bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebral angiography using transauricular access in a rabbit model: a new technique
Authors: Kim Hak Jin , Choi Seon Hee , Kim So-Hyeon , Kim Yong-Woo , Jhun Byung Hak , Lee Deug-Woo , Yoo Jin-Wook 
Published: April 2020

Background Cerebral angiography in a rabbit model is widely used in the field of interventional radiology. Conventionally, the femoral artery is used for cerebral angiography in radiology departments. However, angiographic studies require surgical cutdown of the femoral artery, which is technically difficult. Purpose To evaluate a new cerebral angiography technique involving a transauricular approach in a rabbit model. Material and Methods In each of 10 rabbits, central auricular arteries were punctured in the right or left ear with a 20-gauge i.v. catheter. A microcatheter (2.0 F) with a 0.016-inch guide wire was introduced through the i.v. catheter and advanced to the aortic arch. The microcatheter and guide wire were advanced selectively into cerebral arteries and angiography was performed. Results Central auricular arteries were successfully punctured with 20-gauge i.v. catheters. After approaching the aortic arch, microcatheter tips and guide wires were advanced manually to cerebral arteries on both sides. Difficulties in selecting the carotid arteries were resolved by using a looping technique within the cardiac chamber. Microcatheter loops within the cardiac chamber disappeared or remained during artery superselection. Conclusion Transauricular cerebral angiography appears to be a feasible technique for brain or carotid intervention studies in rabbits. In addition, vertebral angiography using a transauricular approach is possible using the looping technique. Selection of carotid or vertebral arteries on each side was not difficult when the microcatheter and guide wire were looped within the cardiac chamber. The ear chosen for the initial puncture does not appear to be important.
Prevalence and socio-demographic characteristics of persons who have never had a headache among healthy voluntary blood donors – a population-based study
Authors: Olofsson Isa Amalie , Kogelman Lisette , Rasmussen Andreas , Erikstrup Christian , Sørensen Erik , Paarup Helene M , Hjalmgrim Henrik , Banasik Karina , Nielsen Kaspar René , Burgdorf Kristoffer Soelvsten , Pedersen Ole Birger Vesterager , Ullum Henrik , Olesen Jes , Hansen Thomas Folkmann 
Published: April 2020

Introduction Headache is an extremely prevalent disorder with a lifetime prevalence of 90–99%. However, a small fraction of people never experiences a headache. Research on people without headache could uncover protective factors in headache, but to our knowledge no study on headache-free individuals has been published. We aim to estimate the prevalence of headache-free individuals among Danish blood donors, and to describe the socio-demographics and health factors of headache-free participants. Materials and methods In all, 38,557 healthy volunteers were recruited as part of the Danish Blood Donor Study. Headache-free participants were identified based on the question “Have you ever experienced a headache of any kind?”. Utilising the Danish registries and self-reported questionnaires, we analysed socio-demographic and lifestyle factors using logistic regression adjusted for age and sex. Results The prevalence of headache-free individuals was 4.1% (n = 1362) with a female-male ratio of 1:2.2. To be headache free was significantly associated with an employment status as a student, a low level of income and a regular alcohol consumption. Discussion The prevalence of headache-free individuals was comparable to population-wide studies of headache. To be headache free was not associated with a high socio-economic status. Further studies on people without headache will hopefully reveal protective factors in headache, and this novel approach might be useful in other very prevalent disorders.
Impeller (straight blade) design variations and their influence on the performance of a centrifugal blood pump
Authors: Fang Peng , Du Jianjun , Yu Shunzhou 
Published: April 2020

