bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two Decades of Abdominal Aortic Endovascular Repair With the Anatomical FiXation at the Aortic Bifurcation in a Large Single-Center Experience
Authors: Gennai Stefano , Andreoli Francesco , Saitta Giuseppe , Leone Nicola , Migliari Mattia , Covic Tea , Silingardi Roberto 
Published: July 2021

Objective: The introduction of new endograft models improved long-term results of abdominal aortic aneurysm (AAA) endovascular repair (EVAR), but most of them maintained an old and unchanged design: a short body and long legs shifting up the flow divider. This study assessed the long-term results of EVAR with unimodular endoprosthesis fixed at the aorto-iliac bifurcation (Anatomical FiXation), in a large, unselected cohort. Materials and Methods: In a single-center, retrospective cohort study, 623 patients selectively treated between 1999 and 2016, were analyzed. Follow-up protocol included at least a computed tomography angiography within 3 months and a duplex ultrasound and clinical exam yearly. All enrolled patients were analyzed by 2020. The primary outcomes were technical success, clinical success, and survival. Secondary outcomes included survival-free from late-open-conversion (LOC), reintervention, and endoleaks. Results: Median age was 74±11 years and the follow-up 93±54 months. The technical success was achieved in 99.4% and the 30-day clinical success was 98.4%. A 5-year clinical success of 97.7% was registered and at 10 years success was 96.7%. The overall survival at 1, 5, 10, and 15 years was 92.4%, 79.5%, 64.9%, and 45.5%, respectively. Six (0.98%) AAA-related death were registered, 3 caused by infection of the endograft and 3 for secondary rupture. LOCs were 9 (1.47%) and reintervention-free survival at 1, 5, 10, and 15 years were 88.4%, 78.0%, 76.2%, and 74.6%, respectively. Freedom from endoleaks was 88.8% at 1 year and 72.7% at 15 years. A total of 63 high-flow endoleaks were registered (43 type I, 7 type IIIa, 12 type IIIb, and 1 type Ib+IIIb). No migrations were recorded, and the graft limb thrombosis rate was 1.14%. From a multivariate analysis resulted that long-term clinical success appeared to be reduced in patients affected by diabetes [odds ratio (OR) 0.24; p=0.04] and in presence of calcified and thrombotic iliac accesses (OR 0.16; p=0.006). Conclusion: EVAR with the Anatomical FiXation was confirmed to be safe, feasible, and effective to prevent AAA rupture in the long term as well. However, the overall survival remains afflicted by cardiovascular accident. The original concept of unibody bifurcated design allowed a very low rate of graft thrombosis and zeroed the risk of migration and related reintervention.
Weight Loss Following Hepatopancreatobiliary Surgery. How Much is Too Much? A Retrospective Cohort Study
Authors: Zhang Betty H. , Ghazi Faisal Sanaa , Ruo Leyo , Simunovic Marko , Pinto-Sanchez Maria I. , Serrano Pablo E. 
Published: July 2021

Background & Aims. Postoperative weight loss is common following hepato-pancreato-biliary (HPB) surgical resections; however, the extent of weight loss and the association with poor outcomes have not been well described. We assessed the average percentage of weight loss and risk factors associated with sustained postoperative weight loss. Materials and Methods. We enrolled patients undergoing major HPB surgical resections from 2011–2016 at a single institution. We evaluated percent change in weight postoperatively, incidence of complications, and nutritional clinical markers at 1, 3, and 6 months postoperatively compared to preoperative baseline. We used multiple logistic regression to evaluate factors associated with significant weight loss (>10% from baseline) at 3 months from surgery. Results. Among 262 patients undergoing HPB surgery, liver surgery patients lost 2.5% of baseline weight at 3 months postoperatively but regained baseline weight by 6 months. Pancreatic surgery patients lost 7.7% at 3 months and were unable to recover their baseline weights at 6 months. Forty-three (16%) patients had major postoperative complications including abdominal abscess (5.3%) and anastomotic leak (3.8%). Patients who experienced major postoperative complications had a greater percentage weight loss at 3 months compared to those without major complications: median 11% (interquartile range (IQR): 7%–15%) vs 4% (IQR: 0%–8%), P < .001. In the multivariable analysis, major postoperative complications were associated with significant weight loss at 3 months (OR 3.39, 95% CI 1.38–8.33). Conclusions. Due to the association of weight loss and major postoperative complications, patients who experience significant weight loss (>10% from baseline) may benefit from nutritional assessment for dietary intervention.
Results of a Prospective Cohort Study on Open Rives Technique of the Midline Incisional Hernia: Midline Closure and Mesh Overlap
Authors: Juvany Montserrat , Guillaumes Salvador , Hoyuela Carlos , Bachero Irene , Trias Miguel , Ardid Jordi , Martrat Antoni 
Published: July 2021

