bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Recurrent Carpal Tunnel Syndrome with the Abductor Digiti Minimi Flap: A Case Series
Authors: de ROO Saskia F , van LEEUWEN Wouter F. , COERT Jan H. , van der HEIJDEN Brigitte 
Published: August 2022

Background: Approximately 5% of patients experience recurrent symptoms after carpal tunnel release (CTR) and need revision surgery. Several surgical techniques have been described for recurrent carpal tunnel syndrome (CTS) and the abductor digiti minimi (ADM) flap is one of them. Literature concerning clinical results of the ADM flap for recurrent CTS is lacking. The aim of this study is to evaluate the outcomes of the ADM flap for recurrent CTS. Methods: We treated seven patients with the ADM flap (eight hands) between July 2016 and February 2019. Patient characteristics were assessed, and patients were asked about their symptoms (pain, sensation and paresthesia) before and after surgery. Postoperatively, we administered CTS symptoms, satisfaction with the surgery, patient-reported outcome measurements (BCTQ and QuickDASH) and whether they would undergo the same surgery again. Complications were also recorded Results: The median follow-up was 14 months. The success rate measured by CTS symptoms was 88%. Seven out of eight patients were satisfied with the results and two patients would not elect to undergo the same procedure again. Two patients reported having a weaker grip at the donor site. The median BCTQ symptom and function scores were 2.9 (1.7–3.5) and 2.6 (1.8–3.0) respectively. The median QuickDASH score was 41 (IQR 22–52). Complications reported were wound dehiscence (n = 1) and hypertrophic scar (n = 1). Conclusions: The outcomes of the ADM flap in patients with recurrent CTS were like other commonly used procedures in recurrent CTS. Level of Evidence: Level IV (Therapeutic)
Characteristics of Heart Failure With Preserved Ejection Fraction Across the Range of Left Ventricular Ejection Fraction
Authors: Rosch Sebastian , Kresoja Karl-Patrik , Besler Christian , Fengler Karl , Schöber Anne Rebecca , von Roeder Maximilian , Lücke Christian , Gutberlet Matthias , Klingel Karin , Thiele Holger , Rommel Karl-Philipp , Lurz Philipp 
Published: August 2022

Background:
Recent trial data suggest that stratification of patients with heart failure with preserved ejection fraction (HFpEF) according to left ventricular ejection fraction (LVEF) provides a means for dissecting different treatment responses. However, the differential pathophysiologic considerations have rarely been described.

Methods:
This prospective, single-center study analyzed consecutive symptomatic patients with HFpEF diagnosed according to the 2016 European Society of Cardiology heart failure guidelines. Patients were grouped into LVEF 50% to 60% and LVEF >60% cohorts. All patients underwent cardiac magnetic resonance imaging. Transfemoral cardiac catheterization was performed to derive load-dependent and load-independent left ventricular (LV) properties on pressure–volume loop analyses.

Results:

Fifty-six patients with HFpEF were enrolled and divided into LVEF 50% to 60% (n=21) and LVEF >60% (n=35) cohorts. On cardiac magnetic resonance imaging, the LVEF >60% cohort showed lower LV end-diastolic volumes (
P
=0.019) and end-systolic volumes (
P
=0.001) than the LVEF 50% to 60% cohort; stroke volume (
P
=0.821) did not differ between the cohorts. Extracellular volume fraction was higher in the LVEF 50% to 60% cohort than in the LVEF >60% cohort (0.332 versus 0.309;
P
=0.018). Pressure-volume loop analyses demonstrated higher baseline LV contractility (end-systolic elastance, 1.85 vs 1.33 mm Hg/mL;
P
<0.001) and passive diastolic stiffness (β constant, 0.032 versus 0.018;
P
=0.004) in the LVEF >60% cohort. Ventriculo-arterial coupling (end-systolic elastance/arterial elastance) at rest was in the range of optimized stroke work in the LVEF >60% cohort but was impaired in the LVEF 50% to 60% cohort (1.01 versus 0.80;
P
=0.005). During handgrip exercise, patients with LVEF >60% had higher increases in end-systolic elastance (1.85 versus 0.82 mm Hg/mL;
P
=0.023), attenuated increases in indexed end-systolic volume (−1 versus 7 mL/m²;
P
<0.004), and more exaggerated increases in LV filling pressures (8 vs 5 mm Hg;
P
=0.023). LV stroke volume decreased in the LVEF >60% cohort (
P
=0.007) under exertion.

