bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoembryonic antigen levels are increased with pulmonary output in pulmonary hypertension due to congenital heart disease
Authors: Zi-yang Yang , Kaixun Zhao , Dongling Luo , Zhou Yin , Chengbin Zhou , Jimei Chen , Caojin Zhang 
Published: November 2020

Objective Pulmonary artery hypertension (PAH) is a severe complication of congenital heart disease (CHD). Monitoring of pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) is essential during follow-up. This retrospective study aimed to examine carcinoembryonic antigen (CEA) as an additional marker for evaluation by investigating the correlation between CEA levels and hemodynamics in CHD-PAH. Methods Seventy-six patients with CHD-PAH (mean PAP [mPAP] >25 mmHg and PVR >3 Wood units, group A), 71 patients with CHD and pulmonary hypertension (CHD-PH, mPAP >25 mmHg and PVR ≤3 Wood units, group B), and 102 patients with CHD without PH (mPAP ≤25 mmHg, group C) were enrolled. Serum CEA levels and the relationships between CEA levels and hemodynamic data were assessed. Results Mean serum CEA levels were 1.99±1.61, 2.44±1.82, and 1.58±1.07 ng/mL, mPAP was 58.66±20.21, 30.2±4.83, and 17.31±4.51 mmHg, and PVR was 10.12±7.01, 2.19±0.56, and 2.2±1.1 Wood units in groups A, B, and C, respectively. Mean pulmonary output (PO) was 7.24±3.07, 15.79±5.49, 10.18±4.72 L/minute, respectively. CEA levels were positively correlated with PO and negatively correlated with PVR in all of the patients. Conclusion CEA levels are increased with PO and decreased with PVR in CHD-PH.
Body lateropulsion as the primary manifestation of medulla oblongata infarction: a case report
Authors: Li Hui , Wei Na , Zhang Lu , Liu Xiuli , Han Jingzhe 
Published: November 2020

Background Isolated body lateropulsion is a possible predominant manifestation of medulla oblongata infarction, and can occur without vestibular and cerebellar symptoms. However, it is relatively rare and challenging to diagnose. Case presentation A 67-year-old woman was admitted to the Harris International Peace Hospital complaining mainly of instability when standing and walking for the previous 8 hours. Based on the neural localization and multiple head magnetic resonance imaging (MRI) examinations, a diagnosis of cerebral infarction (vertebrobasilar system) was made. Consequently, the patient was managed using therapy aimed at preventing platelet aggregation, lowering plasma lipids, stabilizing plaques, protecting mitochondria, and improving circulation and brain function. The patient’s gait improved and she was discharged after 14 days because she was able to walk unaided. The patient was followed up for 6 months and had no noticeable undesirable side effects or signs of neurological deficits. Conclusion The possibility of lateral medulla oblongata infarction should be considered when patients present with isolated body lateropulsion, without other signs or symptoms of brainstem damage.
Comparative Evaluation of Biofilm Adhesion to Different Types of Archwire and Microbiological Colonization During Orthodontic Treatment
Authors: Polke Pritish , Jain Upendra , Marothiya Sunita , Agrawal Purva , Dixit Siddharth , Dubey Chandrika 
Published: November 2020

Objective: To evaluate the biofilm adhesion to 4 types of ‘as retrieved’ archwires during orthodontic treatment. To compare biofilm formation by viable cell counting (colony-forming units [CFU]) of microbes ( Staphylococcus aureus, Streptococcus mutans and Candida albicans). Methods: The study was conducted on 40 patients who were divided into 4 equal groups based on the type of archwire of same cross-section (0.019" × 0.025"): group 1—copper-nickel titanium (Cu-NiTi); group 2—titanium molybdenum alloy (TMA); group 3—stainless steel (SS); and group 4—aesthetic coated SS. After 1 month of fixed orthodontic therapy, the archwires were removed carefully from the oral cavity. Results: Biofilm absorbance and biofilm concentration were significant ( P ≤ .05) in all the 4 groups. Conclusion: The group 2 wire showed the maximum affinity for biofilm absorbance and biofilm concentration, whereas the group 4 wire showed the least affinity. The group 4 wire promoted less retention of oral bacteria compared with the wires of the other groups, whereas the group 1 wire showed maximum retention. In the present study, all types of wire showed maximum affinity for S mutans and the least affinity for C albicans, except for the group 1 wire, which showed maximum affinity for S aureus. Biofilm adhesion could be a significant determining factor in the selection of orthodontic archwire for patients primarily at risk of dental caries or periodontal diseases, or both.
Real-life treatment of cluster headache in a tertiary headache center – results from the Danish Cluster Headache Survey
Authors: Petersen Anja Sofie , Lund Nunu , Jensen Rigmor Højland , Barloese Mads 
Published: November 2020

