bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of definition and methods on estimates of prevalence of large vessel occlusion in acute ischemic stroke: a systematic review and meta-analysis
Authors: Waqas Muhammad , Rai Ansaar T , Vakharia Kunal , Chin Felix , Siddiqui Adnan H 
Published: August 2019

IntroductionAccurate estimation of the incidence of large vessel occlusion (LVO) is critical for planning stroke systems of care and approximating workforce requirements. This systematic review aimed to estimate the prevalence of LVO among patients with acute ischemic stroke (AIS), with emphasis on definitions and methods used by different studies.MethodsA systematic literature review was performed to search for articles on the prevalence of LVO and AIS. All articles describing the frequency of LVO frequency among AIS patients were included. Studies without consecutive recruitment or confirmation of LVO with CT angiography or MR angiography were excluded. Heterogeneity of the studies was assessed; meta-regression was performed to estimate the effect of LVO definition and study methods on LVO prevalence.Results18 articles met the inclusion criteria: 5 studies presented population based estimates; 13 provided single hospital experiences (5 prospective, 8 retrospective). The AIS denominator (number of all AIS) from which LVO rates were generated was variable. Nine different definitions were used, based on occlusion site. Significant heterogeneity existed among the studies (I2=99%, P<0.001). The prevalence of LVO among patients with suspected AIS ranged from 13% to 52%. Overall prevalence was 30.0% (95% CI 25.0% to 35.0%). Pooled prevalence of LVO among suspected AIS patients was 21% (95% CI 19% to 30%). Based on meta-regression, the method of AIS denominator determination significantly influenced heterogeneity (P=0.018).ConclusionThe heterogeneity of LVO estimates was remarkably high. The method of AIS denominator determination was the most significant predictor of LVO estimates. Studies with a standardized LVO definition and methods of AIS estimation are necessary to estimate the true prevalence of LVO among patients with AIS.
Thoracic meningomyelocele associated with spina bifida in a Malinois dog
Authors: Musso Clément , Bismuth Camille , Cauzinille Laurent 
Published: August 2019

An 8‐month‐old male Malinois dog was presented for progressive chronic pelvic limbs ataxia, paraparesis, arched back since ambulation associated with mild urinary and faecal incontinence. Clinical evaluation revealed a dorsocaudal thoracic spine non‐healing wound with a fistula from which a clear fluid leaked. Neurological examination was compatible with a T3‐L3 spinal cord lesion. CT myelography showed a T11‐T12 spina bifida associated with a meningomyelocele with a fistula tract to the skin (spina bifida aperta). An MRI revealed a syringohydromyelia cranially and caudally to the meningomyelocele. Surgical correction involved removal of the fistula up to the dura mater and closure. A 4 and 12 months clinical and MRI follow up revealed a good locomotion improvement with residual mild ataxia without incontinence. MRI showed no relapse of the meningomyelocele but persistent although reduced syringohydromyelia.
Association between Functional Outcomes and Radiographic Reduction Following Surgery for Distal Radius Fractures
Authors: Wollstein Ronit , Allon Raviv , Zvi Yoav , Katz Alan , Werech Sharon , Palmon Orit 
Published: August 2019

Background: Quality of reduction in distal radius fractures (DRF) is assessed using radiographic parameters, however few studies examine the association between radiographic measurements and functional outcomes. Our purpose was to evaluate the relationship between radiographic measurements and clinical outcome measures following surgery for DRF using detailed testing to demonstrate further associations between post-surgical radiographic measurements and function. Methods: Measurements were performed on postoperative radiographs of 38 patients following ORIF of DRF. Measurements included: radial inclination, radial height, ulnar variance, volar tilt, radiocarpal interval (d2/w2), and the intra-articular step-off. Clinical outcome measures included motion, grip strength, functional dexterity testing, Moberg pick-up test, specific activities of daily living, DASH score, pain scale, manual-assessment questionnaire. Results: Different radiographic parameters correlated with different specific tasks. The parameter correlated with most functional tasks was ulnar-variance. Radial inclination, radial-styloid scaphoid distance, and fracture classification correlated with some functions. Intraarticular step-off, and radial height were not associated with functional testing. Conclusions: Surgical radiographic results may affect post-operative function. Detailed task specific testing may enable a better evaluation of surgical outcomes. Further study and refinement of functional assessment may change our surgical goals in DRF.
Metaphyseal Core Decompression of the Distal Radius for Early Lunate Necrosis
Authors: Schulz Christoph U. 
Published: August 2019

