bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cut-down outperforms complete percutaneous transcatheter valve implantation
Authors: Mach Markus , Wilbring Manuel , Winkler Bernhard , Alexiou Konstantin , Kappert Utz , Delle-Karth Georg , Grabenwöger Martin , Matschke Klaus 
Published: February 2018

Background The ideal approach for transfemoral transcatheter aortic valve implantation is still widely debated. The objective of this study was to compare access and bleeding complications of complete percutaneous versus the surgical cut-down approach for transfemoral transcatheter aortic valve implantation. Methods The study included 667 consecutive patients from November 2008 to December 2016, 466 in the percutaneous group and 201 in the cut-down group. There were no significant differences in baseline characteristics between the 2 groups. Primary study endpoints were vascular access site and bleeding complications according to the Valve Academic Research Consortium II criteria. Results Mean procedure time was shorter in the cut-down group: 93.5 ± 22.0 (percutaneous) vs. 69 ± 19 min (cut-down), p < 0.001. The rate of access complications was higher in the percutaneous group: 20.4% (95/466) vs. 8.5% (17/201), p = 0.037; with predominantly minor complications in the percutaneous cohort: 14.4% (67/466) vs. 2.5% (5/201), p = 0.04. Bleeding complications were more frequent in the percutaneous group: 21.9% (102/466) vs. 4.5% (9/201), p = 0.01. Hospital mortality was 5.2% in the percutaneous group and 1.9% in the cut-down group ( p = 0.075). Conclusions Surgical cut-down provided controlled access and resulted in fewer access site and bleeding complications. Nonetheless, major access complications were not significantly different between the two cohorts. The two approaches must be seen as complementary techniques. A portfolio containing both techniques is the only way to provide a tailor-made and patient-orientated approach ensuring the safest access based on the individual vessel condition.
Weaning adult patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation by pump-controlled retrograde trial off
Authors: Ling Lowell , Chan Kai Man 
Published: February 2018

Background: There is a lack of consensus on the timing of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) liberation. VA-ECMO weaning usually consists of serial decrements until an idling flow is achieved, supported by echocardiographic and haemodynamic assessments. Even with minimal idling flow, right ventricular (RV) preload is reduced and, hence, right heart function is not fully tested under adequate loading conditions. Following the use of a novel technique called Pump Controlled Retrograde Trial Off (PCRTO) in neonate VA-ECMO weaning, we report the use of this technique in seven adult patients on VA-ECMO. Methods: We retrospectively reviewed all adult VA-ECMO patients treated at a tertiary teaching hospital in Hong Kong since 2010. Clinical data, including diagnosis, echocardiography findings, ECMO configuration, PCRTO settings, survival after veno-arterial ECMO (SAVE) score and outcomes, were collected. Mortality and death due to cardiac failure was compared between PCRTO and conventional weaning. Results: Seven patients underwent PCRTO, with a mean SAVE score of -4.4 ± 5.9. All seven patients were successfully decannulated without haemodynamic deterioration. In all cases, no clots or fibrin deposits were found in the circuit after the trial. There was no difference in mean SAVE scores among the seven patients in PCRTO and the 23 patients in the conventional group (-3.6, 95% CI -8.8 to 1.5). The number of deaths due to cardiac failure in the PCRTO group and the conventional group were 0 and 3, respectively (0% vs. 13%, p=0.99). Mortality after decannulation for PCRTO was 42.9% vs. conventional weaning 34.8% (p=0.99). Conclusion: Our study suggests that PCRTO is a simple, safe and reversible alternative weaning method. It may have a particular role in the assessment of patients who have marginal recovery and right heart failure. Prospective controlled studies are needed to establish the potential role of PCRTO in the liberation of patients from VA-ECMO support.
The role of the brainstem in migraine: Potential brainstem effects of CGRP and CGRP receptor activation in animal models
Authors: Holland Philip Robert , Saengjaroentham Chonlawan , Vila-Pueyo Marta 
Published: February 2018

