bluuebunny/crossref_metadata_2025_split huggingface dataset:
Downstream vascular changes after flow-diverting device deployment in a rabbit model
Authors: Kolumam Parameswaran Praveen , Dai Daying , Ding Yong-Hong , Urban Matthew W , Manlove Logan , Sathish Venkatachalem , Cebral Juan R , Kallmes David F , Kadirvel Ramanathan 
Published: November 2018

BackgroundFlow diverters (FDs) are increasingly used in the treatment of intracranial aneurysms, and carry the risk of thromboembolic complications, even in patients treated with dual antiplatelet therapy. The effect of FDs on the downstream vascular is unknown. The aim of the study was to investigate vascular wall pulse wave velocity (PWV) and contractility changes following FD treatment in a rabbit model.MethodsFDs (Pipeline Embolic Device, Medtronic Inc., Irvine, California, USA) were implanted in the aorta of normal rabbits and sham-operated aorta were used as controls (n=6 per group). Pulse wave imaging with ultra-fast ultrasound at 1600 frames per second (Vantage, Verasonics, Inc., Kirkland, WA) was performed in the vessel wall distal to FD prior to device implantation and at 8- week follow-up to measure the PWV. Force contraction vascular reactivity studies were conducted in the aortic rings using an organ bath.ResultsThe difference in mean PWV in the follow-up compared with pre-implantation was significantly higher in the distal vessels compared with sham controls (1.18 m/s [SD=0.54] vs. 0.37 m/s [SD=1.09], P=0.03). Conversely, the aortic segments distal to the FD exhibited a 55% increase in vascular contractility compared with proximal segments (P=0.002). We observed a significant positive correlation between mean PWV and mean vascular contractility.ConclusionImplantation of FD was associated with increased PWV and vascular contractility, suggesting that FD implantation causes changes to the vascular wall. Further studies are needed to understand the clinical implication of changes in vascular PWV and contractility.
Prevalence of large vessel occlusion in patients presenting with acute ischemic stroke: a 10-year systematic review of the literature
Authors: Lakomkin Nikita , Dhamoon Mandip , Carroll Kirsten , Singh Inder Paul , Tuhrim Stanley , Lee Joyce , Fifi Johanna T , Mocco J 
Published: November 2018

BackgroundAccurate assessment of the prevalence of large vessel occlusion (LVO) in patients presenting with acute ischemic stroke (AIS) is critical for optimal resource allocation in neurovascular intervention.ObjectiveTo perform a systematic review of the literature in order to identify the proportion of patients with AIS presenting with LVO on image analysis.MethodsA systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in order to identify studies reporting LVO rates for patients presenting with AIS. Studies that included patients younger than 18 years, were non-clinical, or did not report LVO rates in the context of a consecutive AIS series were excluded. Characteristics regarding presentation, diagnosis, and LVO classification were recorded for each paper.ResultsSixteen studies, spanning a total of 11 763 patients assessed for stroke, were included in the qualitative synthesis. The majority (10/16) of articles reported LVO rates exceeding 30% in patients presenting with AIS. There was substantial variability in the LVO definitions used, with nine unique classification schemes among the 16 studies. The mean prevalence of LVO was 31.1% across all studies, and 29.3% when weighted by the number of patients included in each study.ConclusionsDespite the wide variability in LVO classification, the majority of studies in the last 10 years report a high prevalence of LVO in patients presenting with AIS. These rates of LVO may have implications for the volume of patients with AIS who may benefit from endovascular therapy.
Influence of ASPECTS and endovascular thrombectomy in acute ischemic stroke: a meta-analysis
Authors: Phan Kevin , Saleh Serag , Dmytriw Adam A , Maingard Julian , Barras Christen , Hirsch Joshua A , Kok Hong Kuan , Brooks Mark , Chandra Ronil V , Asadi Hamed 
Published: November 2018

