bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical value of diffusion-weighted MRI for differentiation between benign and malignant gallbladder disease: a systematic review and meta-analysis
Authors: Kuipers Hendrien , Hoogwater Frederik JH , Holtman Gea A , van der Hoorn Anouk , de Boer Marieke T , de Haas Robbert J 
Published: August 2020

Background Radiological differentiation between benign and malignant gallbladder disease is important but remains challenging. Furthermore, the clinical value of diffusion-weighted imaging (DWI) remains unclear. Purpose To determine the value of DWI in discriminating benign from malignant gallbladder disease by conducting a systematic review and meta-analysis. Material and Methods The literature was systematically searched. Studies analyzing diagnostic value of DWI in gallbladder disease with histopathology or follow-up as reference standard were included. Study selection and data extraction were done by two reviewers independently. Methodological quality was assessed using the QUADAS-2 tool. Sensitivity and specificity were calculated and displayed in a forest plot. A sensitivity analysis was performed in case of outliers. Pooled sensitivity and specificity of DWI were plotted on a hierarchical summary receiver operating characteristic curve. If available, the added value of DWI to conventional magnetic resonance imaging (MRI) sequences was analyzed. Results Out of 2456 articles, eight studies fulfilled the inclusion criteria; 592 patients with 221 malignant lesions were included. Pooled sensitivity and specificity rates were 0.87 and 0.84, respectively. In two studies, diagnostic accuracy rates improved after adding DWI to conventional MRI (64% and 75% for conventional MRI vs. 89% and 94% after combining conventional MRI with DWI). In another study, the area under the curve increased from 0.92 to 0.95. Conclusion DWI appears to be an accurate imaging technique in discriminating benign from malignant gallbladder disease. To achieve optimal patient care, it should be part of multiparametric MRI and should be combined with other imaging modalities.
The impact of the Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia training course in Ethiopia: A mixed methods longitudinal cohort study
Authors: Moore Jolene N , Morriss Wayne W , Asfaw Gebrehiwot , Tesfaye Gosa , Ahmed Aaliya R , Walker Isabeau A 
Published: August 2020

Summary Reducing maternal mortality remains a global priority, particularly in low- and middle-income countries (LMICs). The Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia (OB) course is a three-day refresher course for trained anaesthesia providers addressing common causes of maternal mortality in LMICs. This aim of this study was to investigate the impact of SAFE training for a cohort of anaesthesia providers in Ethiopia. We conducted a mixed methods longitudinal cohort study incorporating a behavioural questionnaire, multiple-choice questionnaires (MCQs), structured observational skills tests and structured interviews for anaesthesia providers who attended one of four SAFE-OB courses conducted in two regions of Ethiopia from October 2017 to May 2018. Some 149 participants from 60 facilities attended training. Behavioural questionnaires were completed at baseline ( n = 101, 69% response rate). Pre- and post-course MCQs ( n = 121, n = 123 respectively) and pre- and post-course skills tests ( n = 123, n = 105 respectively) were completed, with repeat MCQ and skills tests, and semi-structured interviews completed at follow-up ( n = 88, n = 76, n = 49 respectively). The mean MCQ scores for all participants improved from 80.3% prior to training to 85.4% following training ( P < 0.0001) and skills test scores improved from 56.5% to 83.2% ( P < 0.0001). Improvements in MCQs and skills were maintained at follow-up 3–11 months post-training compared to baseline ( P = 0.0006, < 0.0001 respectively). Participants reported improved confidence, teamwork and communication at follow-up. This study suggests that the SAFE-OB course can have a sustained impact on knowledge and skills and can improve the confidence of anaesthesia providers and communication within surgical teams.
The migraineur’s brain networks: Continuous resting state fMRI over 30 days
Authors: Schulte Laura H , Menz Mareike M , Haaker Jan , May Arne 
Published: August 2020