Introduction: The miniaturization of blood pumps has become a trend due to the advantage of easier transplantation, especially for pediatric patients. In small-scale pumps, it is much easier and more cost-efficient to manufacture the impeller with straight blades compared to spiral-profile blades. Methods: Straight-blade impeller designs with different blade angles, blade numbers, and impeller flow passage positions are evaluated using the computational fluid dynamics method. Blade angles (θ = 0°, 20°, 30°, and 40°), blade numbers ( N = 5, 6, 7, and 8), and three positions of impeller flow passage (referred to as top, middle, and bottom) are selected as the studied parametric values. Results: The numerical results reveal that with increasing blade angle, the pressure head and the hydraulic efficiency increase, and the average scalar shear stress and the normalized index of hemolysis decrease. The minimum radial force and axial thrust are obtained when θ equals 20°. In addition, the minimum average scalar shear stress and normalized index of hemolysis values are obtained when N = 6, and the maximum values are obtained when N = 5. Regarding the impeller flow passage position, the axial thrust and the stagnation area forming in the impeller eye are reduced as the flow passage height declines. Conclusion: The consideration of a blade angle can greatly improve the performance of blood pumps, although the influence of the blade number is not very easily determined. The bottom position of the impeller flow passage is the best design.
Pediatric-Onset Postural Orthostatic Tachycardia Syndrome in a Single Tertiary Care Center
Authors: Staples Anthony , Thompson Nicolas R. , Moodley Manikum 
Published: April 2020

Aim: We characterize the pediatric postural orthostatic tachycardia syndrome (POTS) population seen at a single tertiary care referral center. Method: Retrospective chart review of all pediatric POTS patients seen in our center between 2015 and 2017. Pediatric POTS was defined as chronic, at least 3 months, symptoms of orthostatic intolerance associated with excessive orthostatic tachycardia as determined by tilt table testing with orthostatic heart rate increment of ≥40 bpm within 5 minutes of head-up tilt or absolute orthostatic heart rate ≥130 bpm for patients 13 years old and younger and ≥120 bpm for those 14 years and older. We looked at demographics, presenting symptoms, comorbidities, examination findings, investigation findings, treatment, and patient reported outcomes. Outcome measures were separated by patient report and group comparisons were made using 2-sample t tests or Mann-Whitney U tests for continuous variables and Fisher exact tests for categorical variables. Results: One hundred thirty-four patients with pediatric onset POTS were identified. The mean age was 15 years. Seventy-nine percent of patients were female and 90% were white. The most common presenting symptoms included dizziness/lightheadedness (88%), syncope (54%), and palpitations (40%). Many patients had significant comorbidities attributable to numerous bodily systems, most commonly headache syndromes (migraine 43%, nonspecific headache 22%, chronic daily headache 14%, and new daily persistent headache 5%) and chronic fatigue (60%). Low vitamin D and insufficient iron stores were commonly seen. The majority of patients improved or had resolution of symptoms following treatment (70%). When separated by outcome, statistically significant differences were found for glucose (patients whose symptoms resolved had higher median glucose), palpitations (patients whose symptoms resolved were less likely to have palpitations), constipation (patients whose symptoms were stable/worsened were more likely to have constipation), and unexplained pain (patients whose symptoms were stable/worsened were more likely to have unexplained pain). Conclusions: Pediatric POTS is a chronic condition with a fairly good prognosis following appropriate treatment. It is associated with numerous comorbidities that necessitate multidisciplinary expert care.
Should Cleft Surgery Always be Performed During the Matutine Time? Analysis of Early and Late Postoperative Complications in a Cleft Center
Authors: Restrepo Daniel Velez , Sato Marilson Hideki , Cardoso Fernanda Saturnino , da Silva Freitas Renato 
Published: April 2020

