bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of interhospital transfer on patients undergoing endovascular thrombectomy for acute ischaemic stroke in an Australian setting
Authors: Edwards Leon Stephen , Blair Christopher , Cordato Dennis , McDougall Alan , Manning Nathan , Cheung Andrew , Wenderoth Jason , Cappelen-Smith Cecilia 
Published: June 2020

ObjectiveTo assess the impact of interhospital transfer on the interplay between functional outcome, mortality, reperfusion rates and workflow time metrics in patients undergoing endovascular thrombectomy (EVT) for acute ischaemic stroke due to large vessel occlusion (LVO) in the anterior cerebral circulation.Design, setting and participantsThis is an analysis of a prospective database of consecutive patients undergoing EVT for LVO presenting between January 2017 and December 2018 at a single Australian comprehensive stroke centre (CSC). Patients presented directly or were transferred to the CSC from 21 sites across New South Wales and the Australian Capital Territory.Main outcome measuresThe main outcome measures were rate of good 90-day functional outcome (modified Rankin Scale 0–2), successful reperfusion (Thrombolysis in Cerebral Infarction scale grade 2b or 3), symptomatic intracerebral haemorrhage (sICH) and 90-day mortality. Key workflow time metric milestones were examined.Results154 of 213 (72%) patients were interhospital transfers. There was no significant difference in baseline characteristics including age, National Institutes of Health Stroke Scale score, intravenous thrombolysis administration or procedure time between transferred and direct presenters (all p>0.05). Transferred patients had worse 90-day functional outcome (39.6% vs 61.0%, OR 0.42, 95% CI 0.23 to 0.78), higher mortality (25.3% vs 6.8%, OR 4.66, CI 1.59 to 13.70) and longer stroke onset to treatment (groin puncture) time (298 min vs 205 min, p<0.01). Successful reperfusion rates and sICH were similar between the cohorts (96.8% vs 98.3%, and 7.8% vs 3.4%).ConclusionInterhospital transfer is associated with longer stroke onset to treatment, worse 90-day functional outcome and higher mortality compared with patients presenting directly to the CSC.
HaNDL with bilateral central venous occlusions
Authors: Wang Wendy , Mack Heather G , Stawell Richard , White Owen , Waterston John 
Published: June 2020

BackgroundThe syndrome of Headache and focal Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) is considered a rare, idiopathic and self-limited condition.MethodsWe present a patient with HaNDL who had unique findings of florid optic disc haemorrhages from bilateral central retinal vein occlusions.ResultsOur patient made a full recovery with conservative management.ConclusionIt is important for medical attendants to recognise that HaNDL syndrome can be associated with neuro-ophthalmic complications.
Chronic inflammatory demyelinating polyradiculoneuropathy presenting as predominantly sciatic monomelic neuropathy
Authors: El-Wahsh Shadi , Cappelen-Smith Cecilia , Spies Judith 
Published: June 2020

BackgroundChronic inflammatory demyelinating polyneuropathy (CIDP) is a common yet underdiagnosed cause of potentially treatable chronic sensorimotor neuropathy. The classical form of the disease is characterised by symmetrical weakness in both distal and proximal muscle groups accompanied by sensory dysfunction and diminished tendon reflexes lasting more than 2 months.MethodThe diagnosis of CIDP is supplemented by electrodiagnostic studies and biopsy findings confirming demyelination, in accordance with well-established diagnostic criteria. Atypical presentations of CIDP often pose a diagnostic challenge.ResultsIn this paper, we present a case of isolated lower limb involvement due to CIDP to raise awareness of this focal lower limb variant. Of particular, significance is the use of lumbosacral plexus MRI to assist in the diagnosis.ConclusionFocal CIDP is an atypical presentation that should be considered in patients presenting with chronic monomelic neuropathy and should be investigated with electrodiagnostic studies, lumbar puncture, nerve biopsy and MRI of the nerve roots and plexuses.
Moyamoya vasculopathy in a young Caucasian woman with significant methamphetamine use
Authors: Lin Tiffany , Yam Charmaine , Lai Su-Ling , Cloud Geoffrey 
Published: June 2020

