bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vasodilation by Verapamil‐Nitroglycerin Solution in Microvascular Surgery
Authors: Seth Rahul , Badran Karam W. , Cedars Elizabeth , Plonowska Karolina , Benjamin Tania , Saggi Satvir , Knott P. Daniel , Heaton Chase M. , Blackwell Keith E. 
Published: July 2020

ObjectivePapaverine is a topical vasodilator commonly used during microvascular surgery to inhibit undesired vasoconstriction. A previous national shortage of papaverine prompted evaluation of an alternative, effective vasodilator. This study aims to assess the experience of a solution of verapamil and nitroglycerin (VG) as a potential alternative pharmacologic vasodilator.Study DesignRetrospective case series.SettingTwo tertiary academic medical centers.Subjects and MethodsAmong 298 patients, 306 consecutive free tissue transfers performed between 2014 and 2017 for head and neck defect reconstruction utilized a VG solution. Patient and flap characteristics, intraoperative patient and flap complications, and postoperative complications were reviewed. Diameter of the cervical recipient artery was measured intraoperatively before and after topical application of the VG solution in a subset of 43 patients (44 flaps).ResultsFlaps included fibula, radial forearm, subscapular system, and anterolateral thigh. In total, 3 (0.98%) flaps failed with varied etiology unrelated to the VG solution (venous thrombosis, arterial anastomosis thrombosis, physical damage to the perforator). Specific to topical application of the VG solution, the mean recipient artery diameter increased from 2.1 to 3.1 mm, a 48% increase (P <. 01). There were no intraoperative cardiac events or complications attributable to the VG solution.ConclusionWe describe the use of a VG solution for pharmacologic vasodilation during microvascular free tissue transfer. Its use was associated with an acceptable incidence of adverse events, none of which were directly attributable to the VG solution. Apparent and sustained vasodilation was demonstrated. The VG solution represents a safe and efficacious alternative to papaverine in microvascular surgery.
Endovenous laser ablation: A comprehensive review
Authors: Teter Katherine A , Kabnick Lowell S. , Sadek Mikel 
Published: July 2020

Objective To provide an evidence-based overview of endovenous laser ablation and describe its role as an effective and durable technique for the management of superficial venous insufficiency. Methods The published literature on the treatment of varicose veins using endovenous laser ablation was reviewed. The literature search focused on the history of endovenous laser ablation, its safety and durability, known complications, and differences in outcomes based on the iterations of fiber type and laser wavelength. Results Treatment safety and efficacy of endovenous laser ablation appear to be based on the amount of energy administered over a defined distance, or the linear endovenous energy density. The ideal linear endovenous energy density varies with the laser wavelength and fiber-type. Post-operative pain and bruising may be reduced by the use of higher wavelength fibers or the use of radial or jacket-tip fibers as compared to bare-tip fibers. The incidence of endothermal heat-induced thrombosis remains low and has declined with increasing experience. Reports have demonstrated a greater than 90% technical success rate with saphenous endovenous laser ablation, long-term durability of ablation, and commensurate improvement in quality of life. Conclusions Endovenous laser ablation is a safe and durable treatment option for the management of incompetent superficial and perforator veins of the lower extremities. As an endothermal technology, it remains a key component of the standard of care for the treatment of chronic venous insufficiency.
Navigating the path: a qualitative exploration of New Zealand general practitioners’ views on integration of care with acupuncturists
Authors: Roberts Kate , Betts Debra , Nie Jing-Bao , Dowell Anthony 
Published: July 2020

