bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of multimodal MRI-guided intravenous thrombolysis in patients with stroke with unknown time of onset
Authors: Zhao Jie , Zhao Hongmei , Li Runtao , Li Jiangtao , Liu Chang , Lv Juan , Li Yanan , Liu Wei , Ma Dongpu , Hao Huaihai , Xiao Xinguang , Liu Junzhong , Yin Yongfeng , Liu Rongli , Yu Qiaoyan , Wei Yingjie , Li Pengyan , Wang Yue , Wang Runqing 
Published: February 2019

ObjectiveIntravenous tissue plasminogen activator (tPA) is the standard therapy for patients with acute ischaemic stroke (AIS) within 4.5 hours of onset. Recent trials have expanded the endovascular treatment window to 24 hours. We investigated the efficacy and safety of using multimodal MRI to guide intravenous tPA treatment for patients with AIS of unknown time of onset (UTO).MethodsData on patients with AIS with UTO and within 4.5 hours of onset were reviewed. Data elements collected and analysed included: demographics, National Institutes of Health Stroke Scale (NIHSS) score at baseline and 2 hours, 24 hours, 7 days after thrombolysis and before discharge, the modified Rankin Scale (mRS) score at 3 months after discharge, imaging findings and any adverse event.ResultsForty-two patients with UTO and 62 in control group treated within 4.5 hours of onset were treated with intravenous tPA. The NIHSS scores after thrombolysis and/or before discharge in UTO group were significantly improved compared with the baseline (p<0.05). Between the two groups, no significant differences in NIHSS score were observed (p>0.05). Utilising the non-inferiority test, to compare mRS scores (0–2) at 3 months between the two groups, the difference was 5.2% (92% CI, OR 0.196). Patients in the UTO group had mRS scores of 0-2, which were non-inferior to the control group. Their incidence of adverse events was similar.ConclusionsUtilising multimodal MRI to guide intravenous only thrombolysis for patients with AIS with UTO was safe and effective. In those patients with AIS between 6 and 24 hours of time of onset but without large arterial occlusion, intravenous thrombolysis could be considered an option.
Is Antithrombotic Therapy Necessary Following Replantation of an Amputated Digit?
Authors: Matsusue Takeo 
Published: February 2019

Background: Antithrombotic therapy following replantation remains controversial, and the survival of replanted digits is affected by various other factors, such as the state of vascular damage and the surgeon’s level of skill. The present study’s aim is to obtain clinical evidence for postoperative antithrombotic therapy in replantation, with antithrombotic therapy being the only variable.Methods: This was a single-center retrospective study of patients who underwent replantation of a completely amputated digit by the same surgeon. The subject sample included 17 patients/19 digits (group A) in whom heparin and prostaglandin E1 (PGE1) were used postoperatively during a 1-year period, 19 patients/22 digits (group B) in whom heparin was not used postoperatively but PGE1 was used for a 1-year period, and 16 patients/19 digits (group C) in whom neither heparin not PGE1 were used postoperatively for a 1-year period.Results: Patient background and surgical procedure were not significantly different among groups, and only the postoperative use of heparin and/or PGE1 showed differences. Incidence of arterial occlusion, venous occlusion, or vascular spasm were not significantly different among groups (arterial occlusion: 1 digit in group A, 2 in group B, and two in group C, p = 1; venous occlusion: 1 digit in group A, 2 in group B, and three in group C, p = 0.67; vascular spasm: 1 digit in group A, 2 in group B, and one in group C, p = 1). Postoperative bleeding was significantly more common in the group using heparin (7 patients in group A, 0 in group B, and zero in group C, p < 0.001).Conclusions: These results suggest that heparin and PGE1 administration do not improve impaired blood flow following replantation. Considering the potential complications, heparin and PGE1 following replantation do not seem necessary.
Clinical Findings and Treatments of a Radially Deviated Type of Thumb Polydactyly
Authors: Suzuki Ayumi , Kawabata Hidehiko , Hayashi Junichiro , Tamura Daisuke 
Published: February 2019

