bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significant variation in the management of cull sows before transport for slaughter: results from a survey of Danish pig farmers
Authors: Herskin Mette S , Aaslyng Margit D , Anneberg Inger , Thomsen Peter T , Gould Louisa M , Thodberg Karen 
Published: January 2020

BackgroundApproximately 50% of sows are slaughtered each year, but management of cull sows is not well described.MethodsWe aimed to describe how cull sows are sent to slaughter using a questionnaire survey emailed to 885 Danish pig farmers, including questions about the use of pick‐up facilities (either a designated pen used for reasons of biosecurity and practicality, in a special part of the barn, where pigs are kept in the last hours before being loaded onto a commercial truck, or a stationary vehicle kept outside the buildings and used for the same purpose) and evaluation of fitness for transport.ResultsA total of 360 farmers answered all questions, constituting a homogeneous group of middle‐aged, experienced males. The management of the sows seemed rather variable, for example regarding choice of pick‐up facility, its available resources, actions taken when sows were not fit for transport and sow conditions leading to doubt about fitness for transport. Special condition transport was only reported rarely, and rejection of sows due to lack of fitness for transport, by drivers or veterinarians at the slaughterhouse, was only rarely experienced.ConclusionThese findings may be used for formulation of hypotheses for future studies in this area characterised by welfare challenges, potentially leading to science‐based recommendations relevant for animal welfare, productivity and biosecurity.
Epicardial Connections Involving Pulmonary Veins
Authors: Barrio-Lopez Maria Teresa , Sanchez-Quintana Damian , Garcia-Martinez Joaquin , Betancur Andres , Castellanos Eduardo , Arceluz Martín , Ortiz Mercedes , Nevado-Medina Jorge , Garcia Fermin , Almendral Jesús 
Published: January 2020

Background:
The presence of epicardial connections (ECs) between pulmonary veins (PVs) and other anatomic structures may hinder PV isolation. In this study, we analyzed their prevalence, location, associated factors, and clinical implications.

Methods:
Five hundred thirty-four consecutive patients with atrial fibrillation undergoing radiofrequency ablation were included. We considered that an EC was present if: (1) the first pass around the PV antrum did not produce PV isolation and (2) subsequent atrial activation during PV pacing showed that the earliest site was located away from the ablation line and later activation sites were observed near the ablation line. Clinical and electrophysiological variables were collected from all patients. Patients were followed during 12.9±9.4 months, and any documented atrial tachyarrhythmia after the 3-month blanking period was classified as a recurrence.

Results:

Out of the 534 patients included, 72 (13.5%) were found to have 81 ECs. There was a significant association between the presence of ECs and structural heart disease (15.3% in patients without ECs versus 36.5% in patient with ECs;
P
<0.001) and patent foramen ovale (4.6% versus 13.5%;
P
=0.002). The presence of a left common trunk was significantly associated with the absence of ECs (29.6% in patients without ECs versus 16.2% in patients with ECs;
P
=0.014). Patients with ECs had lower acute success in PV isolation compared with patients without ECs (99.1% versus 86.1%;
P
<0.001). After adjusting for age, sex, type of atrial fibrillation, left atrium area, hypertension, structural heart disease, presence of left common trunk, patent foramen ovale, and time for atrial fibrillation diagnosis to the ablation, we found a significantly higher risk of atrial tachyarrhythmia recurrences in patients with ECs compared with patients without ECs (hazard ratio, 1.7 [95% CI, 1.1–2.9];
P
=0.04).

Conclusions:
ECs between PVs and other adjacent structures are frequent in patient with atrial fibrillation (prevalence: 13.5%). Structural heart disease and a patent foramen ovale are strongly associated with the presence of ECs. ECs reduce the acute and chronic success of PV isolation.
Brain connectivity during Alzheimer’s disease progression and its
cognitive impact in a transgenic rat model
Authors: Muñoz-Moreno Emma , Tudela Raúl , López-Gil Xavier , Soria Guadalupe 
Published: January 2020

