bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rotational Thromboelastometry Values After On-Pump Cardiac Surgery – A Retrospective Cohort Study
Authors: Gauger Maria S. , Kaufmann Philip , Kamber Firmin , Quitt Jonas , Berdajs Denis , Bolliger Daniel , Mauermann Eckhard 
Published: May 2022

Background Viscoelastic coagulation monitoring is recommended for coagulation management after cardiac surgery, but optimum target values are poorly defined. Aims To determine “to-be-expected” values in rotational thromboelastometry (ROTEM) after heparin reversal, to correlate ROTEM parameters with fibrinogen levels and platelet count, and to estimate the effect of hemoglobin levels on these measurements. Methods We retrospectively analyzed 571 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass from 12/2018 to 08/2020. ROTEM and conventional laboratory measurements were performed 5 to 10 minutes after protamine administration. Results Clotting times in EXTEM, INTEM, and FIBTEM were significantly prolonged (72.6%, 96.1%, and 31.8% above reference ranges, respectively). Clot firmness parameters in EXTEM and INTEM were relevantly reduced (7.9% to 14.4% and 9.1% to 32.3% below the reference ranges, respectively). There was an excellent linear correlation of FIBTEM amplitude after 10 min (A10) and of maximal clot firmness (MCF) with fibrinogen concentrations (r = .81 and .80). Areas under receiver operating characteristic (AUROC) for identifying hypofibrinogenemia <1.5 g/L were between .80 and .87. No effect of hematocrit was observed. We also found a linear correlation of EXTEM, INTEM, and EXTEM-FIBTEM at both A10 and MCF with platelet counts (.32 to .68). The AUROCs for identifying thrombocytopenia (<100,000/μL) were .79 to .84, and were greater for A10 than for MCF measurements ( P=.074, .001, and <.001, respectively). Conclusions “To-be-expected” ROTEM values after CPB are different from the published reference ranges. ROTEM parameters might allow for reliable estimation of fibrinogen level and platelet count without being influenced by hematocrit.
Research on hydrodynamics of foundation structure of offshore wind turbine under typhoon-wave-current coupling
Authors: Wang Shuo , Ke Shi-tang , Zhao Yong-fa , Yun Yi-wen , Zhang Wei , Yang Jie , Ren Hehe 
Published: May 2022

Offshore wind turbine is facing with extremely complicated climatic environment. The accurate prediction of wave movement caused by strong typhoons and its action on foundation of wind turbine are crucial. To disclose hydrodynamic characteristics of foundation structure of wind turbine under typhoon-wave-current coupling effect on the sea, a 10 MW super-large offshore wind turbine in Wailuo Wind Farm, Guangdong was chosen as a research object and a real-time meso-scale WRF-SWAN-FVCOM (W-S-F) coupling simulation platform was constructed by using Model Coupling Toolkit The spatial-temporal evolution of typhoon-wave-current in the offshore wind farm was simulated when a super typhoon “Rammasun” passed through. Next, the hydrodynamic load distribution characteristics of single pile foundation of wind turbine were analyzed by combining the meso-micro scale nested method. Extreme load model of foundation piles under different wave phases was proposed. Results demonstrated that the constructed W-S-F platform increased the simulation precision of typhoon path by 42.51% than single WRF model. The horizontal wave force of the foundation pile reached the negative and positive peaks at phases T0 and T4 under typhoon-wave-current coupling, and it presented symmetric distribution circumferentially around the 180° angle of wave attack. The phase T4 was the most adverse phase for the strength design of single pile foundation of offshore wind turbine. At the bottom of foundation, the maximum shear reached the 7.68 × 106 magnitude and the maximum bending moment reached the 5.2 × 108 magnitude.
Provision of pulmonary rehabilitation in Latin America 18 months after the COVID-19 pandemic: A survey of the Latin American Thoracic Association
Authors: Benavides-Cordoba Vicente , Barros-Poblete Marisol , Vieira Rodolfo P , Mazzucco Guillermo , Fregonezi Guilherme , Torres-Castro Rodrigo 
Published: May 2022