Background: Patients with some thumb polydactyly subtypes are regarded as having a high risk of secondary deformities or poor treatment outcomes. Radially deviated type is one of these subtypes, but its characteristics and definitive treatment outcomes remain unclear. This study aimed to evaluate the pre- and intraoperative findings and surgical outcomes of this subtype. Methods: We identified eight patients with unilateral and proximal phalanx-type polydactyly. The mean age at surgery was 14.6 months, and the mean follow-up period was 7.2 years. We investigated the patients’ initial radiograms, surgical procedures and findings, changes in alignment of the retained thumb, and postoperative outcomes using the Japanese Society for Surgery of the Hand scoring system. Results: Although the gross appearance of the thumb was a radial deviation, there was an ulnar deviation at the metacarpophalangeal joint on radiography. The ulnar proximal phalanges were delta phalanges in three patients and were connected with the radial proximal phalanges by cartilage in five patients. We retained the ulnar thumbs in all patients and corrected the alignment in seven cases; open wedge osteotomy was performed for three patients with a delta phalanx, and tendon transfers from the radial to ulnar thumb were performed for the other four. The mean outcome score was 17.6/20, with one patient with excellent, six with good, one with fair, and none with poor scores. One patient experienced recurrent radial deviation around the interphalangeal joint five years after surgery and underwent corrective osteotomy, but the other patients maintained good alignment. Conclusions: Radially deviated thumb polydactyly is not simply radially deviated; the shape of the proximal phalanx of the ulnar thumb is important to determine the surgical procedure. However, our results indicated that the alignment is almost manageable, and the surgical outcome was comparable to that of patients with a proximal phalanx-type thumb polydactyly.
Hand and Wrist Injuries Related to Motocross Injuries: 5 Year Series
Authors: Singh Rohit , Chojnowski Adrian , Hay Stuart 
Published: February 2019

Background: The increasingly fashionable sport of motocross is practiced worldwide by millions of people, but there is very little in the literature regarding its associated injuries and their prevention. We therefore present the first comprehensive, prospective study looking at hand and wrist injuries resulting from motocross injuries in the UK. Methods: Data was prospectively collected over a 5-year period (from 2010 to 2015) at our regional trauma unit. We exclusively looked at motocross riders. Injuries sustained via motorcycle were excluded from our study. Results: During the period studied (five years), 615 injuries were collected, including 240 patients with 265 hand and wrist injuries. Most of injuries were sustained in male patients. The patient’s age range was from 4–78 years with most injuries occurring during the spring and summer months. A total of 96 (40%) patients required operative treatment. The most common injury pattern was distal radius fractures (n = 53, 20%), followed by metacarpal fractures (n = 38, 14%) and phalangeal fractures (n = 36, 13.5%). Conclusions: This study shows the impact and incidence of related hand and wrist injuries. Motocross is a globally fashionable sport. This study shows that the number of annual tournaments and racers have doubled in last 5 years. The number of hand and wrist related injuries and operative requirements have quadruples over the last five years. It is recognized as a high-risk sport despite the use of protective equipment and course adaptions. These injuries can have implications for nearby treating hospitals.
Current Smoking Is Associated with Delayed Wound Healing But Not with Improvement of Contracture after the Open Palm Technique for Dupuytren’s Disease
Authors: Sakai Akinori , Zenke Yukichi , Menuki Kunitaka , Yamanaka Yoshiaki , Tajima Takafumi , Uchida Soshi 
Published: February 2019

Background: Some cases treated with open palm technique need relatively long wound healing time. This study aims to clarify whether the preoperative lifestyle-related diseases or factors are associated with surgical results after the open palm technique for Dupuytren’s contracture.Methods: The study included 122 fingers of 84 hands of 84 consecutive male patients with Dupuytren’s contracture who were treated with McCash’s open palm technique at our hospital from 1980 to 2016. The average age of the patients was 68.0 years (range, 39–86). The follow-up period was at least 6 months (average, 36.3 months). Using multiple regression analysis, we investigated preoperative factors associated with surgical results. The factors examined were age, affected side, contracture of the little finger, number of contracted fingers, contracture of the proximal interphalangeal (PIP) joint, Meyerding classification, diabetes mellitus, hypertension, alcohol intake, and smoking. Surgical results were judged at 6 months after surgery and wound healing time was evaluated.Results: According to Tubiana’s criteria, there were 59 excellent hands (70.2%), 18 good hands (21.4%), 5 fair hands (6.0%), and 2 poor hands (2.4%) at the final physical examination after surgery. The average of the percentage of improvement in contracture was 86.1%. The average number of days needed until complete open wound closure was 22.9 days. Multiple regression analysis revealed that the significant preoperative factors associated with the percentage of improvement in contracture were multiple contracted fingers and involvement of PIP joint contracture, and that the factor associated with delayed wound healing was current smoking.Conclusions: Multiple contracted fingers and involvement of PIP joint contracture are associated with insufficient improvement of joint contracture. Current smoking is associated with delayed wound healing, but not with improvement of joint contracture, after the open palm technique for Dupuytren’s disease in men.
Chondroitin sulfate attenuates acid-induced augmentation of the mechanical response in rat thin-fiber muscle afferents in vitro
Authors: Hotta Norio , Kubo Asako , Mizumura Kazue 
Published: February 2019