Background: Metaphyseal core decompression of the distal radius (MCD) is clinically effective in early lunate necrosis without changing individual wrist mechanics. Its concept is based on the induction of physiologic mechanisms known as physiologic fracture healing response. However, this biological concept does not yet have its place in the historically developed mechanical concepts about Kienböck’s disease and requires more detailed clarifications to understand when a change of individual wrist mechanics might be unnecessary.Methods: Thirteen consecutive cases, Lichtman stage I (n = 1) or II (n = 12), confirmed by conventional MRI, were treated by MCD. Time off work, changes in magnetic resonance imaging of the lunate, as well as clinical outcome using modified Mayo wrist score were evaluated at final follow-up.Results: Return to work was at six (1–10) weeks after surgery. MRI controls at short-term generally demonstrated stop of progression and signs of bone healing. Independently from ulna variance complete signal normalization was observed in six and a distinct, yet incomplete decrease of lunate bone marrow edema and zones of fat necrosis was confirmed in further six cases after a mean of 21 (13–51) weeks. One patient had radiographic controls only, stating normal healing at 56 months. After a mean follow-up of 37 (12–70) months the clinical outcomes were excellent in eleven and good in two cases (mean 95% in modified Mayo wrist score).Conclusions: In stage I and II lunate necrosis MCD stops disease progression, it improves clinical symptoms and induces normalization of lunate bone signal alterations in MRI. Findings suggest that stage I and II lunate necrosis can be effectively treated without alterations of individual wrist mechanics. Future studies are necessary to readjust common concepts regarding Kienböck’s disease, especially focusing on conservative therapy.
Minimum Ten-Year Outcomes of Partial Ulnar Nerve Transfer for Restoration of Elbow Flexion in Patients with Upper Brachial Plexus Injury
Authors: Nagano Yusuke , Kawamura Daisuke , Terkawi Alaa , Urita Atsushi , Matsui Yuichiro , Iwasaki Norimasa 
Published: August 2019

Background: Partial ulnar nerve transfer to the biceps motor branch of the musculocutaneous nerve (Oberlin’s transfer) is a successful approach to restore elbow flexion in patients with upper brachial plexus injury (BPI). However, there is no report on more than 10 years subjective and objective outcomes. The purpose of this study was to clarify the long-term outcomes of Oberlin’s transfer based on the objective evaluation of elbow flexion strength and subjective functional evaluation of patients.Methods: Six patients with BPI who underwent Oberlin’s transfer were reviewed retrospectively by their medical records. The mean age at surgery was 29.5 years, and the mean follow-up duration was 13 years. The objective functional outcomes were evaluated by biceps muscle strength using the Medical Research Council (MRC) grade at preoperative, postoperative, and final follow-up. The patient-derived subjective functional outcomes were evaluated using the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at final follow-up.Results: All patients had MRC grade 0 (M0) or 1 (M1) elbow flexion strength before operation. Four patients gained M4 postoperatively and maintained or increased muscle strength at the final follow-up. One patient gained M3 postoperatively and at the final follow-up. Although one patient achieved M4 postoperatively, the strength was reduced to M2 due to additional disorder. The mean score of QuickDASH was 36.5 (range, 7–71). Patients were divided into two groups; three patients had lower scores and the other three patients had higher scores of QuickDASH.Conclusions: Oberlin’s transfer is effective in the restoration of elbow flexion and can maintain the strength for more than 10 years. Patients with upper BPI with restored elbow flexion strength and no complicated nerve disorders have over ten-year subjective satisfaction.
Diabetic Hand Infection: An Emerging Challenge
Authors: Bahar Moni Ahmed Suparno , Hoque Monirul , Mollah Rayhan Ali , Ivy Razia Sultana , Mujib Israt 
Published: August 2019