BackgroundMoyamoya is a rare cerebrovascular disorder seen predominantly in Asian populations. Methamphetamine use is a recognised cause of stroke in young people, but its pathophysiology is not fully understood. The incidence of moyamoya vasculopathy in methamphetamine-associated stroke is unknown due to a lack of sufficient data. We present a rare case of moyamoya syndrome in a young Caucasian woman with methamphetamine-associated stroke.CaseA 31-year-old Caucasian woman presented with progressive right arm weakness, speech disturbance and seizures on a background of escalating methamphetamine use in the 9 months prior to admission. She did not have a personal or family history of stroke. MRI revealed both embolic and watershed infarcts in bilateral frontal regions and CT angiography showed development of new lenticulostriate collateral vessels. Digital subtraction angiography confirmed steno-occlusive disease of the bilateral anterior circulations and a ‘puff of smoke’ appearance.ConclusionIn young patients who present with stroke with unclear aetiology, it is important to obtain a thorough substance use history. Moyamoya vasculopathy should be considered when evaluating the pathophysiology of stroke in young people.
Ranking microbiome variance in inflammatory bowel disease: a large longitudinal
intercontinental study
Authors: Clooney Adam G , Eckenberger Julia , Laserna-Mendieta Emilio , Sexton Kathryn A , Bernstein Matthew T , Vagianos Kathy , Sargent Michael , Ryan Feargal J , Moran Carthage , Sheehan Donal , Sleator Roy D , Targownik Laura E , Bernstein Charles N , Shanahan Fergus , Claesson Marcus J 
Published: June 2020

Objective
The microbiome contributes to the pathogenesis of inflammatory bowel disease
(IBD) but the relative contribution of different lifestyle and environmental factors
to the compositional variability of the gut microbiota is unclear.

Design
Here, we rank the size effect of disease activity, medications, diet and
geographic location of the faecal microbiota composition (16S rRNA gene sequencing) in
patients with Crohn’s disease (CD; n=303), ulcerative colitis (UC; n = 228) and
controls (n=161), followed longitudinally (at three time points with 16 weeks
intervals).

Results
Reduced microbiota diversity but increased variability was confirmed in CD and
UC compared with controls. Significant compositional differences between diseases,
particularly CD, and controls were evident. Longitudinal analyses revealed reduced
temporal microbiota stability in IBD, particularly in patients with changes in disease
activity. Machine learning separated disease from controls, and active from inactive
disease, when consecutive time points were modelled. Geographic location accounted for
most of the microbiota variance, second to the presence or absence of CD, followed by
history of surgical resection, alcohol consumption and UC diagnosis, medications and
diet with most (90.3%) of the compositional variance stochastic or
unexplained.

Conclusion
The popular concept of precision medicine and rational design of any therapeutic
manipulation of the microbiota will have to contend not only with the heterogeneity of
the host response, but also with widely differing lifestyles and with much variance
still unaccounted for.
Stromal LAG-3+cells infiltration defines poor prognosis subtype muscle-invasive bladder cancer with immunoevasive contexture
Authors: Zeng Han , Zhou Quan , Wang Zewei , Zhang Hongyu , Liu Zhaopei , Huang Qiuren , Wang Jiajun , Chang Yuan , Bai Qi , Xia Yu , Wang Yiwei , Xu Le , Dai Bo , Guo Jianming , Liu Li , Zhu Yu , Xu Jiejie 
Published: June 2020

BackgroundLymphocyte activation gene 3 (LAG-3) is a promising immune checkpoint therapeutic target being evaluated in clinical trials. We assessed the LAG-3+cells distribution, its association with clinical outcomes and immune contexture and its role in the landscape of muscle-invasive bladder cancer (MIBC) treatment.Methods141 patients with MIBC from Zhongshan Hospital were included for survival and adjuvant chemotherapy (ACT) benefit analyses. 32 fresh resected samples of MIBC were collected to detect CD8+T cells functional state. The molecular classification analyses were based on 391 patients with MIBC from The Cancer Genome Atlas. Immunohistochemistry and flow cytometry were performed to characterize various immune cells infiltration.ResultsIn Kaplan-Meier analyses and Cox regression models, stromal LAG-3+cells enrichment was consistently associated with inferior overall survival and disease-free survival, and indicated suboptimal responsiveness to ACT. Patents with high stromal LAG-3+cells possessed increased protumor cells, immunosuppressive cytokines and immune checkpoint expression. The phenotypic analyses of CD8+T cells correlated its dysfunctional state with LAG-3+cells. Besides, LAG-3 mRNA level was linked to luminal and basal subtypes of MIBC. LAG-3-high tumors exhibited limited FGFR3 mutation and signaling signature, and displayed activated immunotherapeutic and EGFR-associated pathway.ConclusionsStromal LAG-3+cells abundance indicated an immunoevasive contexture with dysfunctional CD8+T cells, and represented an independent predictor for adverse survival outcome and ACT resistance in MIBC. LAG-3 expression could potentially be a novel biomarker for FGFR3-targeted and EGFR-targeted therapies and immunotherapy. The crucial role of LAG-3+cells in the therapeutic landscape of MIBC needs further validation retrospectively and prospectively.
Ultrasonographic needle tip tracking for in-plane infraclavicular brachialis plexus blocks: a randomized controlled volunteer study
Authors: Kåsine Trine , Romundstad Luis , Rosseland L A , Fagerland Morten Wang , Kessler Paul , Omenås Ivar Nagelgaard , Holmberg Anne , Sauter Axel R 
Published: June 2020

