bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of reperfusion pump power on technical and clinical outcomes after direct aspiration thrombectomy (ADAPT)
Authors: Alawieh Ali , Chalhoub Reda , Korson Clayton J , Anadani Mohammad , Lena Jonathan , Spiotta Alejandro 
Published: October 2019

IntroductionHigher aspiration forces using larger bore catheters in direct aspiration thrombectomy (ADAPT) have been associated with shorter procedure time and better outcomes in patients treated for acute ischemic stroke (AIS). However, the effect of using reperfusion pumps of higher aspiration power on outcomes of ADAPT has not been investigated. We evaluated the effect of using pumps with different aspiration powers on technical and clinical outcomes after ADAPT.MethodsWe reviewed a retrospective database of AIS cases between January 2018 and February 2019, while comparing technical and clinical outcomes between patients undergoing ADAPT using the MAX pump (28.5 inHg power) vs the ENGINE pump(29.2 inHg power).ResultsAmong 194 patients (48% females, age 69±15 years) included in the study, 73 patients undergoing ADAPT using the ENGINE pump were age-, gender-, comorbidities-, and operator-matched to 118 patients treated using the MAX pump. The ENGINE group had shorter procedure time (20±17 vs 27±21 mins, p=0.017), lower number of aspiration attempts (2.2±1.6 vs 2.8±1.9, p=0.047), and similar rates of favorable 90 day modified Rankin Scale. Using multivariate linear regression, the use of the ENGINE reperfusion pump with higher vacuum power was independently and inversely correlated with procedure time (coefficient −2.23, p=0.027). While controlling for confounders, there was a trend toward an inverse correlation between use of the ENGINE pump and the number of attempts on linear regression (coefficient −1.04, p=0.09) and lower odds of PH2/intracranial (ICH) hemorrhages on logistic regression (OR 0.227, p=0.075).ConclusionOur findings suggest that the use of the ENGINE reperfusion pump of higher aspiration power during ADAPT decreases procedure time, without increasing complications and post-procedural hemorrhage rates.
Asymptotically flat vacuum solution in modified theory of Einstein’s gravity
Authors: Kalita Surajit , Mukhopadhyay Banibrata 
Published: October 2019

Abstract
A number of recent observations have suggested that the Einstein’s theory of general relativity may not be the ultimate theory of gravity. The f(R) gravity model with R being the scalar curvature turns out to be one of the best bet to surpass the general relativity which explains a number of phenomena where Einstein’s theory of gravity fails. In the f(R) gravity, behaviour of the spacetime is modified as compared to that of given by the Einstein’s theory of general relativity. This theory has already been explored for understanding various compact objects such as neutron stars, white dwarfs etc. and also describing evolution of the universe. Although researchers have already found the vacuum spacetime solutions for the f(R) gravity, yet there is a caveat that the metric does have some diverging terms and hence these solutions are not asymptotically flat. We show that it is possible to have asymptotically flat spherically symmetric vacuum solution for the f(R) gravity, which is different from the Schwarzschild solution. We use this solution for explaining various bound orbits around the black hole and eventually, as an immediate application, in the spherical accretion flow around it.
Role of Muscle Profile in Alzheimer’s Disease: A 3-Year Longitudinal Study
Authors: Moon Yeonsil , Moon Won-Jin , Kim Jin Ok , Kwon Kyoung Ja , Han Seol-Heui 
Published: October 2019

<b><i>Introduction:</i></b> Many factors are known to affect the rate of cognitive decline; however, studies on clinical outcomes are rare. Muscle profile and their relationship to dementia trajectories have not been extensively investigated. We investigated factors that affect the rate of clinical decline and the usefulness of muscle profiles for predicting the clinical outcomes of patients with Alzheimer’s dementia (AD). <b><i>Objective:</i></b> Sixty-nine subjects with probable AD were included and several factors that are known to affect the rate of cognitive decline were evaluated. <b><i>Methods:</i></b> Over a period of 3 years, each subject received an annual evaluation that included a clinical interview and an assessment of their cognitive status as measured by a clinical dementia rating-sum of boxes (CDR-SOB) score. Linear mixed-effects models were used to test for associations between each factor and the ­CDR-SOB score over time. These analyses were repeated in a multivariate linear mixed-effects model after adjusting the covariates. <b><i>Results:</i></b> Age, diabetes mellitus, and baseline dementia severity were identified as potential covariates that influence clinical progression. However, a subject’s muscle profile was not found to predict dementia progression. <b><i>Conclusions:</i></b> We expect that early screening and intervention, as well as new drugs with mechanisms of action similar to those of antidiabetic medications, will help patients with dementia maintain their clinical status.
Association of Body Mass Index and Extreme Obesity With Long‐Term Outcomes Following Percutaneous Coronary Intervention
Authors: Biswas Sinjini , Andrianopoulos Nick , Dinh Diem , Duffy Stephen J. , Lefkovits Jeffrey , Brennan Angela , Noaman Samer , Ajani Andrew , Clark David J. , Freeman Melanie , Oqueli Ernesto , Hiew Chin , Reid Christopher M. , Stub Dion , Chan William 
Published: October 2019