Objective The aim of the current study was to identify typical alterations in resting state connectivity within different stages of the migraine cycle and to thus explore task-free mechanisms of headache attack generation in migraineurs. Background Recent evidence in migraine pathophysiology suggests that hours and even days before headache certain changes in brain activity take place, ultimately leading to an attack. Here, we investigate changes before headache onset using resting state functional magnetic resonance imaging (fMRI). Methods Nine episodic migraineurs underwent daily resting state functional magnetic resonance imaging for a minimum period of 30 consecutive days, leading to a cumulative number of 282 total days scanned. Thus, data from 15 spontaneous headache attacks were acquired. This allows analysing not only the ictal and the interictal phase of migraine but also the preictal phase. ROI-to-ROI (region of interest) and ROI-to-voxel connectivity was calculated over the migraine cycle. Results Within the ROI-to-ROI analysis, the right nucleus accumbens showed enhanced functional connectivity to the left amygdala, hippocampus and gyrus parahippocampalis in the preictal phase compared to the interictal phase. ROI-to-voxel connectivity of the right accumbens with the dorsal rostral pons was enhanced during the preictal phase compared to interictally. Regarding custom defined ROIs, the dorsal pons was ictally functionally more strongly coupled to the hypothalamic area than interictally. Conclusions This unique data set suggests that particularly connectivity changes in dopaminergic centres and between the dorsal pons and the hypothalamus are important within migraine attack generation and sustainment.
Performance and Return to Sport After Excision of the Fractured Hook of the Hamate in Professional Baseball Players
Authors: Erickson Brandon J. , Mcelheny Kathryn , Chalmers Peter N. , Carr James B. , D’Angelo John , Rowe Dana , Poulis George , Lourie Gary M. , Carlson Michelle 
Published: August 2020

Background: A fracture of the hook of the hamate is a common injury affecting professional baseball players. The treatment for these fractures ranges from nonoperative immobilization to excision of the fragment. Purpose/Hypothesis: The purpose was to report the results of surgical treatment of hook of hamate fractures in professional baseball players and determine which factors are associated with return to sport (RTS) and time to RTS. The hypothesis was that there is a high rate of RTS in professional baseball players after surgical treatment of the hook of the hamate fracture with no significant decline in performance after RTS. Study Design: Descriptive epidemiology study. Methods: All professional baseball players who underwent excision of the hook of the hamate between 2010 and 2017 were included. Player characteristic and performance data (before and after surgery) were recorded. Performance metrics were then compared before and after surgery. Results: Overall, 261 players were included. Of total injuries, 96% were due to hitting, 86% occurred on the nondominant hitting side, and 89% were acute fractures (11% were nonunion cases). Most (95%) injuries occurred at the Minor League level and 96.2% of procedures were performed by hand fellowship–trained surgeons. Eight percent of players underwent concomitant procedures. The average tourniquet time was 31 ± 13 minutes. In total, 81% of players returned to sport at the same or higher level; 3% returned to sport at a lower level. The median time to RTS after surgery was 48 days (range, 16-246 days). The tourniquet time and number of days to RTS were significantly associated with one another ( P = .001; Spearman ρ = 0.290; N = 130). Player utilization significantly increased after surgery. While player efficiency, including batting average (BA), on-base percentage (OBP), and on-base plus slugging percentage (OPS), significantly decreased, these changes were numerically small (BA: 0.26 ± 0.04 preoperatively vs 0.25 ± 0.04 postoperatively; OBP: 0.34 ± 0.04 preoperatively vs 0.32 ± 0.04 postoperatively; OPS: 0.73 ± 0.12 preoperatively vs 0.70 ± 0.11 postoperatively) ( P < .001). There were no significant differences between rates of RTS to the same or higher level of play among acute fractures (81%) and nonunion cases (76%) ( P = .837). Conclusion: After surgical excision for hook of hamate fractures in professional baseball players, 84% were able to RTS, with 81% returning to the same or higher level. The median time for players to RTS after surgery was 48 days. Player usage increased after surgery, while hitting efficiency slightly declined.
Circular RNA has circ 0001591 promoted cell proliferation and metastasis of human melanoma via ROCK1/PI3K/AKT by targeting miR-431-5p
Authors: Yin Dong , Wei Guo , Yang Fan , Sun Xiaoyan 
Published: August 2020