BackgroundOnvision is a new technology for needle tip detection and tracking in ultrasound-guided regional anesthesia. The system consists of a piezoelectric sensor close to the needle tip and an electronic console integrated in the ultrasound system. The needle tip is visualized by a green circle on the ultrasound screen. The aim of the study was to investigate the effect of the new needle tip tracking technology on in-plane infraclavicular plexus blocks.MethodsThe study was a randomized, controlled, observer blinded cross-over trial in 26 healthy volunteers. Two specialists in anesthesiology performed an ultrasound-guided infraclavicular lateral sagittal brachial plexus block with and without needle tip tracking. Primary outcome was procedure time, measured from insertion of the needle until local anesthesia injection was completed. Secondary outcome measures included the number of hand movements and path lengths (assessed by hand motion analysis), block success rate, onset time and duration, discomfort experienced by the volunteers, and the anesthesiologists’ confidence as to whether their block would be successful or not.ResultsMean (SD) procedure time was 183.0 (56.1) s with and 206.8 (56.2) s without needle tip tracking (p=0.16). There were no significant differences in any of the secondary outcomes. Two volunteers’ experienced Horner syndrome after blocks without needle tip tracking. No other adverse events occurred during the study.ConclusionOur study on needle tip tracking for infraclavicular blocks did not reveal any significant differences between active needle tip tracking and the control procedures, neither for primary outcome nor secondary outcome measurements.Trial registration numberNCT03631914
Species-specific responses to targeted fertilizer application on reconstructed soils in a reclaimed upland area
Authors: Stack Shauna , Yarmuch Marty , Landhäusser Simon M. 
Published: June 2020

Forested reclamation of oil sand mines in northern Alberta often use peat salvaged from lowland organic soils as a coversoil during soil reconstruction of man-made landforms. Previous studies suggest that planted tree seedlings may be limited in part by low phosphorus (P) and potassium (K) availability in peat. Fertilization is commonly used to treat nutrient limitations on reclamation sites; however, broad spectrum applications can induce strong competition from colonizing vegetation. This study explores the ability of a targeted application of individual macronutrients to (1) reduce nutrient deficiencies in peat coversoils and improve tree growth, while (2) minimizing the colonizing competition. Liquid fertilizer was applied to 6-yr-old aspen, pine, and spruce trees in the field using five nutrient combinations: control (no fertilizer), NPK, PK, P, and K. Tree growth, foliar nutrient concentrations, vegetation cover, and environmental parameters were monitored over two growing seasons. Aspen responded the strongest to fertilization, particularly in the P treatment, whereas pine and spruce marginally responded to NPK. Competing vegetation increased in the NPK but did not respond to the P and K treatments, indicating targeted fertilization can reduce colonizing competition. Additional analyses of the soil conditions of the site suggest that other factors were potentially more limiting to the trees during the study. Targeted fertilization of forest reclamation sites at a later stand age can be an option to improve efficacy and cost savings; however, response will also depend on other site (e.g., soil pH, precipitation, and soil water content) and management (e.g., fertilizer application rate) factors.
Geodesic motion around a supersymmetric $$\hbox {AdS}_5$$ black hole
Authors: Drawer Jens-Christian , Grunau Saskia 
Published: June 2020