Background Increasingly, many patients believe that a combined approach of complementary and alternative medicine (CAM), including acupuncture, and conventional medicine is better than either on its own, and more patients now have the desire to discuss CAM with well-informed general practitioners (GPs). However, to our knowledge, the interaction and collaboration between GPs and acupuncturists specifically in relation to shared care have not been investigated. This research explored interprofessional communication between GPs and acupuncturists in New Zealand. This article specifically reports the GPs’ viewpoints. Methods This study was part of a larger mixed-methods research project. Semi-structured interviews of 14 purposively sampled GP participants were conducted and analysed using thematic analysis. Results The data analysis identified both facilitators of and barriers to integrative health care . Facilitators included the willingness of GPs to engage in communication and a recognition of the importance of patient choice. Barriers included the limited opportunities for sharing information and the lack of current established pathways for communication or direct referrals. GPs also highlighted the confusion around scopes of practice in terms of the different styles of and approaches to acupuncture. Conclusion This research contributes to the body of knowledge concerning interprofessional communication and collaboration between GPs and acupuncturists and suggests that while there are significant barriers to collaboration, there is also the potential to impact provider satisfaction and patient well-being. It provides context within a New Zealand health care setting and also provides additional insights regarding acupuncture, specifically through the disaggregation of specific CAM modalities.
A simplified technique for converting antegrade femoral access to retrograde access for catheterization
Authors: Nazir Salik , Elzanaty Ahmed M , Moukarbel George V 
Published: July 2020

Objectives Femoral access conversion is sometimes required in clinical practice. Various techniques have been reported to convert a retrograde femoral access to antegrade access with a high success rate. However, despite paucity of data, converting an antegrade access to retrograde access is quite challenging with a potentially higher risk of technical failure or loss of access. Methods Here, we report a simple technique of antegrade to retrograde access conversion utilizing a pigtail catheter and an angled Glidewire. Results Successful conversion was achieved with no immediate complications with the proposed technique. Conclusions Techniques that describe antegrade to retrograde access conversion are seldomly reported in the medical literature. Our technique was successful in making the conversion utilizing only pigtail catheter and angled Glidewire.
Evaluation of the Electromyographic Amplitude-to-Work Ratio in the Infraspinatus Muscle During External Shoulder Rotation Exercises: A Comparison of Concentric Isotonic and Isokinetic Exercises
Authors: Park Jung-Ho , Chung Seok Won , Lee Seoung-Joon , Lee Jong-Won , Oh Kyung-Soo 
Published: July 2020

Background: Isotonic exercise is commonly adopted for shoulder rehabilitation, but the efficacy of isokinetic exercise for rehabilitation has not been evaluated. Purpose: To evaluate the efficacy of isotonic and isokinetic external shoulder rotation exercises. Study Design: Controlled laboratory study. Methods: Using surface electromyography (EMG) and the Biodex system, we investigated the EMG amplitude of the infraspinatus (IS), total work (tWK), and EMG(IS)/tWK ratio and examined the relative IS and posterior deltoid (PD) contributions to all exercises. A total of 24 healthy participants without musculoskeletal injuries were included. Participants performed isotonic external shoulder rotation at 10%, 20%, 30%, 40%, and 50% of the maximum voluntary isometric contraction (MVIC) as well as isokinetic external shoulder rotation at angular velocities of 60, 120, 180, 240, and 300 deg/s. Levels of intensity were classified from 1 to 5: level 1 corresponded to 10% of the MVIC and a 300-deg/s angular velocity; level 2 corresponded to 20% MVIC and 240 deg/s; level 3 corresponded to 30% MVIC and 180 deg/s; level 4 corresponded to 40% MVIC and 120 deg/s; and level 5 corresponded to 50% MVIC and 60 deg/s. Normalized IS and tWK amplitudes were calculated for each exercise. Results: During isotonic exercise, the EMG(IS)/tWK ratio significantly decreased from level 5 to 3, 2, and 1; from level 4 to 2 and 1; and from level 3 to 1. During isokinetic exercise, the EMG(IS)/tWK ratio at level 3 was greater than that at all other levels except level 1. Statistical differences were found between isotonic and isokinetic modes at levels 1, 2, and 3. The IS/PD activation ratios were not significantly different between exercise modes at any level. Conclusion: Isokinetic resistance may provide more effective stimulation of the IS muscle compared with isotonic resistance. Clinical Relevance: Isokinetic exercise needs to be considered as a method of rehabilitation that effectively increases infraspinatus muscle activity.
miR-125a-5p regulates megakaryocyte proplatelet formation via the actin-bundling protein L-plastin
Authors: Bhatlekar Seema , Manne Bhanu K. , Basak Indranil , Edelstein Leonard C. , Tugolukova Emilia , Stoller Michelle L. , Cody Mark J. , Morley Sharon C. , Nagalla Srikanth , Weyrich Andrew S. , Rowley Jesse W. , O’Connell Ryan M. , Rondina Matthew T. , Campbell Robert A. , Bray Paul F. 
Published: July 2020