BackgroundPrompt revascularization of the ischemic penumbra following an acute ischemic event (AIS) has established benefit within the literature. However, use of the semi-quantitative Alberta Stroke Program Early CT Score (ASPECTS) to evaluate patient suitability for revascularization has been inconsistent in patient risk stratification and selection.ObjectiveTo conduct a meta-analysis to evaluate the available evidence for a clinically valid ASPECTS threshold in assessment of suitability for revascularization following AIS.MethodsTwo independent reviewers searched Medline (Ovid) and Cochrane Central Register of Systematic Reviews databases for studies appraising outcomes of endovascular thrombectomy (EVT) in relation to a variably-defined preoperative ASPECTS.ResultsA total of 13 articles were included. The pooled good outcome proportion after EVT was 41.4% (95% CI 36.4% to 46.6%; p<0.001), with subjective study-specific definitions of favorable and unfavorable subgroup outcomes of 49.7% (95% CI 44.2% to 55.3%; I2=76.5%; p<0.001) and 33.2% (95% CI 28.5% to 38.3%; I2=33.16%), respectively. Objective trichotomization into low (0–4), intermediate (5–7), and high (8–10) subgroups yielded pooled good outcome proportions of 17.1% (95% CI 6.8% to 36.8%; I2=64.24%; p=0.039), 35.7% (95% CI 30.5% to 41.3%; I2=23.11%; p=0.245), and 49.7% (95% CI 44.2% to 55.3%; I2=76.5%; p<0.001) for low, intermediate, and high ASPECTS, respectively.ConclusionsA subjectively favorable ASPECTS is associated with significantly better outcomes after EVT than an unfavorable ASPECTS, regardless of the cut-off used. EVT is unlikely to be useful in patients with an objectively low ASPECTS and is likely to be useful for those with high ASPECTS; findings in patients with intermediate ASPECTS were equivocal.
Percutaneous transluminal angioplasty using the novel drug-coated balloon catheter SeQuent Please NEO for the treatment of symptomatic intracranial severe stenosis: feasibility and safety study
Authors: Gruber Philipp , Braun Christina , Kahles Timo , Hlavica Martin , Anon Javier , Diepers Michael , Nedeltchev Krassen , Berberat Jatta , Remonda Luca 
Published: November 2018

ObjectivesIntracranial arteriosclerotic disease is a relevant cause of ischemic stroke worldwide with a high recurrence rate despite best medical treatment. Following the SAMMPRIS trial, endovascular treatment has remained a second-line therapy. Meanwhile, there has been significant advances in device technology. SeQuent Please NEO is a novel polymer-free, drug-coated (paclitaxel/iopromide) balloon (DCB) primarily designed for cardiology. Because of its high flexibility and pushability, it may also be suitable for intracranial use. The aim of this study was to assess the feasibility and safety of SeQuent Please NEO DCB in symptomatic intracranial severe stenosis.MethodsA single-center retrospective cohort study of patients with symptomatic intracranial severe stenosis treated with SeQuent Please NEO DCB was performed at a tertiary stroke center.ResultsTen patients (all men, median age 73 years (IQR 69–77)) were included. Median pre-treatment stenosis grade was 78% (IQR 75–80%) with four internal carotid artery, two mid-basilar artery, and four vertebral artery lesions. Median post-treatment stenosis grade was 50% (IQR 45–53%). Successful angioplasty was achieved in all cases without technical failure. There were no cases of peri-procedural reocclusion and no deaths at median follow-up of 3 months (IQR 2–3).ConclusionIn this pilot study, SeQuent Please NEO DCB was feasible and safe in the treatment of symptomatic intracranial severe stenosis. It might represent a promising alternative to medical treatment in selected cases.
The occurrence of neointimal hyperplasia after flow-diverter implantation is associated with cardiovascular risks factors and the stent design
Authors: Caroff Jildaz , Iacobucci Marta , Rouchaud Aymeric , Mihalea Cristian , de Carvalho Fernando Mota , Jocson Victor Erwin D , Chalumeau Vanessa , Da Ros Valerio , King Robert M , Arslanian Rose , Ikka Léon , Ben Achour Nidhal , Moret Jacques , Spelle Laurent 
Published: November 2018