Background

Previous studies have reported a protective effect of obesity compared with normal body mass index (
BMI
) in patients undergoing percutaneous coronary intervention (
PCI
). However, it is unclear whether this effect extends to the extremely obese. In this large multicenter registry‐based study, we sought to examine the relationship between
BMI
and long‐term clinical outcomes following
PCI
, and in particular to evaluate the association between extreme obesity and long‐term survival after
PCI
.

Methods and Results

This cohort study included 25 413 patients who underwent
PCI
between January 1, 2005 and June 30, 2017, who were prospectively enrolled in the Melbourne Interventional Group registry. Patients were stratified by World Health Organization–defined
BMI
categories. The primary end point was National Death Index–linked mortality. The median length of follow‐up was 4.4 years (interquartile range 2.0‐7.6 years). Of the study cohort, 24.8% had normal
BMI
(18.5‐24.9 kg/m
2
), and 3.3% were extremely obese (
BMI
≥40 kg/m
2
). Patients with greater degrees of obesity were younger and included a higher proportion of diabetics (
P
<0.001). After adjustment for age and comorbidities, a J‐shaped association was observed between different
BMI
categories and adjusted hazard ratio (HR) for long‐term mortality (normal
BMI
,
HR
1.00 [ref]; overweight,
HR
0.85, 95%
CI
0.78‐0.93,
P
<0.001; mild obesity,
HR
0.85, 95%
CI
0.76‐0.94,
P
=0.002; moderate obesity,
HR
0.95, 95%
CI
0.80‐1.12,
P
=0.54; extreme obesity
HR
1.33, 95%
CI
1.07‐1.65,
P
=0.01).

Conclusions

An obesity paradox is still apparent in contemporary practice, with elevated
BMI
up to 35 kg/m
2
associated with reduced long‐term mortality after
PCI
. However, this protective effect appears not to extend to patients with extreme obesity.
Corticospinal Tract Injury Estimated From Acute Stroke Imaging Predicts Upper Extremity Motor Recovery After Stroke
Authors: Lin David J. , Cloutier Alison M. , Erler Kimberly S. , Cassidy Jessica M. , Snider Samuel B. , Ranford Jessica , Parlman Kristin , Giatsidis Fabio , Burke James F. , Schwamm Lee H. , Finklestein Seth P. , Hochberg Leigh R. , Cramer Steven C. 
Published: October 2019

Background and Purpose—
Injury to the corticospinal tract (CST) has been shown to have a major effect on upper extremity motor recovery after stroke. This study aimed to examine how well CST injury, measured from neuroimaging acquired during the acute stroke workup, predicts upper extremity motor recovery.

Methods—
Patients with upper extremity weakness after ischemic stroke were assessed using the upper extremity Fugl-Meyer during the acute stroke hospitalization and again at 3-month follow-up. CST injury was quantified and compared, using 4 different methods, from images obtained as part of the stroke standard-of-care workup. Logistic and linear regression were performed using CST injury to predict ΔFugl-Meyer. Injury to primary motor and premotor cortices were included as potential modifiers of the effect of CST injury on recovery.

Results—
N=48 patients were enrolled 4.2±2.7 days poststroke and completed 3-month follow-up (median 90-day modified Rankin Scale score, 3; interquartile range, 1.5). CST injury distinguished patients who reached their recovery potential (as predicted from initial impairment) from those who did not, with area under the curve values ranging from 0.70 to 0.8. In addition, CST injury explained ≈20% of the variance in the magnitude of upper extremity recovery, even after controlling for the severity of initial impairment. Results were consistent when comparing 4 different methods of measuring CST injury. Extent of injury to primary motor and premotor cortices did not significantly influence the predictive value that CST injury had for recovery.

