bluuebunny/crossref_metadata_2025_split huggingface dataset:
1273 Appendicitis and Patient Information: A Systematic Analysis of Websites Using the EQIP Tool
Authors: Fan K S , Ghani S , Fan K H , Lenti L , Raptis D 
Published: October 2021

Abstract

Background
Appendicitis is a common surgical problem amongst the young adult population, who are likely to use the Internet to obtain medical information. This information may determine the health-seeking behaviour of an individual and may delay medical attention. This study aims to study the quality of patient information on appendicitis on the Internet as it has not been previously studied.

Method
A systematic review of health information on appendicitis available online is conducted using 4 search terms via Google: ‘appendicitis’ ‘appendix’, ‘appendectomy’ and ‘appendicectomy’. The top 100 websites of each search term were assessed using the validated ’Ensuring Quality Information for Patients’ (EQIP) tool (score 0-36). Only websites containing health information intended for the general public were included.

Results
A total of 119 websites met the eligibility criteria for evaluation. The overall median EQIP score for all websites was 20 (interquartile range 18-22). More than half the websites originated from the USA (53%). 45% of all websites originated from hospitals but 43% of these did not mention qualitative risks from surgery. Incidence rates were only provided for complications and mortality in 13% and 3% of all websites, respectively.

Conclusions
The assessment of the quality and readability of websites concerning appendicitis by the EQIP tool indicates that most sites online were of poor credibility, with minimal information regarding complication rates and mortality. To improve education and awareness of appendicitis, there is an immediate need for more informative and patient-centred websites that are more compatible with international quality standards.
1303 Obesity: A Growing Concern in Gynaecological Surgery
Authors: Raja P 
Published: October 2021

Abstract

Introduction
Obesity is becoming a major concern in healthcare. The rise in obesity has now reached alarming levels. Obesity is driven by the economic growth, unbalanced diet, and a sedentary lifestyle. Obesity has played a disastrous role in the health of many but significantly has had a detrimental health effect among girls and women. This review focuses on the effect of obesity on various aspects of women’s health including prognosis after gynaecological surgery.

Method
The search engine used for this literature review was Ovid MEDLINE. Only studies reported in English have been included in this review. The snowball and citation searching method was used to find further relevant articles.

Results
Various genetic components have been identified to increase the risk of obesity which is further exacerbated with the current obesogenic environment. Women with a BMI≥35 had longer surgeries and an increased rate of severe postoperative adverse events. Additionally, women with a higher BMI had an increased risk of cervical cancer due to under-diagnosis of cervical precancerous lesions, though obesity did not directly alter the association between preoperative biopsy and final tumour grade.

Conclusions
Despite increased awareness, obesity is still a major contributor of mortality and morbidity. Women in particular are facing severe consequences of the obesogenic environment. In women obesity not only increases their risk of developing gynaecological conditions but also adversely affects prognosis after surgical treatment. In the face of an obesogenic environment, it is important to sought out potential ways to reduce the risk of surgical complications in obese patients.
Phenotyping hypertrophic cardiomyopathy using cardiac diffusion magnetic resonance imaging: the relationship between microvascular dysfunction and microstructural changes
Authors: Das Arka , Kelly Christopher , Teh Irvin , Nguyen Christopher , Brown Louise A E , Chowdhary Amrit , Jex Nicholas , Thirunavukarasu Sharmaine , Sharrack Noor , Gorecka Miroslawa , Swoboda Peter P , Greenwood John P , Kellman Peter , Moon James C , Davies Rhodri H , Lopes Luis R , Joy George , Plein Sven , Schneider Jürgen E , Dall’Armellina Erica 
Published: October 2021

Abstract

Aims
Microvascular dysfunction in hypertrophic cardiomyopathy (HCM) is predictive of clinical decline, however underlying mechanisms remain unclear. Cardiac diffusion tensor imaging (cDTI) allows in vivo characterization of myocardial microstructure by quantifying mean diffusivity (MD), fractional anisotropy (FA) of diffusion, and secondary eigenvector angle (E2A). In this cardiac magnetic resonance (CMR) study, we examine associations between perfusion and cDTI parameters to understand the sequence of pathophysiology and the interrelation between vascular function and underlying microstructure.

