bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fenestration in the Fontan circulation as a strategy for chronic cardioprotection
Authors: Saiki Hirofumi , Kuwata Seiko , Iwamoto Yoichi , Ishido Hirotaka , Taketazu Mio , Masutani Satoshi , Nishida Takashi , Senzaki Hideaki 
Published: March 2019

BackgroundFenestration in the Fontan circulation potentially liberates patients from factors leading to cardiovascular remodelling, through stable haemodynamics with attenuated venous congestion. We hypothesised that a fenestrated Fontan procedure would possess chronic haemodynamic advantages beyond the preload preservation.MethodsWe enrolled 35 patients with fenestrated Fontan with a constructed pressure–volume relationship under dobutamine (DOB) infusion and/or transient fenestration occlusion (TFO). Despite the use of antiplatelets and anticoagulants, natural closure of fenestration was confirmed in 11 patients. Cardiovascular properties in patients with patent fenestration (P-F) were compared with those in patients with naturally closed fenestration (NC-F). To further delineate the roles of fenestration, paired analysis in patients with P-F was performed under DOB or rapid atrial pacing with/without TFO.ResultsAs compared with P-F, patients with NC-F had a higher heart rate (HR), smaller ventricular end-diastolic area, better ejection fraction and higher central venous pressure, with higher pulmonary resistance. While this was similarly observed after DOB infusion, DOB markedly augmented diastolic and systolic ventricular stiffness in patients with NC-F compared with patients with P-F. As a mirror image of the relationship between patients with P-F and NC-F, TFO markedly reduced preload, suppressed cardiac output, and augmented afterload and diastolic stiffness. Importantly, rapid atrial pacing compromised these haemodynamic advantages of fenestration.ConclusionsAs compared with patients with NC-F, patients with P-F had robust haemodynamics with secured preload reserve, reduced afterload and a suppressed beta-adrenergic response, along with a lower HR at baseline, although these advantages had been overshadowed, or worsened, by an increased HR.
Cannabis use is both independently associated with and mediates worse psychosocial health in patients with epilepsy
Authors: Wahby Sandra , Karnik Vikram , Brobbey Anita , Wiebe Samuel , Sajobi Tolulope , Josephson Colin Bruce 
Published: March 2019

ObjectiveTo examine whether cannabis use is associated with or mediates psychosocial health in people with epilepsy.MethodsConsecutive adult epilepsy patients visiting the Calgary Comprehensive Epilepsy Programme clinic were administered validated patient-reported outcome measures (PROMs) including the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Quality of Life in Epilepsy (QOLIE-10-P), EuroQOL five dimensions five level scale (EQ-5D-5L), Global Assessment of Severity of Epilepsy Scale, Global Assessment of Disability Associated with Seizures Scale and the Treatment Satisfaction Questionnaire for Medication scale. We used multiple regression analyses to investigate associations between cannabis use and PROMs. Mediation analyses were performed to determine the degree to which cannabis modulated the associations between current or past psychiatric disorders, monthly seizure frequency, and 1-year seizure freedom on psychosocial health.ResultsOf 337 consecutive patients, 71 (21%) reported cannabis use. Cannabis use was independently associated with depression (NDDI-E score≥14; OR 3.90; 95% CI 2.01 to 7.59; p<0.001), lower quality of life (β=−16.73, 95% CI − 26.26 to − 7.20; p=0.001), worse epilepsy-related disability (OR 2.23, 95% CI 1.19 to 4.17; p=0.01) and lower satisfaction with antiepileptic medication (OR 0.41, 95% CI 0.23 to 0.72; p=0.002). Cannabis use mediates 7%–12% of the effect of a psychiatric history on depression, worse quality of life and worse health valuation.ConclusionsThere is a strong and independent association between cannabis use and poor psychosocial health, and it partially mediates the deleterious effect of a psychiatric history on these same outcomes. Inclusion of PROMs in future cannabis trials is warranted.
Understanding foreign accent syndrome
Authors: McWhirter Laura , Miller Nick , Campbell Catriona , Hoeritzauer Ingrid , Lawton Andrew , Carson Alan , Stone Jon 
Published: March 2019

Objective
Foreign accent syndrome (FAS) is widely understood as an unusual consequence of structural neurological damage, but may sometimes represent a functional neurological disorder. This observational study aimed to assess the prevalence and utility of positive features of functional FAS in a large group of individuals reporting FAS.