Conclusions—
Structural injury to the CST, as estimated from standard-of-care imaging available during the acute stroke hospitalization, is a robust way to distinguish patients who achieve their predicted recovery potential and explains a significant amount of the variance in poststroke upper extremity motor recovery.
Which Hugo? This One! Hugo de Hervorst
Authors: Berger Harald 
Published: October 2019

AbstractOne of the riddles of the history of late medieval philosophy is the identity of a certain Hugo who is frequently quoted in manuscripts as well as in early prints. This article offers solutions to the relevant problems, identifying the work to which these quotations refer. One of the manuscripts presents the author’s name as “Hugo de Reyss,” Reyss being identified with Rees in North-Rhine/Westphalia. A passage in that work links the author to the University of Paris. Among the Hugos documented at the University of Paris at the relevant time, Hugo de Hervorst is the most promising candidate. Hugo of Hervorst and his family had close relations to Rees. In sum, a chain of arguments leads to the identification of Hugo de Reyss as Hugo de Hervorst, whose academic and ecclesiastical careers can thus be outlined. Documented for the first time in 1372, he died in 1399.
First record of a rare copepod Lucicutia hulsemannae Markhaseva & Ferrari, 2005 (Calanoida, Lucicutiidae) for the South China Sea
Authors: Feng Y. Z. , Liu Z. S. 
Published: October 2019

Abstract
The calanoid copepod Lucicutia hulsemannae Markhaseva & Ferrari, 2005 has, until now, only been recorded from the eastern tropical Pacific Ocean, i.e., in its description as a new species. The present study now reports L. hulsemannae for the first time from the southern basin of the South China Sea (7°59.57′N 113°0.1′E), at depths of 500-800 m. The main morphological characteristics of females of this species are: (i) Cephalosome with a pair of strong, triangular, lateral protrusions; (ii) plug of genital double-somite conical in lateral view, with swollen base; (iii) second urosomal somite significantly wider and shorter than third; (iv) inner marginal seta of second exopodal segment of fifth pereiopod (P5) thin towards its tip. This finding considerably expands the reported global distribution of L. hulsemannae, at the same time updating the checklist of copepods for Chinese waters.
Person and Context
Authors: Cha Jaeseung 
Published: October 2019

AbstractThe way in which theology is formulated often relates to three components—texts, traditions, and contexts—each of which has its own distinctive and interactive forces to shape theology. The major conundrum affecting methodology of contemporary theology is, however, a radical shift from text and tradition to context, as if both text and tradition had been contextual and thus theology were always to be contextual. What if our contexts are oppressive and violent? On what basis can we resist such violent contextual values? Who are ‘we’ here and what does ‘resist’ imply for theological method? Reviewing various concepts of person in Max Scheler, Korean neo-Confucian scholar Dasan Cheong Yak Yong (1762–1836), and Emmanuel Levinas, this article argues that person, not as a self-sufficient subjectivity but as one interacting with others and their contexts, must be included as one of the subjects that formulates theology, along with texts, traditions, and contexts, and that interactions among the four components are the actual forces for constructing theology.
A Case Study on the Impact of Ensemble Data Assimilation with GNSS-Zenith Total Delay and Radar Data on Heavy Rainfall Prediction
Authors: Yang Shu-Chih , Huang Zih-Mao , Huang Ching-Yuang , Tsai Chih-Chien , Yeh Ta-Kang 
Published: October 2019