Introduction The Coronavirus disease (COVID-19) pandemic has significantly altered the provision of rehabilitation services, especially pulmonary rehabilitation (PR). Our objective was to assess the provision of PR services in Latin America 18 months after the COVID-19 pandemic was declared. Methods A cross-sectional study that included professionals dedicated to PR in centres in Latin America was applied. Responses to an online questionnaire were collected from May to September 2021. The following data were included for the analysis: demographic data, evaluation strategies, program structure, PR intervention in post-COVID-19 patients, and perception of strategies therapies for the care of post-COVID-19 patients. The questionnaire was distributed in Spanish and Portuguese languages. Results Responses were received from 196 PR centres. Exercise tolerance was predominantly measured with the six-minute walk test. Less than 50% of the institutions evaluate quality of life, physical qualities, symptoms, and lung function. Most of the programmes have physiotherapists (90.8%), as well as pulmonologists (60%), and psychologists (35%), among other professionals. Conclusion PR services in Latin America have adapted in their way to the requirements of the pandemic, and most continued to provide face-to-face services. It was identified that the application of the programs is heterogeneous both in evaluations and interventions.
Assessing Impairments in Visuomotor Adaptation After Stroke
Authors: Moore Robert T. , Piitz Mark A. , Singh Nishita , Dukelow Sean P. , Cluff Tyler 
Published: May 2022

Background: Motor impairment in the arms is common after stroke and many individuals participate in therapy to improve function. It is assumed that individuals with stroke can adapt and improve their movements using feedback that arises from movement or is provided by a therapist. Here we investigated visuomotor adaptation in individuals with sub-acute and chronic stroke. Objective: We examined the impact of the stroke-affected arm (dominant or non-dominant), time post-stroke, and relationships with clinical measures of motor impairment and functional independence. Methods: Participants performed reaching movements with their arm supported in a robotic exoskeleton. We rotated the relationship between the motion of the participant’s hand and a feedback cursor displayed in their workspace. Outcome measures included the amount that participants adapted their arm movements and the number of trials they required to adapt. Results: Participants with stroke (n = 36) adapted less and required more trials to adapt than controls (n = 29). Stroke affecting the dominant arm impaired the amount of adaptation more than stroke affecting the non-dominant arm. Overall, 53% of participants with stroke were impaired in one or more measures of visuomotor adaptation. Initial adaptation was weakly correlated with time post-stroke, and the amount of adaptation correlated moderately with clinical measures of motor impairment and functional independence. Conclusion: Our findings reveal impairments in visuomotor adaptation that are associated with motor impairment and function after stroke. Longitudinal studies are needed to understand the relationship between adaptation and recovery attained in a therapy setting.
Leicester Cough Questionnaire validation and clinically important thresholds for change in refractory or unexplained chronic cough
Authors: Nguyen Allison Martin , Schelfhout Jonathan , Muccino David , Bacci Elizabeth D. , La Rosa Carmen , Vernon Margaret , Birring Surinder S. 
Published: May 2022

Introduction: The Leicester Cough Questionnaire (LCQ), a cough-specific quality-of-life measure, evaluates the impact of cough across physical, psychological, and social domains in patients with chronic cough (CC). This study assessed the psychometric properties of the LCQ. Methods: Data from a phase IIb, randomized controlled trial of the P2X3-receptor antagonist gefapixant were analyzed (NCT02612610). Subjective [Cough Severity Diary, cough severity visual analogue scale, and patient global impression of change (PGIC)] and objective (awake and 24-h cough frequency) data were used to validate the LCQ for use in patients with refractory or unexplained CC (RCC and UCC, respectively). Psychometric analyses included confirmatory factor analyses, internal consistency and test–retest reliability, validity, responsiveness, and estimated within-patient thresholds for clinically meaningful change. Results: Model-fit values for the proposed three-factor LCQ domains and most individual items were acceptable. Analyses suggest that a mean improvement ranging from 1.3 to 2.3 points for the LCQ total and ⩾0.8, ⩾0.9, and ⩾0.8 points for physical, psychological, and social domain scores, respectively, had the best sensitivity and/or specificity for predicting patient ratings of improvement on the PGIC. Conclusions: The LCQ is a valid and reliable measure to evaluate cough-specific quality of life and is a fit-for-purpose measure for use in patients with RCC or UCC. Although a single threshold for defining clinically meaningful change depends on the context of use, the results can help guide both treatment decisions and drug development. Therefore, clinicians may consider a ⩾1.3-point increase in the LCQ total score as clinically meaningful.
Use of linked patient data to assess the effect of Long-COVID on system-wide healthcare utilisation
Authors: Murch Ben J , Hollier Sarah E , Kenward Charlie , Wood Richard M 
Published: May 2022