AbstractIn this article the geodesic motion of test particles in the spacetime of a supersymmetric $$\hbox {AdS}_5$$AdS5 black hole is studied. The equations of motion are derived and solved in terms of the Weierstrass $$\wp $$℘, $$\sigma $$σ, and $$\zeta $$ζ functions. Effective potentials and parametric diagrams are used to analyze and characterize timelike, lightlike, and spacelike particle motion and a list of possible orbit types is given. Furthermore, various plots of orbits are presented.
An improved mathematical prediction of the time evolution of the Covid-19 pandemic in Italy, with a Monte Carlo simulation and error analyses
Authors: Ciufolini Ignazio , Paolozzi Antonio 
Published: June 2020

AbstractWe present an improved mathematical analysis of the time evolution of the Covid-19 pandemic in Italy and a statistical error analyses of its evolution, including a Monte Carlo simulation with a very large number of runs to evaluate the uncertainties in its evolution. A previous analysis was based on the assumption that the number of nasopharyngeal swabs would be constant. However, the number of daily swabs is now more than five times what it was when we did our previous analysis. Therefore, here we consider the time evolution of the ratio of the new daily cases to number of swabs, which is more representative of the evolution of the pandemic when the number of swabs is increasing or changing in time. We consider a number of possible distributions representing the evolution of the pandemic in Italy, and we test their prediction capability over a period of up to 6 weeks. The results show that a distribution of the type of Planck black body radiation law provides very good forecasting. The use of different distributions provides an independent possible estimate of the uncertainty. We then consider five possible trajectories for the number of daily swabs and we estimate the potential dates of a substantial reduction in the number of new daily cases. We then estimate the spread in a substantial reduction, below a certain threshold, of the daily cases per swab among the Italian regions. We finally perform a Monte Carlo simulation with 25,000 runs to evaluate a random uncertainty in the prediction of the date of a substantial reduction in the number of diagnosed daily cases per swab.
A Taxonomic Revision of Nearctic Conostigmus (Hymenoptera: Ceraphronoidea: Megaspilidae)
Authors: TRIETSCH CAROLYN , MIKÓ ISTVÁN , EZRAY BRIANA , DEANS ANDREW R. 
Published: June 2020

We revise the species of Conostigmus Dahlbom, 1858 (Hymenoptera: Ceraphronoidea: Megaspilidae) found in North America, north of Mexico. We describe the following 12 new species: Conostigmus dessarti Trietsch & Mikó sp. nov.; C. duncani Trietsch sp. nov.; C. franzinii Trietsch & Mikó sp. nov.; C. johnsoni Trietsch & Mikó sp. nov.; C. lepus Trietsch sp. nov.; C. longiharpes Trietsch sp. nov.; C. michaeli Trietsch sp. nov.; C. minimus Trietsch & Mikó sp. nov.; C. muratorei Trietsch sp. nov.; C. musettiae Trietsch & Mikó sp. nov.; C. rosemaryae Trietsch sp. nov.; and C. washburni Trietsch sp. nov. We also redescribe the following 12 species: Conostigmus abdominalis (Boheman, 1832); C. bipunctatus Kieffer, 1907; C. dimidiatus (Thomson, 1858); C. erythrothorax (Ashmead, 1893); C. laeviceps (Ashmead, 1893); C. muesebecki Dessart & Masner, 1965; C. nigrorufus Dessart, 1997; C. obscurus (Thomson, 1858); C. orcasensis (Brues, 1909); C. pulchellus Whittaker, 1930; C. quadratogenalis Dessart & Cooper, 1975; and C. triangularis (Thomson, 1858). We report specimens of C. abdominalis (Boheman, 1832) and C. bipunctatus Kieffer, 1907 from the Nearctic for the first time, expanding the range from Palearctic to Holarctic for both species. We regard the following 19 species as having uncertain status due to reasons such as missing type specimens: Conostigmus ambiguus (Ashmead, 1893); C. bacilliger (Kieffer, 1906); C. bakeri Kieffer, 1908; C. californicus (Ashmead, 1893); C. canadensis (Ashmead,1888); C. crawfordi (Mann, 1920); C. harringtoni (Ashmead, 1888); C. hyalinipennis (Ashmead, 1887); C. inermis (Kieffer, 1906); C. integriceps (Kieffer, 1906); C. marylandicus (Ashmead, 1893); C. nevadensis (Kieffer, 1906); C. nigripes (Kieffer, 1906); C. ottawensis (Ashmead, 1888); C. pergandei (Ashmead, 1893); C. popenoei (Ashmead, 1893); C. rufoniger (Provancher, 1888); C. schwarzi (Ashmead, 1893); and C. trapezoidus Kieffer, 1908. We transfer Conostigmus arietinus (Provancher, 1887) to Dendrocerus Ratzeburg, 1852, and consider Conostigmus subinermis (Kieffer, 1907) to be absent from the Nearctic and limited to the Palearctic. The Nearctic species C. timberlakei Kamal, 1926 remains incertae sedis. We provide the name Conostigmus fulgidus Mikό and Trietsch to replace the junior homonym Conostigmus lucidus Mikό and Trietsch 2016. We provide a key for the identification of Nearctic Conostigmus species, and provide comments on their natural history. Finally, we infer evolutionary relationships within Megaspilinae using male genitalia and other morphological characters. This work represents the first in-depth study and revision of Conostigmus in North America, and contributes the first annotated identification key to Nearctic Conostigmus species.
Estimating monthly latent cooling demands
Authors: Hitchin Roger 
Published: June 2020

