bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior cerebral artery embolism during thrombectomy increases disability and mortality
Authors: Chalumeau Vanessa , Blanc Raphaël , Redjem Hocine , Ciccio Gabriele , Smajda Stanislas , Desilles Jean-Philippe , Botta Daniele , Escalard Simon , Boisseau William , Maïer Benjamin , Labreuche Julien , Obadia Mickaël , Piotin Michel , Mazighi Mikael 
Published: May 2018

ObjectiveDuring thrombectomy, thromboembolic migration in previously unaffected territory may occur and is not systematically notified. We report our data on the incidence, predictors, and clinical outcome of anterior cerebral artery emboli (ACAE).MethodsFrom a prospectively collected thrombectomy database of consecutive patients with anterior circulation stroke between January 2012 and December 2016, 690 angiographic images were analyzed to assess ACAE. The primary outcome was a favorable outcome, defined as a 3 month modified Rankin Scale score of 0–2 or equal to the pre-stroke score.ResultsACAE occurred in 65 patients (9.4%; 95% CI 7.2% to 11.6%). Internal carotid artery occlusion (tandem or terminal), Alberta Stroke Program Early CT Score <7, increasing number of passes, and use of stent retriever alone (compared with distal aspiration alone or combined with stent retriever) were found to be independent predictors of ACAE. Compared with patients without ACAE, patients with ACAE had lower rates, with an adjusted OR (95% CI) of 0.48 (0.25 to 0.92; P=0.027) for favorable outcome and 0.49 (0.25 to 0.96; P=0.038) for early neurologic improvement. ACAE was significantly associated with a higher mortality (adjusted OR 1.93; 95% CI 1.03 to 3.61; P=0.039) and intracranial hemorrhagic complications (adjusted OR 2.45; 95% CI 1.33 to 4.47; P=0.004). Despite a successful reperfusion modified Thrombolysis in Cerebral Infarction score of 2b–3 at the end of the procedure, a favorable outcome was reached in 30% of patients with ACAE compared with 52.4% in the other patients (OR 0.39; 95% CI 0.19 to 0.78; P=0.008).ConclusionsProcedural ACAE was not an uncommon condition, and was associated with increased mortality and disability rates, regardless of the success of reperfusion.
Effects of baricitinib on radiographic progression of structural joint damage at 1 year in patients with rheumatoid arthritis and an inadequate response to conventional synthetic disease-modifying antirheumatic drugs
Authors: van der Heijde Desirée , Dougados Maxime , Chen Ying-Chou , Greenwald Maria , Drescher Edit , Klar Rena , Xie Li , de la Torre Inmaculada , Rooney Terence P , Witt Sarah L , Schlichting Douglas E , de Bono Stephanie , Emery Paul 
Published: May 2018

BackgroundBaricitinib was efficacious in a 24-week phase III study in patients with rheumatoid arthritis (RA) and an inadequate response to conventional synthetic disease-modifying anti rheumatic drugs (DMARDs) (csDMARDs) (RA-BUILD).ObjectivesTo evaluate radiographic progression of structural joint damage in RA-BUILD patients over 48 weeks of baricitinib treatment in the long-term extension study, RA-BEYOND.MethodsIn RA-BUILD, patients were randomised to placebo, baricitinib 2 mg or 4 mg once daily, with rescue possible from week 16. Patients completing RA-BUILD and entering RA-BEYOND continued to receive the baricitinib dose received at the end of RA-BUILD. Patients receiving placebo were switched to baricitinib 4 mg in RA-BEYOND. Joint damage was measured using the van der Heijde modified total Sharp score. To account for missing scores and scores obtained after rescue, switch or discontinuation of study drug, data were analysed using (1) linear extrapolation (LE) and (2) observed/last observation carried forward (LOCF). The observed/LOCF method used all available observed data, including after rescue or switch, with patients analysed according to original treatment assignment.ResultsUsing LE, radiographic progression at 24 and 48 weeks was statistically significantly lower for both baricitinib 2 or 4 mg compared with placebo. Only baricitinib 4 mg demonstrated statistically significant inhibition of progressive radiographic joint damage compared with patients initially randomised to placebo using observed/LOCF at week 48.ConclusionsOnce daily oral baricitinib inhibited radiographic progression of structural joint damage in patients with an inadequate response or intolerance to csDMARDs over 48 weeks. The most robust benefit was seen for the 4 mg dose.
Simultaneous Compression of the Median and Ulnar Nerve at the Elbow: A Retrospective Study
Authors: Skouteris Dimitrios , Thoma Sofia , Andritsos Georgios , Tasios Nikolaos , Praxitelous Praxitelis , Psychoyios Vassilios 
Published: May 2018