Abstract
The research of Alzheimer’s disease (AD) in its early stages and its progression till symptomatic onset is essential to understand the pathology and investigate new treatments. Animal models provide a helpful approach to this research, since they allow for controlled follow-up during the disease evolution. In this work, transgenic TgF344-AD rats were longitudinally evaluated starting at 6 months of age. Every 3 months, cognitive abilities were assessed by a memory-related task and magnetic resonance imaging (MRI) was acquired. Structural and functional brain networks were estimated and characterized by graph metrics to identify differences between the groups in connectivity, its evolution with age, and its influence on cognition. Structural networks of transgenic animals were altered since the earliest stage. Likewise, aging significantly affected network metrics in TgF344-AD, but not in the control group. In addition, while the structural brain network influenced cognitive outcome in transgenic animals, functional network impacted how control subjects performed. TgF344-AD brain network alterations were present from very early stages, difficult to identify in clinical research. Likewise, the characterization of aging in these animals, involving structural network reorganization and its effects on cognition, opens a window to evaluate new treatments for the disease.
Thunderstorm Trends over Africa
Authors: Harel Maayan , Price Colin 
Published: January 2020

AbstractThunderstorms inflict death and damage worldwide due to lightning, heavy rains, hail, and strong winds. While the effect of global warming on future thunderstorm activity is still debatable, this work investigates how thunderstorm activity over Africa may have changed over the last 70 years. Thunderstorm data were obtained from the World Wide Lightning Location Network (WWLLN) and processed to produce thunderstorm clusters. The number and area of clusters in one year (2013) were compared with several climate parameters tied to thunderstorm development, taken from the NCEP–NCAR Reanalysis-1 product (NCEP). The two parameters that correlated best with thunderstorm number were lifted index and specific humidity, with correlations of −0.795 and 0.779, respectively. These parameters were used to construct an empirical model that predicts the number and area of thunderstorm clusters over Africa on a particular day, month, or year. The empirical model was run from 1948 to 2016, providing a reconstruction of long-term thunderstorm activity over Africa. The time series was compared to temperature data from NCEP, and showed that the number of clusters increased with rising surface temperature on annual and decadal time scales, particularly since the mid-1990s. On an annual time scale, the number and area of thunderstorm clusters exhibited a highly sensitive relationship with surface temperature, with a ~40% increase in the number of thunderstorm clusters for every 1-K rise in temperature over Africa. The correlation coefficients with surface temperature were 0.745 and 0.743 for cluster number and area, respectively, indicating that surface temperature explains ~55% of the variability in interannual thunderstorm clusters over the past 70 years.
Use of multiple nursing interventions (cluster nursing) in ABO hemolytic disease of neonates and evaluation of its effect
Authors: Wang Wei , Tang Chi , Ji Qing-Lian , Xiu Hong , Shao Hui , Yu Xiao-Man 
Published: January 2020

Objective This study aimed to create a group of nursing intervention (cluster nursing) strategies of phototherapy for neonates and to evaluate clinical effects of intervention measures on reducing neonatal jaundice in neonates. Methods We performed a prospective study. A total of 141 patients with neonatal ABO hemolytic jaundice were included and randomly divided into two groups: intervention group and control group. The intervention group adopted cluster nursing measures in combination with continuous phototherapy (blue light), while the control group adopted routine nursing together with continuous phototherapy (blue light). Results No differences were observed in general characteristics between the groups. On the seventh day of treatment, percutaneous bilirubin levels were significantly lower in the intervention group than in the control group. On the seventh day of treatment, milk intake was significantly higher and the duration of hospitalization was significantly shorter in the intervention group than in the control group. Conclusion Use of cluster nursing measures in combination with phototherapy in neonatal ABO hemolysis can effectively reduce bilirubin levels, improve symptoms of jaundice, and shorten the course of the disease.
Application of fast-track surgery combined with a clinical nursing pathway in the rehabilitation of patients undergoing total hip arthroplasty
Authors: Zhang Chunhua , Xiao Jun 
Published: January 2020