Methods and results
Twenty HCM patients underwent 3.0T CMR which included: spin-echo cDTI, adenosine stress and rest perfusion mapping, cine-imaging, and late gadolinium enhancement (LGE). Ten controls underwent cDTI. Myocardial perfusion reserve (MPR), MD, FA, E2A, and wall thickness were calculated per segment and further divided into subendocardial (inner 50%) and subepicardial (outer 50%) regions. Segments with wall thickness ≤11 mm, MPR ≥2.2, and no visual LGE were classified as ‘normal’. Compared to controls, ‘normal’ HCM segments had increased MD (1.61 ± 0.09 vs. 1.46 ± 0.07 × 10−3 mm2/s, P = 0.02), increased E2A (60 ± 9° vs. 38 ± 12°, P &lt; 0.001), and decreased FA (0.29 ± 0.04 vs. 0.35 ± 0.02, P = 0.002). Across all HCM segments, subendocardial regions had higher MD and lower MPR than subepicardial (MDendo 1.61 ± 0.08 × 10−3 mm2/s vs. MDepi 1.56 ± 0.18 × 10−3 mm2/s, P = 0.003, MPRendo 1.85 ± 0.83, MPRepi 2.28 ± 0.87, P &lt; 0.0001).

Conclusion
In HCM patients, even in segments with normal wall thickness, normal perfusion, and no scar, diffusion is more isotropic than in controls, suggesting the presence of underlying cardiomyocyte disarray. Increased E2A suggests the myocardial sheetlets adopt hypercontracted angulation in systole. Increased MD, most notably in the subendocardium, is suggestive of regional remodelling which may explain the reduced subendocardial blood flow.
Genome silencer therapy leading to ‘regression’ of cardiac amyloid load on cardiovascular magnetic resonance: a case report
Authors: Florian Anca , Bietenbeck Michael , Hüsing-Kabar Anna , Schilling Matthias , Schmidt Hartmut H , Yilmaz Ali 
Published: October 2021

Abstract

Background
Hereditary or variant transthyretin amyloidosis (ATTRv) is a progressive disease manifesting with neuropathy and/or cardiomyopathy. An early and accurate diagnosis of cardiac amyloidosis is a pre-requisite for timely and appropriate patient management, including anti-amyloid therapies, as it is associated with heart failure, conduction disease, and arrhythmias, leading to reduced quality of life and early death.

Case Summary
We present the case of an ATTRv male patient presenting with a mixed amyloidosis phenotype (neuropathy and cardiomyopathy). Cardiac disease manifestation comprised tachyarrhythmias (atrial fibrillation) and conduction abnormalities (atrio-ventricular block) in addition to segmental left ventricular (LV) hypertrophy (septal wall) due to regionally pronounced amyloid deposits in the basal LV myocardium. Interestingly, by means of serial cardiovascular magnetic resonance (CMR) studies, we were able to demonstrate an impressive and unexpected improvement of cardiomyopathy findings within a relatively short period-of-time after the implementation of genome-silencer therapies.

Discussion
This is our second case report that showed ATTRv cardiomyopathy reversal under anti-amyloid therapy—documented by multi-parametric CMR. Our findings support the hypothesis that amyloid infiltration leading to cardiomyopathy is not an irreversible pathological process—but rather a dynamic one, that cannot only be stopped but even reversed (to a certain degree) by currently emerging anti-amyloid therapies. Moreover, the role of serial multi-parametric CMR imaging for surveillance of cardiomyopathy dynamics under these therapies is nicely illustrated.
How exercise can deteriorate the clinical course of an ARVC patient: a case report
Authors: Lüsebrink Enzo , Binzenhöfer Leonhard , Brunner Stefan , Hausleiter Jörg , Massberg Steffen , Orban Martin , Kääb Stefan 
Published: October 2021