AbstractThere is heritability to interindividual variation in platelet count, and better understanding of the regulating genetic factors may provide insights for thrombopoiesis. MicroRNAs (miRs) regulate gene expression in health and disease, and megakaryocytes (MKs) deficient in miRs have lower platelet counts, but information about the role of miRs in normal human MK and platelet production is limited. Using genome-wide miR profiling, we observed strong correlations among human bone marrow MKs, platelets, and differentiating cord blood–derived MK cultures, and identified MK miR-125a-5p as associated with human platelet number but not leukocyte or hemoglobin levels. Overexpression and knockdown studies showed that miR-125a-5p positively regulated human MK proplatelet (PP) formation in vitro. Inhibition of miR-125a-5p in vivo lowered murine platelet counts. Analyses of MK and platelet transcriptomes identified LCP1 as a miR-125a-5p target. LCP1 encodes the actin-bundling protein, L-plastin, not previously studied in MKs. We show that miR-125a-5p directly targets and reduces expression of MK L-plastin. Overexpression and knockdown studies show that L-plastin promotes MK progenitor migration, but negatively correlates with human platelet count and inhibits MK PP formation (PPF). This work provides the first evidence for the actin-bundling protein, L-plastin, as a regulator of human MK PPF via inhibition of the late-stage MK invagination system, podosome and PPF, and PP branching. We also provide resources of primary and differentiating MK transcriptomes and miRs associated with platelet counts. miR-125a-5p and L-plastin may be relevant targets for increasing in vitro platelet manufacturing and for managing quantitative platelet disorders.
Szabo 2-stent technique for coronary bifurcation lesions: procedural and short-term outcomes
Authors: Yang Hongbo , Qian Juying , Huang Zheyong , Ge Junbo 
Published: July 2020

Abstract
Background
Provisional 1-stent technique is currently regarded as the default approach for the majority of bifurcation lesions. Nonetheless, 2-stent techniques may be required for complex bifurcations with high compromise risk or fatal consequences of side branch (SB) occlusion. Limitations exist in current approaches, as stents gap, multiple metal layers and stent malapposition caused by imprecise placement with fluoroscopic guide and intrinsic technical defects. This study was designed to investigate the effectiveness of the novel Szabo 2-stent technique for coronary bifurcation lesions.

Methods
In the Szabo 2-stent technique, one stent is precisely implanted at the SB ostium with Szabo technique resulting in a single strut protruding into the main vessel (MV). After MV rewiring and SB guidewire withdrawal, another stent is implanted in MV followed by proximal optimization technique, SB rewiring, and final kissing inflation (FKI).

Results
The technique tested successfully in silicone tubes (n = 9) with: procedure duration, 31.2 ± 6.8 min; MV and SB rewiring time, 26.8 ± 11.2 s and 33.3 ± 15 s; easy FKI; and 2.3 ± 0.5 balloons/procedure. Bifurcation lesions (n = 22) were treated with angiographic success in MV and SB, respectively: increased minimal lumen diameter (0.63 ± 0.32 mm to 3.20 ± 0.35 mm; 0.49 ± 0.37 mm to 2.67 ± 0.25 mm); low residual stenosis (12.4 ± 2.4%; 12.4 ± 2.3%); and intravascular ultrasound confirmed (n = 19) full coverage; minimal overlap and malapposition; minimal lumen area (2.4 ± 1.2 mm2; 2.1 ± 1.0 mm2); plaque burden (78.1 ± 11.3%; 71.6 ± 15.5%); and minimal stent area (9.1 ± 1.6 mm2; 6.1 ± 1.3 mm2). Periprocedural cardiac troponin increased in 1 asymptomatic patient without electrocardiographic change. There was no target lesion failure (cardiac death, myocardial infarction, target lesion revascularization) at 6-month follow-up.