Background. Rives repair has been traditionally used for large abdominal wall defects with good results on terms of recurrence. However, it is limited by the lateral border of the posterior rectus sheath. The objective of our study was to evaluate recurrence rate, midline closure and mesh overlap in patients operated on elective midline incisional hernia by open Rives retromuscular repair. Methods. This is a prospective observational study of 83 patients who underwent elective open Rives technique between January 2014 and December 2018. Main inclusion criteria were adults with a midline incisional hernia. Recurrence, midline closure and mesh overlap were determined. Results. At a median postoperative follow-up of 32 (5-59) months, 8 cases of recurrence were reported. Patients with recurrence had wider hernia defects (101 ± 52 mm vs 66 ± 36 mm, P = .014) and were repaired with wider meshes (191 ± 93 mm vs 137 ± 68 mm, P = .042). However, although it was not statistically significant, midline closure was lower (38% vs 59%), as well as the overlapping relationship between mesh area and hernia defect area (2.937:1 vs 3.732:1) on patients that developed a recurrence. Conclusions. Rives technique provides good mid-term results in a midline incisional hernia (10% of recurrence at 36 months), including wider hernias in the recurrent cohort. The authors believe that other techniques which allow midline closure and placement of bigger meshes should be considered, especially in those hernias classified as W3 on EuraHS classification (more than 10 cm on width size).
Comparative outcome analysis of osseointegrated reconstruction and replantation for digital amputations
Authors: Li Andrew T. , Shepherd Angela , Gray Steven J. , Slattery Philip , Bruscino-Raiola Frank 
Published: July 2021

The long-term outcomes of osseointegration for digital amputations are not well established, and it is not known whether osseointegration can achieve similar function and patient satisfaction to conventional surgical options such as replantation and microsurgical toe transfer. We compared the long-term outcomes after digital osseointegration and replantation. Six patients treated by osseointegration and seven patients treated by replantation were included, with median follow-ups of 8 years and 4.6 years, respectively. Outcomes were assessed using the Michigan Hand Outcomes Questionnaire, grip and pinch strength, range of motion, two-point discrimination, Semmes-Weinstein tests, Jebsen-Taylor Hand Function Test and clinical photography. Osseointegration was associated with poorer sensibility and range of motion than replantation; no other differences reached statistical significance. Long-term osseointegration is a safe and effective reconstructive option that can deliver excellent outcomes in appropriately selected patients. Level of evidence: IV
Assessment of glenoid baseplate initial micromotion and fixation strength in reverse total shoulder arthroplasty designs using a direct shear force methodology
Authors: Parr Therese E , Anderson Jennifer K , Marionneaux Alan M. , Tokish John M , Tolan Stefan J , Hawkins Richard J , Kissenberth Michael J , DesJardins John D 
Published: July 2021

Background In a reverse total shoulder arthroplasty, the altered glenohumeral joint center of rotation subjects the glenoid baseplate to increased shear forces and potential loosening. Methods This study examined glenoid baseplate micromotion and initial fixation strength with the application of direct shear force in a Sawbone model. The reverse total shoulder arthroplasty systems examined were the DJO Reverse® Shoulder Prosthesis, the Exactech Equinoxe® Reverse System, and the Tornier AequalisTM Reverse Shoulder Prosthesis. Specimens were cyclically tested with increasing shear loads until 150 µm of displacement between the implant and glenoid was achieved, and subsequently until failure, classified as either 1 cm of implant/glenoid displacement or fracture. Results The average load withstood for the 150 µm threshold for DJO, Tornier, and Exactech was 460 ± 88 N, 525 ± 100 N, and 585 ± 160 N, respectively. The average total load at device failure for DJO, Tornier, and Exactech was 980 ± 260 N, 1260 ± 120 N, and 1350 ± 230 N, respectively. Discussion The Exactech implant design trended toward requiring more load to induce micromotion at each threshold and to induce device failure, most commonly seen as inferior screw pull out. This study proposes design features that may enhance fixation and suggests little risk of initial micromotion or failure during initial post-operative recovery.
Clinical associations with stage B heart failure in adults with type 2 diabetes
Authors: Gulsin Gaurav S. , Brady Emer , Marsh Anna-Marie , Squire Gareth , Htike Zin Z. , Wilmot Emma G. , Biglands John D. , Kellman Peter , Xue Hui , Webb David R. , Khunti Kamlesh , Yates Tom , Davies Melanie J. , McCann Gerry P. 
Published: July 2021