AbstractBackground Arrhythmogenic right ventricular cardiomyopathy (ARVC)/dysplasia is a genetic disease characterized by fibro-adipose degeneration of ventricular myocardium. Initial clinical presentation is variable and ranges from asymptomatic cases to chronic heart failure and sudden cardiac death due to malignant arrhythmias.Case summary Here, a 67-year-old male patient who started extensive physical training upon retirement and presented with ventricular tachycardia and progressive heart failure as a first sign of his disease. Arrhythmogenic right ventricular cardiomyopathy diagnosis was established according to the 2010 modified Task Force Criteria and supported by HRS/EHRA consensus-based genotyping. After initial discharge on optimal medical therapy and prophylactic implantable cardioverter-defibrillator implantation according to his individual ARVC risk score, the patient reported rapid decline in physical capacity on a regular follow-up 4 months later. To better understand the aetiology of his clinical deterioration, we performed stress echocardiography, coronary angiogram, and exercise right heart catheterization, which conclusively suggest impaired left ventricular filling secondary to right ventricular failure as a main cause of global circulatory failure.Discussion The present case report focuses on relation of physical activity to disease onset and the concomitant advent of symptoms during exercise as well as a structured and guideline-aided diagnostic workup in ARVC and staged treatment options. Continuous ARVC centre-oriented re-assessment and treatment planning including lifestyle intervention, psychological support, medical, surgical, and interventional options are key elements of sustained long-term care for ARVC patients.
Short-term outcome of adenosine–lidocaine–magnesium polarizing cardioplegia in humans
Authors: Francica Alessandra , Vaccarin Arianna , Dobson Geoffrey Phillip , Rossetti Cecilia , Gardellini Jacopo , Faggian Giuseppe , Onorati Francesco 
Published: October 2021

Abstract

OBJECTIVES
Hyperkalaemic depolarized myocardial arrest is the cornerstone of myocardial protection, although some potassium-related cytotoxicity has been demonstrated. Polarized arrest has gained interest because of a reported better myocardial protection in preclinical studies. The goal of this study was to analyse the quality of myocardial protection and hospital outcome after normokalaemic adenosine–lidocaine–magnesium (ALM) blood polarizing cardioplegia, compared to hyperkalaemic blood Buckberg depolarizing cardioplegia, in elective routine adult cardiac surgery.

METHODS
One thousand consecutive elective adult cardiac patients [627 undergoing ALM-polarizing cardioplegia (ALM-POL) vs 373 Buckberg depolarized cardioplegia (BUCK-DEPOL)] who were operated on were analysed. Perioperative leakage of high-sensitivity troponin I (Hs-TnI), peripheral lactate, inotropic and vasoactive daily requirement [maximal vasoactive inotropic score (VISMAX)], hospital mortality and morbidity were collected and compared in the overall population and in the propensity score (PS) matched population (206 pairs).

RESULTS
A significantly lower leakage of Hs-TnI during hospitalization was detected in patients receiving ALM-POL versus those receiving BUCK-DEPOL (group time P &lt; 0.001 for overall population and PS matched pairs). The maximum value of postoperative Hs-TnI was also lower after ALM-POL (P &lt; 0.001 in both cohorts), and spontaneous recovery of sinus rhythm at aortic declamping was higher (P &lt; 0.001 in favour of ALM-POL). Maximal VISMAX during hospitalization was significantly higher after BUCK-DEPOL in both cohorts (P = 0.019 for overall population; P = 0.031 for PS matched population), with significantly higher VISMAX on the day of surgery in BUCK-DEPOL PS matched patients (P = 0.042). No other significant differences in hospital morbidity and mortality were found.

CONCLUSIONS
Despite comparable short-term clinical outcomes, ALM-POL cardioplegia proved superior in terms of quality of myocardial protection compared to BUCK-DEPOL cardioplegia in elective routine adult cardiac surgery.
Development and Internal Validation of a Risk Prediction Model for Falls Among Older People Using Primary Care Electronic Health Records
Authors: Dormosh Noman , Schut Martijn C , Heymans Martijn W , van der Velde Nathalie , Abu-Hanna Ameen 
Published: October 2021