Conclusions
The Szabo 2-stent technique for bifurcation lesions provided acceptable safety and efficacy at short-term follow-up.
External validation of stroke mimic prediction scales in the emergency department
Authors: Tu Tian Ming , Tan Guan Zhong , Saffari Seyed Ehsan , Wee Chee Keong , Chee David Jeremiah Ming Siang , Tan Camlyn , Lim Hoon Chin 
Published: July 2020

Abstract
Background
Acute ischemic stroke is a time-sensitive emergency where accurate diagnosis is required promptly. Due to time pressures, stroke mimics who present with similar signs and symptoms as acute ischemic stroke, pose a diagnostic challenge to the emergency physician. With limited access to investigative tools, clinical prediction, tools based only on clinical features, may be useful to identify stroke mimics. We aim to externally validate the performance of 4 stroke mimic prediction scales, and derive a novel decision tree, to improve identification of stroke mimics.

Methods
We performed a retrospective cross-sectional study at a primary stroke centre, served by a telestroke hub. We included consecutive patients who were administered intravenous thrombolysis for suspected acute ischemic stroke from January 2015 to October 2017. Four stroke mimic prediction tools (FABS, simplified FABS, Telestroke Mimic Score and Khan Score) were rated simultaneously, using only clinical information prior to administration of thrombolysis. The final diagnosis was ascertained by an independent stroke neurologist. Area under receiver operating curve (AUROC) analysis was performed. A classification tree analysis was also conducted using variables which were found to be significant in the univariate analysis.

Results
Telestroke Mimic Score had the highest discrimination for stroke mimics among the 4 scores tested (AUROC = 0.75, 95% CI = 0.63–0.87). However, all 4 scores performed similarly (DeLong p > 0.05). Telestroke Mimic Score had the highest sensitivity (91.3%), while Khan score had the highest specificity (88.2%). All 4 scores had high positive predictive value (88.1 to 97.5%) and low negative predictive values (4.7 to 32.3%). A novel decision tree, using only age, presence of migraine and psychiatric history, had a higher prediction performance (AUROC = 0.80).

Conclusion
Four tested stroke mimic prediction scales performed similarly to identify stroke mimics in the emergency setting. A novel decision tree may improve the identification of stroke mimics.
Effect of silicone oil on peripapillary capillary density in patients with rhegmatogenous retinal detachment
Authors: Wang Erqian , Chen Youxin , Li Ningning , Min Hanyi 
Published: July 2020

Abstract
Purpose
To evaluate the effect of silicone oil (SO) on peripapillary blood flow using OCT angiography.

Methods
This prospective case series recruited patients with unilateral rhegmatogenous retinal detachment (RRD) who underwent vitrectomy and SO tamponade. Patients were examined before SO removal and at 10 days, 1 month, and 3 months after SO removal on a spectral domain OCT angiography device (RTVue XR Avanti, Optovue Inc., CA, USA) for the measurement of radial peripapillary capillaries (RPC) vessel density (VD) in global field, superior hemifield, and inferior hemifield. Changes in RPC VD following SO removal were compared between affected eyes and contralateral eyes.

Results
Twenty-two patients were analyzed. The average duration of SO tamponade was 101.3 days (range, 90 to 119 days). After SO removal, global RPC VD increased by 1.3% (95%CI, 0.3 to 2.3%), compared with a − 0.4% (95%CI, − 1.4 to 0.7%) change in contralateral eyes (P = 0.007). The increase in RPC VD after SO removal mainly occurred in the superior hemifield, which was 1.6% (95%CI, 0.6 to 2.7%). The increase in RPC VD in the inferior hemifield was 1.0% (95%CI, − 0.2 to 2.1%) after SO removal.

Conclusions
We detected a mild increase in peripapillary capillary density after SO removal, mainly in the superior hemifield. Our results suggested that SO tamponade could have negative effect on peripapillary blood flow, possibly by capillary compression.
Physical activity practice and sports preferences in a group of Spanish schoolchildren depending on sex and parental care: a gender perspective
Authors: Peral-Suárez África , Cuadrado-Soto Esther , Perea José Miguel , Navia Beatriz , López-Sobaler Ana M. , Ortega Rosa M. 
Published: July 2020

Abstract
Background
Physical activity plays an important role in the maintenance of health, and it is especially important during childhood. However, the lack of information about differences in physical activity practice and sports preferences of children considering gender differences can result in non-effective policies that enhance inequalities between sexes. The aim of this study is to identify the sports preferences of Spanish schoolchildren and their physical activity practice behaviors depending on their sex and their parental care, analyzing the possible differences from a gender perspective.