Background: Within the relatively early stages of the COVID-19 pandemic, there had been an awareness of the potential longer-term effects of infection (so called Long-COVID) but little was known of the ongoing demands such patients may place on healthcare services. Objective: To investigate whether COVID-19 illness is associated with increased post-acute healthcare utilisation. Method: Using linked data from primary care, secondary care, mental health and community services, activity volumes were compared across the 3 months preceding and proceeding COVID-19 diagnoses for 7,791 individuals, with a distinction made between whether or not patients were hospitalised for treatment. Differences were assessed against those of a control group containing individuals who had not received a COVID-19 diagnosis. All data were sourced from the authors’ healthcare system in South West England. Results: For hospitalised COVID-19 cases, a statistically significant increase in non-elective admissions was identified for males and females <65 years. For non-hospitalised cases, statistically significant increases were identified in GP Doctor and Nurse attendances and GP prescriptions (males and females, all ages); Emergency Department attendances (females <65 years); Mental Health contacts (males and females ≥65 years); and Outpatient consultations (males ≥65 years). Conclusion: There is evidence of an association between positive COVID-19 diagnosis and increased post-acute activity within particular healthcare settings. Linked patient-level data provides information that can be useful to understand ongoing healthcare needs resulting from Long-COVID, and support the configuration of Long-COVID pathways of care.
Clinico-radiological features of cerebral proliferative angiopathy: A large case series from India
Authors: Srivastava Trilochan , Gandhi Ashok , Kumar Rahul 
Published: May 2022

Background Based on angiographic features, a rare subgroup, different from classical brain AVMs, called cerebral proliferative angiopathy (CPA) was suggested by Lasjaunias et al. in 1989. There are only few reports of CPA described from Asia. Liu et al. has described 5 cases of CPA from China. The objective of study was to evaluate the clinico-radiological features of patients with CPA in our cohort and to find out the differences between our study and the study by Lasjaunias and Liu et al. Methods We retrospectively analysed cases of CPA from March 2012 to April 2020. All radiological images of the patients with AVMs were studied and findings suggestive of CPA were identified. We found 10 patients with CPA out of 272 cases of AVM (10/272) and described the various demographic and clinico-radiological features. Results The age of the patients with CPA in our series varied from 14 to 53 years and the mean age was 28.6 years. There was male preponderance (60%) with male to female ratio of 3:2. The most common presentation was seizure (70%). Intracranial haemorrhage was present in five patients. One patient had cerebral infarction. Conclusions There were substantial differences in clinico-radiological profile of patients with CPA in our cohort as compared to the study by Lasjaunias et al. and Liu et al. in form of male dominance, higher rate of ICH and seizure. In our knowledge, this is the second largest series of CPA worldwide and the first largest series in Asia.
Express improvement of acute stroke care accessibility in large regions using a centralized telestroke network
Authors: Barragán-Prieto Ana , Pérez-Sánchez Soledad , Moniche Francisco , Moyano Roberto Valverde , Delgado Fernando , Martínez-Sánchez Patricia , Moya Miguel , Oropesa Juan M , Mínguez-Castellanos Adolfo , Villegas Inmaculada , Álvarez Soria María José , Tamayo Toledo Jose Antonio , de la Cruz Cosme Carlos , Canto Neguillo Rafael , Herrerías Esteban Juan Manuel , Montero Cobos Daniel José , Moreno Muñoz Jose Antonio , González Alejandro , Montaner Joan 
Published: May 2022