AbstractBackgroundCurrently used prediction tools have limited ability to identify community-dwelling older people at high risk for falls. Prediction models utilizing electronic health records (EHRs) provide opportunities but up to now showed limited clinical value as risk stratification tool, because of among others the underestimation of falls prevalence. The aim of this study was to develop a fall prediction model for community-dwelling older people using a combination of structured data and free text of primary care EHRs and to internally validate its predictive performance.MethodsWe used EHR data of individuals aged 65 or older. Age, sex, history of falls, medications, and medical conditions were included as potential predictors. Falls were ascertained from the free text. We employed the Bootstrap-enhanced penalized logistic regression with the least absolute shrinkage and selection operator to develop the prediction model. We used 10-fold cross-validation to internally validate the prediction strategy. Model performance was assessed in terms of discrimination and calibration.ResultsData of 36 470 eligible participants were extracted from the data set. The number of participants who fell at least once was 4 778 (13.1%). The final prediction model included age, sex, history of falls, 2 medications, and 5 medical conditions. The model had a median area under the receiver operating curve of 0.705 (interquartile range 0.700–0.714).ConclusionsOur prediction model to identify older people at high risk for falls achieved fair discrimination and had reasonable calibration. It can be applied in clinical practice as it relies on routinely collected variables and does not require mobility assessment tests.
Thymolipomatous myasthenia gravis outcomes following thymectomy: a systematic review
Authors: Alghamdi Zeead M , Othman Sharifah A , Abdelmotaleb Mohammed Sabry , Alreshaid Farouk , Alomar Abdullah , Alaklbi Mohammed , Elbawab Hatem Y , Aljehani Yasser 
Published: October 2021

Abstract

OBJECTIVES
Our goal was to evaluate the effect of thymectomy on the progression of thymolipomatous myasthenia gravis.

METHODS
An electronic search performed across PubMed, MEDLINE and Web of Science databases included all article types. We included 15 series comprising 36 cases that met specific criteria, including case reports or case series related to thymolipoma with a myasthenia gravis association, where thymectomy was cited as the primary intervention with postoperative reporting of the prognosis and articles written in the English language.

RESULTS
Our study included 17 men (47.2%) and 19 women (52.8%). Tumour sizes varied between 34 × 18 × 7 cm and 2.8 × 2.3 × 1.9 cm; the weight of the tumours ranged between 38 and 1780 g (mean 190, standard deviation 341). The surgical approaches were a median sternotomy in 29 patients (80.6%), a thoracotomy in 1 patient (2.8%), video-assisted thoracoscopic surgery in 2 patients (5.6%) and unreported approaches in 4 (11.1%) patients. The disease was entirely resolved with complete, stable remission in 5 patients (13.9%); symptoms were improved in 19 (52.8%) and stable in 10 patients (27.7%). We identified 2 groups of patients according to their improvement post-thymectomy (improved group and group with no change).

CONCLUSIONS
Although the cases were uncontrolled and did not demonstrate strong associations, they do support some hypotheses. We found a significant statistical difference between the 2 groups in terms of age, because younger patients tended to improve to a greater degree post-thymectomy. Also, we found that female patients with thymoma visible on the imaging scans were significantly associated with post-thymectomy myasthenia gravis improvement.

Registration number in PROSPERO
CRD42020173229.
Non-fillable Augmentations of Twist Knots
Authors: Gao Honghao , Rutherford Dan 
Published: October 2021

AbstractWe establish new examples of augmentations of Legendrian twist knots that cannot be induced by orientable Lagrangian fillings. To do so, we use a version of the Seidel –Ekholm–Dimitroglou Rizell isomorphism with local coefficients to show that any Lagrangian filling point in the augmentation variety of a Legendrian knot must lie in the injective image of an algebraic torus with dimension equal to the 1st Betti number of the filling. This is a Floer-theoretic version of a result from microlocal sheaf theory. For the augmentations in question, we show that no such algebraic torus can exist.
Exponential Growth of Products of Non-Stationary Markov-Dependent Matrices
Authors: Goldsheid Ilya 
Published: October 2021

Abstract
Let $(\xi _j)_{j\ge 1} $ be a non-stationary Markov chain with phase space $X$ and let $\mathfrak {g}_j:\,X\mapsto \textrm {SL}(m,{\mathbb {R}})$ be a sequence of functions on $X$ with values in the unimodular group. Set $g_j=\mathfrak {g}_j(\xi _j)$ and denote by $S_n=g_n\ldots g_1$, the product of the matrices $g_j$. We provide sufficient conditions for exponential growth of the norm $\|S_n\|$ when the Markov chain is not supposed to be stationary. This generalizes the classical theorem of Furstenberg on the exponential growth of products of independent identically distributed matrices as well as its extension by Virtser to products of stationary Markov-dependent matrices.
PSVI-4 Effect of phytase on mineral digestibility and growth performance of pigs fed diets with pharmacological levels of Zn
Authors: Espinosa Charmaine D , Velayudhan Deepak , Dersjant-Li Yueming , Remus Janet , Stein Hans-Henrik H 
Published: October 2021