Background: There is a high prevalence of asymptomatic (American Heart Association Stage B) heart failure (SBHF) in people with type 2 diabetes (T2D). We aimed to identify associations between clinical characteristics and markers of SBHF in adults with T2D, which may allow therapeutic interventions prior to symptom onset. Methods: Adults with T2D from a multi-ethnic population with no prevalent cardiovascular disease [ n = 247, age 52 ± 12 years, glycated haemoglobin A1c (HbA1c) 7.4 ± 1.1% (57 ± 12 mmol/mol), duration of diabetes 61 (32, 120) months] underwent echocardiography and adenosine stress perfusion cardiovascular magnetic resonance imaging. Multivariable linear regression analyses were performed to identify independent associations between clinical characteristics and markers of SBHF. Results: In a series of multivariable linear regression models containing age, sex, ethnicity, smoking history, number of glucose-lowering agents, systolic blood pressure (BP) duration of diabetes, body mass index (BMI), HbA1c, serum creatinine, and low-density lipoprotein (LDL)-cholesterol, independent associations with: left ventricular mass:volume were age (β = 0.024), number of glucose-lowering agents (β = 0.022) and systolic BP (β = 0.027); global longitudinal strain were never smoking (β = −1.196), systolic BP (β = 0.328), and BMI (β = −0.348); myocardial perfusion reserve were age (β = −0.364) and male sex (β = 0.458); and aortic distensibility were age (β = −0.629) and systolic BP (β = −0.348). HbA1c was not independently associated with any marker of SBHF. Conclusions: In asymptomatic adults with T2D, age, systolic BP, BMI, and smoking history, but not glycaemic control, are the major determinants of SBHF. Given BP and BMI are modifiable, these may be important targets to reduce the development of symptomatic heart failure.
Eye Health, COVID-19, and the Occupational Health Professional: Round Table
Authors: Gallagher Susan , Clasing Jay , Hall Edward , Hammond Stephanie , Howard Gayle , Mohrmann Todd , Vaccaro Jayme Taormina 
Published: July 2021

Background: Eye health has garnered increased attention since the COVID-19 pandemic. This Round Table explored the impact mask wearing, delays in eye examinations, and increased screen time have on vision and ultimately the worker. Methods: Leading experts in the areas of occupational health, risk management, eye health, and communication were identified and invited to participate in a Round Table discussion. Questions posed to experts were based on literature that addressed eye health, such as mask wearing, communication and managing expectations when accessing professional eye health appointments, and increased screen time. Findings: Experts agreed that eye health considerations must be in place. These considerations should address not only clinical care of the patient but ways to protect workers from occupational injury associated with the eye. Conclusion/Application to practice: The occupational health professional is a key resource for assessment and training that pertains to eye health.
Cortical metabolic and structural differences in patients with chronic migraine. An exploratory 18FDG-PET and MRI study
Authors: Torres-Ferrus Marta , Pareto Deborah , Gallardo Victor J , Cuberas-Borrós Gemma , Alpuente Alicia , Caronna Edoardo , Vila-Balló Adrià , Lorenzo-Bosquet Carles , Castell-Conesa Joan , Rovira Alex , Pozo-Rosich Patricia 
Published: July 2021

Abstract
Background
To describe interictal brain structural and metabolic differences between patients with episodic migraine (EM), chronic migraine (CM) and healthy controls (HC).

