bluuebunny/crossref_metadata_2025_split huggingface dataset:
Techniques for Peripheral Nerve Stimulator Implantation of the Upper Extremity
Authors: Singh Vinita , Sandhu Diya , Xiang Nan 
Published: June 2020

Abstract

Objective
To present a technical note on how to perform upper extremity peripheral nerve stimulators for three major nerves: median, ulnar, and radial.

Design
Literature review and expert opinion.

Setting
Single academic center.

Results
Peripheral nerve stimulation has recently become popular with the development and availability of peripheral nerve stimulators with an external pulse generator. Here, we describe ultrasound anatomy and technical details for peripheral nerve stimulation in the upper extremity for three major nerves: median, ulnar, and radial.

Conclusions
Upper extremity peripheral nerve stimulation can be considered as an option for refractory neuropathic upper extremity pain.
Do Foreign Institutional Investors Improve Price Efficiency?
Authors: Kacperczyk Marcin , Sundaresan Savitar , Wang Tianyu 
Published: June 2020

Abstract
We study the impact of foreign institutional investors on price efficiency with firm-level international data. Using additions to the MSCI index and the U.S. Jobs and Growth Tax Relief Reconciliation Act as exogenous shocks to foreign ownership, we show that greater foreign ownership increases stock price informativeness, especially in developed economies. This increase arises from new information that foreign investors bring in and displacement of less-informed domestic retail investors. Finally, we show that foreign ownership, particularly from active investors, increases market liquidity, reduces firms’ cost of equity, and increases firms’ real investment growth.
Ultrasound-guided core needle biopsy compared with open biopsy: a new diagnostic approach to salivary gland enlargement in Sjögren’s syndrome?
Authors: Zabotti Alen , Zandonella Callegher Sara , Lorenzon Michele , Pegolo Enrico , Scott Cathryn A , Tel Alessandro , Giovannini Ivan , Robiony Massimo , Di Loreto Carla , Zuiani Chiara , De Vita Salvatore 
Published: June 2020

Abstract

Objective
Persistent (≥2 months) major salivary gland enlargement in primary SS (pSS) patients is a well-known sign of possible involvement by B cell lymphoma. The study aimed to evaluate the diagnostic accuracy and safety of US-guided core needle biopsy (CNB) of major salivary glands compared with open surgical biopsy.

Methods
Prospective pSS patients (cases) with clinically persistent salivary gland enlargement underwent US-guided CNB and were compared with retrospective pSS patients (controls) submitted to open surgical biopsy. The features analysed were pre-biopsy clinical and laboratory findings, adequacy of the material for histology and diagnostic-rendered and biopsy-related complications (reported by the patient with a questionnaire and clinically verified).

Results
Thirteen cases underwent US-guided CNB: in nine, biopsy was performed on the parotid gland and in four it was performed on the submandibular gland. Sufficient material was obtained for pathological diagnosis in all samples. The final diagnoses were 5 (38.5%) B cell lymphoma, 1 (7.7%) lymphoepithelial sialadenitis, 4 (30.7%) other sialadenitis (granulomatous consistent with sarcoidosis, IgG4-related disease, chronic sclerosing, diffuse chronic) and 3/13 (23.1%) miscellaneous lesions. Thirteen controls underwent open surgical biopsy of the parotid. In one, inadequate material was obtained, while in 12 (92.3%) the pathologic diagnoses were 4 (33.3%) B cell lymphoma, 2 (16.7%) lymphoepithelial sialadenitis, 4 (33.3%) uncertain lymphoproliferative lesions and 2 (16.7%) miscellaneous lesions. Six cases (46.1%) reported six transient complications and 12/13 (92.3%) controls had 2 persistent and 14 transient complications.

Conclusion
US-guided CNB represents a novel, clinically relevant and safe approach for the management of pSS patients with parotid or submandibular persistent enlargement.
Determining the phosphorus release of Smizyme TS G5 2,500 phytase in diets for nursery pigs
Authors: Wensley Madie R , DeRouchey Joel M , Woodworth Jason C , Tokach Mike D , Goodband Robert D , Dritz Steve S , Faser Jill M , Guo Baolin L 
Published: June 2020