Methods
Participants self-reporting FAS recruited from informal unmoderated online support forums and via professional networks completed an online survey. Speech samples were analysed in a subgroup.

Results
Forty-nine respondents (24 UK, 23 North America, 2 Australia) reported FAS of mean duration 3 years (range 2 months to 18 years). Common triggers were: migraine/severe headache (15), stroke (12), surgery or injury to mouth or face (6) and seizure (5, including 3 non-epileptic). High levels of comorbidity included migraine (33), irritable bowel syndrome (17), functional neurological disorder (12) and chronic pain (12). Five reported structural lesions on imaging. Author consensus on aetiology divided into, ‘probably functional (n=35.71%), ‘possibly structural’ (n=4.8%) and ‘probably structural’ (n=10.20%), but positive features of functional FAS were present in all groups. Blinded analysis of speech recordings supplied by 13 respondents correctly categorised 11 (85%) on the basis of probable aetiology (functional vs structural) in agreement with case history assignment.

Conclusions
This largest case series to date details the experience of individuals with self-reported FAS. Although conclusions are limited by the recruitment methods, high levels of functional disorder comorbidity, symptom variability and additional linguistic and behavioural features suggest that chronic FAS may in some cases represent a functional neurological disorder, even when a structural lesion is present.
Diastolic-systolic velocity ratio to detect coronary stenoses under physiological resting conditions: a mechanistic study
Authors: de Waard Guus A , Broyd Christopher J , Cook Christopher M , van der Hoeven Nina W , Petraco Ricardo , Nijjer Sukhjinder S , van de Hoef Tim P , Echavarria-Pinto Mauro , Meuwissen Martijn , Sen Sayan , Knaapen Paul , Escaned Javier , Piek Jan J , van Royen Niels , Davies Justin E 
Published: March 2019

ObjectiveDiastolic-systolic velocity ratio (DSVR) is a resting index to assess stenoses in the left anterior descending artery (LAD). DSVR can be measured by echocardiographic or intracoronary Doppler flow velocity. The objective of this cohort study was to elucidate the fundamental rationale underlying the decreased DSVR in coronary stenoses.MethodsIn cohort 1, simultaneous measurements of intracoronary Doppler flow velocity and pressure were acquired in the LAD of 228 stable patients. Phasic stenosis resistance, microvascular resistance and total vascular resistance (defined as stenosis and microvascular resistance combined) were studied during physiological resting conditions. Stenoses were classified according to severity by strata of 0.10 fractional flow reserve (FFR) units.ResultsDSVR was decreased in stenoses with lower FFR. Stenosis resistance was equal in systole and diastole for every FFR stratum. Microvascular resistance was consistently higher during systole than diastole. In lower FFR strata, stenosis resistance as a percentage of the total vascular resistance increases both during systole and diastole. The difference between the stenosis resistance as a percentage of total vascular resistance during systole and diastole increases for lower FFR strata, with an accompanying rise in diastolic-systolic resistance ratio. A significant inverse correlation was observed between DSVR and the diastolic-systolic resistance ratio (r=0.91, p<0.001). In cohort 2 (n=23), DSVR was measured both invasively and non-invasively by transthoracic echocardiography, yielding a good correlation (r=0.82, p<0.001).ConclusionsThe rationale by which DSVR is decreased distal to coronary stenoses is dependent on a comparatively higher influence of the increased stenosis resistance on total vascular resistance during diastole than systole.
Fatal cardiac arrest in a calf with uroperitoneum
Authors: Tayari Hamaseh , Cuypers Charlotte , Schäffler Lisa , Proost Kirsten , Schauvliege Stijn 
Published: March 2019