BackgroundNeo-intimal hyperplasia (NIH) is frequently observed after flow-diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular response can sometimes lead to delayed ischemic strokes. This study intended to evaluate the factors potentially influencing the rates of NIH following FDS treatment.Material and MethodsAll aneurysm treatments performed with a Pipeline embolization device (PED) or a SILK stent from May 2011 to May 2015 were collected in a prospectively maintained database. Patient demographics, clinical, and angiographic outcomes including both digital subtraction angiography and C-arm cone-beam CT were registered. Two blind reviewers rated the presence of NIH on a binary scale (present/absent).ResultsFrom 148 patients, 63 datasets were available for analysis. Inter-reader agreement was excellent (Kappa=0.88). NIH was positively correlated with smoking, dyslipidemia, and high blood pressure, but not with aneurysm characteristics. At early follow-up (<12 months), NIH was more frequently associated with the use of the SILK stent (68%) rather than the PED (38%): P<0.02. At long-term follow-up, the NIH rate in the total population dropped from 55% to 26% with no more significant difference between the two stents. The complete occlusion rate as seen in early follow-up was higher in the SILK group with 76% vs 65% but without statistical significance (P=0.4).ConclusionNIH is a dual-vessel reaction after FDS implant. When planning a treatment in locations at risk of ischemic complications if severe NIH would occur, then the stent design should be considered. However, minimal NIH might also be needed as it is involved in aneurysm healing. Before treatment patients should be recommended best medical management of their cardiovascular risks factors to prevent an excessive NIH reaction.
Early detection of lung cancer in a population at high risk due to occupation and smoking
Authors: Welch Laura S , Dement John M , Cranford Kim , Shorter Janet , Quinn Patricia S , Madtes David K , Ringen Knut 
Published: November 2018

ObjectiveThe US National Comprehensive Cancer Network (NCCN) recommends two pathways for eligibility for Early Lung Cancer Detection (ELCD) programmes. Option 2 includes individuals with occupational exposures to lung carcinogens, in combination with a lesser requirement on smoking. Our objective was to determine if this algorithm resulted in a similar prevalence of lung cancer as has been found using smoking risk alone, and if so to present an approach for lung cancer screening in high-risk worker populations.MethodsWe enrolled 1260 former workers meeting NCCN criteria, with modifications to account for occupational exposures in an ELCD programme.ResultsAt baseline, 1.6% had a lung cancer diagnosed, a rate similar to the National Lung Cancer Screening Trial (NLST). Among NLST participants, 59% were current smokers at the time of baseline scan or had quit smoking fewer than 15 years prior to baseline; all had a minimum of 30 pack-years of smoking. Among our population, only 24.5% were current smokers and 40.1% of our participants had smoked fewer than 30 pack-years; only 43.5% would meet entry criteria for the NLST. The most likely explanation for the high prevalence of screen-detected lung cancers in the face of a reduced risk from smoking is the addition of occupational risk factors for lung cancer.ConclusionOccupational exposures to lung carcinogens should be incorporated into criteria used for ELCD programmes, using the algorithm developed by NCCN or with an individualised risk assessment; current risk assessment tools can be modified to incorporate occupational risk.
Patient and physician view on patient information and decision-making in congenital aortic and pulmonary valve surgery
Authors: Etnel Jonathan R G , Helbing Willem A , Roos-Hesselink Jolien W , The Regina , Bogers Ad J J C , Takkenberg Johanna J M 
Published: November 2018