Abstract
The performance of a numerical weather prediction model using convective-scale ensemble data assimilation with ground-based global navigation satellite systems-zenith total delay (ZTD) and radar data is investigated on a heavy rainfall event that occurred in Taiwan on 10 June 2012. The assimilation of ZTD and/or radar data is performed using the framework of the WRF local ensemble transform Kalman filter with a model grid spacing of 2 km. Assimilating radar data is beneficial for predicting the rainfall intensity of this local event but produces overprediction in southern Taiwan and underprediction in central Taiwan during the first 3 h. Both errors are largely overcome by assimilating ZTD data to improve mesoconvective-scale moisture analyses. Consequently, assimilating both the ZTD and radar data show advantages in terms of the location and intensity of the heavy rainfall. Sensitivity experiments involving this event indicate that the impact of ZTD data is improved by using a broader horizontal localization scale than the convective scale used for radar data assimilation. This optimization is necessary in order to consider more fully the network density of the ZTD observations and the horizontal scale of the moisture transport by the southwesterly flow in this case.
A surgical girdle postoperatively may prevent pain and tunnel infections of peritoneal dialysis patients
Authors: Nilsson Christina , Sperker Wolfgang , Schien Claudia , Isaksson Malin , Stegmayr Bernd G 
Published: October 2019

Aim: When performing acute onset dialysis after insertion of catheters for peritoneal dialysis, pain exists and tunnel infections may develop. This study investigated whether patients benefit from the use of a surgical girdle and specific dressing postoperatively to prevent pain and tunnel infections. Materials and Methods: In 85 consecutive patients, the development of tunnel infections was followed. The patients used a surgical girdle when they were in supine position from day 1 to day 3. The peritoneal dialysis catheter was fixed in a curvature avoiding stretch in the exit. A total of 53 patients participated in a retrospective questionnaire to evaluate abdominal pain within the first 3 days after surgery either with or without girdle. A visual analogue scale from 0 to 10 was used. Results: In 23 patients, data on pain both with and without the girdle could be recorded. Pain was relieved more when using the girdle versus no girdle (median day 1 3.0 vs 4.0, p < 0.001, n = 30, Wilcoxon paired). The development of tunnel infections during the latest 7-year period (exposure period 1487 months) showed a total of three episodes (one every 495 months) of which one caused a subsequent peritonitis, while the other two resolved after antibiotic therapy. Peritonitis episodes appeared at a mean of 37-month interval. Conclusion: The use a surgical girdle for 3 days postoperatively and a fixation of the peritoneal dialysis catheter in a curved loop relieves the pain and results in few tunnel infections and subsequent episodes of peritonitis.
Retropalatal Cross-Sectional Area Is Predictive of Obstructive Sleep Apnea in Patients With Syndromic Craniosynostosis
Authors: Resnick Cory M. , Middleton Jason K. , Calabrese Carly E. , Ganjawalla Karan , Padwa Bonnie L. 
Published: October 2019

Objective: There is a high rate of obstructive sleep apnea (OSA) in patients with syndromic craniosynostosis (SCS). Little is known about the airway anatomy in this population. The purpose of this study is to characterize the 3 dimensional (3D) upper airway in patients with SCS with and without OSA. Design: This is a retrospective study of patients with SCS treated at Boston Children’s Hospital from 2000 to 2015. Patients were divided into OSA and no-OSA groups based on polysomnography. Predictor variables included age, sex, body mass index (BMI), and 3D upper airway measurements. The primary outcome variable was the presence or absence of OSA. Secondary outcome variables were apnea–hypopnea index and oxygen saturation nadir. Descriptive and bivariate statistics were computed, and significance was set as P < .05. Results: There were 24 patients: 16 in the OSA group and 8 in the no-OSA group. The 2 groups did not differ significantly by age, BMI, or syndromic diagnosis. The presence of OSA was associated with a smaller minimum retropalatal cross-sectional area (minRPCSA; P < .001). In a logistic regression model controlling for age, sex, and upper airway length, minRPCSA was the primary predictor of OSA ( P ≤ .002). Receiver operating characteristic analysis determined minRPCSA = 55.3 mm2 to be the optimal diagnostic threshold for OSA, with sensitivity = 100% and specificity = 87.5% ( P < .001). Conclusion: A minRPCSA ≤55.3 mm2 is predictive of the presence of OSA in patients with SCS.
Avoiding Breach of Patient Confidentiality: Trial of a Smartphone Application That Enables Secure Clinical Photography and Communication
Authors: Dumestre Danielle O. , Fraulin Frankie 
Published: October 2019