Abstract
Two experiments were conducted to determine the available P (aP) release of Smizyme TS G5 2,500 (Origination, LLC., Maplewood, MN) phytase. Pigs were weaned at approximately 21-d of age, randomly allotted to pens based on initial body weight (BW) and fed a common diet. On d 21 post-weaning, pens were blocked by BW and randomly allotted to 1 of 8 (experiment 1) or 7 (experiment 2) dietary treatments with five pigs per pen and eight pens per treatment. Treatments were formulated to include increasing aP from either inorganic P (0.12%, 0.18%, or 0.24% in experiment 1 and 0.11%, 0.19%, or 0.27% in experiment 2 from monocalcium P) or increasing phytase (150, 250, 500, 750, or 1,000 FTU/kg in experiment 1 and 250, 500, 1,000, or 1,500 FTU/kg in experiment 2). Prior to beginning the 21-d studies, all pigs were fed the lowest inorganic P diet for a 3-d period. At the conclusion of each experiment, the pig closest to the pen mean BW was euthanized and fibulas were collected to determine bone ash weight and percentage bone ash. Fibulas were processed using defatted bone mineral procedures. In both experiments, pigs fed increasing aP from inorganic P had increased (linear, P &lt; 0.01) average daily gain (ADG), G:F, and final BW. Additionally, pigs fed diets with increasing phytase had increased (experiment 1 linear, P &lt; 0.01; experiment 2 linear and quadratic, P &lt; 0.05) performance across all growth response criteria. For bone composition, pigs fed increasing aP from inorganic P had increased bone ash weights (linear, P &lt; 0.01) and percentage bone ash (experiment 1 quadratic, P &lt; 0.01; experiment 2 linear, P &lt; 0.01). Similarly, pigs fed increasing phytase had increased bone ash weights (linear, P &lt; 0.01) and percentage bone ash (experiment 1 linear, P &lt; 0.01; experiment 2 linear and quadratic, P &lt; 0.05). The percentage aP released from Smizyme TS G5 2,500 for both experiments varied depending on the response criteria used. As the amount of phytase in the diet increased, the calculated aP release increased when ADG (experiment 1 linear, P &lt; 0.01; experiment 2 linear and quadratic, P &lt; 0.01), G:F (linear, P &lt; 0.01), or percentage bone ash (experiment 1 linear and quadratic, P &lt; 0.05; experiment 2 linear, P &lt; 0.01) were used the predictor variable. When combining the data from experiment 1 and 2, the aP release prediction equations for Smizyme TS G5 2,500 are aP = (0.197 × FTU)/(584.956 + FTU), aP = (0.175 × FTU)/(248.348 + FTU), and aP = (0.165 × FTU)/(178.146 + FTU) when using ADG, G:F, and percentage bone ash, respectively as the predictor variable.
Lonomiaenvenomation in Brazil: an epidemiological overview for the period 2007–2018
Authors: Favalesso Marília Melo , Cuervo Pablo Fernando , Casafús Milena Gisela , Guimarães Ana Tereza Bittencourt , Peichoto Maria Elisa 
Published: June 2020

AbstractBackgroundAmong the Lepidoptera with medical importance in Brazil, larvae of Lonomia moth (Saturniidae: Hemileucinae) stand out by being the etiological agent of the lonomism, a form of erucism in which the most troubling symptoms include systemic hemorrhage that can lead to death.MethodsThis study provides an epidemiological overview of accident notifications with Lonomia registered by the Brazilian Reportable Disease Information System (SINAN) between 2007 and 2018. The categories of sociodemographic aspects of the victim, accident characteristics, and clinical data (6,636 records) were analysed by the chi-square test for goodness of fit (α=0.05). By the same test, accident frequencies by month, year, and state were also compared. To explore the spatial distribution of notifications and to identify significant space-time and purely spatial clusters, a spatial scan statistic (SaTScan) was used.ResultsThe epidemiological profile of most of the victims had at least one of the following characteristics: male, &gt;50 y of age, ethnically classified as white, and with a low level of education. Accidents in urban areas were as frequent as in rural areas. A higher frequency of non-work-related accidents was detected. Victims were mostly stung on the upper limbs. Most victims received medical care within the first 3 h after the accident. Most cases were classified as mild, although 12 deaths were reported. The south states of Brazil concentrate the highest frequencies of notifications. Summer was the season with the greatest number of cases, and the majority of the notifications occurred between 2017 and 2018.ConclusionThese results provide an overall and current situation assessment of the lonomism in Brazil, and they should enable health authorities to improve the management of this envenomation in states/regions that share the high epidemiological risk of exposure to Lonomia.
Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Predictors of Performance
Authors: Debruyne Joke A. , Janssen A. Miranda , Brokx Jan P. L. 
Published: June 2020

Objectives:
Early-deafened, late-implanted adolescents and adults constitute a unique group of cochlear implant (CI) users, showing a large variability in outcomes. The current systematic review aimed to determine which preimplantation factors are relevant in predicting postoperative outcomes in this patient group.

