bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score
Authors: Montalvo Mayra , Mistry Eva , Chang Andrew Davey , Yakhkind Aleksandra , Dakay Katarina , Azher Idrees , Kaushal Ashutosh , Mistry Akshitkumar , Chitale Rohan , Cutting Shawna , Burton Tina , Mac Grory Brian , Reznik Michael , Mahta Ali , Thompson Bradford B , Ishida Koto , Frontera Jennifer , Riina Howard A , Gordon David , Parella David , Scher Erica , Farkas Jeffrey , McTaggart Ryan , Khatri Pooja , Furie Karen L , Jayaraman Mahesh , Yaghi Shadi 
Published: August 2019

BackgroundThere is limited data on predictors of symptomatic intracranial haemorrhage (sICH) in patients who underwent mechanical thrombectomy. In this study, we aim to determine those predictors with external validation.MethodsWe evaluated mechanical thrombectomy in a derivation cohort of patients at a comprehensive stroke centre over a 30-month period. Clinical and radiographic data on these patients were obtained from the prospective quality improvement database. sICH was defined using the European Cooperative Acute Stroke Study III. We compared clinical and radiographic characteristics between patients with and without sICH using χ2 and t tests to identify independent predictors of sICH with p<0.1. Significant variables were then combined in a multivariate logistic regression model to derive an sICH prediction score. This score was then validated using data from the Blood Pressure After Endovascular Treatment multicentre prospective registry.ResultsWe identified 578 patients with acute ischaemic stroke who received thrombectomy, 19 had sICH (3.3%). Predictive factors of sICH were: thrombolysis in cerebral ischaemia (TICI) score, Alberta stroke program early CT score (ASPECTS), and glucose level, and from these predictors, we derived the weighted TICI-ASPECTS-glucose (TAG) score, which was associated with sICH in the derivation (OR per unit increase 1.98, 95% CI 1.48 to 2.66, p<0.001, area under curve ((AUC)=0.79) and validation (OR per unit increase 1.48, 95% CI 1.22 to 1.79, p<0.001, AUC=0.69) cohorts.ConclusionHigh TAG scores are associated with sICH in patients receiving mechanical thrombectomy. Larger studies are needed to validate this scoring system and test strategies to reduce sICH risk and make thrombectomy safer in patients with elevated TAG scores.
MT-DRAGON score for outcome prediction in acute ischemic stroke treated by mechanical thrombectomy within 8 hours
Authors: Ben Hassen Wagih , Raynaud Nicolas , Bricout Nicolas , Boulouis Gregoire , Legrand Laurence , Ferrigno Marc , Kazemi Apolline , Bretzner Martin , Soize Sebastien , Farhat Wassim , Seners Pierre , Turc Guillaume , Zuber Mathieu , Oppenheim Catherine , Cordonnier Charlotte , Naggara Olivier , Henon Hilde 
Published: August 2019

ObjectivesThe MRI-DRAGON score includes clinical and MRI parameters and demonstrates a high specificity in predicting 3 month outcome in patients with acute ischemic stroke (AIS) treated with intravenous tissue plasminogen activator (IV tPA). The aim of this study was to adapt this score to mechanical thrombectomy (MT) in a large multicenter cohort.MethodsConsecutive cases of AIS treated by MT between January 2015 and December 2017 from three stroke centers were reviewed (n=1077). We derived the MT-DRAGON score by keeping all variables of the MRI-DRAGON score (age, initial National Institutes of Health Stroke Scale score, glucose level, pre-stroke modified Rankin Scale (mRS) score, diffusion weighted imaging-Alberta Stroke Program Early CT score ≤5) and considering the following variables: time to groin puncture instead of onset to IV tPA time and occlusion site. Unfavorable 3 month outcome was defined as a mRS score >2. Score performance was evaluated by c statistics and an external validation was performed.ResultsAmong 679 included patients (derivation and validation cohorts, n=431 and 248, respectively), an unfavorable outcome was similar between the derivation (51.5%) and validation (58.1%, P=0.7) cohorts, and was significantly associated with all MT-DRAGON parameters in the multivariable analysis. The c statistics for unfavorable outcome prediction was 0.83 (95%CI 0.79 to 0.88) in the derivation and 0.8 (95%CI 0.75 to 0.86) in the validation cohort. All patients (n=55) with an MT-DRAGONscore ≥11 had an unfavorable outcome and 60/63 (95%) patients with an MT-DRAGON score ≤2 points had a favorable outcome.ConclusionThe MT-DRAGON score is a simple tool, combining admission clinical and radiological parameters that can reliably predict 3 month outcome after MT.
Facts or Fables?
Authors: Modarressi Hossein 
Published: August 2019

