaluated every 2 months. Quality of life was assessed using the Medical Outcome Survey and the Diabetes Quality of Life questionnaire.


RESULTS
The S group did not consume more calories (fat or sugar) and in fact ate significantly less carbohydrate (-15 vs. 10 g) and less starch (-7 vs. 8 g) and had a tendency to eat fewer calories (-77 vs. 81 kcal) than the C group. Weight remained stable, and there was no evidence that consuming more sugar worsened metabolic profile or improved their perceived quality of life.


CONCLUSIONS
Giving individuals with type 2 diabetes the freedom to include sugar in their daily meal plan had no negative impact on dietary habits or metabolic control. Health professionals can be reassured and encouraged to teach the new "sugar guidelines," because doing so may result in a more conscientious carbohydrate consumption.
Cytomegalovirus infection with interleukin-6 response predicts cardiac mortality in patients with coronary artery disease.

BACKGROUND
Prospective data relating previous exposure to cytomegalovirus (CMV) to the risk of cardiac mortality are controversial. We investigated the effect of previous exposure to CMV infection on the risk of future cardiac disease-related death in relation to an underlying inflammatory response.


METHODS AND RESULTS
coronary angiography was performed in 1134 subjects, and 989 patients with documented coronary artery disease were studied prospectively. CMV-IgG titers and interleukin (IL)-6 levels were measured before angiography. Increasing titers of CMV correlated with the elevation of IL-6 levels (P<0.001) after adjustment for possible confounders. All patients were followed up for a median of 3.1 years (maximum 4.3 years). During follow-up, 96 patients died, 70 of cardiac disease. Overall, CMV seropositivity was not related to cardiac mortality after adjustment for confounding variables (P=0.19). In contrast, in patients with elevated IL-6 levels (>/=11.9 pg/mL, median level), CMV seropositivity was independently associated with a 3.2-fold (95% CI 1.4 to 7.3, P=0.007) increase in risk of future cardiac death, whereas in individuals without IL-6 elevation, previous CMV infection had no effect on cardiac mortality.


CONCLUSIONS
MV seropositivity in patients with an inflammatory response is independently associated with future cardiac mortality, whereas this association is lost in patients who do not demonstrate an inflammatory response. These data support the hypothesis that the atherosclerotic effects of CMV are mediated through an underlying inflammatory response.
A digitally programmable delay element: design and analysis

Variable delay elements are often used to manipulate the rising or falling edges of the clock or any other signal in integrated circuits (ICs). Delay elements are also used in delay locked loops (DLLs). Although, a few types of digitally controlled delay elements have been proposed, an analytical expression for the delay of these circuits has not been reported. In this paper, we propose a new delay element architecture and develop an analytical equation for the output voltage and an empirical relation for the delay of the circuit. The proposed circuit exhibits improved delay characteristics over previously reported digitally controlled delay elements.
Mandibular muscle morphology in children with different vertical facial patterns: A 3-dimensional computed tomography study.

INTRODUCTION
This study was undertaken to assess whether 3-dimensional computed tomography (CT) can be used to evaluate the relationships between the mandibular muscles and craniofacial morphology in children with different underlying vertical facial patterns.


METHODS
Twenty children (mean age, 11.9 +/- 1.6 years) underwent cranial CT examination. Three-dimensional CT images were reconstructed for the evaluation of the cross-sectional size, volume, and spatial orientation of the masseter, medial pterygoid, and lateral pterygoid muscles. These muscle factors were also assessed in relation to vertical and transverse craniofacial form.


RESULTS
Positive correlations were found between the muscles' cross-sectional area and volume, and between muscle size and transverse facial width. Despite the limited sample size, differences were also found in the orientation of the masseter and medial pterygoid muscles in growing patients with different underlying vertical facial patterns.


CONCLUSIONS
Three-dimensional CT can be used for the assessment of soft- and hard-tissue dentofacial forms. Clinicians should note the potential differences in muscle cross-sectional area, volume, and orientation in subjects with different underlying vertical facial patterns.
Allergic contact dermatitis caused by rotigotine in a transdermal therapeutic system.