Background: Simultaneous compression of the median and ulnar nerve at the elbow region has not been sufficiently highlighted in the literature. The purposes of the present study are to report our experience regarding this entity, to elucidate the clinical features, and to describe the operative technique and findings as well as the results of simultaneous decompression performed through the same medial incision.Methods: We performed a retrospective study of thirteen elbows in thirteen patients -nine men and four women- with simultaneous compression of the median and ulnar nerve at the elbow region between 2000 and 2011. All were manual workers. Diagnosis was largely based on symptoms, patterns of paresthesia, and specific tests. Surgical decompression of both nerves at the same time was performed through a single anteromedial incision creating large flaps.Results: Patients were followed for a mean of thirty-eight months (range seven to ninety six). Resting pain in the proximal forearm as well as sudden onset of numbness in the ring and little fingers were reported by all patients. Nerve conduction studies were positive only for cubital tunnel syndrome. In all patients symptoms subsided following surgical decompression. At the time of final follow up there is no evidence of recurrence.Conclusions: Proximal median nerve compression can be seen in association with cubital tunnel syndrome. Careful evaluation of the reported symptoms as well as thorough clinical examination are the keystone of the correct diagnosis. Also, on the basis of this study, we believe that concurrent decompression can be performed through a single medial incision, though extensive dissection may be required.
Arteriography and Histopathology of Vascular Beds in Traumatically Amputated Fingers
Authors: Uysal Mehmet Ali , Gulabi Deniz , Mete Güven , Tunalı Selçuk , Avcı Arzu , Bora Osman Arslan 
Published: May 2018

Background: The success of replantation following traumatic amputation is determined by the quality of the vascular anastomoses. The purpose of this study was to assess the vascularity of injured arteries from traumatically amputated digits using arteriographic and histopathological analysis. Methods: 25 amputated digits were included in the study. Crush and avulsion injuries were evaluated according to the Venkatramani classification. The amputated arteries were dissected under a microscope, and the arterial route determined with a transducer. Arteriography using fluoroscopy was evaluated by a radiologist. The area thought to be damaged was dissected and 2-mm slices taken for histopathological examination, and scored using the parameters of fibrin accumulation, oedema, separation, and bleeding. Results: Arterial flow was observed in 6 of 7 in the avulsion group. In the crush group, arterial flow was observed in 11 of 16 cases. On histopathological examination in all cases there were 2 or more findings of either oedema, fibrin formation, bleeding or hernia. These findings were more common in the crush group then the avulsion group. Conclusions: The intravascular introduction of radio contrast agents to amputated digit prior to replantation may give further information particularly in avulsion amputations.
The Effect of Suture Materials on the Biomechanical Performance of Different Flexor Tendon Repairs and the Concept of Construct Efficiency
Authors: Wong Yoke Rung , Loke Austin Mun Kitt , Tay Shian Chao 
Published: May 2018

Background: To propose a new term (‘construct efficiency’) for the evaluation of multi strands flexor tendon repairs using different suture materials. Methods: A total of twenty specimens from 4-0 braided polyblend sutures (FiberLoop/FiberWire; Arthrex, Naples, FL) and 4-0 nylon sutures (Supramid Extra II; S. Jackson, Inc., Alexandria, VA) were subjected to tensile testing using Pneumatic Cord-and-Yarn Grips (Instron Corp., Canton MA, USA). The ultimate tensile strengths of the suture materials were measured. The expected repair strengths and construct efficiencies were computed based on the experimental results and from available literature on actual repair strengths of the 4-strand Becker, Cruciate repairs and 6-strand Tang, modified Lim-Tsai repairs. Results: The ultimate tensile strength of nylon suture was 15.4 ± 0.6N, lower than that of braided polyblend suture (45.3 ± 2.3N) with a difference of 194%. The construct efficiency of multi strand repairs varied with respect to different repair techniques and suture materials. It was found that the Becker repairs using FiberWire had the highest construct efficiency (55.7%) followed by the modified Lim-Tsai using Supramid (50.9%), Tang repair using Supramid (49.8%), Cruciate repair using Fiberwire (49.1%), and modified Lim-Tsai repair using FiberLoop (33.5%). Conclusions: The construct efficiency is more accurate in showing that, in terms of biomechanical strength, the use of FiberWire for the 4-strand Becker and Cruciate repair is more efficient than that of using FiberLoop for 6-strand modified Lim-Tsai repair.
“In Situ Vascular Nerve Graft” for Restoration of Intrinsic Hand Function: An Anatomical Study
Authors: Mozaffarian Kamran , Zemoodeh Hamid Reza , Zarenezhad Mohammad , Owji Mohammad 
Published: May 2018