Background Pharmacological treatment of cluster headache constitutes the core of clinical management, but evidence is sparse. We aimed to generate insight in the existing treatment and identify associations between clinical features and treatment response. Methods Patients aged 18–65 diagnosed with cluster headache according to the ICHD-2 completed a questionnaire followed by a structured interview. Multiple logistic regression was used to identify associations. Results The population consisted of 400 patients with an episodic: chronic ratio of 1.7:1. Episodic patients were more likely to respond to triptans (odds ratio = 1.77, confidence interval: 1.08–2.91, p = 0.023) and oxygen (odds ratio = 1.64, confidence interval: 1.05–2.57, p = 0.031) than chronic. Oxygen response was less likely if pain intensity was very severe (odds ratio = 0.53, confidence interval: 0.33–2.57, p = 0.006) and the risk of a poor response increased with disease duration (odds ratio = 0.79, confidence interval: 0.65–0.96, p = 0.016). Among current users of sumatriptan injection and oxygen, the proportion achieving 100% relief was higher with sumatriptan injection ( p > 0.001) than with oxygen. No associations were identified regarding verapamil. Only 57% of current users of preventive medication responded at a 50% level. Conclusion Episodic cluster headache is more responsive to acute therapy than chronic. Further, sumatriptan injection was more effective than oxygen and the responder-rate was limited with verapamil. More effective acute and preventive therapies are needed for cluster headache patients.
Responses of spinal trigeminal neurons to noxious stimulation of paranasal cavities – a rat model of rhinosinusitis headache
Authors: Koch Michael , Sertel-Nakajima Julika , Messlinger Karl 
Published: November 2020

Background The pathophysiology of headaches associated with rhinosinusitis is poorly known. Since the generation of headaches is thought to be linked to the activation of intracranial afferents, we used an animal model to characterise spinal trigeminal neurons with nociceptive input from the dura mater and paranasal sinuses. Methods In isoflurane anaesthetised rats, extracellular recordings were made from neurons in the spinal trigeminal nucleus with afferent input from the exposed frontal dura mater. Dural and facial receptive fields were mapped and the paranasal cavities below the thinned nasal bone were stimulated by sequential application of synthetic interstitial fluid, 40 mM potassium chloride, 100 µM bradykinin, 1% ethanol (vehicle) and 100 µm capsaicin. Results Twenty-five neurons with input from the frontal dura mater and responses to chemical stimulation of the paranasal cavities were identified. Some of these neurons had additional receptive fields in the parietal dura, most of them in the face. The administration of synthetic interstitial fluid, potassium chloride and ethanol was not followed by significant changes in activity, but bradykinin provoked a cluster of action potentials in 20 and capsaicin in 23 neurons. Conclusion Specific spinal trigeminal neurons with afferent input from the cranial dura mater respond to stimulation of paranasal cavities with noxious agents like bradykinin and capsaicin. This pattern of activation may be due to convergent input of trigeminal afferents that innervate dura mater and nasal cavities and project to spinal trigeminal neurons, which could explain the genesis of headaches due to disorders of paranasal sinuses.
Sex differences in prevalence of migraine trigger factors: A cross-sectional study
Authors: van Casteren Daphne S , Verhagen Iris E , Onderwater Gerrit LJ , MaassenVanDenBrink Antoinette , Terwindt Gisela M 
Published: November 2020