BackgroundTo assess the current state of patient information and decision-making in congenital aortic and pulmonary valve disease, we conducted a survey among patients, parents and physicians.MethodsA questionnaire was sent by ground mail to 157 adults and 32 parents of children who previously underwent surgery for congenital aortic or pulmonary valve disease at 0–40 years of age between January 2005 and February 2014 at the Erasmus University Medical Center and to all paediatric and adult congenital cardiologists and congenital cardiac surgeons in the Netherlands (n=88).Results73 patients/parents (39% response rate, 62 adult patients, 11 parents of paediatric patients) and 35 physicians (40% response rate) responded. Median patient age at the time of surgery was 25.7 years. Basic disease-specific knowledge was adequate in 42% of patients/parents and numeracy was sufficient in 47%. Patients/parents reported that they rely heavily on their physicians for information and often experience difficulty in finding reliable information elsewhere. They lack information on psychosocial aspects of disease (29% of respondents) and risks and benefits of treatment options (26%). They feel less involved in decision-making than they would prefer to be (p=0.014). Decisional conflict at the time of surgery was experienced by 31% of patients/parents. If they had to do it again, 72% of patients/parents would want the same treatment. Quality of life is often impaired due to various valve-related anxieties and lifestyle changes. Physicians reported that they are unable to fully inform and sufficiently involve patients, due to limited patient/parent knowledge and understanding (56%) and limited time during consultations (32%). Patients/parents (98%) and physicians (97%) agree that they should have shared roles in decision-making.ConclusionThe substantial shortcomings in our current practice of patient information and decision-making underline the need for innovative solutions, such as careful implementation of patient information tools and shared decision-making in the care path.
Intermittent systemic hypoxic–hyperoxic training for myocardial protection in patients undergoing coronary artery bypass surgery: first results from a single-centre, randomised controlled trial
Authors: Tuter Denis S , Kopylov Philippe Y , Syrkin Abram L , Glazachev Oleg S , Komarov Roman N , Katkov Andrei I , Severova Ljudmila P , Ivanova Ekaterina V , Zhang Young , Saner Hugo 
Published: November 2018

BackgroundAlthough remote ischaemic preconditioning (RIP) provides protection against myocardial ischaemia and reperfusion injury during cardiac surgery, it is not widely used. Systemic intermittent hypoxic–hyperoxic training (IHHT) may be a suitable alternative.MethodsThis is a prospective, single-centre, randomised controlled trial. 127 patients with ischaemic heart disease and indication for coronary artery bypass graft (CABG) surgery from the Cardiology Clinic IM Sechenov First Moscow State Medical University were randomly assigned to IHHT, IHHT-control or RIP. Primary endpoint was serum concentration of troponin I and lactate 2 and 24 hours after surgery.ResultsMedian value for troponin I 24 hours after surgery was 1.068 (0.388–1.397) ng/mL in the IHHT group and was significantly lower compared with IHHT-controls with 1.980 (1.068–3.239) ng/mL (p=0.012) and to the RIP group with 1.762 (1.288–2.186) ng/mL (p=0.029), while there was no significant difference between RIP and the IHHT-control. Serum lactate after surgery was 1.74 (1.23–2.04) mmol/L in the IHHT group and was also significantly lower compared with IHHT-controls with 2.10 (1.80–2.29) mmol/L (p=0.045) and RIP with 2.12 (1.91–2.33) mmol/L (p=0.032). No significant complications or serious adverse events were observed during IHHT. Intraoperative and early postoperative complications did not differ significantly between groups.ConclusionsThe results of this first trial using IHHT for myocardial protection against perioperative ischaemic myocardial injury in patients undergoing CABG surgery are promising and further larger trials should be done with adequate power to detect clinical rather than surrogate marker benefits.
The role of feedback in building design 1980–2018 and onwards
Authors: Clements-Croome Derek 
Published: November 2018

This is a paper updating the paper I wrote on this topic for BSERT in issue 1 volume 1 in 1980. The original paper set out the causes of failure in building design as being due to various issues such as an inadequate brief, lack of data, poor communication, inadequate analysis or synthesis, quirks of human behaviour which could all contribute. Systematic appraisal – now referred to as post-occupancy evaluation – of buildings in use provides feedback which helps us to understand why theory and practice do not always agree and also gives evidence for improved building economics. It concluded that we have to involve users more in the design of buildings, and for the next generations, we need a much broader based education of building designers. This paper continues the theme by considering the latest methods of measurement and assessment which provide feedback data for sustainability but focusing more on health and wellbeing rating assessments. Practical application: Our professions need more interaction across sectors and to foster a transdisciplinary approach. This means more communication with other professional kinsmen from the health and wellbeing sectors in order to make valuable interventions in the building design process. This paper updates the 1980 paper from the first edition of BSER&T that sets out the causes of failure in building design as being due to various issues such as an inadequate brief, lack of data, poor communication, inadequate analysis or synthesis, quirks of human behaviour which could all contribute. The paper determines that the need for feedback in order to improve building performance and provide data to develop existing guidelines, codes and standards is as valid now as it was in 1980 but the way we do this has changed.
Intermediate-term Experience With the STAR Total Ankle in the United States
Authors: Loewy Evan M. , Sanders Thomas H. , Walling Arthur K. 
Published: November 2018