Melanoma a common skin tumor induced by excessive hyperplasia of abnormal melanocyte. Circular RNAs (circRNAs) play critical roles in various diseases and presented as the prognostic markers of melanoma. The present study was designed to confirm the effect of circ 0001591 on human melanoma cell growth and to elucidate its mechanism. Patient with melanoma was obtained from Shaanxi Provincial People’s Hospital. Cell viability of A2058 cell was detected by MTT assay. The expression of circ 0001591 in serum of patients with melanoma was increased. Up-regulation of circ 0001591 promoted cell growth and cell invasion, and reduced apoptotic rate of melanoma. Down-regulation of circ 0001591 reduced cell growth and cell invasion, and promoted apoptotic rate of melanoma. Up-regulation of circ 0001591 induced PI3 K and p-Akt protein expressions in melanoma through induction of ROCK1 by suppression of miR-431-5p. Over-expression of circ 0001591 suppressed PI3 K and p-Akt protein expressions via suppression of ROCK1 in melanoma by induction of miR-431-5p. MiR-431-5p reduced the effects of circ 0001591 down-regulation on cell growth of melanoma through PI3K/AKT signal pathway. ROCK1 reduced the effects of circ 0001591 on cell growth of melanoma through PI3K/AKT signal pathway. Our findings demonstrated that circ 0001591 inhibits the progression of human melanoma through ROCK1/PI3K/AKT signal pathway by targeting ROCK1 by miR-431-5p.
Cross-Cultural Analysis of Gamer Identity: A Comparison of the United States and Poland
Authors: Ćwil Małgorzata , Howe William T. 
Published: August 2020

Who is a gamer? What kind of people are perceived to be gamers? And finally – who perceives themselves as a gamer? In this article the authors attempt to answer these three questions from a multinational perspective. Background. Games are nowadays one of the most frequently encountered forms of entertainment and constitute an ever-increasing part of many people’s day-to-day lives. With the rising popularity of video games, there is a need to conduct a research concerning gamer identity and to find out who perceives themselves as a gamer. The aim of this study is to compare the results of the survey conducted in two different countries to better understand the characteristics of players that self-identified as gamers. Methods. The quantitative study was conducted in two countries – Poland and the United States – in order to research gamer identity. The questionnaire consisted of questions about the self-identification as a gamer, time spent playing video games, types of games played, and the platforms used. It was conducted among 223 students who play video games. Results. The results show that there are both similarities and differences in the meaning of gamer identity between Poland and the United States. People who consider themselves gamers generally spend more time playing games than non-gamers regardless of the country. However, some differences can be spotted between Poland and the U.S. concerning among others types of games played, used platforms or different styles of playing video games. Limitations and further research. The main problem in the study was the limited age range in the sample. In the future it seems valuable to include people of different age groups to broaden the study of self-identified gamer identity.
Diagnosis and long-term monitoring of adenomas of the ciliary body epithelium by ultrasound biomicroscopy
Authors: Méndez-Martínez Silvia , Santiago Varela María , Blanco-Teijeiro María José , Piñeiro-Ces Antonio 
Published: August 2020

Introduction: The natural course of adenomas of the ciliary-body epithelium (ACE) is uncertain, due to their low incidence and their frequent initial surgical management. Their differential diagnosis with amelanotic melanoma or metastasis is challenging and diagnostic biopsies require sufficient tissue and highly specialized pathologists. Ultrasound biomicroscopy offers high resolution images and clear sonographic signs suggestive of ACE allowing a more precise differential diagnosis and therefore, a more conservative initial attitude. Methods: Descriptive, retrospective, non-comparative study of consecutive cases of ACE observed between October 2003 and December 2019 in a reference unit in ocular oncology of a tertiary hospital. Patients were studied on a quarterly basis the first year and, subsequently, every 6 months with a complete ophthalmological exam and ultrasound biomicroscopy with the platform Aviso linear scanning 50 MHz probe (Quantel Medical, Clermont-Ferrand, France). Results: Three ACE were analysed for a median of 3 years (interquartile range: 2.5–5.5 years). Clinical features include a whitish-to-brown spherical mass, with engorged superficial vessels. Ultrasound biomicroscopy shows an oval-spherical shape, medium-to-high echogenicity, low acoustic attenuation, regular internal structure, and respect for the neighboring structures. By their clinical-ultrasonographic characteristics, one was considered an adenoma of the pigmented ciliary-body epithelium (browner and hyperechogenic) and two were classified as adenomas of the non-pigmented ciliary epithelium (whitish appearance and medium-echogenicity). Conclusion: Ultrasound biomicroscopy allows a reasonable clinicalsonographic suspicion of ACE. An initial conservative management is proposed as a safer option for stable, mildly symptomatic patients, avoiding aggressive sight threatening treatments.
Mortality in 787,666 school pupils with and without autism: A cohort study
Authors: Smith Gillian S , Fleming Michael , Kinnear Deborah , Henderson Angela , Pell Jill P , Melville Craig , Cooper Sally-Ann 
Published: August 2020