Background: Hand infection in diabetics is an often ignored but challenging condition. If not addressed effectively, it may result in long term disability, contracture, amputation and even death.Methods: From August 2014 to December 2015, a study was done in our centre, where 49 diabetic hand infection cases were analyzed in two groups, superficial and deep hand infection.Results: Mean age of the patients was 51.63 years. There were 21 superficial infections and 28 deep infections. Cause of infection was unknown or spontaneous in 16 cases, traumatic laceration or crush in 14 patients, following minor prick in 10 cases. Most of the cases were the results of neglected minor wound. Forty-one patients were insulin dependent. Five cases were diagnosed as diabetic at the time of treatment. Four patients were treated conservatively and 45 (92%) cases required operation in the form of incision, drainage and debridement. In 16 (35%) cases, wound was left open and was healed by secondary intention following regular dressing. In five patients, wound was closed secondarily. Partial thickness skin graft was applied in 15 cases. Seven patients were treated with flap coverage. Partial digital or ray amputation were done in 16 cases. All fingers except thumb were amputated in one case and amputation from wrist was done in another patient. Wound swabs were taken, and antibiotics were changed or continued accordingly. But reports of 26 cases were available. No growth was found in four cases, monomicrobial infection was found in 15 patients and polymicrobial in seven cases. Infection resolved with healing in 47 cases. Two patients died during treatment from sepsis, both were insulin dependent, had associated renal failure and from deep infection group. One patient developed severe mental disorder.Conclusions: For diabetic hand infection, early diagnosis and prompt treatment with appropriate antibiotics and emergency surgery with extensile incision is crucial. Primary amputation of the part could be life and limb saving.
Carpal Tunnel Release Surgery Plus Intraoperative Corticosteroid Injection versus Carpal Tunnel Release Surgery Alone: A Double Blinded Clinical Trial
Authors: Mottaghi Mohammad , Zare Mostafa , Pahlavanhosseini Hamid , Mottaghi Mina 
Published: August 2019

Background: Carpal tunnel syndrome is a prevalent disease with significant morbidity. The current treatments range from oral medication and local corticosteroid injection to surgical carpal tunnel release (CTR). In this study, we tried to assess the results of Carpal Tunnel Release surgery in combination with the anti-inflammatory effect of local corticosteroid injection. Methods: 65 patients were enrolled by clinical and electrodiagnostic tests and randomly divided into two groups, 32 in group one which underwent surgery with Dexamethasone injection and 33 in group 2 which intervened with carpal tunnel release surgery alone. Data on Boston questionnaire of patients were conducted before and two weeks after surgery. Distal motor and sensory latencies of patients were recorded before and two months after surgery. Mean values were compared between groups before and after surgery. Results: The mean preoperative Boston index was 35.83 in group one and 37.7 in group two, these data postoperative were 15.83 and 19.15 respectively. The mean preoperative distal sensory latency was 54.8 in group one and 47.6 in group two, these data postoperative were 34.1 and 35.1 respectively. The mean preoperative distal motor latency was 63.2 in group one and 62.3 in group two, these data postoperative were 44.5 and 46.55 respectively. Conclusions: CTR surgery plus local corticosteroid injection did not significantly change in results of Electrodiagnostic test or Boston index compared to the non-injection group.
Les démêlés des écrivains avec la justice
Authors: Masson Jean-Pol 
Published: August 2019