Background: Limited intermediate and no real long-term follow-up data have been published for total ankle arthroplasty (TAA) in the United States. This is a report of clinical follow-up data of a prospective, consecutive cohort of patients who underwent TAA by a single surgeon from 1999 to 2013 with the Scandinavian Total Ankle Replacement (STAR) prosthesis. Methods: Patients undergoing TAA at a single US institution were enrolled into a prospective study. These patients were followed at regular intervals with history, physical examination, and radiographs; American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale scores were obtained and recorded. Primary outcomes included implant survivability and functional outcomes scores. Secondary outcomes included perioperative complications such as periprosthetic or polyethylene fracture. Between 1999 and 2013, a total of 138 STAR TAAs were performed in 131 patients; 81 patients were female. The mean age at surgery was 61.5 ± 12.3 years (range, 30-88 years). The mean duration of follow-up for living patients who retained both initial components at final follow-up was 8.8±4.3 years (range 2-16.9 years). Results: The mean change in AOFAS Ankle-Hindfoot scores from preoperative to final follow-up was 36.0 ± 16.8 ( P < .0001). There were 21 (15.2%) implant failures that occurred at a mean 4.9 ± 4.5 years postoperation. Ten polyethylene components in 9 TAAs (6.5%) required replacement for fracture at an average 8.9 ± 3.3 years postoperatively. Fourteen patients died with their initial implants in place. Conclusion: This cohort of patients with true intermediate follow-up after TAA with the STAR prosthesis had acceptable implant survival, maintenance of improved patient-reported outcome scores, and low major complication rates. Level of Evidence: Level IV, case series.
Effect of Gender, Toe Extension Position, and Plantar Fasciitis on Plantar Fascia Thickness
Authors: Granado Michael J. , Lohman Everett B. , Daher Noha S. , Gordon Keith E. 
Published: November 2018

Background: Ultrasound is a widely used diagnostic tool for patients with plantar fasciitis. However, the lack of standardization during the measurement for plantar fascia thickness has made it challenging to understand the etiology of plantar fasciitis, as well as identify risk factors, such as gender. The purpose of this study was to investigate gender differences regarding plantar fascia thickness while controlling for metatarsophalangeal (MTP) joint position in the healthy and those with unilateral plantar fasciitis. Methods: Forty participants (20 with unilateral plantar fasciitis and 20 controls) with plantar fascia thickness (mean age, 44.8 ± 12.2 years) participated in this study. The majority were females (n = 26, 65%). Plantar fascia thickness was measured via ultrasound 3 times at 3 different MTP joint positions: (1) at rest, (2) at 30 degrees of extension, and (3) at maximal extension. Results: When comparing gender differences, the males in the plantar fasciitis group had a significantly thicker plantar fascia than the females ( P = .048, η2 = 2.35). However, no significant differences were observed between healthy males and females. The males with unilateral plantar fasciitis also had significantly thicker asymptomatic plantar fasciae collectively compared with controls ( P < .05), whereas females with unilateral plantar fasciitis had a similar but not significant change. Conclusion: It appears that healthy males and females have similar plantar fascia thickness. However, as plantar fasciitis develops, males tend to develop thicker plantar fasciae than their female counterparts, which could have future treatment implications. Level of Evidence: Level III, case-control comparative study.
Sonographic Discovery of Autotransplanted Splenic Implants in a Pregnant Patient
Authors: Downs Emily M. , Reeves Shane 
Published: November 2018

It is important to include splenic implants in the differential diagnosis of patients with a history of splenic trauma. Autotransplanted splenic implants may have a sonographic appearance similar to that of pathologies such as lymphadenopathy or carcinomatosis. This is the first known case to discuss a pregnant patient with a history of autologous autotransplanted splenic tissue, which was discovered on sonography and confirmed during the patient’s cesearean section.