Objective To explore the effect of fast-track surgery combined with a clinical nursing pathway in the rehabilitation of patients treated with total hip arthroplasty (THA). Methods We enrolled 70 patients diagnosed with avascular necrosis who were treated with a THA. All patients were randomly divided into either a control or a study group. The control group received routine nursing during the perioperative period while the study group received a fast-track surgery combined with a clinical nursing pathway. Results There was no significant difference in general condition between the two groups, including the Harris hip score and the SF-36 scale of health. At the third week and the third month after the operation, the Harris hip score and the health SF-36 score of the study group increased significantly compared with the control group. In addition, the study group had a lower incidence of total complications and a shorter hospitalization time, as well as higher satisfaction scores for nursing work compared with the control group. Conclusion Fast-track surgery combined with a clinical nursing pathway can effectively improve the clinical symptoms and self-efficacy of patients undergoing THA, and improve the patients' satisfaction with hospitalization.
High expression of VCAN is an independent predictor of poor prognosis in gastric cancer
Authors: Li Wenfei , Han Fang , Fu Min , Wang Zhanqiu 
Published: January 2020

Objective Versican (VCAN) has been reported as a potential biomarker in some cancers. However, its role in gastric cancer (GC) is poorly understood. Methods Associations between clinical variables and VCAN were assessed. The diagnostic value of VCAN expression in GC patients was determined through receiver operating characteristic (ROC) curve analysis. Cox regression and the Kaplan–Meier method were used to explore clinicopathologic factors related to overall survival in GC patients. The Gene Expression Omnibus and the Human Protein Atlas were used for further validation. Gene set enrichment analysis (GSEA) was performed using The Cancer Genome Atlas dataset. Results High expression of VCAN was associated with high stage and T classification in GC. The area under the ROC curve was 0.853. Patients with high VCAN expression had worse prognoses than those with low VCAN expression. Multivariate analysis showed that VCAN was an independent risk factor for overall survival in both cohorts. GSEA identified pathways involved in cancer, ECM-receptor interaction, Wnt signaling, T cell receptor signaling, and chemokine signaling as differentially enriched in GCs with high VCAN expression. Conclusion We demonstrated that VCAN is expressed at high levels in GC, and represents a potential independent molecular marker for diagnosis and prognosis of GC.
Clinical significance of the monocyte:lymphocyte ratio for ankylosing spondylitis patients with thoracolumbar kyphotic deformities
Authors: Zhuang Jianxiong , Huang Yongxiong , Liang Guoyan 
Published: January 2020

Purpose This study aimed to determine the clinical significance of the monocyte:lymphocyte ratio (MLR) in ankylosing spondylitis (AS) patients with thoracolumbar kyphotic deformity. Methods Ninety AS patients and 45 healthy controls were retrospectively enrolled. AS patients were divided into thoracolumbar kyphotic deformity (AS deformity) and spine normal (AS normal) groups. Blood parameters including C-reactive protein and erythrocyte sedimentation rate were determined. Receiver operating characteristic (ROC) curves and binary logistic regression analysis were conducted. Results Counts of white blood cells, neutrophils, and monocytes, and the neutrophil:lymphocyte ratio, platelet:lymphocyte ratio, and MLR were significantly higher in the AS than the control group. ROC curve results showed that the MLR yielded a higher area under the curve (AUC) value than other parameters, compared with controls. The MLR and monocyte count were higher in the AS deformity group than the AS normal group. ROC curve results indicated that the MLR yielded a higher AUC value than other parameters, compared with the AS normal group. Logistic regression suggested that the MLR was an independent predictor for thoracolumbar kyphotic deformity. Conclusions The MLR was elevated in AS patients, and was shown to be an independent predictor for thoracolumbar kyphotic deformity.
Obesity affects graft function but not graft loss in kidney transplant recipients
Authors: Bellini Maria Irene , Koutroutsos Kostas , Nananpragasam Hannah , Deurloo Emily , Galliford Jack , Herbert Paul Elliot 
Published: January 2020