Introduction: Acute ischemic stroke therapy has improved in recent decades, decreasing the rates of disability and death among stroke patients. Unfortunately, all health care systems have geographical disparities in infrastructure for stroke patients. A centralized telestroke network might be a low-cost strategy to reduce differences in terms of geographical barriers, equitable access, and quality monitoring across different hospitals. Aims: We aimed to quantify changes in stroke patients’ geographic access to specialized evaluation by neurologists and to intravenous acute stroke reperfusion treatments following the rapid implementation of a centralized telestroke network in the large region of Andalusia (8.5 million inhabitants). Methods: We conducted an observational study using spatial and analytical methods to examine how a centralized telestroke network influences the quality and accessibility of stroke care for a large region. Results: In the pre-implementation period, 5,005,477 (59.72% of the Andalusian population) had access to specialized stroke care in less than 30 min. After the 5-month process of implementing the telestroke network, 7,832,988 (93.5%) inhabitants had an access time of less than 30 min, bridging the gap in acute stroke care in rural hospitals. Conclusions: A centralized telestroke network may be an efficient tool to reduce the differences in stroke care access and quality monitoring across different hospitals, especially in large regions with low population density.
Molecular Classification of Gastric Cancer With Emphasis on PDL-1 Expression: The First Report From Iran
Authors: Amirmoezi Fatemeh , Geramizadeh Bita 
Published: May 2022

Background: Gastric cancer is one of the lethal cancers and there is no effective treatment for these patients and still, 5-year survival rate is about 25% to 30%. Finding reliable biomarkers for early-stage diagnosis, targeted therapy, and survival prediction is a priority in this cancer. Objectives: In this study we were trying to know about the molecular classification of gastric cancers in a group of patients from the South of Iran. Patients and Methods: In a cross sectional study, 50 specimens of gastric cancer were selected that have enough tissue to be stained by immunohistochemistry (IHC). IHC was performed for Her-2, mismatch repair genes (MLH-1, MSH-2, MSH-6, and PMS-2), and PDL-1. Frequency of positive makers was compared with survival and outcome. Results and Conclusion: In our study, deficient MMR (dMMR) was detected in 4 patients (8.0%). PD-L1 expression in tumor cells (TC) was observed in 1 of 4 cases (25%) with PMS2 loss. However, PD-L1 in TCs and TILs (tumor infiltrating lymphocytes) was negative in 1 case with MLH1 loss and in 3 of 4 cases with PMS2 loss, which was not statistically significant. All of our 50 cases were positive for MSH2 and MSH6, 24% of which showed TCs with PDL-1 expression and 32% of them in TIL. HER2 was positive in 2 (2/50, 4.0%) cases, among which all of the cases were positive for PD-L1 expression in TCs and TILs, respectively. However, in HER2-negative group, 26.2% (11/42) and 28.6% (12/42) of tumors were positive for PD-L1 in TCs and TILs, respectively. The expression rate of PD-L1 in HER2 negative TCs was significantly higher than that in HER2 positive TCs ( P = .033). Immunohistochemistry for Her-2 was equivocal in 6 cases (12.0%) none of which expressed PD-L1 in tumor cells. In our study minimum and maximum survival times from detection of gastric cancer were 1 and 87 months, respectively. The mean ± SD and median ± SD of overall survival time were 30.69 ± 4.88 and 18 ± 1.45 months, respectively. One and 3-year survival rates of 40% and 24%, respectively. PD-L1 expression was not associated with survival, but its expression was associated with intestinal type Lauren classification and negative HER-2. PD-L1 positivity in tumor cells or tumor infiltrating lymphocytes was not an independent prognostic factor in gastric cancer.
An emerging phenotype of pulmonary arterial hypertension patients carryingSOX17variants
Authors: Montani David , Lechartier Benoit , Girerd Barbara , Eyries Mélanie , Ghigna Maria-Rosa , Savale Laurent , Jaïs Xavier , Seferian Andrei , Jevnikar Mitja , Boucly Athénais , Riou Marianne , Traclet Julie , Chaouat Ari , Levy Maryline , Le Pavec Jerome , Fadel Elie , Perros Frédéric , Soubrier Florent , Remy-Jardin Martine , Sitbon Olivier , Bonnet Damien , Humbert Marc 
Published: May 2022