AbstractMuslim scholars maintain that the report of a text or event could be considered as indisputably true if it has been confirmed by the collective historical memory of the community throughout the ages and down the generations. Some suggested that if the authority of historical memory came into doubt, the entire edifice of religion and history would collapse as both were firmly based on historical memory. They were however aware of the possibility that an unconscious, spontaneous coordination of minds due to a shared feeling of a people might create a common assumption that turns a statement or event into a common knowledge for future generations and builds what we know as historical memory. They knew that stories are not fixed but can change over time, and that people might add additional material including their own interpretation of an event to their observation and thus form a collective memory that may have no truth embedded in it. They knew that the first hearing of an event or a report might influence the mind in such a way that the mind always remembered the event or report within that original understanding. So, how to prove that a piece of historical memory was really true and that it was not merely hearsay that people at the time happened to believe in, or wanted to believe in, and narrated to one another, passing it down from generation to generation? What is the line between fact and rumor and when does historical memory represent the truth, that is, the actual occurrence of an event or utterance of a statement? A number of requirements have been suggested in the Islamic tradition to narrow down the scope of error and increase the credibility of a piece of historical memory as representative of the actual occurrence of an alleged fact. This paper attempts to present those suggestions.
Analytical Investigation of the Role of Lateral Mixing in the Evolution of Nonprecipitating Cumulus. Part I: Developing Clouds
Authors: Pinsky M. , Khain A. 
Published: August 2019

AbstractEvolution of nonprecipitating cumulus clouds (Cu) at the developing stage under the influence of lateral entrainment and mixing is studied analytically using a minimalistic analytical model. We present a model of an ascending cloud volume (a model of developing Cu) whose structure is determined by the processes of droplet diffusion growth/evaporation and entrainment mixing in the horizontal direction. Spatial and time changes of liquid water content, the adiabatic fraction, droplet concentration, and the mean volume droplet radius are calculated. It is shown that the existence of a nondiluted core in a growing cumulus cloud significantly depends on the cloud width and vertical velocity. While at the updraft velocity of 2 m s−1 the core of a 400-m-wide cloud becomes diluted at distances of a few hundred meters above cloud base, the core of a cloud of 1000-m width remains nondiluted at distances up to 1500 m above cloud base. The explanation of this result is simple: the increase in cloud width and the decrease in the updraft velocity increase the time during which the cloud is diluted due to mixing. Since lateral mixing synchronously decreases both the cloud water content and droplet concentration, the variation of the mean volume droplet radius is low inside the cloud. The approximate quantitative condition for cloud formation in updraft is derived. It is shown that a cloud can arise when its vertical velocity exceeds a critical value. To produce clouds, narrow turbulent plumes should ascend at higher velocity as compared to wider plumes. High humidity of the environment air is favorable for formation of clouds from plumes. The comparison of the obtained results with previously published observational data indicates a reasonable agreement. The results can be useful for parameterization purposes.
Energetic Topographic Rossby Waves in the Northern South China Sea
Authors: Wang Qiang , Zeng Lili , Shu Yeqiang , Li Jian , Chen Ju , He Yunkai , Yao Jinglong , Wang Dongxiao , Zhou Weidong 
Published: August 2019