Methods of estimating monthly cooling loads in buildings are usually confined to sensible demands only, with latent loads either ignored or added as an arbitrary proportion of sensible cooling demands. This note describes an extension of an existing monthly method for estimating sensible cooling demands that takes account of latent cooling. It reflects the effects of climate, ventilation rate and indoor moisture gains and also of some less widely appreciated impacts of system design. These are illustrated by an example typifying UK office conditions. In order to be workable, the methodology contains a number of simplifications, where precise estimates are needed, and more sophisticated methods should be used. Practical application: Estimates of annual cooling energy demand made with existing monthly procedures do not account for the size of latent cooling loads or the ways these vary between different forms of air conditioning systems. This note shows how this can be done though, where this is a critical design parameter more complex methods are recommended.
Current Treatment Options for Patulous Eustachian Tube: A Review of the Literature
Authors: Koltsidopoulos Petros , Skoulakis Charalampos 
Published: June 2020

Objective:Patulous Eustachian tube (PET) is a clinical condition that is associated with troublesome aural symptoms and is difficult to be treated successfully. The purpose of this review is to examine the published literature regarding the therapeutic value of the current treatment options for PET.Methods:We searched Web of Science, PubMed and Medline from 1999 to 2019. The search focused on papers concerning the clinical evaluation of treatment methods in PET patients. Statistical techniques were not used.Results:Prospective and retrospective case series were the types of trials available for review. We included 28 articles that evaluated the efficacy of various conservative and surgical therapeutic options. The recovery rates ranged from 50% to 100%. In most studies the assessment of efficacy was based on the subjective improvement of patient symptoms as there is no validated outcome tool available. No severe adverse events were observed in any study.Conclusion:On the basis of the available literature, it seems that conservative treatments can be considered as a primary therapeutic option for PET. Concerning the surgical interventions they seem to be a safe and valuable solution in patients with refractory disease. Finally, given the low level of evidence, prospective case–control studies with long follow-up and robust setting looking into the therapeutic approach of PET are required. The need for establishment of standard criteria of PET recovery should be underlined.
Evaluation of adenomyosis after gonadotrophin-releasing hormone agonist therapy using ultrasound post-processing imaging: a pilot study
Authors: Chou Szu-Yuan , Chan Cindy , Lee Yu-Chieh , Yu Tzu-Ning , Tzeng Chii-Ruey , Chen Chi-Huang 
Published: June 2020

Objective We explored a method for the quantitative sonographic analysis of myometrial texture using computer-aided image analysis software to assess outcomes following treatment with gonadotrophin-releasing hormone (GnRH) agonist for adenomyosis in women with infertility. Method Data for patients with ultrasound images of the myometrium obtained at Taipei Medical University Hospital from 1 September 2018 to 5 April 5 2019 were analyzed. Only 10 patients with 20 ultrasound images matched the eligibility criteria. The images were divided into pre-treatment (n = 10) and post-treatment images (n = 10) and quantitative grayscale histograms were obtained from the ultrasound images using publicly available ImageJ computer-aided image analysis software. We analyzed the differences between the pre- and post-treatment images using the Mann–Whitney test and compared the results with outcomes assessed by serum CA-125 levels. Results Image analysis of the grayscale histograms revealed significant differences between before and after treatment. The classification of the myometrium pre-treatment and post-treatment was similar using CA-125 and histogram grayscale analysis. Conclusion Computer-aided image analysis of grayscale histograms of the myometrium obtained from ultrasound images is an alternative method for assessing myometrial conditions after GnRH agonist treatment in patients with adenomyosis.