Methods
This is an exploratory study including right-handed age-matched women with EM, CM and HC. On the same day, a sequential interictal scan was performed with 18FDG-PET and MRI. 3D T1-weighted images were segmented with FreeSurfer, normalized to a reference atlas and the mean values of metabolism, cortical thickness (CTh) and local gyrification index (IGI) were determined. Groups were compared using age-adjusted linear models, corrected for multiple comparisons. 18FDG-PET measurements between groups were also analysed adjusting by patient’s age, CTh and lGI. The variables independently associated with diagnosis were obtained using a logistic regression analysis.

Results
Fifteen patients (8 EM, 7 CM) and 11 HC were included. Morphometric data showed an increased CTh in 6 frontal areas (L/R-Caudal Middle Frontal, L/R-Rostral Middle Frontal, L-Medial Orbitofrontal and L-Superior Frontal) in CM patients compared to HC without differences for IGI. The structural adjusted analysis in CM showed a statistically significantly hypometabolism in 9 frontal areas (L-Lateral Orbitofrontal, L/R-Medial Orbitofrontal, L-Frontal Superior, R-Frontal pole, R-Parts Triangularis, L/R-Paracentral and R-Precentral) and 7 temporal areas (L/R-Insula, L/R-Inferior temporal, L/R-Temporal pole and R-Banks superior temporal sulcus) compared to HC. EM patients presented intermediate metabolic values ​​between EM and HC (non-significant).

Conclusions
CM patients showed frontotemporal hypometabolism and increased frontal cortical thickness when compared to HC that may explain some cognitive and behavioural pain-processing and sensory integration alterations in CM patients. Combined information from sequential or simultaneous PET and MRI could optimize the study of complex functional neurological disorders such as migraine.
Case report: appendicitis induced Staphylococcus aureus and Klebsiella pneumoniae bacteremia in a young healthy male
Authors: Deodatus Jan Arne , Paas Sander Ferdinand Emiel , Wagenvoort Gerrit Hendrik Johan , de Kubber Marije Matilde 
Published: July 2021

Abstract
Background
Appendicitis is one of the most frequently encountered conditions at the emergency department. Distinction is made between complicated and uncomplicated appendicitis. Complicated appendicitis may cause serious intra-abdominal infection, bacteremia, or sepsis. Emergency health providers should be highly alert to any early signs indicating such complications.

Case presentation
We present the case of a healthy young male with a gangrenous appendicitis, who received antibiotics and underwent appendectomy. Blood cultures showed unequivocal Staphylococcus aureus and concomitant Klebsiella pneumoniae bacteremia requiring prolonged antibiotic treatment and further diagnostic evaluation.

Conclusions
Although rare, appendicitis can cause Staphylococcus aureus and Klebsiella pneumoniae bacteremia with extensive implications for workup and antibiotic management. Our case stresses the importance of obtaining cultures in patients with suspicion of bacteremia given its consequences for clinical management.
Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand
Authors: Tansuwannarat Phantakan , Atiksawedparit Pongsakorn , Wibulpolprasert Arrug , Mankasetkit Natdanai 
Published: July 2021

Abstract
Background
This work was to study the prehospital time among suspected stroke patients who were transported by an emergency medical service (EMS) system using a national database.

Methods
National EMS database of suspected stroke patients who were treated by EMS system across 77 provinces of Thailand between January 1, 2015, and December 31, 2018, was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance, and distance to the scene) and prehospital time (i.e., dispatch, activation, response, scene, and transportation time) were extracted. Time parameters were also categorized according to the guidelines.

Results
Total 53,536 subjects were included in the analysis. Most of the subjects were transported during 06.00-18.00 (77.5%) and were 10 km from the ambulance parking (80.2%). Half of the subjects (50.1%) were served by advanced life support (ALS) ambulance. Median total time was 29 min (IQR 21, 39). There was a significant difference of median total time among ALS (30 min), basic (27 min), and first responder (28 min) ambulances, Holm P = 0.009. Although 91.7% and 88.3% of the subjects had dispatch time ≤ 1 min and activation time ≤ 2 min, only 48.3% had RT ≤ 8 min. However, 95% of the services were at the scene ≤ 15 min.