Objective: Surgeries performed in the afternoon schedule were discouraged by Smile Train Foundation for patients younger than 2 years. The aim of this study is to present the incidence of complications discriminating time of surgery (morning/afternoon) in a reference center in Curitiba (Brazil) during 2017. Design: Retrospective study that evaluated all cleft surgeries that were performed at Assistance Center for Cleft Lip and Palate during 2017. Complications correlated with surgery period (morning/afternoon), type of surgery, and operating surgeon were studied. Statistical analysis was performed to find any association between discrete variables. Setting: Tertiary, institutional Participants: One hundred eighty-seven patients with cleft lip and/or cleft palate/cleft lip and palate, who were evaluated and submitted to surgery in the center and had less than 24 months of age, were included in the study. Interventions: One hundred twenty-four cheiloplasties and 63 palatoplasties were performed. Main Outcome Measure: Incidence of complications. Results: From the total of cheiloplasties, the number of complications was 2 (1.6%) and from the total of palatoplasties the number of complications was 11 (17%); 8.1% of surgeries that were performed in the morning had any complication compared to 5.1% of surgeries performed in the afternoon. Statistical analysis of discrete variables with χ2 test showed no correlation between surgery schedule and complications (χ2 = 0.62). Conclusion: The number of complications was not higher in the afternoon scheduled surgeries. Surgeon expertise had a statistically significant correlation with the absence of complications (χ2 = 20.57).
The effect of adenosine in inducing cardiac arrest for endovascular treatment of paediatric high-flow brain and spinal vascular malformation
Authors: Ghorbani Mohammad , Asaadi Sina , Nouri Mohsen , Asl Mahdi Kadkhodazadeh , Lafta Ghazwan Alwan , Bahrami Reza , Mortazavi Abolghasem 
Published: April 2020

Introduction Endovascular treatment of high-flow vascular lesions with onyx may be very dangerous due to premature occlusion of the vein resulting from high flow-induced migration of this embolic substance without occlusion of the feeding vessels and the nidus. It is also dangerous because of the risk of occlusion of the normal vessels around the lesion. Inducing temporary cardiac arrest using adenosine may be helpful in limiting and minimizing these risks. However anaesthetic management of this procedure in children suffering from high-flow vascular lesions is difficult and challenging. Methods We report three paediatric patients with high-flow cerebrospinal vascular lesions that underwent endovascular treatment under general anaesthesia and temporary cardiac arrest with adenosine. Adenosine was administered in escalating doses to induce a few seconds of cardiac standstill and the onyx injection was synchronized with the onset of adenosine-induced cardiac standstill, the fistula being occluded by onyx. Results There were no complications in peri-procedural treatment in all three cases. Post-embolization angiography revealed complete obliteration of the lesion, and the patients’ neurological status progressively improved at follow-up. Conclusion Adenosine-induced temporary cardiac standstill was successfully used to facilitate safe and controlled endovascular onyx embolization of high-flow central nervous system vascular lesions.
Epithelial–Myoepithelial Carcinoma of the Lacrimal Sac and Literature Review of the Lacrimal System
Authors: Sharma Dhruv , Neiweem Ashley , Davis Kyle , Prendes Mark , Chundury Rao , Illing Elisa 
Published: April 2020

BackgroundEpithelial–myoepithelial carcinomas make up less than 0.1% of head and neck malignancies and are regarded as rare, low-grade malignant neoplasms of the salivary gland. They are thought to arise from intercalated ducts with histopathology showing a classic biphasic morphology of an outer layer of myoepithelial cells and inner layer of epithelial cells. These tumors most commonly occur in the parotid gland; however, rare cases have also been described in the nasal cavity, nasopharynx, subglottis, base of tongue, and the lacrimal gland.ObjectiveTo describe the clinical presentation, surgical management, and histopathology of the first reported case of lacrimal sac epithelial–myoepithelial carcinoma. To conduct a literature review of this malignancy, which is present in the lacrimal system.MethodsCase report (n = 1) and literature review.ResultsWe report a case of a 72-year-old man presenting with epiphora and a lacrimal sac mass with intranasal extension on imaging and nasal endoscopy. A combined endoscopic endonasal and open approach provided successful definitive treatment for final pathologic diagnosis of epithelial–myoepithelial carcinoma of the lacrimal sac, with orbital reconstruction and lacrimal stenting providing good cosmetic and functional results.ConclusionsAfter PubMed database search for any case series or reports of lacrimal system epithelial–myoepithelial carcinomas, we believe this is the first documented case originating from the lacrimal sac. Although the histopathology of this tumor is distinct, unusual location and clinical presentation may pose significant diagnostic difficulties.
Rescue Augmentation: Increased Stability in Augmentation After Initial Loosening of Pedicle Screws
Authors: Weiser Lukas , Huber Gerd , Sellenschloh Kay , Püschel Klaus , Morlock Michael M. , Viezens Lennart , Lehmann Wolfgang 
Published: April 2020