A five‐month‐old Belgian Blue female calf presented with a 72‐hour history of depression, anorexia, muscle weakness and severe abdominal distension. Abdominal ultrasonography and abdominocentesis revealed the presence of uroperitoneum due to bladder rupture.Venous blood gas analysis showed haemoconcentration, hyperkalaemia and metabolic acidosis. Electrolytes and fluid balance were corrected with aggressive fluid therapy and peritoneal drainage overnight, and surgery was scheduled for the following day.Intraoperatively, gradual drainage of abdominal fluid was performed to avoid sudden haemodynamic changes, and despite successful bladder reconstruction, near the end of surgery, the patient developed severe bradycardia, atrial standstill, sine waves and pulseless electrical activity, unresponsive to cardiopulmonary resuscitation. Cardiac arrest in this calf was likely caused by a combination of washout of toxic product from previous ischaemic tissues, severe acidosis, severe hypoxaemia and electrolyte disturbances. Clinicians should be prepared to handle possible complications of uroperitoneum.
Intradural‐extramedullary osteosarcoma in a dog
Authors: Bonanno Giuseppe , Gomes Sergio Andrade , Dawson Sandra , Bass Joyce , Lowrie Mark 
Published: March 2019

An 11‐year‐old male crossbreed dog was referred for progressive left forelimb lameness and proprioceptive deficits over four weeks. Neurolocalisation was consistent with a cervical lesion affecting the C1–C5 spinal segments. CT revealed a hyperattenuating lesion within the vertebral column. MRI revealed a suspected intradural‐extramedullary, oval‐shaped lesion displacing the spinal parenchyma. Surgical exploration confirmed this was an intradural lesion and so a durotomy was performed to remove the mass. The histopathological diagnosis was an extradural osteosarcoma. Chemotherapy was commenced and despite initial improvement, euthanasia was performed following acute deterioration two months later.This is the first report of an extraskeletal and intradural‐extramedullary spinal osteosarcoma in a dog. Extraskeletal osteosarcoma should be included as a differential diagnosis for an intradural‐extramedullary lesion in dogs, particularly in the presence of suspected mineralised material on advanced imaging. As reported in human medicine, prognosis appears to be grave in dogs.
Amoebic gill disease in farmed halibut (Hippoglossus hippoglossus) in the United Kingdom
Authors: Rodger Hamish D 
Published: March 2019

Amoebic gill disease (AGD) is one of the most significant infectious diseases affecting marine farmed Atlantic salmon and is caused by the marine amoeba Neoparamoeba perurans. Atlantic halibut are also farmed in Norway, Canada, Chile and Scotland; however, the total production is approximately 0.1 per cent that of salmon. Halibut reared in a net pen sea site in Scotland presented with low‐level mortalities and pale, raised patches on the gills. Fresh microscopy of the gills demonstrated amoeboid organisms and histology of the gills confirmed typical AGD pathology. Gill samples tested by PCR confirmed the presence of N perurans. Freshwater baths of three hours duration are the preferred treatment for AGD in salmon; however, hydrogen peroxide has also been used and as halibut do not tolerate freshwater low‐level hydrogen peroxide baths (1000 mg/l) were administered as a 15‐minute bath. Net changes were also undertaken, and mortalities subsequently reduced.
Effect of adenotonsillectomy on sleep problems, attention deficit hyperactivity disorder symptoms, and quality of life of children with adenotonsillar hypertrophy and sleep-disordered breathing
Authors: Türkoğlu Serhat , Tahsin Somuk Battal , Sapmaz Emrah , Bilgiç Ayhan 
Published: March 2019

Objective Chronic adenotonsillar hypertrophy is the most common etiologic reason for upper airway obstruction in childhood and has been found to be associated with a variety of psychiatric disorders and poor quality of life. In the present study, we investigated the impact of adenotonsillectomy on attention deficit hyperactivity disorder symptoms, sleep problems, and quality of life in children with chronic adenotonsillar hypertrophy. Methods The parents of children with chronic adenotonsillar hypertrophy filled out the Conners’s Parent Rating Scale-Revised Short form (CPRS-RS), Children’s Sleep Habits Questionnaire (CSHQ), and Pediatric Quality of Life Inventory, Parent version (PedsQL-P) before and six months after adenotonsillectomy. Results A total of 64 children were included in the study (mean age = 6.8 ± 2.4 years; boy:girl ratio= 1). The mean attention deficit hyperactivity disorder index and oppositionality subdomain scores of the CPRS-RS and all of the CSHQ subdomain scores (bedtime resistance, sleep-onset delay, sleep anxiety, night waking, parasomnias, sleep-disordered breathing, and daytime sleepiness) except for sleep duration significantly decreased after adenotonsillectomy ( p < 0.05). The PedsQL-P total score and both PedsQL-P physical health and psychosocial health subdomain scores were significantly higher at six months after adenotonsillectomy ( p < 0.001). Conclusions Child and adolescent psychiatrists should check the symptoms of chronic adenotonsillar hypertrophy to identify children with chronic adenotonsillar hypertrophy who suffer from sleep disturbance, attention deficit hyperactivity disorder symptoms, and oppositionality. Adenotonsillectomy seems to be beneficial for coexisting attention deficit hyperactivity disorder and sleep disorder symptoms and quality of life in these children.
Early and long-term results of aortic valve sparing aortic root reimplantation surgery for bicuspid and tricuspid aortic valves
Authors: Karciauskas Dainius , Mizariene Vaida , Jakuska Povilas , Ereminiene Egle , Orda Paulius , Ordiene Rasa , Vaskelyte Jolanta Justina , Nedzelskiene Irena , Kinduris Sarunas , Benetis Rimantas 
Published: March 2019