Aim To examine the effect of sex on migraine trigger factors. Methods Prevalence of 11 frequently reported trigger factors was determined in a cross-sectional study among migraine patients from a validated migraine database (n = 5725 females and n = 1061 males). Female-to-male odds ratios were calculated for each trigger, using a logistic regression model with attack frequency and migraine subtype (with or without aura) as covariates. Additionally, the effect of sex on total number of triggers per individual was determined. Results The top three most reported triggers in women were menstruation (78%), stress (77%), and bright light (69%). Men reported stress (69%), bright light (63%), and sleep deprivation (60%) most frequently as provoking factors. The following triggers were more often reported by women than men: Bright light (odds ratio 1.29 [95% CI 1.12–1.48]; p = 0.003), stress (1.47 [1.27–1.69]; p < 0.001), skipping a meal (1.24 [1.09–1.42]; p = 0.015), sleep deprivation (1.37 [1.20–1.57]; p < 0.001), high altitudes (1.70 [1.40–2.09]; p < 0.001), and weather changes (1.35 [1.18–1.55]; p < 0.001). Women reported more triggers than men, even when menstruation was disregarded (mean ± SD: 4.6 ± 2.3 and 4.3 ± 2.3; p < 0.001). Conclusion: Women report migraine trigger factors to be provocative of their attacks more frequently than men, which may be related to a lower migraine threshold due to sex hormonal changes.
Quality measures of a multicentre universal newborn hearing screening program in Malaysia
Authors: Wong Yun Ai , Mazlan Rafidah , Abdul Wahab Noor Alaudin , Ja’afar Roslan , Huda Bani Nurul , Abdullah Nurul Ain 
Published: November 2020

Objective To evaluate and discuss the outcomes of the universal newborn hearing screening program conducted at four public hospitals in Malaysia. Method A retrospective analysis of the universal newborn hearing screening database from each hospital was performed. The database consisted of 28,432 and 30,340 screening results of babies born in 2015 and 2016, respectively. Quality indicators (coverage rate, referral rate, return for follow-up rate, and ages at screening and diagnosis) were calculated. Results Overall coverage rate across the four hospitals was 75% in 2015 and 87.4% in 2016. Over the two years, the referral rates for the first screening ranged from 2.7% to 33.93% with only one hospital achieving the recommended benchmark of <4% in both years. The return for follow-up rates for each participating hospital was generally below the recommended benchmark of ≥95%. The mean age at screening was 3.9 ± 1.2 days and 3.3 ± 0.4 days, respectively. The mean age at diagnosis for 70 infants diagnosed with permanent hearing loss was 4.7 ± 0.7 months in 2015 and 3.6 ± 0.9 months in 2016. Conclusions Quality measures for the universal newborn hearing screening program in four public hospitals in Malaysia were lower than the required standards. Nevertheless, some quality indicators showed statistically significant improvements over the two years. Next steps involve identifying and implementing the best practice strategies to improve the outcome measures and thus the quality of the program.
Traditional Approach vs Posterior Approach for Ankle Fractures Involving the Posterior Malleolus
Authors: Pilskog Kristian , Gote Teresa Brnic , Odland Heid Elin Johannessen , Fjeldsgaard Knut Andreas , Dale Håvard , Inderhaug Eivind , Fevang Jonas Meling 
Published: November 2020