Exercise-induced tissue acidosis augments the exercise pressor reflex (EPR). One reason for this may be acid-induced mechanical sensitization in thin-fiber muscle afferents, which is presumably related to EPR. Acid-induced sensitization to mechanical stimulation has been reported to be attenuated in cultured primary-sensory neurons by exogenous chondroitin sulfate (CS) and chondroitinase ABC, suggesting that the extracellular matrix CS proteoglycan is involved in this sensitization. The purpose of this study was to clarify whether acid-induced sensitization of the mechanical response in the thin-fiber muscle afferents is also suppressed by exogenous CS and chondroitinase ABC using a single-fiber recording technique. A total of 88 thin fibers (conduction velocity <15.0 m/s) dissected from 86 male Sprague-Dawley rats were identified. A buffer solution at pH 6.2 lowered their mechanical threshold and increased their response magnitude. Five minutes after CS (0.3 and 0.03%) injection near the receptive field, these acid-induced changes were significantly reduced. No significant difference in attenuation was detected between the two CS concentrations. Chondroitinase ABC also significantly attenuated this sensitization. The control solution (0% CS) did not significantly alter the mechanical sensitization. Furthermore, no significant differences were detected in this sensitization and CS-based suppression between fibers with and without acid-sensitive channels [transient receptor potential vanilloid 1 (TRPV1), acid-sensing ion channel (ASIC)]. In addition, this mechanical sensitization was not changed by TRPV1 and ASIC antagonists, suggesting that these ion channels are not involved in the acid-induced mechanical sensitization of muscle thin-fiber afferents. In conclusion, CS administration has a potential to attenuate the acidosis-induced exaggeration of muscle mechanoreflex. NEW & NOTEWORTHY We found that exogenous chondroitin sulfate attenuated acid-induced mechanical sensitization in thin-fiber muscle afferents that play a crucial role in the exercise pressor reflex. This finding suggests that extracellular matrix chondroitin sulfate proteoglycans may be involved in the mechanism of acid-induced mechanical sensitization and that daily intake of chondroitin sulfate may potentially attenuate this amplification of muscle mechanoreflex and therefore reduce muscle pain related to acidic muscle conditions.
Inspiratory muscle activation via ventral lower thoracic high-frequency spinal cord stimulation
Authors: Kowalski Krzysztof E. , Romaniuk Jaroslaw Richard , Kirkwood Peter A. , DiMarco Anthony F. 
Published: February 2019

