bluuebunny/crossref_metadata_2025_split huggingface dataset:
P09 Juvenile osteochondritis dissecans in juvenile idiopathic arthritis: a case series review
Authors: Ward Oliver , Leach Samantha , McMahon Anne-Marie , Tattersall Rachel S. , Nicolaou Nicolas , Hawley Daniel 
Published: September 2019

Abstract

Background
Juvenile osteochondritis dissecans (JOCD) is a condition of bone and cartilage lesions. Contributory factors may include ischaemia, trauma, genetic or biomechanical factors such as abnormal joint loading. Children and young people (CYP) with juvenile idiopathic arthritis (JIA) have low physical activity levels, present with joint abnormalities and are exposed to immunosuppression including steroids which may cause reduced bone density. Here we describe JOCD in CYP with JIA in our service.

Methods
Retrospective reviews of case notes were conducted for current CYP with JIA in our service with known JOCD, detailing: JIA diagnosis Age & BMI at diagnosisSymptom duration pre-diagnosisManagement (including steroids)JOCD diagnosis Age & BMI at diagnosisImagingManagement

Results
Table 1 summarises the results. Twelve (n = 10 female) CYP in our cohort of 270 had JOCD with 20 lesions diagnosed on magnetic resonance imaging (MRI). Polyarticular (n = 4) and extended oligoarticular (n = 5) were the commonest JIA sub-types with all CYP receiving systemic therapy and 75% (n = 9) requiring more than one biologic.
Mean symptom duration before JIA diagnosis was 6 months (range: 1-24 months) with a mean age of 6.5 years (range: 1.5-13 years). Mean time to JOCD diagnosis was 5.5 years (range: 1.5-10.25 years) with a mean age of 12 years (range: 8-17 years) and 7 CYP having a high BMI (>85th percentile for age). The mean number of previous steroid injections per JOCD joint was 4 (range: 0-17) compared with 3 (range: 0-8) in the non-JOCD joint. Talar dome lesions (n = 9) were commonest, followed by femoral condyle (n = 4 medial, n = 3 lateral). Initial management was conservative, with half (n = 10) requiring surgery. P09 Table 1

Conclusion
This review identifies that 4% (n = 12/270) of our CYP with JIA have known JOCD, compared with 0.03% (n = 29/100,000) of the general population. Risk factors appear to be polyarticular disease, exposure to ≥ 4 steroid injections per joint, biologic-resistant disease and high BMI with low physical activity. Where CYP with JIA report symptoms which do not fit an inflammatory pattern there should be a low threshold to consider JOCD, with prospective research needed to better understand the relationship between JOCD and JIA.

Conflicts of Interest
The authors declare no conflicts of interest.
P17 What is the experience of pain pre- and post intra-articular steroid injections in children and young people with juvenile idiopathic arthritis?
Authors: Bull Samantha , Hawley Daniel , Lee Helen , Armstrong Shirley , Peech Francesca , Edgerton Jenny , Leach Samantha , Nash Clare , McMahon Anne-Marie 
Published: September 2019

Abstract

Background
A rheumatology service evaluation was carried out in 2016 whereby we sought to understand whether children and young people (CYP) are receiving appropriate pain relief post-administration of steroid intra-articular injections (IAI’s) and whether extended time waiting for IAI’s increases CYP experience of pain.
The British Society for Rheumatology BSPAR section Standard of Care for children and young people with JIA recommends 4 weeks or less waiting time for steroid IAI under general anaesthetic (GA) and 10 days or less for steroid IAI under entonox.

Methods
Data collection was obtained by patient questionnaire over a 4-month period. Parents/carers and CYP were asked to complete a questionnaire pre-steroid IAI (by a member of staff on the day of the IAI) and the same questionnaire post-steroid IAI (by telephone by the author within 2 weeks of the date of the IAI).
Twenty parents/carers or CYP completed the questionnaires. Sixteen of the CYP were female and 4 were male. Median age was 3 years. Eighty percent had a diagnosis of oligoarticular juvenile idiopathic arthritis (JIA). Seventy-five percent had IAI’s under GA and 25% with Entonox. Fifty-four percent had knee(s) injected and 23.5% had ankle(s) injected.