Design:
A systematic search for studies published between 2000 and September 2017 was performed in five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo). Prognostic studies that assessed the relation between patient-related factors and CI outcomes in early-deafened but late-implanted adolescent and adult CI users were included. Study quality was assessed with the Quality In Prognosis Studies (QUIPS) tool.

Results:
The systematic search and subsequent full-text evaluation identified 13 studies that had a clear prognostic study goal. Eight out of these 13 studies had a high risk of bias for at least one of the five QUIPS domains. Analysis of the outcomes identified that communication mode (in childhood), preoperative speech intelligibility, and preoperative speech recognition scores were significantly related to speech perception outcomes for this group of CI users. A number of additional factors considered worth for further investigation were also identified.

Conclusions:
The analysis of the studies assessing the effect of a number of patient-related factors on outcome with CI in early-deafened adolescents and adults identified three potential prognostic factors and a number of additional factors to be incorporated in future research. More high-quality prognosis studies in the investigated patient population are still needed.
Prehospital Administration of Unfractionated Heparin in ST-Segment Elevation Myocardial Infarction Is Associated With Improved Long-Term Survival
Authors: McGinley Christopher , Mordi Ify R , Kell Paul , Currie Peter , Hutcheon Stuart , Koch Stephan , Martin Thomas , Irving John 
Published: June 2020

Objective:
Administration of unfractionated heparin to STEMI patients by the ambulance service is an established practice in Scotland, but the efficacy is unknown. We studied the effects of unfractionated heparin in STEMI patients treated by primary percutaneous coronary intervention, on infarct artery patency and mortality.

Methods and Results:
Consecutive patients (n = 1000) admitted to Ninewells Hospital, Dundee, from 2010 to 2014 for primary percutaneous coronary intervention were allocated to 2 groups: 437 (44%) prehospital heparin (PHH) administered by paramedics, and 563 (56%) in-hospital heparin. A trained medical student assessed coronary flow at presentation and collected the data. Mortality status was ascertained at 30 days and 5 years. Cox proportional hazards regression models were generated. The patient groups were similar, although PHH had shorter symptom onset-treatment time (187 vs. 251 minutes, P < 0.001) and less cardiogenic shock (3.9% vs. 8.0%, P = 0.008). Initial coronary flow was not different between the groups. Thirty day mortality in PHH was 2.5% versus 8.3%, P < 0.001. Independent predictors of 30-day mortality were age (odds ratio 1.07, 95% CI 1.04–1.09), cardiogenic shock (5.97, 3.33–10.69), radial access (0.53, 0.28–0.98), and PHH (0.33, 0.17–0.66). Five-year mortality in PHH was 13.0% versus 21.6%, P < 0.001. Significant predictors of long-term mortality were age (1.07, 1.06–1.09), cardiogenic shock (3.40, 2.23–5.17), and PHH (0.68, 0.49–0.96).

Conclusions:
PHH was associated with reduced short- and long-term mortality after adjusting for important potential confounders.
Beneficial Effects of Sacubitril/Valsartan at Low Doses in an Asian Real-World Heart Failure Population
Authors: Hu Jingwen , Wu Yucheng , Zhou Xiujuan , Wang Xiaozhi , Jiang Wanying , Huo Junyu , Shan Qijun 
Published: June 2020