Cette contribution vise à donner un aperçu des difficultés que les écrivains français et belges ont eues avec la justice de leur pays, plus précisément des poursuites que leur activité littéraire leur a values de la part du ministère public. Les poursuites intentées contre les auteurs peuvent être dues à des écrits de nature politique. On en rencontre sous l’Ancien Régime (Diderot, Rousseau), pendant la Révolution (André Chénier), sous la Restauration (Paul-Louis Courier, Béranger), sous le règne de Louis-Philippe (Daumier), chaque fois lorsque l’écrivain s’en prend à un aspect ou l’autre du système politique. On traite aussi, du procès fait à Zola, sous la démocratique IIIe République, pour avoir critiqué le fonctionnement de la justice militaire. Nouvelles poursuites pendant la seconde guerre mondiale, à l’encontre des auteurs déplaisant au gouvernement de Vichy ou à l’occupant allemand. Renversement de situation à la Libération : ce sont cette fois les écrivains collaborationnistes qui se retrouvent devant les juridictions et qui sont parfois sévèrement condamnés (ainsi Brasillach, condamné à mort). L’autre type de poursuites dirigées contre les écrivains concerne les ouvrages jugés contraires aux bonnes mœurs. Il y a des procès de ce genre dès le XVIIe siècle (Théophile de Viau). On en rencontre au XIXe siècle, les plus célèbres étant ceux qui visaient Flaubert et Baudelaire. La contribution examine, pour conclure, la question de la responsabilité des écrivains. Si nous sommes choqués par les ennuis faits à plusieurs auteurs par des régimes non démocratiques, il est en revanche normal que certains écrits, comme ceux qui glorifiaient l’antisémitisme ou d’autres théories des nationaux-socialistes, aient valu des poursuites à leurs auteurs.
In-vitro performance of a low flow extracorporeal carbon dioxide removal circuit
Authors: Barrett Nicholas A , Hart Nicholas , Camporota Luigi 
Published: August 2019

Introduction: Extracorporeal gas exchange requires the passage of oxygen and carbon dioxide (CO2) across an artificial membrane. Current European Union regulations do not require the transfer to be assessed in models using clinically relevant haemoglobin, making it difficult for clinicians to understand the CO2 clearance of a membrane, and how it changes in relation to sweep gas flow through the membrane. The characteristics of membrane CO2 clearance are described using a single membrane at different sweep gas flows in an in vitro model with clinically relevant haemoglobin concentrations using three separate methods of calculating CO2 clearance. Methods: To define the CO2 removal characteristics of the extra-corporeal CO2 removal (ECCO2R) device, we devised an in-vitro gas exchange circuit formed by a dedicated ECCO2R circuit (ALung, Pittsburgh, USA) in series with two membrane oxygenators. The system was primed with donated expired human red cells provided by the local blood bank. The experimental set-up allowed constant CO2 input (via one membrane oxygenator) with variable removal from a portion of the blood in a manner which was analogous to that seen in vivo. Blood gases were measured from different ports in the circuit in order to measure the experimental membrane CO2 clearance (VCO2). Results: Results demonstrate that the relationship between VCO2 and gas flow at a constant blood flow of 0.4 L/minute with a haemoglobin of 7 g/dL increases sharply from a gas flow of 0 to 2 L/min but plateaus at gas flows >4 L/minute. VCO2, calculated using three different methods, showed a strong linear correlation with minimal bias. Conclusions: The CO2 clearance of the membrane used in this bench test is non-linear. This has implications for clinical practice, especially during the weaning phase of the device.
Ethanol Alters Phenotype and Synthesis Activity of Rat Neonatal Articular Chondrocytes Grown in 2- and 3-Dimensional Culture
Authors: Tamiasso Natalia Viana , Silva Carla Maria Osório , Reis Amanda Maria Sena , Ocarino Natália Melo , Serakides Rogéria 
Published: August 2019