Introduction: To evaluate early and long-term clinical outcomes following aortic valve sparing aortic root reimplantation surgery in patients with leaking bicuspid and tricuspid aortic valves. Methods: The study consisted of 92 consecutive adult patients (tricuspid aortic valve group = 63 and bicuspid aortic valve group = 29) who underwent aortic valve sparing aortic root reimplantation surgery with or without aortic cusp repair for dilatation of the aortic root and/or aortic valve regurgitation at our institution from April 2004 to October 2016. Clinical outcomes were investigated using Kaplan–Meier and log-rank tests between groups. Results: The follow-up was 100% complete with a mean time of 5.3 ± 3.3 years. The 30-day in-hospital mortality was 3.1% in tricuspid aortic valve group and 3.4% in bicuspid aortic valve group patients. The overall survival rates at 10 years did not differ between bicuspid aortic valve and tricuspid aortic valve patient groups (96.6 ± 3.3% vs. 90.3 ± 4.2%, p = 0.3). Freedom from recurrent aortic valve regurgitation (>2+) at 10 years was 90.5 ± 4.1% in tricuspid aortic valve group and 75.7 ± 8.7% in bicuspid aortic valve group (p = 0.06). Freedom from aortic valve reoperation at 10 years was 100% in tricuspid aortic valve group and 83.9 ± 7.4% in bicuspid aortic valve group (p = 0.002). Conclusion: Aortic valve sparing aortic root reimplantation surgery is a safe and efficient technique, providing acceptable long-term survival with low rates of valve-related complications in both tricuspid aortic valve and bicuspid aortic valve patient groups. However, aortic valve reoperation rates at 10 years follow-up were higher in bicuspid aortic valve group patients compared to tricuspid aortic valve group patients.
Participation and quality of life for persons with oculomotor impairments after acquired brain injury
Authors: Wagener Sharon Gowdy , Kreiger Robert 
Published: March 2019

Introduction Acquired brain injury is a major diagnostic group treated by occupational therapists. This study explored participation in everyday activities and social roles, and quality of life for persons with acquired brain injury-related oculomotor impairments. Method Using a cross-sectional descriptive approach, 40 rehabilitation outpatients with acquired brain injury-related oculomotor impairments underwent semi-structured interviews using self-report measures of visual symptoms (ABI Vision Questionnaire), quality of life (PROMIS Global Health Scale), and participation (Assessment of Life Habits). Descriptive, correlational, and simple regression statistics were used for analysis. Results Visual symptoms were significant for 96.7% of the participants. Physical and mental quality of life scores were one standard deviation below population norms. Participation areas identified as very difficult or harder for 82% or more included recreation, education, work, home maintenance, and volunteering. Approximately 68% or more identified communicating in a group, reading, computer use, and driving as very difficult. Correlations between scores of visual symptoms and participation, and visual symptoms and physical quality of life, showed significant moderate negative relationships. Regression analyses indicated visual symptoms explained about half the measured difficulties in participation. Conclusion Awareness of the activities and roles that are likely to be disrupted by acquired brain injury-related oculomotor impairments enables occupational therapists to direct therapy where it matters most. Findings highlight the identified symptoms and participation areas.
How not to waste a crisis: a qualitative study of problem definition and its consequences in three hospitals
Authors: Martin Graham , Ozieranski Piotr , Leslie Myles , Dixon-Woods Mary 
Published: March 2019