Objective This study was performed to examine the suitability of transplantation in kidney transplant recipients (KTRs) with a high body mass index (BMI). Methods In total, 370 consecutive KTRs stratified according to the World Health Organization BMI categories were retrospectively analysed. The estimated glomerular filtration rate (eGFR) was used to assess allograft function. Results The mean BMI was 26.2 kg/m2. Among all patients, 148 (40.0%) were pre-obese, 47 (12.7%) were class I obese, 11 (3.0%) were class II obese, and 9 (2.4%) were class III obese. A linear trend for male sex and younger age was observed from the normal BMI group through the progressively higher groups. Overweight and obese KTRs had a significantly higher incidence of pre-transplant diabetes, but there was no difference in post-transplant new-onset hyperglycaemia. Obesity was not a significant risk factor for a lower eGFR at the 1-year follow-up, but it became significant at the 2- and 3-year follow-ups. Graft loss occurred in 28 patients, and 25 patients died during follow-up. No difference in all-cause allograft loss was found among the different BMI groups during follow-up. Conclusion Obesity affects the eGFR in the long term. Allograft survival was lower, but not significantly.
Next-day discharge following small uniportal thoracoscopic bullectomy assisted with an anchoring suture
Authors: Zhang Chu , Zhang Miao , Wang Haiyong , Ma Zhifeng , Wu Yuanlin , Fu Linhai , Zhu Ting , Yu Guangmao 
Published: January 2020

Objective Manipulating the instruments during uniportal video-assisted thoracoscopic surgery (U-VATS) bullectomy requires a relatively large incision. This study aimed to investigate the feasibility of next-day discharge following U-VATS bullectomy using an anchoring suture. Methods A stapler and a scope were inserted through a single incision in the anchoring group. The bullae were retracted by the suture, which was inserted from outside of the chest wall into the thorax, and then bullectomy was performed. For those in the control group, resection of the bullae was performed with the assistance of a grasping forceps. Results The length of the incision of the patients in the anchoring group ([13.2 ± 2.2] mm) was significantly smaller than in the control group ([26.2 ± 3.9] mm). In addition, the number of staplers used in the anchoring group was significantly less than in the control group ([1.2 ± 0.4] vs. [1.4 ± 0.5]). Furthermore, 36 (92.3%) cases in the anchoring group were uneventfully discharged within 24 hours after bullectomy. Conclusion Next-day discharge after U-VATS bullectomy through a small incision assisted with an anchoring suture is safe and feasible.
Asymmetric superior oblique split Z-tendon lengthening for face turn in bilateral asymmetric superior oblique overaction and exotropia
Authors: Serafino Massimiliano , Scaramuzzi Matteo , Specchia Claudia , Bonsignore Francesco , Nucci Paolo 
Published: January 2020

Introduction: The aim was to evaluate the effectiveness of the procedure of the superior oblique split Z-tendon lengthening to collapse A pattern and treat face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique overaction. Methods: We retrospectively reviewed the clinical records of patients with facial turn associated with intermittent exotropia and bilateral asymmetric superior oblique overaction, who underwent superior oblique muscle split tendon lengthening and concurrent horizontal surgery between 2009 and 2017. Results: A total of eight patients met the inclusion criteria. The preoperative average face turn was 26.8° (range, 20°–5°), and it significantly improved to 5.4° (range, 2°–8°) ( p < 0.05). All the patients showed an improvement in the face turn with neutralization of the vertical deviation. The vertical deviation in the right gaze for the patient with a right turn and the left gaze in patients with left turn improved significantly (values of p < 0.05). Conclusion: The superior oblique split Z-tendon lengthening was an effective procedure to collapse the A pattern and the treatment of the face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique muscle overaction with less complications, and less varying results.
Near-infrared spectroscopy as a predictor of cerebral ischaemia during carotid endarterectomy in awake patients
Authors: Inčiūra Donatas , Antuševas Aleksandras , Aladaitis Adomas , Gimžauskaitė Agnė , Velička Linas , Kavaliauskienė Žana 
Published: January 2020