Conclusions:
Patients with HFpEF in whom LVEF ranged from 50% to 60% demonstrated reduced contractility, impaired ventriculo-arterial coupling, and higher extracellular volume fraction. In contrast, patients with HFpEF and a LVEF >60% demonstrated a hypercontractile state with excessive LV afterload and diminished preload reserve. A LVEF-based stratification of patients with HFpEF identified distinct morphologic and pathophysiologic subphenotypes.
Genome-wide association study identifying genetic variants associated with carcass backfat thickness, lean percentage and fat percentage in a four-way crossbred pig population using SLAF-seq technology
Authors: Wang Huiyu , Wang Xiaoyi , Yan Dawei , Sun Hao , Chen Qiang , Li Mingli , Dong Xinxing , Pan Yuchun , Lu Shaoxiong 
Published: August 2022

AbstractBackgroundCarcass backfat thickness (BFT), carcass lean percentage (CLP) and carcass fat percentage (CFP) are important to the commercial pig industry. Nevertheless, the genetic architecture of BFT, CLP and CFP is still elusive. Here, we performed a genome-wide association study (GWAS) based on specific-locus amplified fragment sequencing (SLAF-seq) to analyze seven fatness-related traits, including five BFTs, CLP, and CFP on 223 four-way crossbred pigs.ResultsA total of 227, 921 highly consistent single nucleotide polymorphisms (SNPs) evenly distributed throughout the genome were used to perform GWAS. Using the mixed linear model (MLM), a total of 20 SNP loci significantly related to these traits were identified on tenSus scrofachromosomes (SSC), of which 10 SNPs were located in previously reported quantitative trait loci (QTL) regions. On SSC7, two SNPs (SSC7:29,503,670 and rs1112937671) for average backfat thickness (ABFT) exceeded 1% and 10% Bonferroni genome-wide significance levels, respectively. These two SNP loci were located within an intron region of theCOL21A1gene, which was a protein-coding gene that played an important role in the porcine backfat deposition by affecting extracellular matrix (ECM) remodeling. In addition, based on the other three significant SNPs on SSC7, five candidate genes,ZNF184,ZNF391,HMGA1,GRM4andNUDT3were proposed to influence BFT. On SSC9, two SNPs for backfat thickness at 6–7 ribs (67RBFT) and one SNP for CLP were in the same locus region (19 kb interval). These three SNPs were located in thePGM2L1gene, which encoded a protein that played an indispensable role in glycogen metabolism, glycolysis and gluconeogenesis as a key enzyme. Finally, one significant SNP on SSC14 for CLP was located within thePLBD2gene, which participated in the lipid catabolic process.ConclusionsA total of two regions on SSC7 and SSC9 and eight potential candidate genes were found for fatness-related traits in pigs. The results of this GWAS based on SLAF-seq will greatly advance our understanding of the genetic architecture of BFT, CLP, and CFP traits. These identified SNP loci and candidate genes might serve as a biological basis for improving the important fatness-related traits of pigs.
Development and validation of a predictive model to identify the active phase of labor
Authors: Fumagalli Simona , Antolini Laura , Cosmai Greta , Gramegna Teresa , Nespoli Antonella , Pedranzini Astrid , Colciago Elisabetta , Valsecchi Maria Grazia , Vergani Patrizia , Locatelli Anna 
Published: August 2022

Abstract
Background
The diagnosis of the active phase of labor is a crucial clinical decision, thus requiring an accurate assessment. This study aimed to build and to validate a predictive model, based on maternal signs and symptoms to identify a cervical dilatation ≥4 cm.

Methods
A prospective study was conducted from May to September 2018 in a II Level Maternity Unit (development data), and from May to September 2019 in a I Level Maternity Unit (validation data). Women with singleton, term pregnancy, cephalic presentation and presence of contractions were consecutively enrolled during the initial assessment to diagnose the stage of labor. Women < 18 years old, with language barrier or induction of labor were excluded. A nomogram for the calculation of the predictions of cervical dilatation ≥4 cm on the ground of 11 maternal signs and symptoms was obtained from a multivariate logistic model. The predictive performance of the model was investigated by internal and external validation.