Background: In combined high median and ulnar nerve injury, transfer of the posterior interosseous nerve branches to the motor branch of the ulnar nerve (MUN) is previously described in order to restore intrinsic hand function. In this operation a segment of sural nerve graft is required to close the gap between the donor and recipient nerves. However the thenar muscles are not innervated by this nerve transfer. The aim of the present study was to evaluate whether the superficial radial nerve (SRN) can be used as an “in situ vascular nerve graft” to connect the donor nerves to the MUN and the motor branch of median nerve (MMN) at the same time in order to address all denervated intrinsic and thenar muscles.Methods: Twenty fresh male cadavers were dissected in order to evaluate the feasibility of this modification of technique. The size of nerve branches, the number of axons and the tension at repair site were evaluated.Results: This nerve transfer was technically feasible in all specimens. There was no significant size mismatch between the donor and recipient nervesConclusions: The possible advantages of this modification include innervation of both median and ulnar nerve innervated intrinsic muscles, preservation of vascularity of the nerve graft which might accelerate the nerve regeneration, avoidance of leg incision and therefore the possibility of performing surgery under regional instead of general anesthesia. Briefly, this novel technique is a viable option which can be used instead of conventional nerve graft in some brachial plexus or combined high median and ulnar nerve injuries when restoration of intrinsic hand function by transfer of posterior interosseous nerve branches is attempted.
Towards defining a baseline status of scarce groundwater resources in anticipation of hydraulic fracturing in the Eastern Cape Karoo, South Africa: salinity, aquifer yields and groundwater levels
Authors: Stroebel Divan H. , Thiart Christien , de Wit Maarten 
Published: May 2018

Abstract

The Eastern Cape Karoo region is water stressed and will become increasingly so with further climate change. Effective and reliable groundwater management is crucial for a development such as the proposed hydraulic fracturing for shale gas. This is especially critical across this region of agriculture and protected ecosystem services. The research, as part of baseline data gathering, aims to characterize the hydrochemistry for both the shallow groundwater (<500 m) and saline groundwater closer to the
c.
2–5 km deep shale gas. The classification will be used to determine possible vertical hydraulic connectivity between the shallow and deep aquifers, prior to anticipated hydraulic fracturing. This paper reports on the baseline framework that includes the sampling design and a hydrocensus with field-recorded parameters shown as interpolated maps. This includes electrical conductivity, groundwater level and borehole yield. Together with completed sampling results, these data provide a record against which the environmental impact of hydraulic fracturing and the reinjection of production water can be determined. The research is a critical first step towards the successful governance of groundwater in light of proposed shale gas development in the Karoo. In its absence, effective regulation of the sector will not be effective.
Phase IB/II Study of Second-Line Therapy with Panitumumab, Irinotecan, and Everolimus (PIE) in KRAS Wild-Type Metastatic Colorectal Cancer
Authors: Townsend Amanda , Tebbutt Niall , Karapetis Christos , Cooper Pamela , Singhal Nimit , Yeend Susan , Pirc Louise , Joshi Rohit , Hardingham Jennifer , Price Timothy 
Published: May 2018

Abstract
Purpose: Inhibition of mTOR in addition to EGFR may overcome resistance to EGFR inhibitors in metastatic colorectal cancer (mCRC). This phase Ib/II study evaluated the safety and efficacy of the combination of irinotecan, panitumumab, and everolimus.
Patients and Methods: Patients with KRAS exon 2 wild-type (WT) mCRC following failure of fluoropyrimidine-based therapy received i.v. irinotecan and panitumumab every 2 weeks, and everolimus orally throughout a 14-day cycle. The primary endpoint of the phase II study was response rate (RR). Secondary survival outcomes were calculated using the Kaplan–Meier method, and results were analyzed as intention to treat. A preplanned exploratory biomarker analysis was performed.
Results: Forty-nine patients were enrolled. Dose level 1 (irinotecan 200 mg/m2, panitumumab 6 mg/kg, and everolimus 5 mg alternate day) was declared the MTD with no dose-limiting toxicities in six patients. Forty patients were treated at dose level 1: median age, 60 years (37–76); 65% male; 45% and 52.5%, respectively, with Eastern Cooperative Oncology Group values of 0/1. Median dose intensity was 85%. Grade 3 toxicities were diarrhea (23%), mucositis (18%), rash (13%), fatigue (8%), dehydration (5%), neutropenia (20%), febrile neutropenia (8%), hypomagnesemia (20%), and hypokalemia (8%). Grade 4 toxicities were hypomagnesemia (5%) and neutropenia (3%). RR was 48%, and stable disease was 43%. Median progression-free survival (PFS) was 5.6 months, and median overall survival (OS) was 10.8 months. Twenty-five patients were RAS/RAF WT and had an RR of 60%, median PFS of 6.4 months, and OS of 11.8 months.
Conclusions: The toxicity of the panitumumab, irinotecan, and everolimus regimen is as expected and manageable. The RR of 60% in all RAS/RAF WT supports further study of this combination. Clin Cancer Res; 24(16); 3838–44. ©2018 AACR.
Left Ventricular Mechanical Unloading by Total Support of Impella in Myocardial Infarction Reduces Infarct Size, Preserves Left Ventricular Function, and Prevents Subsequent Heart Failure in Dogs
Authors: Saku Keita , Kakino Takamori , Arimura Takahiro , Sunagawa Genya , Nishikawa Takuya , Sakamoto Takafumi , Kishi Takuya , Tsutsui Hiroyuki , Sunagawa Kenji 
Published: May 2018