Studies on children and adults combined suggest higher mortality rates for autistic than other people, but few report mortality rates for autistic children. In addition, past studies may not be representative of the current generation of children diagnosed with autism. We examined mortality in children using data from Scotland’s annual pupil census, linked to National Records of Scotland deaths register, between 2008 and 2015. In total, 9754 (1.2%) of 787,666 pupils had autism. They were more likely to live in neighbourhoods of greater deprivation and receive free school meals. Six autistic pupils died; crude mortality rate 15.8/100,000 person-years (95% CI = 7.1–35.1), compared with 458 other pupils; crude mortality rate 12.5/100,000 person-years (95% CI = 11.4–13.7). The indirectly standardised mortality ratio was 1.1 (95% CI = 0.5–2.5). In the autistic pupils, the most common causes of death were nervous system diseases, for example, epilepsy. Avoidable causes were common. In the comparison group, external causes and cancers were the most common causes of death. We cautiously conclude that mortality in the current generation of autistic children is no higher than for other children, perhaps due to recent widening of criteria for autism spectrum diagnosis, but some deaths could have been avoided by better care. Lay abstract There are few studies on the deaths of children and young people with autism; some studies on children and adults combined suggest that those with autism may have higher death rates than other people. More children are diagnosed with autism than in the past, suggesting that there are now more children with milder autism who have the diagnosis than in the past, so studies in the past might not apply to the current generation of children and young people diagnosed with autism. We examined the rates of death in children and young people in Scotland using recorded information in Scotland’s annual pupil census, linked to the National Records of Scotland deaths register, between 2008 and 2015. In total, 9754 (1.2%) out of 787,666 pupils had autism. Six pupils with autism died in the study period, compared with 458 other pupils. This was equivalent to 16 per 100,000 for pupils with autism and 13 per 100,000 pupils without autism; hence, the rate of death was very similar. In the pupils with autism, the most common causes of death were diseases of the nervous system, whereas they were from external causes in the comparison pupils. The autism group had some deaths due to epilepsy which might have been prevented by good quality care. We cautiously conclude that the death rate in the current generation of children and young adults with autism is no higher than for other children, but that even in this high-income country, some deaths could be prevented by high quality care.
A Novel Quantitative Ex Vivo Model of Functional Mitral Regurgitation
Authors: Pasrija Chetan , Quinn Rachael , Ghoreishi Mehrdad , Eperjesi Thomas , Lai Eric , Gorman Robert C. , Gorman Joseph H. , Gorman Robert C. , Pouch Alison , Cortez Felino V. , D'Ambra Michael N , Gammie James S. 
Published: August 2020

Objective Durability of mitral valve (MV) repair for functional mitral regurgitation (FMR) remains suboptimal. We sought to create a highly reproducible, quantitative ex vivo model of FMR that functions as a platform to test novel repair techniques. Methods Fresh swine hearts ( n = 10) were pressurized with air to a left ventricular pressure of 120 mmHg. The left atrium was excised and the altered geometry of FMR was created by radially dilating the annulus and displacing the papillary muscle tips apically and radially in a calibrated fashion. This was continued in a graduated fashion until coaptation was exhausted. Imaging of the MV was performed with a 3-dimensional (3D) structured-light scanner, which records 3D structure, texture, and color. The model was validated using transesophageal echocardiography in patients with normal MVs and severe FMR. Results Compared to controls, the anteroposterior diameter in the FMR state increased 32% and the annular area increased 35% ( P < 0.001). While the anterior annular circumference remained fixed, the posterior circumference increased by 20% ( P = 0.026). The annulus became more planar and the tenting height increased 56% (9 to 14 mm, P < 0.001). The median coaptation depth significantly decreased (anterior leaflet: 5 vs 2 mm; posterior leaflet: 7 vs 3 mm, P < 0.001). The ex vivo normal and FMR models had similar characteristics as clinical controls and patients with severe FMR. Conclusions This novel quantitative ex vivo model provides a simple, reproducible, and inexpensive benchtop representation of FMR that mimics the systolic valvular changes of patients with FMR.
Oleuropein Improved Post Cerebral Stroke Cognitive Function by Promoting Histone Acetylation and Phosphorylation of cAMP Response Element-Binding Protein in MCAO Rats
Authors: Gao Yang , Li Xiaojin , Xu Rongjian , Guo Yan , Yin Haiyan , Tan Ruifeng , Qi Ze , Liu Guangzhe , Liang Jiahui , Ya Bailiu 
Published: August 2020