Objective We sought to evaluate the effect of different concentrations of ethanol on phenotype and activity of articular chondrocyte synthesis of neonatal rats in 2-dimensional (2D) and 3-dimensional (3D) culture. Methods Chondrocytes were cultured in chondrogenic medium with different concentrations of ethanol: 0.0% v/v (control); 0.05% v/v (8.6 mM); 0.25% v/v (42.9 mM), and 0.5% v/v (85.7 mM). Chondrocytes under 2D culture were subjected to MTT assay, while chondrocytes under 3D culture were processed for paraffin inclusion and stained by periodic acid Schiff (PAS) to evaluate mean chondrocyte diameter and percentages of cells, nucleus, cytoplasm, well-differentiated matrix, and PAS+ areas. The expression of gene transcripts for aggrecan, Sox9, and type II collagen was evaluated by real-time quantitative polymerase chain reaction. Results There was no difference between groups by the MTT assay. PAS staining revealed that chondrocytes treated with 0.5% v/v ethanol had higher percentages of cytoplasm and nuclear areas, but with a reduction in PAS+ matrix area. The mean diameter of chondrocytes was similar between groups. The expression of aggrecan in the group treated with 0.5% v/v ethanol was lower in comparison to that in the control. In the groups treated with 0.25% v/v and 0.5% v/v ethanol, the percentage of differentiated cartilage was lower in comparison with that in the control. The group treated with 0.05% v/v ethanol was similar to the control in all parameters. Conclusions Ethanol acted directly on in vitro cultured articular chondrocytes of newborn rats, altering the chondrocyte phenotype and its synthesis activity, and these effects were dose dependent.
Polypharmacy among community-dwelling elderly in Singapore: Prevalence, risk factors and association with medication non-adherence
Authors: Tan Yi Wen , Suppiah Sumithra , Bautista Mary Ann C , Malhotra Rahul 
Published: August 2019

Background: Polypharmacy, given its link with drug interactions, potentially inappropriate medications and medication non-adherence, may pose a significant health risk, especially among the elderly. A comprehensive understanding of the epidemiology of polypharmacy is essential for countries facing population ageing and growing chronic disease burden, like Singapore. Objectives: We assessed the prevalence and risk factors of polypharmacy (⩾5 prescription medications) among community-dwelling elderly in Singapore and established the association of polypharmacy with medication non-adherence. Methods: We used data from a national sample of 1499 community-dwelling elderly aged ⩾66 years. Using logistic regression, we assessed the association of socio-demographic, health and healthcare use variables with polypharmacy, and polypharmacy with medication non-adherence. Results: The weighted prevalence of polypharmacy was 14.5%. In multivariable analysis, elderly who were men (versus women), with ⩾2 (versus 0–1) chronic diseases, aged ⩾85 (versus 66–69) years, and of Malay and Indian (versus Chinese) ethnicity were significantly more likely to have polypharmacy; healthcare use variables were not associated. Polypharmacy was significantly correlated with medication non-adherence. Conclusions: The prevalence of polypharmacy among community-dwelling elderly in Singapore is lower than that reported in other countries; however, polypharmacy is associated with medication non-adherence. Elderly subgroups, defined by gender, health status, age and ethnicity, who are at a higher risk of polypharmacy will benefit from medication review and de-prescribing services.
A new primer construction technique that effectively increases amplification of rare mutant templates in samples
Authors: Huang Jr-Kai , Fan Ling , Wang Tao-Yeuan , Wu Pao-Shu 
Published: August 2019

AbstractBackgroundIn personalized medicine, companion diagnostic tests provide additional information to help select a treatment option likely to be optimal for a patient. Although such tests include several techniques for detecting low levels of mutant genes in wild-type backgrounds with fairly high sensitivity, most tests are not specific, and may exhibit high false positive rates. In this study, we describe a new primer structure, named ‘stuntmer’, to selectively suppress amplification of wild-type templates, and promote amplification of mutant templates.ResultsA single stuntmer for a defined region of DNA can detect several kinds of mutations, including point mutations, deletions, and insertions. Stuntmer PCRs are also highly sensitive, being able to amplify mutant sequences that may make up as little as 0.1% of the DNA sample.ConclusionIn conclusion, our technique, stuntmer PCR, can provide a simple, low-cost, highly sensitive, highly accurate, and highly specific platform for developing companion diagnostic tests.