AbstractTopographic Rossby waves (TRWs) are reported to make a significant contribution to the deep-ocean current variability. On the northern South China Sea (NSCS) continental slope, TRWs with peak spectral energy at ~14.5 days are observed over about a year at deep moorings aligned east–west around the Dongsha Islands. The TRWs with a group velocity of O(10) cm s−1 contribute more than 40% of total bottom velocity fluctuations at the two mooring stations. The energy propagation and source are further identified using a ray-tracing model. The TRW energy mainly propagates westward along the NSCS continental slope with a slight downslope component. The possible energy source is upper-ocean 10–20-day fluctuations on the east side of the Dongsha Islands, which are transferred through the first baroclinic mode (i.e., the second EOF mode). These 10–20-day fluctuations in the upper ocean are associated with mesoscale eddies. However, to the west of the Dongsha Islands, the 10–20-day fluctuations in the upper ocean are too weak to effectively generate TRWs locally. This work provides an interesting insight toward understanding the NSCS deep current variability and the linkage between the upper- and deep-ocean currents.
Pharmacist Survey: Pharmacist Perception of Vancomycin Area Under the Curve Therapeutic Drug Monitoring
Authors: Gregory Eric R. , Burgess Donna R. , Cotner Sarah E. , VanHoose Jeremy D. , Flannery Alexander H. , Gardner Brian , Autry Elizabeth B. , Forster Derek W. , Burgess David S. , Wallace Katie L. 
Published: August 2019

Background: Evidence suggests the standard vancomycin trough goal of 15 to 20 mg/L for serious Staphylococcus aureus infections is associated with acute kidney injury, whereas appropriate monitoring of 24-hour area under the curve (AUC) may decrease nephrotoxicity. As a result, institutions have transitioned to AUC monitoring, the predictive pharmacokinetic/pharmacodynamic parameter of vancomycin to improve safety outcomes. However, this method may require increased pharmacist time and effort. Pharmacist perception of the practice change is largely unknown and warrants investigation. Methods: An electronic survey was disseminated via e-mail to pharmacists 5 months post-AUC implementation. Items of interest were focused on pharmacist perception, including quantity of patients monitored using AUC, justification of the practice change, differences in efficacy and safety, and changes in monitoring time requirements. Results: The pharmacist survey was distributed to 196 pharmacists and 84 responded (43% response rate). Eighty-one pharmacists had monitored patients using AUC methods. Sixty-nine percent of these respondents perceived the change to result in increased or slightly increased patient safety, 27% described no difference, and 4% stated safety was decreased or slightly decreased. Forty-two percent perceived the transition to result in increased or slightly increased efficacy, while 48% noted no difference and 10% responded that efficacy was decreased or slightly decreased. Pharmacists stated the creation of an institutional calculator decreased the time required to calculate AUC. Conclusion: After the change to AUC monitoring, pharmacists perceived improvements in safety outcomes while efficacy was at least similar if not increased.
Fibular Nail Fixation: Topical Review
Authors: Bäcker Henrik C. , Vosseller J. Turner 
Published: August 2019

Background: Intramedullary implants have been used historically in long bone fractures with success. In recent years, a variety of intramedullary implants for the treatment of fibular fractures have been investigated. These various implants have not been assessed together in a cohesive manner. In this review, we assess implants used for intramedullary fixation of fibular fractures with respect to implant design and clinical results. Methods: A comprehensive systematic literature review for intramedullary implants in fibular fractures was performed. All publications that assessed intramedullary fibular implants were reviewed. In total, 11 different intramedullary nails were found. Clinical results obtained from these studies were reviewed. Results: The intramedullary implants used for fibular fracture fixation generally fell into one of 3 categories: an unlocked longitudinal strut, an implant roughly equivalent to a large screw, or a more traditionally locked intramedullary nail. Reported clinical results were generally good, although inconsistent outcome reporting greatly limited comparison between studies. Complication rates varied with the implants but were generally low. Conclusion: Intramedullary implants for fibular fracture stabilization have changed over the years to improve stability. Although clinical results are limited, data suggest that these implants are safe and can potentially approximate more traditional implants. Level of Evidence: Level II, systematic review.
Ankle Motion and Offloading in Short Leg Cast and Low and High Fracture Boots
Authors: Nahm Nickolas , Bey Michael J. , Liu Serena , Guthrie S. Trent 
Published: August 2019