Background: In the past, posterior malleolus fragments (PMFs) commonly have been indirectly reduced and fixed when fragments involve 25% or more of the tibial articular surface, while smaller fragments were left unfixed. The posterior approach has become increasingly popular and allows fixation of even smaller fragments. This study compares clinical outcome for the 2 treatment strategies. Methods: Patients with ankle fractures involving a PMF treated from 2014 to 2016 were eligible for inclusion. Patients were allocated to group A (treated with a posterior approach) or group B (treated with the traditional approach) according to the treatment given. A one-to-one matching of patients from each group based on the size of the PMF was performed. Patient charts were reviewed, and outcome evaluation was performed clinically, radiographically, and by patient-reported outcome measures (PROMs; Self-Reported Foot and Ankle Score, RAND-36, visual analog scale [VAS] of pain, and VAS of satisfaction). Forty-three patients from each group were matched. Median follow-up was 26 (interquartile range [IQR], 19-35) months postoperatively. Results: The median PMF size was 17% (IQR, 12-24) in both groups, and they reported similar results in terms of PROMs. Fixation of the PMF was performed in 42 of 43 (98%) patients in group A and 7 of 43 (16%) patients in group B ( P < .001). The former group more frequently got temporary external fixation (56% vs 12%, P < .01) and less frequently had syndesmotic fixation (14% vs 49%, P < .01), and they had less mechanical irritation and hardware removal but more noninfectious skin problems (28% vs 5%, P < .01). Median time from injury to definitive surgery (8 vs 0 days, P < .001) and median length of stay (12 vs 3 days, P < .001) were longer in group A. Conclusion: Comparison of treatment strategies for ankle fractures involving the posterior malleolus showed similar results between patients treated with a traditional approach and a posterior approach. Level of Evidence: Level III, retrospective comparative study.
Risk Factors Associated With Foot and Ankle Insufficiency Fractures in Postmenopausal Sedentary Women
Authors: Pereira Filho Miguel Viana , Stéfani Kelly Cristina , Ferreira Gabriel Ferraz , Nogueira Monica Paschoal 
Published: November 2020

Background: Insufficiency fractures occur in bones with low elastic resistance. In contrast to stress fractures, which affect normal bones and have been extensively studied, insufficiency fractures of the foot and ankle have been the subject of little research. The objective of this study was to identify risk factors associated with the development of foot and ankle insufficiency fractures. Methods: The study included 55 postmenopausal sedentary women with foot and ankle insufficiency fractures and 51 women in the control group. The data collected were the fracture site, body mass index, use of corticosteroids, T scores of the femur and lumbar spine measured by bone densitometry, and serum 25-OH vitamin D level. The calcaneal pitch (CP), talar–first metatarsal, and metatarsus adductus (MA) angles were measured on radiographs. Results: In 49 patients (89%), fractures occurred in the metatarsals. All metatarsals were affected, and the most common fracture site was the base of the fifth metatarsal, with 21 cases (33%). Twenty patients (36%) in the study group reported chronic use of corticosteroids and had lower bone mineral density levels than controls ( P < .05). The factors associated with fracture development ( P < .05) were the CP and MA angles and low lumbar bone mineral density. Conclusion: Insufficiency fractures in this population were associated with low bone mineral density and unfavorable biomechanical characteristics such as pes cavus and metatarsus adductus. Level of Evidence: Level IIIB, case-control study.
Effect of Lateral Column Lengthening on Subtalar Motion in a Cadaveric Model
Authors: Harris Mitchell C. , Hedrick Brittany N. , Zide Jacob R. , Thomas Danielle M. , Shivers Claire , Siebert Matthew J. , Pierce William A. , Kanaan Yassine , Riccio Anthony I. 
Published: November 2020