Background Migraine is a severe debilitating disorder of the brain that is ranked as the sixth most disabling disorder globally, with respect to disability adjusted life years, and there remains a significant unmet demand for an improved understanding of its underlying mechanisms. In conjunction with perturbed sensory processing, migraine sufferers often present with diverse neurological manifestations (premonitory symptoms) that highlight potential brainstem involvement. Thus, as the field moves away from the view of migraine as a consequence of purely vasodilation to a greater understanding of migraine as a complex brain disorder, it is critical to consider the underlying physiology and pharmacology of key neural networks likely involved. Discussion The current review will therefore focus on the available evidence for the brainstem as a key regulator of migraine biology and associated symptoms. We will further discuss the potential role of CGRP in the brainstem and its modulation for migraine therapy, given the emergence of targeted CGRP small molecule and monoclonal antibody therapies. Conclusion The brainstem forms a functional unit with several hypothalamic nuclei that are capable of modulating diverse functions including migraine-relevant trigeminal pain processing, appetite and arousal regulatory networks. As such, the brainstem has emerged as a key regulator of migraine and is appropriately considered as a potential therapeutic target. While currently available CGRP targeted therapies have limited blood brain barrier penetrability, the expression of CGRP and its receptors in several key brainstem nuclei and the demonstration of brainstem effects of CGRP modulation highlight the significant potential for the development of CNS penetrant molecules.
Prospective memory is dysfunctional in migraine without aura
Authors: Santangelo Gabriella , Russo Antonio , Tessitore Alessandro , Garramone Federica , Silvestro Marcello , Della Mura Maria Rosaria , Marcuccio Laura , Fornaro Ilaria , Trojano Luigi , Tedeschi Gioacchino 
Published: February 2018

Introduction Prospective memory is the ability to carry out a delayed intended action, so to maintain and retrieve future plans, goals and activities. Deficits of prospective memory negatively impact on patients and caregivers’ everyday living and determine poor adherence to treatment. Since frontal regions are involved in both event- and time-based prospective memory tasks and are impaired in migraine without aura, defects of prospective memory might occur in migraine without aura patients; until now this issue has not been investigated. The aim of the current study was to explore time- versus event-based prospective memory in migraine without aura. Patients and methods Ninty-one consecutive migraine without aura patients and 84 healthy subjects were enrolled in the study. They underwent a standardized measure of prospective memory evaluating both time-based and event-based prospective memory, and the Montreal Cognitive Assessment assessing global cognitive status. Moreover, all participants completed the Beck Depression Inventory-II and a self-administered version of the Apathy Evaluation Scale, to assess severity of depressive symptoms and apathy, respectively. Results Migraine without aura and healthy subjects did not differ on demographic aspects (i.e. age, education and gender). However, individuals with migraine without aura demonstrated impaired prospective memory performance compared to healthy subjects, with a greater impairment demonstrated for the time-based tasks. Within the migraine without aura group, no significant association was found between prospective memory performance and clinical scores, apathy, and depression. Conclusions Individuals with migraine without aura experience particular difficulty executing a future intention; therefore, migraine without aura is associated with dysfunction of prospective memory.
Geographic Clustering of Admissions to Inpatient Psychiatry among Adults with Cognitive Disorders in Ontario, Canada: Does Distance to Hospital Matter?
Authors: Perlman Christopher M. , Law Jane , Luan Hui , Rios Sebastian , Seitz Dallas , Stolee Paul 
Published: February 2018

Objective: This study examined relationships among hospital accessibility, socio-economic context, and geographic clustering of inpatient psychiatry admissions for adults with cognitive disorders in Ontario, Canada. Method: A retrospective cross-sectional analysis was conducted using admissions data from 71 hospitals with inpatient psychiatry beds in Ontario, Canada between 2011 and 2014. Data included 7,637 unique admissions for 4,550 adults with a DSM-IV diagnosis of Delirium, Dementia, Amnestic and other Cognitive Disorders. Bayesian spatial Poisson regression was employed to examine the relationship between accessibility of general hospitals with psychiatric beds and psychiatric hospitals, area-level marginalization, and hospitalization rate with the risk of admission to inpatient psychiatry among adults with cognitive disorders across 516 Forward Sortation Areas (FSA) in Ontario. Results: Residential instability and the overall hospitalization rate were significantly associated with an increase in the relative risk of admissions to inpatient psychiatry. Accessibility to general hospitals and psychiatric hospitals were marginally insignificant at the 95% credible interval in the final model. Significant geographic clustering of admissions was identified where individuals residing in FSA's with the highest relative risk were 2.0 to 7.1 times more likely to be admitted to inpatient psychiatry compared to the average. Conclusions: Geographic clustering of inpatient psychiatry admissions for adults with cognitive disorders exists across the Province of Ontario, Canada. At the geographic level, the risk of admission was positively associated with residential instability and the overall hospitalization rate, but not distance to the closest general or psychiatric hospital.
Ultrasound-Guided Percutaneous Dilational Tracheostomy: A Systematic Review of Randomized Controlled Trials and Meta-Analysis
Authors: Gobatto André L. N. , Besen Bruno A. M. P. , Cestari Mino , Pelosi Paolo , Malbouisson Luiz M. S. 
Published: February 2018