Results
Sixty percent of CYP waited for 4 weeks or less for steroid IAI under GA. Twenty percent of CYP waited for less than 10 days for steroid IAI under entonox. The range of pain scores for CYP pre IAI was 0-10 and the median was 5. Post IAI the range of pain scores was 0-8 and the median was 3. A positive correlation was found between those waiting longer for IAI’s and higher pain scores.
P17 Table 1: CYP experience of pain Pre IAI Post IAI Pain in joints injected or due to be injected 95% 55% CYP taking pain medication 85% 55% Type of pain medication: Diclofenac 10% 10% Ibuprofen 25% 10% Naproxen 5% 5% Naproxen & codeine 5% 0% Naproxen & oramorph 0% 5% Paracetamol 10% 10% Paracetamol & ibuprofen 30% 15% None 15% 40% Refusing 0% 5% General activity affected 90% 60% Pain medication required 80% 50% Pain medication effective 80% (100% of CYP requiring medication) 50% (100% of CYP requiring medication)

Conclusion
In our small cohort, fifty percent of CYP required no pain medication post-IAI, and fifty percent of CYP who did require pain medication post-IAI perceived the pain medication they were receiving was adequate (Table 1).
A positive correlation was found between CYP waiting longer for IAI’s and CYP experiencing higher pain scores therefore, accepting our modest sample size, this service evaluation supports ensuring timely access to IAI and the avoidance of longer waiting times.

Conflicts of Interest
The authors declare no conflicts of interest.
Risk Factors for Dry Eye After Refractive Surgery
Authors: Shehadeh-Mashor Raneen , Mimouni Michael , Shapira Yinon , Sela Tzahi , Munzer Gur , Kaiserman Igor 
Published: September 2019

Purpose:
To determine the factors associated with clinically significant dry eye after keratorefractive surgery.

Methods:
This is a large database retrospective study that included consecutive cases of myopic laser in situ keratomileusis (LASIK) or photorefractive keratectomy performed between 2008 and 2016 at Care-Vision Laser Center, Israel. Patients were divided into 2 groups according to whether they developed clinically significant dry eye.

Results:
A total of 25,317 right eyes of 25,317 patients, with a mean age of 27.0 ± 8.3 years, were included. Postoperative dry eye developed in 1518 eyes (6.0%). The dry eye group was older (29.2 ± 9.0 vs. 27.6 ± 8.3 yrs, P < 0.001) and had a higher proportion of women (48.5% vs. 44.8%, P = 0.005), lower preoperative spherical equivalent (3.7 ± 2.0 vs. 4.0 ± 2.3D, P < 0.001), lower preoperative best-corrected visual acuity (0.019 ± 0.057 vs. 0.016 ± 0.064 Logarithm of the Minimum Angle of Resolution (LogMAR), P = 0.04), and lower proportion of preoperative soft contact lens wearers (40.6% vs. 45.5%, P < 0.001). In the postoperative dry eye group, a high proportion underwent LASIK (52.4% vs. 38.7%, P < 0.001) and were treated with a 7.0-mm (as opposed to 6.0 mm) optic zone (18.9% vs. 16.3%, P < 0.001). In multivariable analysis, older age [odds ratio (OR) 1.013, P < 0.001], female gender (OR 0.87, P = 0.009), lower preoperative refractive error (OR 1.05, P < 0.001), and LASIK (OR 0.67, P < 0.001) were associated with postoperative dry eye.

Conclusions:
Patients who are of older age, are of female gender, and have a lower preoperative refractive error and those undergoing LASIK are more likely to develop dry eye disease after keratorefractive surgery.
The Weekend Effect in Older Adult Urosepsis Admissions
Authors: Peach Brian C. , Li Yin , Cimiotti Jeannie P. 
Published: September 2019

Background:
Urosepsis is common in older adults with more infections identified as community-acquired as opposed to hospital-acquired. Despite the prevalence of urosepsis and its high mortality rates, very little is known about the care outcomes of older adult patients with community-acquired urosepsis who are admitted to the hospital on a weekend.

Objectives:
To determine if a weekend admission was associated with inpatient mortality in older adults admitted to an acute care hospital with a diagnosis of community-acquired urosepsis.

Methods:
Data from the State Inpatient Datasets for Florida were merged with data from the American Hospital Association Annual Survey on hospital characteristics for the year 2014. Logistic regression models with a sizable number of patient and hospital controls were used to identify factors associated with inpatient mortality in patients 65 years of age and older with a primary or secondary diagnosis of community-acquired urosepsis.