Background: Short leg casts (SLCs) and fracture boots are used to treat foot and ankle injuries, but the decision to use one device over the other is often subjective. This study compared the impact of SLCs and low and high fracture boots on ankle motion and offloading. Methods: Twenty healthy adults were prospectively studied. High-speed dynamic radiography was utilized to determine tibiotalar range of motion in the sagittal plane during nonweightbearing (NWB) and weightbearing (WB) gait in a shoe (control), SLC, and low and high fracture boots. Sensors captured peak plantar surface forces to determine ankle offloading. Results: In NWB, the low fracture boot (2.2 ± 2.0 degrees), high fracture boot (2.3 ± 1.6 degrees), and SLC (2.3 ± 1.5 degrees) had significantly less motion compared with the control (3.6 ± 2.1 degrees; P ≤ .026). During WB, the SLC (3.4 ± 1.4 degrees) and high fracture boot (4.8 ± 2.0 degrees) had less motion compared with the low fracture boot (7.8 ± 3.4 degrees; P < .001). Finally, the SLC (172.6% ± 48.3% body weight [BW]) and low fracture (165.1% ± 36.2% BW) and high fracture (154.5% ± 32.9% BW) boots were associated with less peak plantar surface force compared with the control (195.0% ± 43.8% BW; P ≤ .087). Conclusion: The SLC and high fracture boot immobilized the ankle in NWB and offloaded and immobilized the ankle in WB. The low fracture boot also immobilized the ankle in NWB, but in WB, the low fracture boot only offloaded the ankle and did not immobilize it. Clinical Relevance: The low fracture boot may be more suited for NWB or possibly immobilizing the foot in WB.
Clinical Results of Bioabsorbable Pin Fixation Relative to the Bone Condition for Osteochondral Lesion of the Talus
Authors: Nakasa Tomoyuki , Ikuta Yasunari , Ota Yuki , Kanemitsu Munekazu , Adachi Nobuo 
Published: August 2019

Background: Fixation of an osteochondral lesion of the talus (OLT) can restore the natural congruency of the joint surface with hyaline cartilage. In this procedure, the bone condition of the osteochondral fragment is important for stabilizing the lesion, and it may affect clinical outcomes. The aim of this study was to explore the influence of the fragment’s bone condition on clinical outcomes. Methods: Eighteen ankles in 17 patients with a mean age of 20.1 years, which had undergone fixation of an OLT using bioabsorbable pins, were included. Based on the fragment’s bone condition on preoperative computed tomography scans, ankles were divided into 3 groups: normal, segmentation, and absorption. The American Orthopaedic Foot & Ankle Society (AOFAS) scale and magnetic resonance imaging (MRI) findings were evaluated both pre- and postoperatively. Second-look arthroscopic findings were evaluated in 15 ankles and were compared with biopsy specimens from the initial surgery. Results: The AOFAS scale significantly improved at the final follow-up in all groups with no significant differences among the 3 groups. MRI at 1 year showed good bone incorporation and a congruent cartilage surface in all groups, but the bone marrow lesion in the absorption group was significantly larger than that in the other groups. In second-look arthroscopy, all ankles showed stable and near-normal cartilage. There was no significant correlation between arthroscopic and histological findings. Conclusion: We found that fixation can be considered when there is a good cartilage surface on a large OLT, even if bone absorption in the fragment exists. Level of Evidence: Level III, comparative study.
Reliability of colour perimetry to assess macular pigment optical density in age-related macular degeneration
Authors: Coco-Martín Rosa M , Pichel-Mouzo María , Fernández Itziar , Plata-Cordero María , Lopez-Miguel Alberto 
Published: August 2019