Abstract:
This study aimed at analyzing the clinical profile of real-world patients with heart failure with reduced ejection fraction (HFrEF) and evaluating the safety and efficacy of sacubitril/valsartan among Asian patients in daily practice. We conducted a single-center prospective observational cohort study of HFrEF patients treated with sacubitril/valsartan from September 2017 to September 2018 with a follow-up of 6 months. The mean (SD) age of the 110 patients enrolled was 59.7 ± 13.3, 85 (77.3%) were men and 41 (37.3%) had ischemic cardiomyopathy. Thirty-one (27.2%) patients with low systolic blood pressure initiated sacubitril/valsartan on a tiny dose of 12/13 mg. Despite the low mean daily dose achieved in real world mainly because of hypotension, left ventricular ejection fraction increased significantly from 35.4 ± 8.9% at baseline to 43.0 ± 12.2% after 6-month follow-up (P < 0.001). We also observed a significant improvement in a 6-minute walk test (6-MWT) distance and N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration reduction. No severe adverse event was recorded. Low dose sacubitril/valsartan induces beneficial cardiac reverse remodeling and improves clinical functional performance in real-world HFrEF patients without severe adverse effect. A tiny initial dose may enhance tolerability and reduce discontinuation rate by minimizing hypotension events in patients with low systolic blood pressure. These data further support using low-dose sacubitril/valsartan among eligible patients with HFrEF in Asia.
A Brief Overview of a Round Table Discussion About Venous Thromboembolism in Pregnancy During the First International Forum on Chinese Maternal-Fetal Medicine
Authors: Wang Chen , Yang Hui-Xia 
Published: June 2020

Abstract
Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality though with low rates. Compared to non-pregnant women of comparable age, women during pregnancy have five- to ten-fold increased risk of VTE, additional risk factors for VTE during pregnancy include a personal history of thrombosis, the presence of a thrombophilia, cesarean delivery, obesity, hypertension, preeclampsia, autoimmune disease, heart disease, sickle cell disease and multiple gestation. Thus, early clinical evaluation, preferably in peri-conceptional period, is crucial for VTE risk detection and, thus, for prophylaxis decision making. VTE thromboprophylaxis brought significant advantages in pregnancy outcomes and maternal deaths. Common pharmacological and mechanical forms of thromboprophylaxis includes heparin compounds, anti-embolic stockings and intermittent pneumatic compression devices. Low-molecular-weight heparin as first line strategy. Current guidelines or expert opinions on VTE treatment or prophylaxis during pregnancy diverge significantly. High quality research in this area is still needed, and China needs to develop its own VTE guidelines. Importantly, absolute risks and potential benefits of VTE thromboprophylaxis should be evaluated to make the best decisions on VTE screening, prevention, and treatment.
Reduced Fine Particulate Matter Air Pollution Exposures Using In-Home Portable Air Cleaners
Authors: Bard Robert L. , Rubenfire Melvyn , Fink Samantha , Bryant Joseph , Wang Lu , Speth Kelly , Zhou Nina , Morishita Masako , Brook Robert D. 
Published: June 2020

Purpose:
Fine particulate matter (PM2.5) air pollution is a leading risk factor for cardiovascular disease. Even low levels common to millions of Americans pose health risks. However, no study has tested protective measures such as in-home portable air cleaners (PACs) among at-risk cardiac patients. We conducted a pilot phase of the Cardiac Rehabilitation Air Filter Trial (CRAFT)—a randomized, double-blind, crossover study of outpatient cardiac rehabilitation patients at Michigan Medicine.

Methods:
During a routine visit, patients were provided with 2 PACs to run continuously for 5 d in both the bedroom and the main living space. PACs were randomized as active (with HEPA filter) versus sham. On day 4, subjects wore a personal PM2.5 monitor for 24-hr without activity restrictions. After a 1-wk washout, patients crossed over to the opposite mode.

Results:
Patients (n = 20; 4 women) were elderly (70.8 ± 9.6 yr) nonsmokers with cardiovascular disease living near the facility (10.7 ± 6.0 mi). Compared with sham, active in-home PAC use significantly lowered personal-level 24-hr PM2.5 exposures by 43.8% (−12.2 μg·m−3; 95% CI, −24.2 to −0.2). Sensitivity analyses corroborated the reductions in most patients.

Conclusion:
An inexpensive in-home PAC can effectively lower personal PM2.5 exposures in cardiac patients. These benefits occurred even in a region with overall good air quality and if maintained over the long-term could translate into major reductions in cardiovascular events.
Aortic Aneurysm
Authors: Ehrman Jonathan K. , Fernandez Antonio B. , Myers Jonathan , Oh Paul , Thompson Paul D. , Keteyian Steven J. 
Published: June 2020