Study Design: Biomechanical study. Objectives: Failure of pedicle screws is a major problem in spinal surgery not only postoperatively, but also intraoperatively. The aim of this study was to evaluate whether cement augmentation may restore mounting of initially loosened pedicle screws. Methods: A total of 14 osteoporotic or osteopenic human cadaveric vertebral bodies (L2)—according to quantitative computed tomography (QCT)—were instrumented on both sides by conventional pedicle screws and cement augmented on 1 side. In vitro fatigue loading (cranial-caudal sinusoidal, 0.5 Hz) with increasing peak force (100 N + 0.1 N/cycles) was applied until a screw head displacement of 5.4 mm (∼20°) was reached. After loosening, the nonaugmented screw was rescue augmented, and fatigue testing was repeated. Results: The fatigue load reached 207.3 N for the nonaugmented screws and was significantly ( P = .009) exceeded because of initial cement augmentation (300.6 N). The rescue augmentation after screw loosening showed a fatigue load of 370.1 N which was significantly higher ( P < .001) compared with the nonaugmented screws. The impact of bone density on fatigue strength decreased from the nonaugmented to the augmented to the rescue-augmented screws and shows the greatest effect of cement augmentation on fatigue strength at low bone density. Conclusions: Rescue augmentation leads to similar or higher fatigue strengths compared with those of the initially augmented screws. Therefore, the cement augmentation of initially loosened pedicle screws is a promising option to restore adequate screw stability.
Exercise intolerance in chronic thromboembolic pulmonary hypertension after pulmonary angioplasty
Authors: Kikuchi Hanako , Goda Ayumi , Takeuchi Kaori , Inami Takumi , Kohno Takashi , Sakata Konomi , Soejima Kyoko , Satoh Toru 
Published: April 2020

IntroductionExercise pulmonary hypertension is common in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who experience shortness of breath during exercise and reduced exercise capacity despite normalised pulmonary arterial pressure (PAP) at rest; however, the relationship between exercise pulmonary hypertension and exercise capacity remains unclear. Here we aimed to determine whether exercise pulmonary hypertension is related to exercise capacity and ventilatory efficiency in CTEPH patients with normalised resting haemodynamics after pulmonary balloon angioplasty (BPA).Patients and methodsIn total, 249 patients with CTEPH treated with BPA (mean±sd age 63±14 years; male:female 62:187) with normal mean PAP (mPAP) (<25 mmHg) and pulmonary arterial wedge pressure (≤15 mmHg) at rest underwent cardiopulmonary exercise testing with right heart catheterisation. mPAP–cardiac output (CO) during exercise was plotted using multipoint plots. Exercise pulmonary hypertension was defined by a mPAP–CO slope >3.0.ResultsAt rest, pulmonary vascular resistance was significantly higher in the exercise pulmonary hypertension group (n=116) than in the non-exercise pulmonary hypertension group (n=133). Lower peak oxygen consumption (13.5±3.8 versus 16.6±4.7 mL·min−1·kg−1; p<0.001) was observed in the former group. The mPAP–CO slope was negatively correlated with peak oxygen consumption (r= −0.45, p<0.001) and positively correlated with the minute ventilation versus carbon dioxide output slope (r=0.39, p<0.001).ConclusionsImpaired exercise capacity and ventilatory efficiency were observed in patients with CTEPH who had normalised PAP at rest but exercise pulmonary hypertension.
The effect of e-health interventions promoting physical activity in older people: a systematic review and meta-analysis
Authors: Kwan Rick Yiu Cho , Salihu Dauda , Lee Paul Hong , Tse Mimi , Cheung Daphne Sze Ki , Roopsawang Inthira , Choi Kup Sze 
Published: April 2020

Abstract
Introduction
The objectives of this review paper were to synthesize the data from randomized controlled trials in the literature to come to a conclusion on the effects of e-health interventions on promoting physical activity in older people.