Method
Three hundred sixty-four Spanish schoolchildren (179 girls, 185 boys) participated in this cross-sectional study. A daily physical activity questionnaire was used to evaluate physical activity level (PAL), moderate-to-vigorous physical activity (MVPA) and sports preferences and a socio-health questionnaire were used to collect data about parental care. Statistical analysis was performed using SPSS and applying Student’s T-test for normal variables, Mann-Whitney U-test for non-parametrical variables, and chi-square (χ2) test for categorical variables. Subsequently, odds ratios were used to analyze associations between the physical activity practice of the children and parental care.

Results
PAL and time spent in MVPA was significantly lower for girls compared to boys (1.44 ± 0.07 vs. 1.46 ± 0.07, p < 0.001 and 0.74 ± 0.40 h/day vs. 0.90 ± 0.45 h/day; p < 0.001, respectively). Dancing, rhythmic gymnastics, skating, and water sports were practiced more by girls, while football, wrestling sports, handball, and racket sports were practiced more by boys (p < 0.05). Children cared for by their fathers had higher odds for physical activity practice (OR = 1.995 (1.202–3.310), p = 0.008).

Conclusion
Physical activity among girls was less frequent and less intense. Girls opted for individual sports with artistic connotations, while boys often practiced more team contact sports. Furthermore, children are more physically actives when their father is in charge of them.
The role of reassurance seeking in obsessive compulsive disorder: the associations between reassurance seeking, dysfunctional beliefs, negative emotions, and obsessive- compulsive symptoms
Authors: Haciomeroglu Bikem 
Published: July 2020

Abstract
Background
This study investigates the association of reassurance seeking with obsessive compulsive (OC) symptoms, dysfunctional beliefs, and negative emotions.

Methods
Reassurance Seeking Questionnaire, Obsessive-Compulsive Inventory, Obsessive Beliefs Questionnaire, Trait Anger Expression Inventory, and Guilt Inventory were applied to 53 obsessive compulsive disorder (OCD) patients and 591 non-clinical participants.

Results
The results showed that the severity of the OC symptoms significantly predicted the carefulness of OCD patients during reassurance seeking, indicating increased carefulness during reassurance seeking as the severity of OC symptoms increased. Moreover, feelings of guilt increased with increasing intensity of reassurance seeking. In addition, carefulness during reassurance seeking significantly predicted the level of anxiety. Responsibility/threat estimation, perfectionism/need for certainty, and importance/control of thoughts significantly predicted the OC symptoms. Moreover, the dysfunctional beliefs directly associated with an increased need to seek reassurance from different sources and seek reassurance more carefully. In terms of mediational effect, the results revealed that the individuals who had distorted beliefs were more likely to have OC symptoms and, in turn, the OC symptoms increased carefulness during reassurance seeking. The analysis of the model test revealed mostly similar results to those obtained for the clinical sample.

Conclusions
The findings revealed a close relationship between OC symptoms and reassurance-seeking behaviors.
How to choose kinematic or mechanical alignment individually according to preoperative characteristics of patients?
Authors: Luan Chong , Xu Dong-Tan , Chen Ning-Jie , Wang Fei-Fei , Tian Kang-Song , Wei Chao , Wang Xian-Bin 
Published: July 2020

Abstract
Background
Making decisions in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA).

Methods
We reviewed 296 consecutive patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a computer-assisted navigation from 2016 to 2018 in our prospectively maintained database. The minimum followup was 1 year. Clinical outcomes including the range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS.

Results
ROM and KSS at the 1-year followup didn’t differ between MA-TKAs and KA-TKAs (all p > 0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β = 0.4, 95% confidence interval [CI]: − 0.3, 1.6; p = 0.752) or 1-year KSS (Adjusted β = 2.2, 95%CI: − 0.7, 5.6; p = 0.107). Patients with a BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction< 0.05). Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction< 0.05).

Conclusions
Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.