Results
A total of 288 assessments were analyzed. All maternal signs and symptoms showed a significant impact on increasing the probability of cervical dilatation ≥4 cm. In the final logistic model, “Rhythm” (OR 6.26), “Duration” (OR 8.15) of contractions and “Show” (OR 4.29) confirmed their significance while, unexpectedly, “Frequency” of contractions had no impact. The area under the ROC curve in the model of the uterine activity was 0.865 (development data) and 0.927 (validation data), with an increment to 0.905 and 0.956, respectively, when adding maternal signs.
The Brier Score error in the model of the uterine activity was 0.140 (development data) and 0.097 (validation data), with a decrement to 0.121 and 0.092, respectively, when adding maternal signs.

Conclusion
Our predictive model showed a good performance. The introduction of a non-invasive tool might assist midwives in the decision-making process, avoiding interventions and thus offering an evidenced-base care.
Consecutive reference intervals for biochemical indices related to serum lipid levels and renal function during normal pregnancy
Authors: Wu Lina , Wu Qijun , Li Qiang , Cao Shuang , Zhang Yue , Liu Yong , Qin Xiaosong 
Published: August 2022

Abstract
Background
Physiological changes that occur during pregnancy can influence serum lipid levels and laboratory tests for renal function. Therefore, we established consecutive and reliable RIs for serum lipid and renal function indices for pregnant women in China throughout the entirety of pregnancy.

Methods
We included 120 healthy pregnant women who underwent a naturally conceived and uncomplicated pregnancy and delivered a healthy singleton neonate. Serum samples were collected at ten time points (pre-pregnancy, gestational age ≤ 8 weeks (W), 8 W+1 to 12 W, 12 W+1 to 16 W, 16 W+1 to 20 W, 20 W+1 to 24 W, 24 W+1 to 28 W, 28 W+1 to 32 W, 32 W+1 to 36 W, and 36 W+1 to 40 W) and analyzed for ten common serum lipid and renal function analytes. RIs were calculated according to the International Federation of Clinical Chemistry and Laboratory Medicine recommendations and compared with the established RIs for healthy adult women.

Results
During pregnancy, we observed significant increases in total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), cystatin C (Cys-C), and estimated glomerular filtration rate (eGFR). We also observed clear reductions in urea, creatinine (Crea), and uric acid (UA). Compared with the previously established RIs, the most significant misclassifications were recorded for TG, Apo-A1, Crea, and eGFR.

Conclusions
We successfully described key changes in serum lipid levels and renal function indices throughout pregnancy. It is important to establish RIs for blood indices in women undergoing normal pregnancies during different period of pregnancy to avoid the misdiagnosis of disease states.
The impact of a breast cancer educational intervention in Ghanaian high schools
Authors: Nsaful Josephine , Dedey Florence , Nartey Edmund , Labi Juliana , Adu-Aryee Nii Armah , Clegg-Lamptey Joe Nat 
Published: August 2022

AbstractIntroductionGlobally breast cancer is the leading cause of cancer with an estimated 2.3 million new cases and 685,000 deaths in 2020. Late presentation is the hallmark of breast cancer in Ghana for which ignorance and fear are the major reasons fuelled largely by myths and misconceptions. Breast cancer awareness and education needs to start early to bring about a change in knowledge, attitude and practices. However, Breast cancer awareness activities in Ghana have usually targeted adult women.This study assessed the impact of breast cancer education among adolescent high school girls in Ghana.MethodologyA pre- post-test quasi experimental study was conducted at two senior high schools. A self-administered pre-educational questionnaire was followed by an educational intervention consisting of a drama, PowerPoint lecture, question and answer session and distribution of breast cancer information leaflets. After 3 months the same questionnaire was administered as a post-education test to assess the impact of the educational intervention. The total score for each domain was categorised into adequate knowledge > 50% and inadequate knowledge < 50%.ResultsThe number of participants in the pre-test and post-test were 1043 and 1274; the median ages [IQR] were 16.0 [15.0–17.0] for both the pre and post-test students. General knowledge on breast cancer at pre-education (29.1%) improved to 72.5% (p < 0.001). Knowledge on signs and symptoms improved from 33.1 to 55% (p < 0.001); knowledge on risk factors improved from 55.3 to 79.2% (p < 0.001), and knowledge on breast self-examination and screening improved from 9.8 to 22.2% (p < 0.001). The overall performance of the students improved from 17.2 to 59.4% (p < 0.001).ConclusionThere is inadequate knowledge about breast cancer and self-examination among senior high school girls in Ghana. Our breast cancer educational intervention was effective in improving general knowledge of breast cancer, risk factors, signs and symptoms and breast self-examination. The overall knowledge base improved from 17.2 to 59.4% 3 months post intervention, accompanied by an increase in the reported practice of breast self-examination and a greater belief that breast cancer is curable. This study has demonstrated the need for a school breast cancer educational program and that breast cancer education in high schools is effective.
Space–time dynamics regression models to assess variations of composite index for anthropometric failure across the administrative zones in Ethiopia
Authors: Fenta Haile Mekonnen , Zewotir Temesgen , Muluneh Essey Kebede 
Published: August 2022