BackgroundThe phenotype of pulmonary arterial hypertension (PAH) patients carryingSOX17pathogenic variants remains mostly unknown.MethodsWe report the genetic analysis findings, characteristics and outcomes of patients with heritable PAH carryingSOX17variants from the French Pulmonary Hypertension Network.Results20 patients and eight unaffected relatives were identified. The median (range) age at diagnosis was 17 (2–53) years, with a female:male ratio of 1.5. At diagnosis, most of the patients (74%) were in New York Heart Association Functional Class III or IV with severe haemodynamic compromise, including a median pulmonary vascular resistance of 14.0 (4.2–31.5) WU. An associated congenital heart disease (CHD) was found in seven PAH patients (35%). Patients with CHD-associated PAH were significantly younger at diagnosis than PAH patients without CHD. Four patients (20%) suffered from recurrent haemoptysis requiring repeated arterial embolisations. 13 out of 16 patients (81%) for whom imaging was available displayed chest computed tomography abnormalities, including dilated, tortuous pulmonary vessels, ground-glass opacities as well as anomalies of the bronchial and nonbronchial arteries. After a median (range) follow-up of 47 (1–591) months, 10 patients underwent lung transplantation and one patient benefited from a heart–lung transplantation due to associated CHD. Histopathological analysis of lung explants showed a congested lung architecture with severe pulmonary arterial remodelling, subpleural vessel dilation and numerous haemorrhagic foci.ConclusionsPAH due toSOX17pathogenic variants is a severe phenotype, frequently associated with CHD, haemoptysis and radiological abnormalities. Pathological assessment reveals severe pulmonary arterial remodelling and malformations affecting pulmonary vessels and thoracic systemic arteries.
The prevalence and physiological impacts of centrilobular and paraseptal emphysema on computed tomography in smokers with preserved ratio impaired spirometry
Authors: Shiraishi Yusuke , Shimada Takafumi , Tanabe Naoya , Terada Kunihiko , Sakamoto Ryo , Maetani Tomoki , Shima Hiroshi , Mochizuki Fumi , Oguma Tsuyoshi , Shimizu Kaoruko , Sato Susumu , Muro Shigeo , Hizawa Nobuyuki , Fukui Motonari , Iijima Hiroaki , Masuda Izuru , Hirai Toyohiro 
Published: May 2022

Centrilobular emphysema (CLE) and paraseptal emphysema (PSE) are observed in smokers with preserved ratio impaired spirometry (PRISm, defined as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ≥0.7 and FEV1<80%), but their prevalence and physiological impacts remain unestablished. This multicentre study aimed to investigate its prevalence and to test whether emphysema subtypes are differently associated with physiological impairments in smokers with PRISm.Both never- and ever-smokers aged ≥40 years who underwent computed tomography (CT) for lung cancer screening and spirometry were retrospectively and consecutively enrolled at three hospitals and a clinic. Emphysema subtypes were visually classified according to the Fleischner system. Air-trapping was assessed as the ratio of FVC to total lung capacity on CT (TLCCT).In 1046 never-smokers and 772 smokers with ≥10 pack-years, the prevalence of PRISm was 8.2% and 11.3%, respectively. The prevalence of PSE and CLE in smokers with PRISm was comparable to that in smokers with normal spirometry (PSE 43.7%versus36.2%, p=1.00; CLE 46.0%versus31.8%, p=0.21), but higher than that in never-smokers with PRISm (PSE 43.7%versus1.2%, p<0.01; CLE 46%versus4.7%, p<0.01) and lower than that in smokers with airflow limitation (PSE 43.7%versus71.0%, p<0.01; CLE 46%versus79.3%, p<0.01). The presence of CLE, but not PSE, was independently associated with reduced FVC/TLCCTin smokers with PRISm.Both PSE and CLE were common, but only CLE was associated with air-trapping in smokers with PRISm, suggesting different physiological roles of these emphysema subtypes.
Porosity analysis of three types of balsa (Ochroma pyramidale) wood depending on density
Authors: Jang Eun-Suk , Kang Chun-Won 
Published: May 2022

AbstractBalsa (Ochroma pyramidale), which is the lowest density wood, is a useful species in various industries. In general, balsa can be divided into three types (low density: LD, middle density: MD, high density: HD). In this study, we classified the porosities of the three balsa types into through-pore porosity, blind-pore porosity, and closed-pore porosity. As a result, the total porosity of balsa showed a high positive (+) correlation with closed-pore porosity, but total porosity of balsa showed negative (−) correlations with blind-pore porosity and through-pore porosity. Such information can be useful when using balsa as a natural porous material.