Background:Some patients who participate in cardiac rehabilitation have aortic abnormalities, including abdominal and thoracic aneurysm (AAA and TAA, respectively). There is scant guidance on implementing exercise training in these individuals. This article reviews the epidemiology, diagnostic process, medical issues, and the available exercise training literature, and provides recommendations for performing regular exercise.Clinical Considerations:Patients with aortic abnormalities are at risk for enlargement, aneurysm development, dissection, and rupture. During exercise, individuals with large aneurysms may be at greater risk of an adverse event. The available literature suggests little increased risk of complications when training at low and moderate intensities in those with an AAA, and exercise may be protective for aneurysm expansion. There is little exercise data for TAA, but the available literature suggests training at lower intensities and avoidance of excessive increases of blood pressure.Exercise Testing and Training:When exercise testing and training are performed, the intensity should be controlled to avoid complications. It is prudent to keep systolic blood pressure <180 mm Hg in most patients and <160 mm Hg in those at greater risk of dissection or rupture (eg, women and larger sized aneurysm) during aerobic training. During resistance training, patients should avoid sudden excessive blood pressure increases (ie, avoid the Valsalva maneuver), and keep intensity below 40-50% of the 1-repetition maximum. Existing data suggest these patients may improve functional capacity and reduce the rate of aneurysm expansion.Summary:Most patients with AAA can safely perform exercise training when conservative guidelines are followed. Additional research is needed to fully determine whether exercise is protective against aneurysm expansion, and the effects of exercise in those who have had surgical repair. More research is necessary to provide specific recommendations for those with a TAA.
Evidence of Large Vestibulo-Ocular Reflex Reduction in Patients With Menière Attacks
Authors: Yacovino Dario A. , Schubert Michael C. , Zanotti Estefania 
Published: June 2020

Objective:To examine the high frequency horizontal vestibular ocular-reflex (hVOR) during acute attacks of vertigo in Menière's disease (MD).Study Design:Retrospective case series and literature review.Setting:Tertiary academic medical center.Patients:Patients with clinical diagnosis of unilateral “definite MD.”Intervention:Review of medical records.Main Outcome Measures:Spontaneous nystagmus and the dynamic hVOR gain change at different stages of an acute episode of MD attack.Results:We studied 10 vertigo attacks during the unique stages of the episode. During the acme stage of the attack, lower hVOR gain was recorded on the affected side (mean 0.48 ± 0.23), which was associated with a paralytic nystagmus (beating away from the affected ear). Additionally, the mean hVOR gain remained significantly (p < 0.05) reduced during each of the other stages of the attack as compared with the unaffected side and a control group. After the attack, mean hVOR gains normalized in the affected ear. Mean hVOR gain of the unaffected ear remained normal during all stages.Conclusion:Vestibular function during an attack of MD is a dynamic process associated with fluctuation of the dynamic (hVOR gain) and static (spontaneous nystagmus) processes, which exist in parallel with the perception of vertigo. Our data support vHIT monitoring during an episode to provide objective and accurate evidence of the ear with active disease. This would be particularly useful for those patients with MD presentations of unreliable hearing or assisting to identify the ear to be treated in the case of bilateral MD.
Consequences of Mastoidectomy on Bone Conducted Sound Based on Simulations in a Whole Human Head
Authors: Prodanovic Srdjan , Stenfelt Stefan 
Published: June 2020

Hypothesis:
The aim of this study is to investigate how a mastoidectomy surgery affects bone conduction (BC) sound transmission using a whole head finite element model.

Background:
Air conduction (AC) and BC hearing thresholds are normally used to evaluate the effect of an ear surgery. It is then assumed that the BC hearing thresholds are unaffected by the surgery. Moreover, BC hearing aids are used in cases of unilateral or conductive hearing loss in heads that have undergone a mastoidectomy surgery. Given the invasiveness of the surgery, the BC hearing sensitivity may be altered by the surgery itself.

Methods:
Two types of mastoid surgery, canal wall up and canal wall down, with and without obliteration, were simulated in a whole head finite element model for BC stimulation, the LiUHead. The evaluations were conducted for two different methods of applying the BC sound, at the skin surface (B71 transducer) and directly at the bone (BC hearing aid).

Results:
The results showed that a mastoidectomy surgery increased the cochlear vibration responses with BC stimulation. The increase was less than 5 dB, except for a canal wall down surgery which gave an increase of up to 8 dB at frequencies close to 10 kHz. The increase was greater at the ipsilateral cochlea compared with the contralateral cochlea.

Conclusion:
A mastoidectomy surgery increases the vibration at both cochleae for BC stimulation and the increase generally improved with frequency. Obliteration of the surgical cavity does not influence BC sound transmission.