AbstractBackgroundA single anthropometric index such as stunting, wasting, or underweight does not show the holistic picture of under-five children's undernutrition status. To alleviate this problem, we adopted a multifaceted single index known as the composite index for anthropometric failure (CIAF). Using this undernutrition index, we investigated the disparities of Ethiopian under-five children's undernutrition status in space and time.MethodsData for analysis were extracted from the Ethiopian Demographic and Health Surveys (EDHSs). The space–time dynamics models were formulated to explore the effects of different covariates on undernutrition among children under five in 72 administrative zones in Ethiopia.ResultsThe general nested spatial–temporal dynamic model with spatial and temporal lags autoregressive components was found to be the most adequate (AIC = -409.33, R2 = 96.01) model. According to the model results, the increase in the percentage of breastfeeding mothers in the zone decreases the CIAF rates of children in the zone. Similarly, the increase in the percentages of parental education, and mothers’ nutritional status in the zones decreases the CIAF rate in the zone. On the hand, increased percentages of households with unimproved water access, unimproved sanitation facilities, deprivation of women's autonomy, unemployment of women, and lower wealth index contributed to the increased CIAF rate in the zone.ConclusionThe CIAF risk factors are spatially and temporally correlated across 72 administrative zones in Ethiopia. There exist geographical differences in CIAF among the zones, which are influenced by spatial neighborhoods of the zone and temporal lags within the zone. Hence these findings emphasize the need to take the spatial neighborhood and historical/temporal contexts into account when planning CIAF prevention.
Deoxynivalenol damages the intestinal barrier and biota of the broiler chickens
Authors: Wan Shuangxiu , Sun Na , Li Hongquan , Khan Ajab , Zheng Xiaozhong , Sun Yaogui , Fan Ruiwen 
Published: August 2022

Abstract
Background
In the livestock feed industry, feed and feed raw materials are extremely susceptible to mycotoxin contamination. Deoxynivalenol (DON) is one of the main risk factors for mycotoxin contamination in broiler feed and feedstuff, however, there is still little knowledge about this. Hence, the purpose of this study was to explore the toxicity effect of DON on the intestinal barrier and the microecological balance of the biota in broiler chickens.

Results
In our present study, we compared the pathological scores of the small intestines of broilers on the 5th, 7th, and 10th day, and chose the 7th day to analyze the small intestine histomorphology, tight junctions, and cecal biota of the broilers. The results showed the damage to the small intestine worsened over time, the small intestinal villi of broilers were breakage, the tight junctions of the small intestine were destroyed, the cecal biota was unbalanced, and the growth performance of broilers was reduced on the 7th day.

Conclusions
DON could damage the functional and structural completeness of the intestinal tract, disorder the Intestinal biota, and finally lead to declined broiler performance. Our study provided a basis for the prevention and treatment of DON in broiler production.
A case of esophageal atresia with the bronchial-like lower esophagus which originates from the left lower lobe bronchus
Authors: Tanimoto Terutaka , Noda Takuo , Imaji Reisuke , Nouso Hiroshi 
Published: August 2022

Abstract
Background
Esophageal atresia with or without a trachea–esophageal fistula occurs due to the failure of separation or incomplete development of the foregut. Therefore, esophageal atresia is often associated with various forms of tracheobronchial anomalies. We report an extremely rare case of esophageal atresia.