Objectives The prominence given to issues of patient safety in health care organizations varies, but little is known about how or why this variation occurs. We sought to compare and contrast how three English hospitals came to identify, prioritize and address patient safety issues, drawing on insights from the sociological and political science literature on the process of problem definition. Methods In-depth qualitative fieldwork, involving 99 interviews, 246 hours of ethnographic observation, and document collection, was carried out in three case-study hospitals as part of a wider mixed-methods study. Data analysis was based on the constant comparative method. Results How problems of patient safety came to be recognized, conceptualized, prioritized and matched to solutions varied across the three hospitals. In each organization, it took certain ‘triggers’ to problematize safety, with crises having a particularly important role. How problems were constructed – and whose definitions were prioritized in the process – was highly consequential for organizational response, influencing which solutions were seen as most appropriate, and allocation of responsibility for implementing them. Conclusions A process of problem definition is crucial to raising the profile of patient safety and to rendering problems amenable to intervention. How problems of patient safety are defined and constructed is highly consequential, influencing selection of solutions and their likely sustainability.
Why the “real” numbers on Roma are fictitious: Revisiting practices of ethnic quantification
Authors: Surdu Mihai 
Published: March 2019

This article scrutinizes the administrative and scientific practices by which the Gypsy/Roma category has been historically constructed in Europe, particularly in Central and South Eastern Europe. Censuses, police-led inquiries, social surveys and expert estimates made the ‘Roma’ category appear objective, making invisible the multiple technical and political decisions behind their interpretations. This paper examines the technologies behind the production of ethnic categories and that of Roma in particular: namely, guidelines and manuals for field workers, recruitment and census campaigns, consent forms, questionnaires, data processing, basic assumptions and interpretation of data.  While expert networks give objectivity and flexibility to the collection and circulation of data, the labour involved in crafting ethnic statistics often remains obscure. This paper follows the historical departures and continuities of Roma categorization from the 18th century to present times. The category ‘Roma’ was produced and reproduced through quantification practices with the justification that ethnic data (or categorization) would help solve social problems and contribute to Roma integration. The technical literature reviewed in this paper and the auto-ethnographic analysis shed light on the machinery of ethnic categorization, and allows us to assess the impact of various kinds of labour upon this categorization: from the more visible work performed by ethnopolitical entrepreneurs and scholars – to the relatively invisible contributions of field workers, administrators and census takers. This article calls for a critical scrutiny of how Roma ethnicity is crafted through practices of ethnic quantification and encourages researchers to use methodological prudence and more self-reflection in their own academic practices.
Serum chitotriosidase and neopterin levels in patients with ankylosing spondylitis
Authors: Yavuz Ferdi , Kesikburun Bilge , Öztürk Özlem , Güzelküçük Ümüt 
Published: March 2019

Background: The aim of this study was to assess the serum chitotriosidase (ChT) and neopterin levels in patients with ankylosing spondylitis (AS) and to evaluate whether serum ChT and neopterin levels are related to disease activity. Methods: A total of 86 patients with AS were included in the study. Patients were divided into two groups based on Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores: The active AS patients group included 40 patients who had a BASDAI score ⩾4. The inactive AS patients group included 46 patients who had a BASDAI score <4. We compared the serum level of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ChT and neopterin between the two groups. Results: Active AS patients had significantly higher ESR, CRP, serum ChT and neopterin levels compared with the inactive AS patients group ( p < 0.05). Positive correlations were found between serum ChT levels and ESR ( r = 0.87, p = 0.005), and CRP levels ( r = 0.86, p = 0.006). Also, there was a positive significant correlation between serum ChT levels and BASDAI scores ( r = 0.67, p = 0.03). No correlation was found between serum neopterin levels and the BASDAI scores, ESR, and CRP levels ( p > 0.05). Higher disease activity (BASDAI score ⩾4) was found to be associated with ChT ( p = 0.012) in the multiple logistic regression analysis. Conclusion: The present study emphasized that serum ChT levels can be useful in the determination of the disease activity of AS patients.