Background:
Acute myocardial infarction remains a leading cause of chronic heart failure. Excessive myocardial oxygen demand relative to supply is the fundamental mechanism of myocardial infarction. We thus hypothesized that left ventricular (LV) mechanical unloading by the total support of transvascular LV assist device Impella could minimize oxygen demand, thereby reducing infarct size and preventing subsequent heart failure.

Methods and Results:

In 20 dogs, we ligated the left anterior descending coronary artery for 180 minutes and then reperfused. We introduced Impella from 60 minutes after the onset of ischemia to 60 minutes after reperfusion. In the partial support group, Impella supported 50% of total cardiac output. In the total support group, systemic flow totally depends on Impella flow. Four weeks after ischemia/reperfusion (I/R), we compared LV function and infarct size among 4 groups: sham (no I/R), I/R (no Impella support), partial support, and total support. Compared with I/R, total support lowered LV end-diastolic pressure (15.0±3.5 versus 4.7±1.7 mm Hg;
P
<0.001), increased LV end-systolic elastance (4.3±0.8 versus 13.9±5.1 mm Hg/mL;
P
<0.001), and decreased NT-proBNP (N-terminal pro-B-type natriuretic peptide) level (4081±1123 versus 1773±390 pg/mL;
P
<0.05). Furthermore, total support markedly reduced infarct size relative to I/R, whereas partial support decreased infarct size to a lesser extent (I/R, 16.3±2.6; partial support, 8.5±4.3; and total support, 2.1±1.6%;
P
<0.001).

Conclusions:
LV mechanical unloading by the total support of Impella during the acute phase of myocardial infarction reduced infarct size and prevented subsequent heart failure in dogs.
Association Between Adiposity and Lean Mass With Long‐Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox
Authors: Medina‐Inojosa Jose R. , Somers Virend K. , Thomas Randal J. , Jean Nathalie , Jenkins Sarah M. , Gomez‐Ibarra Miguel Angel , Supervia Marta , Lopez‐Jimenez Francisco 
Published: May 2018

Background

Prognosis based on body fat percentage (
BF
%) in patients with coronary artery disease has not been extensively studied. We tested the hypothesis that patients with coronary artery disease and increased
BF
% have a higher risk for major adverse cardiovascular events (
MACEs
) and that fat‐free mass is associated with better prognosis.

Methods and Results

We included 717 patients referred to cardiac rehabilitation after coronary artery disease events or procedures who underwent air displacement plethysmography to assess
BF
%; 75% were men, with a mean age 61.4±11.4 years and a mean body mass index of 30±5.4 kg/m
2
. Follow‐up was performed using a record linkage system. Patients were classified in sex‐specific quartiles of
BF
% and fat‐free mass index. The composite outcome of
MACEs
included acute coronary syndromes, coronary revascularization, stroke, or death from any cause. After a median follow‐up of 3.9 years, 201 patients had a
MACE
. After adjusting for covariates, body mass index was not associated with
MACEs
(
P
=0.12). However, the risk of
MACEs
for those in the highest
BF
% quartile was nearly double when compared with those in the lowest quartile (hazard ratio, 1.89; 95% confidence interval, 1.30–2.77;
P
=0.0008). In contrast, fat‐free mass was inversely associated with
MACEs
. The risk of
MACEs
for those in the fourth fat‐free mass quartile was lower (adjusted hazard ratio, 0.53; 95% confidence interval, 0.35–0.82;
P
=0.004), when compared with those in the first quartile.