Results:
In total 21,904 older adults were admitted to a Florida hospital with a diagnosis of community-acquired urosepsis; 5736 of these patients were admitted on a weekend. In a fully adjusted logistic regression model, weekend admission was associated with a 12% increase in the odds of mortality, and each additional hour of nursing care per patient day was associated with a 2% decrease in the odds of mortality.

Conclusions:
Our findings suggest that weekend admission was associated with an increase in the odds of mortality in older adults with community-acquired urosepsis. Small increases in nurse staffing seem to reduce the odds of mortality.
Minor Hepatectomies: Focusing a Blurred Picture
Authors: Viganò Luca , Torzilli Guido , Troisi Roberto , Aldrighetti Luca , Ferrero Alessandro , Majno Pietro , Toso Christian , Figueras Joan , Cherqui Daniel , Adam René , Kokudo Norihiro , Hasegawa Kiyoshi , Guglielmi Alfredo , Krawczyk Marek , Giuliante Felice , Hilal Mohammad Abu , Costa-Maia José , Pinna Antonio Daniele , Cescon Matteo , De Santibanes Eduardo , Urbani Lucio , Pawlik Timothy , Costa Guido , Zugna Daniela 
Published: September 2019

Objective:To elucidate minor hepatectomy (MiH) outcomes.Summary Background Data:Liver surgery has moved toward a parenchyma-sparing approach, favoring MiHs over major resections. MiHs encompass a wide range of procedures.Methods:We retrospectively evaluated consecutive patients who underwent open liver resections in 17 high-volume centers. Exclusion criteria: cirrhosis and associated digestive/biliary resections. Resections were classified as (Brisbane nomenclature): limited resections (LR); (mono)segmentectomies/bisegmentectomies (Segm/Bisegm); right anterior and right posterior sectionectomies (RightAnteriorSect/RightPosteriorSect). Additionally, we defined: complex LRs (ComplexLR = LRs with exposed vessels); postero-superior segmentectomies (PosteroSuperiorSegm = segment (Sg)7, Sg8, and Sg7+Sg8 segmentectomies); and complex core hepatectomies (ComplexCoreHeps = Sg1 segmentectomies and combined resections of Sg4s+Sg8+Sg1). Left lateral sectionectomies (LLSs, n = 442) and right hepatectomies (RHs, n = 1042) were reference standards. Outcomes were adjusted for potential confounders.Results:Four thousand four hundred seventy-one MiHs were analyzed. Compared with RHs, MiHs had lower 90-day mortality (0.5%/2.2%), severe morbidity (8.6%/14.4%), and liver failure rates (2.4%/11.6%,P< 0.001), but similar bile leak rates. LR and LLS had similar outcomes. ComplexLR and Segm/Bisegm of anterolateral segments had higher bile leak rates than LLS rates (OR = 2.35 and OR = 3.24), but similar severe morbidity rates. ComplexCoreHeps had higher bile leak rates than RH rates (OR = 1.94); the severe morbidity rate approached that of RH. PosteroSuperiorSegm, RightAnteriorSect, and RightPosteriorSect had severe morbidity and bile leak rates similar to RH rates. MiHs had low liver failure rates, except RightAnteriorSect (vs LLS OR = 4.02).Conclusions:MiHs had heterogeneous outcomes. Mortality was low, but MiHs could be stratified according to severe morbidity, bile leak, and liver failure rates. Some MiHs had postoperative outcomes similar to RH.
Vortex motion and geometric function theory: the role of connections
Authors: Gustafsson Björn 
Published: September 2019

We formulate the equations for point vortex dynamics on a closed two-dimensional Riemannian manifold in the language of affine and other kinds of connections. This can be viewed as a relaxation of standard approaches, using the Riemannian metric directly, to an approach based more on local coordinates provided with a minimal amount of extra structure. The speed of a vortex is then expressed in terms of the difference between an affine connection derived from the coordinate Robin function and the Levi–Civita connection associated with the Riemannian metric. A Hamiltonian formulation of the same dynamics is also given. The relevant Hamiltonian function consists of two main terms. One of the terms is the well-known quadratic form based on a matrix whose entries are Green and Robin functions, while the other term describes the energy contribution from those circulating flows which are not implicit in the Green functions. One main issue of the paper is a detailed analysis of the somewhat intricate exchanges of energy between these two terms of the Hamiltonian. This analysis confirms the mentioned dynamical equations formulated in terms of connections.
This article is part of the theme issue ‘Topological and geometrical aspects of mass and vortex dynamics’.
Winding of a Brownian particle around a point vortex
Authors: Wen Huanyu , Thiffeault Jean-Luc 
Published: September 2019