Methods
The Medline, CINAHL, Embase, PsycINFO, and SportDiscus databases were searched for articles about studies that 1) recruited subjects with a mean age of > 50 years, 2) tested e-health interventions, 3) employed control groups with no or less advanced e-health strategies, 4) measured physical activity as an outcome, 5) were published between 1st January 2008 and 31st May 2019, and 6) employed randomized controlled trials. The risk of bias in individual studies was assessed using the Physiotherapy Evidence Database scale. To examine the effects of the interventions, variables quantifying the amount of physical activity were extracted. The within-group effects of individual studies were summarized using Hedges g and 95% confidence intervals. Between-group effects were summarized by meta-analyses using RevMan 5.0 with a random effect model.

Results
Of the 2810 identified studies, 38 were eligible, 25 were included in the meta-analyses. The within-group effect sizes (Hedges g) of physical activity in the intervention group at T1 ranged from small to large: physical activity time (0.12 to 0.84), step counts (− 0.01 to 11.19), energy expenditure (− 0.05 to 0.86), walking time (0.13 to 3.33), and sedentary time (− 0.12 to − 0.28). The delayed effects as observed in T2 and T3 also ranged from small to large: physical activity time (0.24 to 1.24) and energy expenditure (0.15 to 1.32). In the meta-analysis, the between-group effect of the e-health intervention on physical activity time measured by questionnaires, physical activity time measured by objective wearable devices, energy expenditure, and step counts were all significant with minimal heterogeneity.

Conclusion
E-health interventions are effective at increasing the time spent on physical activity, energy expenditure in physical activity, and the number of walking steps. It is recommended that e-health interventions be included in guidelines to enhance physical activity in older people. Further studies should be conducted to determine the most effective e-health strategies.
Transcriptome analysis identifies genes and co-expression networks underlying heat tolerance in pigs
Authors: He Yuqing , Maltecca Christian , Tiezzi Francesco , Soto Emmanuel Lozada , Flowers William L. 
Published: April 2020

Abstract
Background
Heat stress adversely affects pig growth and reproduction performance by reducing feed intake, weight gain, farrowing rate, and litter size. Heat tolerance is an important characteristic in pigs, allowing them to mitigate the negative effects of heat stress on their physiological activities. Yet, genetic variation and signaling pathways associated with the biological processes of heat-tolerant pigs are currently not fully understood. This study examined differentially expressed genes and constructed gene co-expression networks on mRNAs of pigs under different heat-stress conditions using whole transcriptomic RNA-seq analyses. Semen parameters, including total sperm number per ejaculate, motility, normal morphology rate, droplets, and rejected ejaculate rate, were measured weekly on 12 boars for two time periods: thermoneutral (January to May), and heat stress (July to October). Boars were classified into heat-tolerant (n = 6) and heat-susceptible (n = 6) groups based on the variation of their ejaculate parameters across the two periods. RNA was isolated from the blood samples collected from the thermoneutral and heat stress periods for gene expression analysis.

Results
Under heat stress, a total of 66 differentially expressed genes (25 down-regulated, 41 up-regulated) were identified in heat-tolerant pigs compared to themselves during the thermoneutral period. A total of 1041 differentially expressed genes (282 down-regulated, 759 up-regulated) were identified in the comparison between heat-tolerant pigs and heat-susceptible pigs under heat stress. Weighted gene co-expression network analysis detected 4 and 7 modules with genes highly associated (r > 0.50, p < 0.05) with semen quality parameters in heat-tolerant and heat-susceptible pigs under the effects of heat stress, respectively.

Conclusion
This study utilized the sensitivity of semen to heat stress to discriminate the heat-tolerance ability of pigs. The gene expression profiles under the thermoneutral and heat stress conditions were documented in heat-tolerant and heat-susceptible boars. Findings contribute to the understanding of genes and biological mechanisms related to heat stress response in pigs and provide potential biomarkers for future investigations on the reproductive performance of pigs.