Conclusions

In patients with coronary artery disease, there is no obesity paradox when measuring
BF
% instead of body mass index.
BF
% is associated with a higher risk of
MACEs
, whereas fat‐free mass is associated with a lower risk of
MACEs
. Body mass index was not associated with
MACEs
.
Computed Tomographic Perfusion Predicts Poor Outcomes in a Randomized Trial of Endovascular Therapy
Authors: Wannamaker Robert , Guinand Taurian , Menon Bijoy K. , Demchuk Andrew , Goyal Mayank , Frei Donald , Bharatha Aditya , Jovin Tudor G. , Shankar Jai , Krings Timo , Baxter Blaise , Holmstedt Christine , Swartz Richard , Dowlatshahi Dar , Chan Richard , Tampieri Donatella , Choe Hana , Burns Paul , Gentile Nina , Rempel Jeremy , Shuaib Ashfaq , Buck Brian , Bivard Andrew , Hill Michael , Butcher Kenneth 
Published: May 2018

Background and Purpose—
In the ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion with Emphasis on Minimizing CT to Recanalization Times), patients with large vessel occlusions and small infarct cores identified with computed tomography (CT)/CT angiography were randomized to endovascular therapy or standard of care. CT perfusion (CTP) was obtained in some cases but was not used to select patients. We tested the hypothesis that patients with penumbral CTP patterns have higher rates of good clinical outcome.

Methods—
All CTP data acquired in ESCAPE patients were analyzed centrally using a semiautomated perfusion threshold-based approach. A penumbral pattern was defined as an infarct core <70 mL, penumbral volume >15 mL, and a total hypoperfused volume:core volume ratio of >1.8. The primary outcome was good functional outcome at 90 days (modified Rankin Scale score, 0–2).

Results—

CTP was acquired in 138 of 316 ESCAPE patients. Penumbral patterns were present in 116 of 128 (90.6%) of patients with interpretable CTP data. The rate of good functional outcome in penumbral pattern patients (53 of 114; 46%) was higher than that in nonpenumbral patients (2 of 12; 17%;
P
=0.041). In penumbral patients, endovascular therapy increased the likelihood of a good clinical outcome (34 of 58; 57%) compared with those in the control group (19 of 58; 33%; odds ratio, 2.68; 95% confidence interval, 1.25–5.76;
P
=0.011). Only 3 of 12 nonpenumbral patients were randomized to the endovascular group, preventing an analysis of treatment effect.

Conclusions—
The majority of patients with CTP imaging in the ESCAPE trial had penumbral patterns, which were associated with better outcomes overall. Patients with penumbra treated with endovascular therapy had the greatest odds of good functional outcome. Nonpenumbral patients were much less likely to achieve good outcomes.
A revised classification of genera in the subfamily Eucalliacinae Manning & Felder, 1991 [sensu Sakai], with confirmation of the validity of Calliaxiopsis madagassa Sakai & Türkay, 2014 (Decapoda, Thalassinidea auct.)
Authors: Sakai Katsushi 
Published: May 2018

Abstract
Re-examination of Calliaxiopsis madagassa Sakai & Türkay, 2014, which was regarded by Poore & Dworschak (2017) as Calliaxina madagassa (Sakai & Türkay, 2014), a senior synonym of Calliaxina thomassini Ngoc-Ho, 2014, required the present author to review the subfamily Eucalliacinae Manning & Felder, 1991. This review has resulted in a revised classification of eleven genera including three new ones in this subfamily, and also in the confirmation of the validity of Calliaxiopsis madagassa Sakai & Türkay, 2014.
Occurrence of two sympatric species of Palaemonidae and Hippolytidae (Decapoda, Caridea) in a coastal ecosystem in western Mexico
Authors: Hendrickx Michel E. 
Published: May 2018

AbstractOne species of Hippolytidae,Hippolyte californiensisHolmes, 1895, and one species of Palaemonidae,Periclimenes infraspinis(Rathbun, 1902), were collected in a single sample among sea grass in the northern Gulf of California, Mexico.Hippolyte californiensisis partly illustrated and compared to the descriptions available in the literature, noting minor differences with material from California where it was originally described. Diagnostic characters ofP. infraspinisare also illustrated. Sex proportion and size distribution indicate a higher incidence of females (male : female ratio, 1 : 2.59), smaller size in males, a strong incidence of ovigerous females (31%), and a brood clutch of 82-200 embryos inP. infraspinis. InH. californiensis, males were more abundant (1.41 : 1), the incidence of ovigerous females was low (15%), and females carried 51-115 embryos. In both species, males, females, and ovigerous females were significantly different in size. These two species have not been reported as sympatric.