We derive the asymptotic winding law for a Brownian particle in the plane subjected to a tangential drift due to a point vortex. For winding around a point, the normalized winding angle converges to an inverse Gamma distribution. For winding around a disc, the angle converges to a distribution given by an elliptic theta function. For winding in an annulus, the winding angle is asymptotically Gaussian with a linear drift term. We validate our results with numerical simulations.This article is part of the theme issue ‘Topological and geometrical aspects of mass and vortex dynamics’.
Vortices and atoms in the Maxwellian era
Authors: Falconer Isobel 
Published: September 2019

The mathematical study of vortices began with Herman von Helmholtz's pioneering study in 1858. It was pursued vigorously over the next two decades, largely by British physicists and mathematicians, in two contexts: Maxwell's vortex analogy for the electromagnetic field and William Thomson's (Lord Kelvin) theory that atoms were vortex rings in an all-pervading ether. By the time of Maxwell's death in 1879, the basic laws of vortices in a perfect fluid in three-dimensional Euclidean space had been established, as had their importance to physics. Early vortex studies were embedded in a web of issues spanning the fields we now know as ‘mathematics’ and ‘physics’—fields which had not yet become institutionally distinct disciplines but overlapped. This paper investigates the conceptual issues with ideas of force, matter, and space, that underlay mechanics and led to vortex models being an attractive proposition for British physicists, and how these issues played out in the mathematics of vortices, paying particular attention to problems around continuity. It concludes that while they made valuable contributions to hydrodynamics and the nascent field of topology, the British ultimately failed in their more physical objectives.This article is part of the theme issue ‘Topological and geometrical aspects of mass and vortex dynamics’.
Euler flows and singular geometric structures
Authors: Cardona Robert , Miranda Eva , Peralta-Salas Daniel 
Published: September 2019

Tichler proved (Tischler D. 1970Topology9, 153–154. (doi:10.1016/0040-9383(70)90037-6)) that a manifold admitting a smooth non-vanishing and closed one-form fibres over a circle. More generally, a manifold admittingk-independent closed one-form fibres over a torusTk. In this article, we explain a version of this construction for manifolds with boundary using the techniques ofb-calculus (Melrose R. 1993The Atiyah Patodi Singer index theorem. Research Notes in Mathematics. Wellesley, MA: A. K. Peters; Guillemin V, Miranda E, Pires AR. 2014Adv. Math.(N. Y.)264, 864–896. (doi:10.1016/j.aim.2014.07.032)). We explore new applications of this idea to fluid dynamics and more concretely in the study of stationary solutions of the Euler equations. In the study of Euler flows on manifolds, two dichotomic situations appear. For the first one, in which the Bernoulli function is not constant, we provide a new proof of Arnold's structure theorem and describeb-symplectic structures on some of the singular sets of the Bernoulli function. When the Bernoulli function is constant, a correspondence between contact structures with singularities (Miranda E, Oms C. 2018 Contact structures with singularities.https://arxiv.org/abs/1806.05638) and what we callb-Beltrami fields is established, thus mimicking the classical correspondence between Beltrami fields and contact structures (see for instance Etnyre J, Ghrist R. 2000Trans. Am. Math. Soc.352, 5781–5794. (doi:10.1090/S0002-9947-00-02651-9)). These results provide a new technique to analyse the geometry of steady fluid flows on non-compact manifolds with cylindrical ends.This article is part of the theme issue ‘Topological and geometrical aspects of mass and vortex dynamics’.
Travel time to health facilities as a marker of geographical accessibility across heterogeneous land coverage in Peru
Authors: Carrasco-Escobar Gabriel , Manrique Edgar , Tello-Lizarraga Kelly , Miranda J. Jaime 
Published: September 2019