Background: Although lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, concern exists as to the effect of this intra-articular osteotomy on subtalar motion. The purpose of this study was to quantify the alterations in subtalar motion following lateral column lengthening (LCL). Methods: The subtalar motion of 14 fresh-frozen cadaveric feet was assessed using a 3-dimensional motion capture system and materials testing system (MTS). Following potting of the tibia and calcaneus, optic markers were placed into the tibia, calcaneus, and talus. The MTS was used to apply a rotational force across the subtalar joint to a torque of 5 Nm. Abduction/adduction, supination/pronation, and plantarflexion/dorsiflexion about the talus were recorded. Specimens then underwent LCL via a calcaneal neck osteotomy, which was maintained with a 12-mm porous titanium wedge. Repeat subtalar motion analysis was performed and compared to pre-LCL motion using a paired t test. Results: No statistically significant differences in subtalar abduction/adduction (10.9 vs 11.8 degrees, P = .48), supination/pronation (3.5 vs 2.7 degrees, P = .31), or plantarflexion/dorsiflexion (1.6 vs 1.0 degrees, P = .10) were identified following LCL. Conclusion: No significant changes in subtalar motion were observed following lateral column lengthening in this biomechanical cadaveric study. Clinical Relevance: Although these findings do not obviate concerns of clinical subtalar stiffness following lateral column lengthening for planovalgus deformity correction, they suggest that diminished postoperative subtalar motion, when it occurs, may be due to soft tissue scarring rather than alterations of joint anatomy.
Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome
Authors: Rodriguez Natalia Andrea Reyes , Bailey Steven J , Langley-Hobbs Sorrel J 
Published: November 2020

Objectives The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information. Results Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures. Conclusions and relevance Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.
Educational attainment by children with parental alcohol problems in Denmark and Finland
Authors: Raitasalo Kirsimarja , Østergaard Jeanette , Andrade Stefan Bastholm 
Published: November 2020

Background: Adverse childhood experiences have negative outcomes for children, yet previous research suggests the independent effect of parental alcohol problems is inconsistent. Objectives: Our aim was (1) to compare educational attainment among Danish and Finnish youth with parental alcohol problems and (2) to study the associations between parental alcohol problems and children’s educational attainment in these two Nordic welfare states. Data and methods: Administrative longitudinal data on children born in 1991 in Finland ( n = 64,696) and Denmark ( n = 64,138) and their biological parents. The children were followed until their 21st birthdays. We applied a mediation analysis to investigate how the association between parental alcohol problems and children’s educational attainment is mediated by four indicators for poor socioeconomic family background (low parental education, long-term economic distress, psychiatric disorders, and living in a non-intact family). Results: At age 20 years, Finnish children were more likely to complete their education than their Danish peers. Young adults with parental alcohol problems faced early school leaving more frequently in both countries compared with their peers, but the relative risk was higher in Finland. In both countries, long-term economic distress mediated the highest proportion of the effect of alcohol problems (39% in Denmark and 34% in Finland). Low parental education and psychiatric disorders mediated part of the effect, but not to the same degree as economic distress. Conclusions: Ensuring education for children with parental alcohol problems is a key to improving their long-term outcomes in different life domains. Consequently, healthcare, social work and education sectors should prioritise advancing education among these children in order to prevent their exclusion from education and labour markets, and they should cooperate closely in doing so.
Effect of norepinephrine combined with sodium phosphocreatine on cardiac function and prognosis of patients with septic shock
Authors: Kang Dawei , Yu Jian , Xia Jiading , Li Xiuhua , Wang Huarong , Zhao Yanjun 
Published: November 2020

Septic shock (SS) leads to a high mortality rate for sepsis patients. Norepinephrine (NE) is a preferred vasoactive agent in SS treatment. This study aimed to assess the effects of NE at different administration time and NE combined with SP treatment on the cardiac function and prognosis of SS. SS patients received NE treatment at different administration time and NE combined with SP treatment were enrolled in this study. The serum levels of cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP), ejection fraction (EF), and pressure-adjusted heart rate (PAR) value were analyzed to evaluate cardiac function. The 28-day survival information was collected and assessed using the Kaplan-Meier method and log-rank test. The cardiac function of SS patients was improved significantly by NE treatment, especially in the patients received NE at 2 h after fluid infusion, which evidenced by the increased BNP and cTnI levels and EF% and the decreased RAP. In the NE-2 h group, SS patients had a better 28-day survival rate compared with those patients in NE-1 h and -3 h groups. Furthermore, the significantly improved cardiac function and survival outcomes were found in patients received NE combined SP treatment. Taken together, this study results show that NE administration at 2 h after fluid infusion may be the optimal time point for the treatment of SS and NE combined with SP treatment can improve early cardiac dysfunction and 28-day survival outcomes in patients with SS.