Introduction: Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. Objective: To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks–guided PDT with regard to procedural-related and clinical complications. Methods: A systematic review of randomized clinical trials was conducted comparing an ultrasound-guided PDT to the control groups (either a bronchoscopy-guided PDT or an anatomical landmark–guided PDT) in patients undergoing a PDT in the ICU. The primary outcome was the incidence of major procedural-related and clinical complication rates. The secondary outcome was the incidence of minor complication rates. Random-effect meta-analyzes were used to pool the results. Results: Four studies fulfilled the inclusion criteria and they were analyzed. The studies included 588 participants. There were no differences in the major complication rates between the patients who were assigned to the ultrasound-guided PDT when compared to the control groups (pooled risk ratio [RR]: 0.48; 95% confidence interval [CI]: 0.13-1.71, I2 = 0%). The minor complication rates were not different between the groups, but they had a high heterogeneity (pooled RR: 0.49; 95% CI 0.16-1.50; I2 = 85%). The sensitivity analyzes that only included the randomized controlled trials that used a landmark-guided PDT as the control group showed lower rates of minor complications in the ultrasound-guided PDT group (pooled RR: 0.55; 95% CI: 0.31-0.98, I2 = 0%). Conclusion: The ultrasound-guided PDT seems to be safe and it is comparable to the bronchoscopy-guided PDT regarding the major and minor procedural-related or clinical complications. It also seems to reduce the minor complications when compared to the anatomical landmark–guided PDT.
Impact of Store and Product Attributes on Purchase Intentions: An Analytical Study of Apparel Shoppers in Indian Organized Retail Stores
Authors: Hasan Arif 
Published: February 2018

Purpose: Store positioning of domestic organized apparel retail stores has become a concern to retailers in view of FDI in retail, entrance of new giant retailers and growing competition among retailers. Therefore, this study makes an attempt to identify the predictors of intention to purchase (ITP). Besides this, the study aims to examine and identify the current positions of select stores and causal relationships among store attributes (SAs), product attributes (PAs) and ITP. Research Design: Mixed method approach and exploratory cum descriptive research design is adopted. A self-administered questionnaire was administered to 600 shoppers; they were approached after completion of their shopping from the select stores. Statistical techniques like exploratory factor analysis, confirmatory factor analysis, perceptual mapping and structural equation modelling were employed using MS Excel, SPSS 20.0 and AMOS 20.0 versions. Further, reliability and validity tests were also performed. Findings: The findings of the study indicate that on the whole, SAs as well as PAs had a positive effect on ITP. The findings are discussed in light of what retailers can do to enhance the intention of shoppers to purchase. Originality/Value: It will provide practical implications to organized apparel retailers for the betterment of the shoppers and growth of stores.
Fryldeficiency is associated with defective kidney development and function in mice
Authors: Byun Yong-Sub , Kim Eun-Kyoung , Araki Kimi , Yamamura Ken-ichi , Lee Kihoon , Yoon Won-Kee , Won Young-Suk , Kim Hyoung-Chin , Choi Kyung-Chul , Nam Ki-Hoan 
Published: February 2018

FRY like transcription coactivator ( Fryl) gene located on chromosome 5 is a paralog of FRY microtubule binding protein ( Fry) in vertebrates. It encodes a protein with unknown functions. Fryl gene is conserved in various species ranging from eukaryotes to human. Although there are several reports on functions of Fry gene, functions of Fryl gene remain unclear. A mouse line containing null mutation in Fryl gene by gene trapping was produced in this study for the first time. The survival and growth of Fryl−/−mice were observed. Fryl gene expression levels in mouse tissues were determined and histopathologic analyses were conducted. Most Fryl−/−mice died soon after birth. Rare Fryl−/−survivors showed growth retardation with significantly lower body weight compared to their littermate controls. Although they could breed, more than half of Fryl−/−survivors died of hydronephrosis before age 1. No abnormal histopathologic lesion was apparent in full-term embryo or adult tissues except the kidney. Abnormal lining cell layer detachments from walls of collecting and convoluted tubules in kidneys were apparent in Fryl−/−neonates and full-term embryos. Fryl gene was expressed in renal tubular tissues including the glomeruli and convoluted and collecting tubules. This indicates that defects in tubular systems are associated with Fryl functions and death of Fryl−/−neonates. Fryl protein is required for normal development and functional maintenance of kidney in mice. This is the first report of in vivo Fryl gene functions.Impact statementFRY like transcription coactivator ( Fryl) gene is conserved in various species ranging from eukaryotes to human. It expresses a protein with unknown function. We generated a Fryl gene mutant mouse line and found that most homozygous mice died soon after their birth. Rare Fryl−/−survivors showed growth retardation with significantly lower body weight compared to their littermate controls. Although they could breed, more than half of Fryl−/−survivors died of hydronephrosis before age 1. Full-term mutant embryos showed abnormal collecting and convoluted tubules in kidneys where Fryl gene was expressed. Collectively, these results indicate that Fryl protein is required for normal development and functional maintenance of kidney in mice. To the best of our knowledge, this is the first report on in vivo Fryl gene functions.
Assessing the accuracy of ultrasound estimation of gestational age during routine antenatal care in in vitro fertilization (IVF) pregnancies
Authors: Knight Bridget , Brereton Aaron , Powell Roy J , Liversedge Helen 
Published: February 2018