Conclusion
Prehospital time from EMS call to hospital was approximately 30 min which was mainly utilized for traveling from the ambulance parking to the scene and transporting patients from the scene to hospitals. Even though only 48% of the services had RT ≤ 8 min, 95% of them had the scene time ≤ 15 min.
A tubby-like protein CsTLP8 acts in the ABA signaling pathway and negatively regulates osmotic stresses tolerance during seed germination
Authors: Li Shuangtao , Wang Zhirong , Wang Fei , Lv Hongmei , Cao Meng , Zhang Na , Li Fengju , Wang Hao , Li Xingsheng , Yuan Xiaowei , Zhao Bing , Guo Yang-Dong 
Published: July 2021

Abstract
Background
TLPs (Tubby-like proteins) are widespread in eukaryotes and highly conserved in plants and animals. TLP is involved in many biological processes, such as growth, development, biotic and abiotic stress responses, while the underlying molecular mechanism remains largely unknown. In this paper we characterized the biological function of cucumber (Cucumis sativus L.) Tubby-like protein 8 (CsTLP8) in Arabidopsis.

Results
In cucumber, the expression of the tubby-like protein CsTLP8 was induced by NaCl treatment, but reduced by PEG (Polyethylene Glycol) and ABA (Abscisic Acid) treatment. Subcellular localization and transcriptional activation activity analysis revealed that CsTLP8 possessed two characteristics of classical transcription factors: nuclear localization and trans-activation activity. Yeast two-hybrid assay revealed interactions of CsTLP8 with CsSKP1a and CsSKP1c, suggesting that CsTLP8 might function as a subunit of E3 ubiquitin ligase. The growth activity of yeast with ectopically expressed CsTLP8 was lower than the control under NaCl and mannitol treatments. Under osmotic and salt stresses, overexpression of CsTLP8 inhibited seed germination and the growth of Arabidopsis seedlings, increased the content of MDA (Malondialdehyde), and decreased the activities of SOD (Superoxide Dismutase), POD (Peroxidase) and CAT (Catalase) in Arabidopsis seedlings. Overexpression of CsTLP8 also increased the sensitivity to ABA during seed germination and ABA-mediated stomatal closure.

Conclusion
Under osmotic stress, CsTLP8 might inhibit seed germination and seedling growth by affecting antioxidant enzymes activities. CsTLP8 acts as a negative regulator in osmotic stress and its effects may be related to ABA.
Subclinical cardiac perforation by cardiac implantable electronic device leads detected by cardiac computed tomography
Authors: Lim Yeong-Min , Uhm Jae-Sun , Kim Min , Kim In-Soo , Jin Moo-Nyun , Yu Hee Tae , Kim Tae-Hoon , Lee Hye-Jeong , Kim Young-Jin , Joung Boyoung , Pak Hui-Nam , Lee Moon-Hyoung 
Published: July 2021

Abstract
Background
The relationship between the characteristics of cardiac implantable electronic device (CIED) leads and subclinical cardiac perforations remains unclear. This study aimed to evaluate the incidence of subclinical cardiac perforation among various CIED leads using cardiac computed tomography (CT).

Methods
A total of 271 consecutive patients with 463 CIED leads, who underwent cardiac CT after CIED implantation, were included in this retrospective observational study. Cardiac CT images were reviewed by one radiologist and two cardiologists. Subclinical perforation was defined as traversal of the lead tip past the outer myocardial layer without symptoms and signs related to cardiac perforation. We compared the subclinical cardiac perforation rates of the available lead types.

Results
A total of 219, 49, and 3 patients had pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy, respectively. The total subclinical cardiac perforation rate was 5.6%. Subclinical cardiac perforation by screw-in ventricular leads was significantly more frequent than that caused by tined ventricular leads (13.3% vs 3.3%, respectively, p = 0.002). There were no significant differences in the incidence of cardiac perforation between atrial and ventricular leads, screw-in and tined atrial leads, pacing and defibrillator ventricular leads, nor between magnetic resonance (MR)-conditional and MR-unsafe screw-in ventricular leads. Screw-in ventricular leads were significantly associated with subclinical cardiac perforation [odds ratio, 4.554; 95% confidence interval, 1.587–13.065, p = 0.005]. There was no case subclinical cardiac perforation by septal ventricular leads.

Conclusions
Subclinical cardiac perforation by screw-in ventricular leads is not rare. Septal pacing may be helpful in avoiding cardiac perforation.