Background: To evaluate a smartphone application for clinical photography that prioritizes and facilitates patient security. Methods: Ethics was obtained to trial the application Sharesmart. Calgary plastic surgeons/residents used the application for clinical photography and communication. Surveys gauging the application usability, incorporated consent process, and photograph storage/sharing were then sent to surgeons and patients. Results: Over a 1-year trial period, 16 Calgary plastic surgeons and 24 residents used the application to photograph 84 patients. Half (56%) of the patients completed the survey. The majority of patients found the applications consent process acceptable (89%) and felt their photograph was secure (89%). Half (51%) of the surgeons/residents completed the survey and would use the application as is (67%) or with modifications (33%). The consent process was felt to be superior (73%) or equivalent (23%) to participant’s prior methods and was felt to resolve issues present with current photography practices of secure transmission and storage of photographs by 100% and 95% of respondents, respectively. Perceived limitations of the application included difficulties in use with poor cellphone service or Internet, decreased speed compared to current practices, the lack of a desktop platform, video capability, and ability to transmit the photograph directly to the patient’s medical record. Conclusions: A smartphone clinical photography application addresses the risks of patient confidentiality breach present with current photography methods; broad implementation should be considered.
Comparative Cost-Effectiveness of Cranioplasty Implants
Authors: Binhammer Adam , Jakubowski Josie , Antonyshyn Oleh , Binhammer Paul 
Published: October 2019

Purpose: The aim of this study was to compare operative duration and total hospital costs incurred for patients undergoing elective cranioplasty with a variety of materials, including manually shaped autogenous bone graft and titanium mesh, custom patient-specific titanium mesh, polymethyl methacrylate (PMMA) acrylic, and polyetheretherketone (PEEK) implants. Methods: A single-centre retrospective chart review was used. Patient demographics, defect characteristics, total operative time, and length of hospital stay were obtained. Total costs were sourced from Sunnybrook and standardized to the 2014 to 2015 year. Bivariate and age-controlled multivariate analyses were performed with (n = 119) and without (n = 101) outliers. Results: When outliers were removed, an age-controlled analysis revealed that autogenous implants resulted in an operative time of 178 ± 37 minutes longer than manually shaped titanium implants ( P < .01). The average cost of cranioplasty was CAD$18 335 ± CAD$10 265 for manually shaped titanium implants, CAD$31 956 ± CAD$31 206 for custom patient-specific titanium implants, CAD$20 786 ± CAD$13 075 for PMMA, CAD$14 291 ± CAD$5562 for autogenous implants, and CAD$27 379 ± CAD$4945 for PEEK implants ( P = .013). When outliers were removed, cranioplasty with PMMA and PEEK incurred greater costs, CAD$4442 ± CAD$2100 and CAD$13 372 ± CAD$2728, respectively, more than manually shaped titanium implants ( P < .01). Conclusions: Manually shaped titanium mesh is the most cost-effective implant choice for small cranial defects. Large unknown defects and frontal paranasal sinus defects are most effectively treated with autogenous bone or titanium mesh. Despite prolonged operative duration and inpatient admission, total costs were not significantly increased. Both PMMA and PEEK implants were significantly more costly, which may be a result of higher complications necessitating reoperation.
Concordance for clonal hematopoiesis is limited in elderly twins
Authors: Fabre Margarete A. , McKerrell Thomas , Zwiebel Maximillian , Vijayabaskar M. S. , Park Naomi , Wells Philippa M. , Rad Roland , Deloukas Panagiotis , Small Kerrin , Steves Claire J. , Vassiliou George S. 
Published: October 2019

Abstract
Although acquisition of leukemia-associated somatic mutations by 1 or more hematopoietic stem cells is inevitable with advancing age, its consequences are highly variable, ranging from clinically silent clonal hematopoiesis (CH) to leukemic progression. To investigate the influence of heritable factors on CH, we performed deep targeted sequencing of blood DNA from 52 monozygotic (MZ) and 27 dizygotic (DZ) twin pairs (aged 70-99 years). Using this highly sensitive approach, we identified CH (variant allele frequency ≥0.5%) in 62% of individuals. We did not observe higher concordance for CH within MZ twin pairs as compared with that within DZ twin pairs, or to that expected by chance. However, we did identify 2 MZ pairs in which both twins harbored identical rare somatic mutations, suggesting a shared cell of origin. Finally, in 3 MZ twin pairs harboring mutations in the same driver genes, serial blood samples taken 4 to 5 years apart showed substantial twin-to-twin variability in clonal trajectories. Our findings propose that the inherited genome does not exert a dominant influence on the behavior of adult CH and provide evidence that CH mutations may be acquired in utero.