Introduction In the UK an accurate gestational age is confirmed by ultrasound measured foetal crown rump length (CRL) at 11 + 2–14 + 1 weeks of gestation. The currently recommended Robinson and Fleming crown rump length reference chart was develop in 1975. Advances in ultrasound technology and standardized crown rump length measurement training could mean this is now out of date. Our study aimed to assess its accuracy in current routine antenatal care. Methods Retrospective data from 178 IVF pregnancies seen for routine antenatal care at a UK Regional Maternity Unit between 1 January 2006 and 1 January 2016 was retrieved. We compared ultrasound calculated crown rump length gestational age taken at the routine First Trimester Screening Clinic (FTSC) with the ‘true’ gestational age calculated from the known IVF fertilization date. Results We identified a systematic overestimation of gestational age by ultrasound using the currently recommended crown rump length reference chart when compared to IVF gestational age. The mean overestimation was 3.0 days (95% CI: 2.7 to 3.4), p < 0.001. A range of alternative ultrasound reference charts also generated a systematic overestimation, ranging from 1.6 to 2.9 days ( p < 0.001, for each). Conclusions The current crown rump length reference chart systematically overestimates gestational age by an average of three days when assessed in IVF pregnancies. A systematic overestimation was also identified in alternative crown rump length reference charts. These differences, although slight, were systematic with implications for the accuracy of gestational age estimation particularly in pregnancies at risk of pre-term delivery or growth restriction. Our findings need confirming in larger, non IVF cohorts and could lead to the need for an updated crown rump length reference chart.
How will telemedicine change clinical practice in chronic obstructive pulmonary disease?
Authors: Vitacca Michele , Montini Alessandra , Comini Laura 
Published: February 2018

Within telehealth there are a number of domains relevant to pulmonary care: telemonitoring, teleassistance, telerehabilitation, teleconsultation and second opinion calls. In the last decade, several studies focusing on the effects of various telemanagement programs for patients with chronic obstructive pulmonary disease (COPD) have been published but with contradictory findings. From the literature, the best telemonitoring outcomes come from programs dedicated to aged and very sick patients, frequent exacerbators with multimorbidity and limited community support; programs using third-generation telemonitoring systems providing constant analytical and decisionmaking support (24 h/day, 7 days/week); countries where strong community links are not available; and zones where telemonitoring and rehabilitation can be delivered directly to the patient’s location. In the near future, it is expected that telemedicine will produce changes in work practices, cultural attitudes and organization, which will affect all professional figures involved in the provision of care. The key to optimizing the use of telemonitoring is to correctly identify who the ideal candidates are, at what time they need it, and for how long. The time course of disease progression varies from patient to patient; hence identifying for each patient a ‘correct window’ for initiating telemonitoring could be the correct solution. In conclusion, as clinicians, we need to identify the specific challenges we face in delivering care, and implement flexible systems that can be customized to individual patients’ requirements and adapted to our diverse healthcare contexts.
Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: A systematic review
Authors: Alhowimel Ahmed , AlOtaibi Mazyad , Radford Kathryn , Coulson Neil 
Published: February 2018

Background: Almost 80% of people have low back pain at least once in their life. Clinical guidelines emphasize the use of conservative physiotherapy and the importance of staying active. While the psychological factors predicting poor recovery following surgical intervention are understood, the psychosocial factors associated with poor outcomes following physiotherapy have yet to be identified. Methods: Electronic searches of PubMed, Medline, CINAHL, PsycINFO and EBSCO were conducted using terms relating to psychosocial factors, chronic low back pain, disability and physiotherapy. Papers examining the relationship between psychosocial factors and pain and disability outcomes following physiotherapy were included. Two reviewers selected, appraised and extracted studies independently. Results: In total, 10 observational studies were identified that suggested an association between fear of movement, depression, self-efficacy and catastrophizing in modifying pain and disability outcomes following physiotherapy. Discussion: Although limited by methodological shortcomings of included studies, and heterogeneity of physiotherapy interventions and measures of disability and psychosocial outcomes, the findings are consistent with other research in the context of back pain and physiotherapy, which suggest an association between psychosocial factors, including fear of movement, catastrophizing and self-efficacy and pain and disability outcomes in chronic low back pain patients treated by physiotherapist. However, a direct relationship cannot be concluded from this study. Conclusion: Findings suggest an association between psychosocial factors, including fear of movement, catastrophizing and self-efficacy and pain and disability outcomes in chronic low back pain patients treated by physiotherapist, which warrants further study.