In animals, high-frequency spinal cord stimulation (HF-SCS) applied on the ventral epidural surface at the T2 level results in negative airway pressure generation consistent with inspiratory muscle activation. In the present study, in anesthetized dogs, we found that ventral HF-SCS (500 Hz) applied at all thoracic levels resulted in negative airway pressure generation. In the region of the lower thoracic spinal cord, negative airway pressure generation was most pronounced at the T9 level. At this level, airway pressure generation was monitored: 1) during ventral HF-SCS over a wide range of stimulus amplitudes (0.5–15 mA) and frequencies (50–1,000 Hz) and 2) following spinal sections at C8 (to assess potential diaphragm activation) and subsequently at T6 (to assess potential intercostal muscle activation). The application of low stimulus currents between 1 and 2 mA and high stimulus frequencies (>300 Hz) resulted in the development of large negative airway pressure generation. Stimulation with 1 mA, 500 Hz resulted in a highest negative airway pressure generation of 47 ± 2 cmH2O. Increasing stimulus current was associated with progressive reductions in the magnitude of negative airway pressure generation. HF-SCS (500 Hz) with 15 mA resulted in a negative airway pressure generation of 7 ± 3 cmH2O. C8 section markedly reduced negative airway pressure generation, and subsequent T6 section resulted in positive airway pressure generation after HF-SCS. Our results indicate the existence of pathways with connections to both the phrenic and inspiratory intercostal motoneuron pools in the ventral part of the lower thoracic spinal cord. We speculate that the circuits mediating the previously described excitatory intercostal-to-phrenic reflex mediate the observed responses. NEW & NOTEWORTHY This study suggests that, in contrast to dorsal high-frequency spinal cord stimulation at the T9 spinal level, which results in positive pressure generation, ventral high-frequency spinal cord stimulation at the same spinal level results in large negative airway pressure generation with low stimulus currents. This method, therefore, may provide an alternative method to restore ventilation in ventilator-dependent spinal cord-injured patients.
Disuse-induced insulin resistance susceptibility coincides with a dysregulated skeletal muscle metabolic transcriptome
Authors: Mahmassani Ziad S. , Reidy Paul T. , McKenzie Alec I. , Stubben Chris , Howard Michael T. , Drummond Micah J. 
Published: February 2019

Short-term muscle disuse is characterized by skeletal muscle insulin resistance, although this response is divergent across subjects. The mechanisms regulating inactivity-induced insulin resistance between populations that are more or less susceptible to disuse-induced insulin resistance are not known. RNA sequencing was conducted on vastus lateralis muscle biopsies from subjects before and after bed rest ( n = 26) to describe the transcriptome of inactivity-induced insulin resistance. Subjects were separated into Low ( n = 14) or High ( n = 12) Susceptibility Groups based on the magnitude of change in insulin sensitivity after 5 days of bed rest. Both groups became insulin-resistant after bed rest, and there were no differences between groups in nonmetabolic characteristics (body mass, body mass index, fat mass, and lean mass). The High Susceptibility Group had more genes altered >1.5-fold (426 high versus 391 low) and more than twofold (73 high versus 55 low). Twenty-four genes were altered more than twofold in the High Susceptibility Group that did not change in the Low Susceptibility Group. 95 gene changes correlated with the changes in insulin sensitivity; 6 of these genes changed more than twofold in the High Susceptibility Group. Participants in the High Susceptibility Group were uniquely characterized with muscle gene responses described by a decrease in pathways responsible for lipid uptake and oxidation, decreased capacity for triglyceride export (APOB), increased lipogenesis (i.e., PFKFB3, FASN), and increased amino acid export (SLC43A1). These transcriptomic data provide a comprehensive examination of pathways and genes that may be useful biomarkers, or novel targets to offset muscle disuse-induced insulin resistance. NEW & NOTEWORTHY Short-term muscle disuse results in skeletal muscle insulin resistance through mechanisms that are not fully understood. Following a 5-day bed rest intervention, subjects were divided into High and Low Susceptibility Groups to inactivity-induced insulin resistance. This was followed by a genome-wide transcriptional analysis on muscle biopsy samples to gain insight on divergent insulin sensitivity responses. Our primary finding was that the skeletal muscle of subjects who experienced the most inactivity-induced insulin resistance (high susceptibility) was characterized by a decreased preference for lipid oxidation, increased lipogenesis, and increased amino acid export.
Age-related differences in water and sodium handling after commercial hydration beverage ingestion
Authors: Wolf S. Tony , Stanhewicz Anna E. , Clarke Megan M. , Cheuvront Samuel N. , Kenefick Robert W. , Kenney W. Larry 
Published: February 2019