Objectives The aim of our study was to evaluate the near-infrared spectroscopy monitoring system to detect cerebral ischaemia, find indications for selective shunting during carotid endarterectomy and compare it with an internal carotid artery stump pressure monitoring technique in patients operated under local anaesthesia. Methods During January 2015 and November 2018, 131 patients undergoing carotid endarterectomy under local anaesthesia were prospectively included in the study. Near-infrared spectroscopy as intraoperative monitoring was applied and compared with stump pressure. Results Carotid endarterectomy was performed successfully in 106 patients operated under local anaesthesia. Meanwhile, 25 patients developed neurological changes (motor or consciousness impairment, weakness of extremities, cognitive decline) during clamping, and all of them received a shunt. ΔrSO2, stump pressure and rSO2 (–11 ± 8%, 31 ± 6mmHg, 58 ± 11) values were smaller in the group of shunted subjects versus non-shunted group subjects (–2 ± 5%, 61 ± 17 mmHg, 64 ± 8) after 1 min of internal carotid artery clamping ( p < 0.05). Statistical analysis showed a sensitivity of 90% (95% CI: 0.85–0.95) and a specificity of 70% (95% CI: 0.62–0.78) for a ≥10% drop in ΔrSO2 to predict ischaemia symptoms during carotid clamping. Using stump pressure with a cut-off value of ≤40 mmHg for predicting symptoms, the sensitivity was 82% and specificity 54%. Conclusions Near-infrared spectroscopy is a suitable non-invasive cerebral oxygenation monitoring method during carotid endarterectomy. A 10% decrease of ΔrSO2 had a good correlation with clinical cerebral ischaemia signs and matched well with the stump pressure cut-off value of ≤40 mmHg. There is a possibility of near-infrared spectroscopy to replace stump pressure in cerebral oxygenation monitoring during carotid endarterectomy. However, we need larger prospective multicentre studies to identify the optimal threshold for shunt requirement.
Does a previous aortic endograft confer any protective effect during abdominal aortic aneurysm rupture? Systematic review and meta-analysis of comparative studies
Authors: Galanakis Nikolaos , Kontopodis Nikolaos , Tavlas Emmanouil , Tsetis Dimitrios , Ioannou Christos V 
Published: January 2020

Objectives Whether prior endovascular aneurysm repair confers a protective effect in patients with ruptured abdominal aortic aneurysm (rAAA) is not known. We aimed to systematically review and compare the outcomes of rAAA in patients with and without prior endovascular aneurysm repair. Methods We performed a systematic review that conformed to the Preferred Reporting Items for Systematic Reviews and Meta-analysis. We selected studies comparing the outcomes in patients with rAAA after prior endovascular aneurysm repair (group 1) and those with de novo rAAAs (group 2). We conducted a proportion meta-analysis of perioperative mortality and obtained summary estimates of odds ratios (ORs) and 95% confidence intervals (CIs) using random-effects models. Results We included four studies (retrospective observational studies) in quantitative synthesis reporting a total of 719 patients (group 1 (89) group 2 (630)). The perioperative mortality in groups 1 and 2 was 30.4% and 41%, respectively, and there was no statistical significant difference between the groups (OR 0.66, 95% CI 0.30–1.43, P = 0.29, I2=58%). However, patients presenting with rAAA following previous endovascular aneurysm repair were more hemodynamically stable (OR 0.33, 95% CI 0.12–0.90, P = 0.03, I2=74%). The choice between endovascular or open surgery treatment in group 1 did not affect the perioperative mortality (OR 1.12, 95% CI 0.41–3.04  P = 0.82, I2=0%). Endoleak types I and III were the main causes of rAAA in group 1. Conclusions Perioperative mortality was similar for rAAA either de novo or after prior endovascular aneurysm repair. However, ruptures in patients with prior endovascular aneurysm repair presented hemodynamically more stable.
Fixation of fifth metacarpal neck fractures: a comparison of medial locking plates with intramedullary K-wires
Authors: Chen Kuan-Jung , Wang Jung-Pan , Yin Cheng-Yu , Huang Hui-Kuang , Chang Ming-Chau , Huang Yi-Chao 
Published: January 2020

Surgical treatment for metacarpal neck fractures may be indicated for malrotation, palmar angulation exceeding 30° or metacarpal shortening exceeding 3 mm, although these thresholds have not been firmly established. In a retrospective study, we compared the clinical and radiographic results of 54 patients with displaced fifth metacarpal neck fractures who were treated with either medial locking plates (14 patients) or retrograde intramedullary K-wires (40 patients). At a mean follow-up of 26 months (range 12 to 62), metacarpal shortening and angulation were 2 mm greater and 4° greater, respectively, in the K-wire group. The plate group had an earlier return to work and greater aesthetic satisfaction, but operative time and complication incidence were higher. Range of motion, time to union, grip strength and Quick Disability of the Arm, Shoulder and Hand scores were similar. We conclude that medial plating offers no clear advantage over K-wire fixation in treating metacarpal neck fractures. Level of evidence: III