Case presentation
A female infant was born at 37 weeks of gestation and weighed 2596 g. A diagnosis of esophageal atresia and total anomalous pulmonary vein return type III were confirmed. The infant had respiratory distress that required tracheal intubation and ventilatory support soon after birth. Temporary banding of the gastroesophageal junction and gastrostomy were performed on the second day of life. However, her respiratory condition deteriorated due to atelectasis of the left lung and compensatory hyperinflation of the right lung. Preoperative examinations showed the unilobe and atelectatic left lung. The trachea was trifurcated in three directions, and the branch that was expected to be the left main bronchus was blind-ended. The dorsal branch was cartilaginous and bifurcated into the left lower lobe bronchus and lower esophagus approximately 1 cm distal from the tracheal trifurcation. The cartilaginous tissue continued to the lower esophagus. The diagnosis of esophageal atresia with the lower esophagus which originated from the left lower lobe bronchus was made. Esophageal atresia repair was performed when the patient was 4 months of age. The esophagus was dissected distally to the bifurcation of the left lower lobe bronchus via right thoracotomy. The lower esophagus was bronchial-like in appearance, transitioning to the normal esophageal wall approximately 7 mm distal to the transected edge. The cartilage tissue was completely resected during surgery, and a primary end-to-end anastomosis of the esophagus was successfully performed. Histopathological findings revealed that the extracted specimen was surrounded by tracheal cartilage and that the inner surface was covered by stratified squamous epithelium that originated from the esophagus.

Conclusions
In cases of esophageal atresia with an atypical clinical presentation, there may be unique structural abnormalities of the foregut. We emphasize the importance of a preoperative surgical planning since an inadequate operation can lead to fatal complications.
Increased pulsatility index of the basilar artery is a risk factor for neurological deterioration after stroke: a case control study
Authors: Yoo Il-Han , Kim Jeong-Min , Han Su-Hyun , Ryu Jaiyoung , Jung Keun-Hwa , Park Kwang-Yeol 
Published: August 2022

Abstract
Background
Higher pulsatility of the middle cerebral artery (MCA) is known to be associated with stroke progression. We investigated whether pulsatility index (PI) of the basilar artery (BA) can predict neurological deterioration (ND) after acute cerebral infarction.

Methods
A total of 708 consecutive patients with acute ischemic stroke who had undergone transcranial Doppler (TCD) ultrasonography were included. ND was defined as an increase in the National Institutes of Health Stroke Scale scores by two or more points after admission. The patients were categorized into quartiles according to BA PI. Multivariable logistic regression analysis was performed to examine whether BA PI is independently associated with ND.

Results
BA PI was well correlated with the right (n = 474, r2 = 0.573, P < 0.001) by Pearson correlation analysis although MCA PI could not be measured from right MCA (n = 234, 33.05%) and left MCA (n = 252, 35.59%) by TCD owing to insufficient temporal bone window. Multivariable logistic regression analysis including age, sex, cerebral atherosclerosis burden, National Institutes of Health Stroke Scale at admission, and the proportion of patients with current smoking status, hypertension, diabetes mellitus, atrial fibrillation revealed that the higher BA PI (odds ratio, 3.28; confidence interval, 1.07–10.17; P = 0.038) was independently associated with ND.

Conclusions
BA PI, which would be identified regardless of temporal window, could predict ND among acute stroke patients.
An exploration of enhancing thermal stability of leather by hydrophilicity regulation: effect of hydrophilicity of phenolic syntan
Authors: Sun Qingyong , Zeng Yunhang , Yu Yue , Wang Ya-nan , Shi Bi 
Published: August 2022

AbstractEffect of retanning on the thermal stability of leather is eliciting increasing attention. However, the relationship between the hydrophilicity of retanning agents and the heat resistance of leather and the corresponding mechanism remain unclear. Herein, phenolic formaldehyde syntans (PFSs) were selected as models to explore the effect of the hydrophilicity of retanning agents on the thermal stability of retanned leather. The thermal stability of leather was closely correlated to the hydrophilic group content (sulfonation degree) of PFSs. As the sulfonation degree decreased, the water absorption rate of PFSs and their retanned leathers decreased, whereas the thermal stability of leather increased. Molecular dynamics simulation results proved that the introduction of PFSs could reduce the binding ability of collagen molecules with water and thus decreased the water molecules around the PFS-treated collagen. These results may provide guidance for the tanners to select retanning agents reasonably to improve the thermal stability of leather.
Graphical Abstract