Conflicts of interest: No conflict of interests. desquamation at the application sites of a rotigotine TTS (Neupro® 6 mg/24 h; UCB Pharma, France Colombes) for 3 months, with extension on the neckline and the upper back (Fig. 1). These reactions began 2 weeks after the patient had used this TTS for early signs of Parkinson’s disease, with a progressive increase in the dose of rotigotine (initial dose, 2 mg/24 h). The patient changed the application site every day, and did not apply the TTS to the same area of skin more often than once every 14 days, as recommended. Applications of Neupro® were stopped, and it was replaced with an oral non-ergolinic dopamine agonist, pramiprexole (Sifrol®), with good tolerance. Later, patch tests were carried out with European baseline series (Chemotechnique Diagnostics, Vellinge, Sweden), sodium metabisulfite present as excipient (2% pet.; Chemotechnique), the placebo TTS, and the pure drug rotigotine, the latter two materials being kindly provided
Posteroventral Pallidotomy in Parkinson's Disease

¶ Objective. We analyse the clinical aspects, results and reliability of posteroventral pallidotomy (PVP) carried out as treatment for the principal symptoms and treatment induced complications in patients with Parkinson's disease (PD).  Patients and Methods. Between August 1995–January 1998, 17 patients with PD were treated surgically, 13 patients with PVP. A pre- and post-surgical clinical evaluation was carried out. Riechert's Stereotactic System (MHT, Freiburg, Germany) was used. Ventriculography under stereotactic conditions was used in the PVP procedures, Laitinen's co-ordinates as anatomical target, and electrical stimulation for physiological determination. 3–4 radiofrequency lesions were made at 83°C for 20″. The mean age was 60±10.8 years, ages ranging from 45–79 years. 8 (60.5%) of the patients were male. The cardinal symptoms of the series were bradykinesia and rigidity. The duration of the illness ranged from 8.6±3.7 years with a range of 4–15 years. 7 (53.8%) presented with a duration of 10 years or more. 6 (46,2%) of the patients underwent left PVP, the remaining 7 (53.8%) right PVP. Only one patient received treatment with right PVP and ipsilateral thalamotomy in the same surgical procedure. The mean post-surgical follow up was 16±7 months, with a range of 2 to 26 months.  Results. An up to date evaluation was carried out on all patients showing significant changes after PVP in UPDRS motor (P<0.005), complete rigidity relief (P<0.005), bradykinesia relief (P<0.005) and complete tremor relief (P<0.005). An important improvement in contralateral dyskinesia was noted after PVP. A subjective evaluation of the results showed excellent results in 4 (30.8%) patients, good in 6 (46.2%) and fair in 3 (23%). No significant correlation was found between age and duration of illness (P=0.7). Two patients suffered slight side effects, one patient with worsening of hypophonia whilst the other suffered subjective visual impairment controlled by normal post operative ophthalmological examinations. There was no peri-operative mortality.  Conclusion. PVP is considered a safe and effective surgical method for the treatment of both the principal symptoms of PD and the complications of DOPA medication.
A Power Decoupling Method Based on Four-Switch Three-Port DC/DC/AC Converter in DC Microgrid

This paper presents a power decoupling method based on a four-switch three-port dc/dc/ac converter in dc microgrid. The proposed topology has three interfaces which can be connected with a dc source, a capacitor, and an ac port. With a corresponding power flow control method, this converter can decouple the low-frequency ripple power which is necessary for the ac port and undesirable for the dc source with small capacitor. The proposed topology is compact and cost-effective because, compared with the H-bridge inverter, no extra switches or devices are required. With the model of the proposed dc/dc/ac converter, a power control method with two inductors' current control is presented for power decoupling. In addition, the control parameters are designed as well. Experimental results on the laboratory prototype verified the feasibility of the proposed topology and the designed power control method.
One-year interim follow-up results of the TRAVERCE trial: the initial feasibility study for trans-apical aortic-valve implantation.

OBJECTIVES
To evaluate the interim results of the initial multicenter feasibility trial for trans-apical aortic-valve implantation (TA-AVI) in high-risk elderly patients with severe aortic stenosis.