Abstract
An experiment was conducted to test the hypothesis that increasing levels of phytase increases mineral digestibility and growth performance of pigs fed diets with 3,000 mg/kg of Zn. A positive control (PC) diet that met nutrient requirements and a negative control (NC) diet that was deficient in total Ca (-0.16%), digestible P (-0.14%), metabolizable energy (-50 kcal/kg), and digestible amino acids (-0.02%) were formulated. Eight additional diets were formulated by adding 500, 1,000, 1,500, or 2,000 phytase units/kg of a novel bacterial 6-phytase (PhyG) or a commercial Buttiauxella phytase (PhyB) to the NC diet. A randomized complete block design with 400 weanling pigs (5.82 ± 0.70 kg), 10 diets, 4 pigs per pen, and 10 replicate pens per diet was used. Pigs were fed the experimental diets for 28 d. Fecal samples were collected from 1 pig per pen on d 26 to 28. Linear and quadratic effects of PhyG and PhyB were determined using polynomial contrast statements. Contrast statements were used to compare effects of PC diet with NC diet, and to compare effects of PhyG diets with PhyB diets. Overall, pigs fed the NC diet had reduced growth performance (P &lt; 0.05) compared with pigs fed the NC diet (Table 1). Linear (P &lt; 0.01) and quadratic (P &lt; 0.05) increases in overall average daily gain and average daily feed intake of pigs were observed as dietary concentrations of PhyG or PhyB increased. Increasing levels of PhyG or PhyB linearly increased (P &lt; 0.01) the apparent total tract digestibility (ATTD) of P and Ca. PhyG increased ATTD of P more (P &lt; 0.05) than PhyB. In conclusion, both phytases are effective in increasing mineral digestibility and growth performance in pigs fed diets with pharmacological levels of Zn; however, PhyG improved P digestibility more than PhyB.
PSVI-5 Effect of probiotic supplementation on performance and intestinal integrity in weaned piglets
Authors: Carvalho Illa Carla S , Silva Bruno Alexander N , Moraes Elenice A , Brand Henrique G , Luspa Maria M , Carvalho Debora Cristine O , Luna Fabrina S , Cardoso Larissa A , Domingos Rodrigo L , Rebordoes Flavio Igor G , Gonçalves Mateus F , Motta Stephane A 
Published: October 2021

Abstract
Probiotics are being considered as an alternative means to reduce pathogen infection and improve animal health especially around the time of weaning. The objective of our study was to evaluate the effects of the use of a probiotic in diets for piglets on their performance and intestinal integrity during nursery phase. Thirty-six piglets (18 barrows and 18 females), weaned at 24 days of age were distributed in a randomized block design, with six repetitions per treatment (with or without addition of 50g/ton of the probiotic Bacillus subtilis DSM 32315, GutCare®, Evonik Industries) and each repetition with three pigs per experimental unit. During the experimental period, performance parameters evaluated were body weight (BW), daily feed intake (ADFI), feed conversion, average daily weight gain (ADG) and the intestinal integrity assessed via galactose absorption capacity. The performance data were submitted to the PDIFF option of the SAS and compared using the Tukey test. During phase 1 (24 to 31 days of age) the use of the probiotic tended (P = 0.07) to improve ADG (+76 g/ d) in comparison to control. As for phase 2 (32 to 39 days of age), 3 (40 to 53 days of age) and 4 (54 to 70 days of age) the use of the probiotic increased the ADFI (+118, +66 and +162 g/ d, respectively; P &lt; 0.05) and ADG (+5 and +8%, respectively for phase 2 and 3; P &lt; 0.05) compared to control. The use of the probiotic improved (P = 0.05) nursery end BW (+1.3 kg) and overall ADFI (+8%; P = 0.046). The intestinal integrity was not affected by treatments (P &gt; 0.10) at any stage. In conclusion, the use of the probiotic Bacillus subtilis DSM 32315 in diets for weaned piglets can be used as a viable formulation strategy to improve performance and the intestinal health of the animals during nursery phase.