ABSTRACTThe geographical accessibility to health facilities is conditioned by the topography and environmental conditions overlapped with different transport facilities between rural and urban areas. To better estimate the travel time to the most proximate health facility infrastructure and determine the differences across heterogeneous land coverage types, this study explored the use of a novel cloud-based geospatial modeling approach and use as a case study the unique geographical and ecological diversity in the Peruvian territory. Geospatial data of 145,134 cities and villages and 8,067 health facilities in Peru were gathered with land coverage types, roads infrastructure, navigable river networks, and digital elevation data to produce high-resolution (30 m) estimates of travel time to the most proximate health facility across the country. This study estimated important variations in travel time between urban and rural settings across the 16 major land coverage types in Peru, that in turn, overlaps with socio-economic profiles of the villages. The median travel time to primary, secondary, and tertiary healthcare facilities was 1.9, 2.3, and 2.2 folds higher in rural than urban settings, respectively. Also, higher travel time values were observed in areas with a high proportion of the population with unsatisfied basic needs. In so doing, this study provides a new methodology to estimate travel time to health facilities as a tool to enhance the understanding and characterization of the profiles of accessibility to health facilities in low- and middle-income countries (LMIC), calling for a service delivery redesign to maximize high quality of care.
Behavior-dependent directional tuning in the human visual-navigation network
Authors: Nau Matthias , Navarro Schröder Tobias , Frey Markus , Doeller Christian F. 
Published: September 2019

AbstractThe brain derives cognitive maps from sensory experience that guide memory formation and behavior. Despite extensive efforts, it still remains unclear how the underlying population activity relates to active behavior and memory performance. To examine these processes, we here combined 7T-fMRI with a kernel-based encoding model of virtual navigation to map world-centered directional tuning across the human cortex. First, we present an in-depth analysis of directional tuning in visual, retrosplenial, parahippocampal and medial temporal cortices. Second, we show that tuning strength, width and topology of this directional code during memory-guided navigation depend on successful encoding of the environment. Finally, we show that participants’ locomotory state influences this tuning in sensory and mnemonic regions such as the hippocampus. We demonstrate a direct link between neural population tuning and human cognition and show that high-level memory processing interacts with network-wide environmental coding in the service of behavior.
Spinal signaling of C-fiber mediated pleasant touch in humans
Authors: Marshall Andrew G. , Sharma Manohar L , Marley Kate , Olausson Hakan , McGlone Francis P. 
Published: September 2019

AbstractC-tactile afferents form a distinct channel that encodes pleasant tactile stimulation. Prevailing views indicate they project, as with other unmyelinated afferents, in lamina I-spinothalamic pathways. However, we found that spinothalamic ablation in humans, whilst profoundly impairing pain, temperature and itch, had no effect on pleasant touch perception. Only discriminative touch deficits were seen. These findings preclude privileged C-tactile-lamina I-spinothalamic projections and imply integrated hedonic and discriminative spinal processing from the body.
ZapLine: a simple and effective method to remove power line artifacts
Authors: de Cheveigné Alain 
Published: September 2019

AbstractPower line artifacts are the bane of animal and human electrophysiology. A number of methods are available to help attenuate or eliminate them, but each has its own set of drawbacks. In this brief note I present a simple method that combines the advantages of spectral and spatial filtering, while minimizing their downsides. This method is applicable to multichannel data such as electroencephalography (EEG), magnetoencephalography (MEG), or multichannel local field potentials (LFP). I briefly review past methods, pointing out their drawbacks, describe the new method, and evaluate the outcome using synthetic and real data.
Peripherally expressed misfolded proteins remotely disrupt brain function and aggravate stroke-induced brain injury
Authors: Liu Yanying , Subedi Kalpana , Baride Aravind , Romanova Svetlana , Huber Christa C. , Wang Xuejun , Wang Hongmin 
Published: September 2019

AbstractImpaired proteostasis has been linked to various diseases, whereas little is known about the impact of peripherally misfolded proteins on the brain. We here studied the brain of mice with cardiomyocyte-restricted overexpression of a missense (R120G) mutant small heat shock protein, αB-crystallin (CryABR120G). At baseline, the CryABR120G mice showed impaired cognitive and motor functions, aberrant protein aggregates, neuroinflammation, impaired blood-brain barrier, and reduced proteasome activity in the brain compared with their non-transgenic (Ntg) littermates. Ischemic stroke dramatically exacerbated these pathological alterations and caused more severe brain dysfunction in CryABR120G mice than in the Ntg mice. Intravenously injecting the exosomes isolated from CryABR120G mouse blood into wild-type mice caused the similar phenotypes seen from CryABR120G mice. Importantly, the CryABR120G protein showed the prion-like properties. These results suggest that peripherally misfolded proteins in the heart remotely disrupt brain function through prion-like neuropathology, which may represent an underappreciated mechanism underlying heart-brain crosstalk.