Background: The aim of this study was to determine the intra-session repeatability and inter-examiner reproducibility of the colour perimetry technique when assessing in vivo macular pigment optical density in age-related macular degeneration patients. Methods: Age-related macular degeneration patients were classified into four groups: early age-related macular degeneration, intermediate age-related macular degeneration, atrophic age-related macular degeneration and neovascular age-related macular degeneration after undergoing fundus photography (TRC 50DX type IA) and spectral-domain optical coherence tomography analysis (Topcon 3D-2000). Central fixation was confirmed in all patients using the MP-1 microperimeter (Nidek, Padua, Italy). To analyse repeatability, one examiner obtained three consecutive macular pigment optical density measures with MonCV3 device (Metrovision, Perenchies, France). To study agreement between two observers, a second examiner performed another macular pigment optical density measurement in random order. Within-subject standard deviation, coefficient of variation, and intraclass correlation coefficient data were obtained. Results: Fifty two (32 females and 20 males) consecutive age-related macular degeneration patients having a mean age of 71.5 ± 8.2 years were recruited. Six had early age-related macular degeneration, 25 had intermediate age-related macular degeneration, 10 had atrophic age-related macular degeneration and 11 had neovascular age-related macular degeneration. For repeatability, coefficient of variation values ranged from 22.3% (neovascular age-related macular degeneration) to 41.0% (atrophic age-related macular degeneration) and intraclass correlation coefficient values from 0.52 (intermediate age-related macular degeneration) to 0.79 (neovascular age-related macular degeneration). For agreement between two examiners, coefficient of variation values ranged from 20.1% (intermediate age-related macular degeneration) to 37.8% (neovascular age-related macular degeneration) and intraclass correlation coefficient values from 0.61 (neovascular age-related macular degeneration) to 0.80 (atrophic age-related macular degeneration). Conclusion: The reliability (intra-session repeatability and inter-examiner reproducibility) of colour perimetry technique to assess macular pigment optical density in age-related macular degeneration patients is only moderate. Thus, it cannot be recommended to be performed when evaluating and monitoring age-related macular degeneration patients in the daily clinic.
Cannulation practices at haemodialysis initiation via an arteriovenous fistula or arteriovenous graft
Authors: Hill Kathleen , Sharp Rebecca , Childs Jessie , Esterman Adrian , Le Leu Richard , Juneja Rajiv , Jesudason Shilpa 
Published: August 2019

Introduction: A functioning long-term vascular access is required for haemodialysis therapy; however, establishing this can be challenging in the setting of advanced age and vessels damaged by diabetes. Complications include the inability to insert two needles for the treatment resulting in miscannulation trauma and in some cases insertion of a temporary central venous access device. The broad objective of this review is to define the evidence base regarding cannulation practices in the initiation of haemodialysis via an arteriovenous fistula or an arteriovenous graft. Methods: This review uses the framework recommended by the Joanna Briggs Institute and the process by which papers were included or excluded followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses group approach. A total of 20 primary research studies met the inclusion criteria. Results: Cannulation in the 10- to 15-week period rather than delaying past this time frame is associated with the best outcomes. New vascular access given time to mature through single-needle haemodialysis treatments may improve long-term patency. Duplex ultrasound mapping prior to initiation of cannulation supports the clinical decision-making process on timing of and selection of cannulation sites. Conclusion: Cannulation trauma at the initiation of haemodialysis could potentially be reduced with a strategy of incremental haemodialysis using single-needle treatment supported with duplex ultrasonography assessment to ‘map’ the vascular access as a guide for clinicians prior to cannulation initiation.
The Correlation Between Preoperative Findings of High-Resolution Computed Tomography (HRCT) and Intraoperative Findings of Chronic Otitis Media (COM)
Authors: Aljehani Mariam , Alhussini Rayan 
Published: August 2019

Objectives: The aim of this study was to investigate the correlation between the preoperative findings of high-resolution computed tomography (HRCT) of temporal bone in chronic otitis media (COM) and the intraoperative findings. Methods: This retrospective study was conducted in the ORL-HNS Unit at Ohud Hospital, Medina, Saudi Arabia, during the period from January to September 2018. We included all patients with COM, and an informed consent was obtained from all participants. The HRCT images were studied in comparison with the intraoperative findings. The parameters of comparison were tympanic membrane, middle ear structures, and the status of cholesteatoma. Results: A total of 39 patients were included in the analysis: 14 male and 25 female patients. The age range was 9 to 50 years. As a result of the comparison between HRCT findings and intraoperative observations, we found that incus erosion through computed tomography (CT) was the same as during surgical observation in 12 cases (30.8%). Malleus appeared eroded on CT in 1 case (2.6%); however, 5 cases were seen with that observation during operation (12.8%). Cholesteatoma was similarly seen in the CT scan and during surgery with a significant relation between intraoperative cholesteatoma extending and HRCT findings of the disease (95% confidence level, P-value = 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 100% for detecting sigmoid plate erosion, dura exposure, incus erosion, stapes erosion, and malleus-incus joint discontinuity through preoperative CT. Conclusions: Intraoperative findings and HRCT have shown better results with good correlation of diagnostic value regarding the comparisons between recorded observations, especially in detecting sigmoidal plate erosion, dural exposure, incus and stapes erosion, and malleus-incus joint discontinuity. Preoperative CT scan is beneficial and contributory in the decision of indicating surgery to patients.