METHODS
A total of 168 patients were prospectively included in three European centers between February 2006 and April 2008. The Cribier-Edwards or Edwards SAPIEN™ Trans-catheter Heart Valve (23 mm and 26 mm) was implanted using an oversizing concept. Interventions were performed in a hybrid operative room (OR) (one center), with a mobile C-arm in the OR (one) and in the catheterization laboratory (one). Inclusion criteria included age ≥70 years and an increased risk profile (additive European System for Cardiac Operative Risk Evaluation (EuroSCORE) ≥9).


RESULTS
Patient age was 82.1±5.6 years, 76% were female and the EuroSCORE was 11.3±1.8 (additive) and 27±12.7% (logistic). Cardiopulmonary bypass was used by intention in 14.2% during the initial phase, secondarily in 10.1% and 75% of the patients were treated off-pump. Valve implantation led to a good immediate result in 161 (95.8%) patients and problems were encountered in seven patients (malposition (two patients), migration (three patients) and severe incompetence (two patients)). Nine patients were converted to conventional surgery, early stroke occurred in two (1.2%) patients and 10 (6%) patients received a new pacemaker. At 30 days, 25 patients died, 48% of them due to cardiac-related causes. Overall survival at 30 days, 6 months and 1 year was 85%, 70% and 63%, respectively.


CONCLUSIONS
The initial multicenter feasibility trial for TA-AVI (TRAVERCE) shows acceptable results of this promising technique, especially in view of the high-risk profile of the patients.
The Effects of Game-Based Breathing Exercise on Pulmonary Function in Stroke Patients: A Preliminary Study

BACKGROUND
Reduction of respiratory function along with hemiparesis leads to decreased endurance, dyspnea, and increased sedentary behavior, as well as to an increased risk of stroke. The main purpose of this study was to investigate the preliminary effects of game-based breathing exercise (GBE) on pulmonary function in stroke patients.


MATERIAL AND METHODS
Thirty-eight in-patients with stroke (22 men, 16 women) were recruited for the study. Participants were randomly allocated into 2 groups: patients assigned to the GBE group (n=19), and the control group (n=19). The GBE group participated in a GBE program for 25 minutes a day, 3 days a week, during a 5 week period. For the same period, both groups participated in a conventional stroke rehabilitation program. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), FEV1/FVC, and maximum voluntary ventilation (MVV) were measured by a spirometer in pre- and post-testing.


RESULTS
The GBE group had significantly improved FVC, FEV1, and MVV values compared with the control group (p<0.05), although there was no significant difference in FEV1/FVC value between groups. Significant short-term effects of the GBE program on pulmonary function in stroke patients were recorded in this study.


CONCLUSIONS
These findings gave some indications that it may be feasible to include GBE in rehabilitation interventions with this population.
Common cues to emotion in the dynamic facial expressions of speech and song

Speech and song are universal forms of vocalization that may share aspects of emotional expression. Research has focused on parallels in acoustic features, overlooking facial cues to emotion. In three experiments, we compared moving facial expressions in speech and song. In Experiment 1, vocalists spoke and sang statements each with five emotions. Vocalists exhibited emotion-dependent movements of the eyebrows and lip corners that transcended speech-song differences. Vocalists' jaw movements were coupled to their acoustic intensity, exhibiting differences across emotion and speech-song. Vocalists' emotional movements extended beyond vocal sound to include large sustained expressions, suggesting a communicative function. In Experiment 2, viewers judged silent videos of vocalists' facial expressions prior to, during, and following vocalization. Emotional intentions were identified accurately for movements during and after vocalization, suggesting that these movements support the acoustic message. Experiment 3 compared emotional identification in voice-only, face-only, and face-and-voice recordings. Emotion judgements for voice-only singing were poorly identified, yet were accurate for all other conditions, confirming that facial expressions conveyed emotion more accurately than the voice in song, yet were equivalent in speech. Collectively, these findings highlight broad commonalities in the facial cues to emotion in speech and song, yet highlight differences in perception and acoustic-motor production.