Background: Post-stroke cognitive impairment (PSCI) is commonest clinical disorder in which peripheral cholinergic activity is important. Oleuropein (OLP) is polyphenol is present in olive oil. Here we evaluated the effect of OLP in cognitive dysfunction rats in post cerebral stroke model. Methods: The post cerebral stroke cognitive dysfunction PSD rat model was created by occlusion of transient middle cerebral artery. The rats were divided into 6 groups named, Sham + Vehicle, Sham + OLP (50 mg/kg), PSD rats + Vehicle, PSD rats + OLP (20, 50 or 100 mg/kg). The spatial learning was assessed by Morris water maze (MWM). The expression of choline acetyltransferase (ChAT), acetylcholine (ACH), extent of histone acetylation and phosphorylation of cAMP response element-binding protein (CREB) were evaluated by Western blot assay and immunofluorescence staining. Results: Treatment of OLP at various doses showed higher number of spontaneous and rewarded alterations and lesser percentage bias compared to vehicle treated PSD rats. OLP resulted in decreased levels of ChAT and ACH, whereas the degree of histone acetylation and phosphorylation of CREB improved in dose dependent pattern. Conclusion: treatment of OLP improved PSCI via increasing the phosphorylation of CREB and histone acetylation, thus attenuating cholinergic activity.
Radial artery neuro guide catheter entrapment during mechanical thrombectomy for acute ischemic stroke: Rescue brachial plexus block
Authors: Satti Sudhakar R , Sivapatham Thinesh , Eden Tim 
Published: August 2020

To our knowledge, radial artery catheter entrapment during mechanical thrombectomy for acute ischemic stroke using an 8 F neuro guiding catheter (.088 in ID) and successful use of a brachial plexus block has not been described in the literature. In this technical note, we describe a patient that underwent rapid and successful radial access mechanical thrombectomy for an acute right middle cerebral artery occlusion, however, during withdrawal of the Balt Ballast 0.088 inch long sheath (Balt USA, Irvine, CA, USA), radial/brachial artery entrapment was encountered. We describe a modified step-wise approach to previously published online article by Pitta et al. from 2017 SCAI communication in the management of catheter entrapment and describe the technique for ultrasound guided brachial plexus block, which helped avoid need for surgical removal.
Successful surgical management of a ruptured popliteal artery aneurysm with acute common peroneal nerve neuropathy: A rare case
Authors: Wang Tiehao , Zhao Jichun , Yuan Ding 
Published: August 2020

Objectives Ruptured popliteal artery aneurysm is a rare entity, which can cause severe nerve neuropathy. Open surgical repair is the preferred treatment for ruptured popliteal artery aneurysm but may aggravate nerve injuries or lead to postoperative aneurysm enlargement. The current surgical techniques for ruptured popliteal artery aneurysm have some deficiencies. Methods We present the case of a 78-year-old woman with sudden swelling of left knee joint and left foot drop, which was caused by the ruptured popliteal artery aneurysm and its compression. A modified open surgical repair was applied in our case, and glucocorticoid therapy was given perioperatively. Results The motor function of left lower limb had rapidly recovered after operation, and six-month follow-up showed patency of prosthetic vessel and significant shrinkage of aneurysm sac. Conclusions Our modified open surgical repair can relieve the compression and prevent possible “type II endoleak” without dissecting in popliteal fossa. Acute common peroneal nerve neuropathy and foot drop are reversible with immediate removal of compression and glucocorticoid therapy for patients with ruptured popliteal artery aneurysm.