Aging is associated with altered water, electrolyte, and glucose handling. Alternative beverages to those containing carbohydrate (CHO) should be considered for older adults. We hypothesized that reduced sodium (CNa+) and/or water (CH2O) clearance would underlie greater beverage retention in older compared with young adults, secondary to reduced glomerular filtration rate (GFR). We further hypothesized that amino acid (AA)- and CHO-based beverages would promote retention better than water. Over five visits, 12 young (23 ± 3 yr; 7 men, 5 women) and 12 older (67 ± 6 yr; 5 men, 7 women) subjects consumed 1 liter of distilled water or beverages with 6% CHO, 0.46 g/l Na+ [Gatorade (GAT)]; 2.5% CHO, 0.74 g/l Na+ [Pedialyte (PED)]; 5 AA, 1.04 g/l Na+ [enterade (ENT)-5]; or 8 AA, 1.38 g/l Na+ (ENT-8) over 30 min. Blood and urine were collected every hour for 4 h after ingestion; retention, CH2O, and CNa+ were calculated at 2 and 4 h. Additional calculations adjusted CH2O and CNa+ for estimated GFR (eGFR). Water yielded the lowest retention in both groups ( P ≤ 0.02). Retention was higher in older vs. young adults except for ENT-8 at 4 h ( P = 0.73). CH2O was higher for older vs. young adults for GAT at 2 h ( P < 0.01) and GAT and PED at 4 h ( P < 0.01) after ingestion but was otherwise similar between groups. CNa+ was lower in older vs. young adults except for ENT-8 ( P ≥ 0.19). Adjusting for eGFR resulted in higher CH2O for all beverages in older vs. young adults ( P < 0.05) but did not influence CNa+. Older adults may better retain beverages with less Na+ than young adults because of reduced CNa+. AA- and CHO-based electrolyte-rich beverages may similarly promote beverage retention. NEW & NOTEWORTHY Commercially available amino acid (AA)-containing beverages may provide an alternative to traditional carbohydrate (CHO)-containing beverages, particularly for older adults with attenuated water, electrolyte, and glucose handling. We compared beverage retention and free water and sodium clearance between young and older adults after ingestion of water, two CHO-based beverages, and two AA-based beverages. Our data suggest that older adults better retain beverages with less sodium compared with young adults and that AA-based and CHO-based electrolyte-containing beverages similarly promote retention.
Effect of Tensile Force on Magnetostrictive Sensors for Generating and Receiving Longitudinal Mode Guided Waves in Steel Wires
Authors: Xu Jiang , Li Yong , Chen Guang 
Published: February 2019

When the longitudinal mode guided waves based on magnetostrictive effect were employed to inspect the bridge cables, we found that there was a large difference in the signal’s amplitude of the same specification cable under different tensile force. This difference would affect the test results and the identification of defects. It is necessary to study the effect of tensile force on the signal for the reliability of detection. Firstly, the effective field theory is employed to take the force as an additional bias magnetic field. Then, the effect of the tensile force on generating and receiving longitudinal mode guided waves based on magnetostrictive effect is obtained by the relationship between the bias magnetic field and the magnetostrictive coupling coefficient. Finally, the experiment of the magnetostrictive sensor is carried out on a Φ5 mm steel wire under different force. The experimental results are in good agreement with the theoretical results. The results show that the existence of the tensile force would change the operation point for generating and receiving the longitudinal mode guided waves based on magnetostrictive effect, which associated with the coupling coefficient. In order to obtain the optimal conversion efficiency for the force state wire and cable, the applied bias magnetic field should be set smaller than the bias magnetic field for the force-free state.
Estrutura Entoacional de Sentenças Neutras em Português Brasileiro na variedade de Minas Gerais
Authors: Toneli Priscila Marques , Abaurre Maria Bernadete Marques , Vigário Marina 
Published: February 2019

O presente trabalho analisa a estrutura entoacional de sentenças declarativas neutras na variedade de Minas Gerais do Português Brasileiro (PB), destacando a influência do número de sílabas em palavra prosódica (PW) e a importância do grupo de palavra prosódica (PWG) para a distribuição de acentos tonais. Foram analisados dados da variedade mineira, falada no Triângulo Mineiro, os quais foram obtidos de modo controlado experimentalmente e analisados com base nos modelos teóricos da Fonologia Prosódica e Entoacional (Beckman; Pierrehumbert, 1986; Ladd, 1996, 2008; Selkirk, 1982, 1984, 1986; Nespor e Vogel, 1986). Os resultados apresentados e analisados estatisticamente mostram que há associação praticamente categórica de um acento tonal a cada PW(G) no interior da sentença. A análise mostrou que o número de sílabas das PWs em interior de sentença também desempenha um papel relevante na alta densidade tonal na variedade analisada, assim como na variedade paulista, tal como mostrado em Vigário e Fernandes-Svartman (2010) e Fernandes-Svartman e Romano (2017).