bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicians for CARE: A Systematic Review and Meta‐Analysis of Interventions to Support Caregivers of Patients With Heart Disease
Authors: Knowles Kellen A. , Xun Helen , Jang Sunyoung , Pang Sharon , Ng Charles , Sharma Apurva , Spaulding Erin M. , Singh Rohanit , Diab Alaa , Osuji Ngozi , Materi Joshua , Amundsen Danielle , Wongvibulsin Shannon , Weng Daniel , Huynh Pauline , Nanavati Julie , Wolff Jennifer , Marvel Francoise A. , Martin Seth S. 
Published: December 2021

Background
Caregivers provide critical support for patients with chronic diseases, including heart disease, but often experience caregiver stress that negatively impacts their health, quality of life, and patient outcomes. We aimed to inform health care teams on an evidence‐based approach to supporting the caregivers of patients with heart disease.

Methods and Results
We conducted a systematic review and meta‐analysis of randomized controlled trials written in English that evaluated interventions to support caregivers of patients with heart disease. We identified 15,561 articles as of April 2, 2020 from 6 databases; of which 20 unique randomized controlled trials were evaluated, representing a total of 1570 patients and 1776 caregivers. Most interventions focused on improving quality of life, and reducing burden, depression, and anxiety; 85% (17 of 20) of the randomized controlled trials provided psychoeducation for caregivers. Interventions had mixed results, with moderate non‐significant effects observed for depression (Hedges’ g=−0.64; 95% CI, −1.34 to 0.06) and burden (Hedges’ g=−0.51; 95% CI, −2.71 to 1.70) at 2 to 4 months postintervention and small non‐significant effects observed for quality of life and anxiety. These results were limited by the heterogeneity of outcome measures and intervention delivery methods. A qualitative synthesis of major themes of the interventions resulted in clinical recommendations represented with the acronym “CARE” (Caregiver‐Centered, Active engagement, Reinforcement, Education).

Conclusions
This systematic review highlights the need for greater understanding of the challenges faced by caregivers and the development of guidelines to help clinicians address those challenges. More research is necessary to develop clinical interventions that consistently improve caregiver outcomes.
Age‐Dependent Effect of Ticagrelor Monotherapy Versus Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events: A Post Hoc Analysis of the TICO Randomized Trial
Authors: Kim Byung Gyu , Hong Sung‐Jin , Kim Byeong‐Keuk , Lee Seung‐Jun , Ahn Chul‐Min , Shin Dong‐Ho , Kim Jung‐Sun , Ko Young‐Guk , Choi Donghoon , Hong Myeong‐Ki , Jang Yangsoo 
Published: December 2021

Background
We aimed to evaluate the age‐dependent effect of ticagrelor monotherapy after 3‐month dual‐antiplatelet therapy (DAPT) versus ticagrelor‐based 12‐month DAPT on major bleeding and cardiovascular events in patients with acute coronary syndrome.

Methods and Results

From the TICO trial (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus‐eluting Stent for Acute Coronary Syndrome), which randomized 3056 patients (median age, 61 years) to the ticagrelor monotherapy after 3‐month DAPT group or ticagrelor‐based 12‐month DAPT group, this post hoc analysis evaluated the age‐dependent effect of the treatment strategies on the primary end point (a composite of major bleeding, death, myocardial infarction, stent thrombosis, stroke, or target‐vessel revascularization) using the subpopulation treatment effect pattern plot. The cutoff age for distinguishing patients with greater benefit from this strategy was also determined. The risk reduction effect of ticagrelor monotherapy after 3‐month DAPT versus ticagrelor‐based 12‐month DAPT on the primary end point gradually increased with age and was more marked from the subpopulation of age 64 years with the change point. With this cutoff value of 64 years, the occurrence of the primary end point was significantly lower in the ticagrelor monotherapy after 3‐month DAPT group than in the ticagrelor‐based 12‐month DAPT group (4.4% versus 9.0%;
P
=0.002) in patients aged ≥64 years (n=1278), but it was not different in those aged <64 years (n=1778) with a significant interaction (
P
‐interaction=0.036).

Conclusions
The age‐dependent increase in the benefit of ticagrelor monotherapy after 3‐month DAPT versus ticagrelor‐based 12‐month DAPT was observed in the patients with acute coronary syndrome. In elderly patients with acute coronary syndrome, ticagrelor monotherapy after short‐term DAPT might be more optimal than ticagrelor‐based 12‐month DAPT.
A Visual Programming Interface for Digital Luthiery: Implementing Circuits with Veneer
Authors: Norilo Vesa , Olarte Alejandro 
Published: December 2021

Abstract
This article presents a method for programming musical signal-processing circuits visually, using expressive idioms and abstractions from functional programming. Special attention is paid to the creative workflow, framing the education in a constructionist context. Our aim is to empower musicians in signal processing: The claim was tested in a university workshop for relatively inexperienced programmers. The participants were able to study and implement signal-processing algorithms from literature and integrate them into their preexisting workflow, and appeared to gain self-confidence while doing so.
Children’s Leisure Reading in the Nahḍah
Authors: Ayalon Ami 
Published: December 2021

Abstract
Children made up a substantial segment of the literate public that emerged during the Arab nahḍah period. Of these, an apparent minority applied skills they acquired in school to reading for pleasure or satisfying juvenile curiosity. This study explores the novel practice of Arab youth leisure-time reading as reported in retrospective memories and autobiographies. It reveals that during the nahḍah’s early decades, the inventory of Arabic readings fit for children was strikingly limited—unlike the multitude of books that were available to adults—a reality that forced curious boys and girls from different classes to make do with adult books for their after-school reading. This article examines cultural factors for that scarcity (primarily the status of children in society) and economic ones (e.g., publishers’ business concerns) and considers its implications. Probing a seemingly marginal section of a wider scene, it sheds light on hitherto neglected facets of the Arab transition from widespread illiteracy to extensive literacy at this point in history.
The Traceability of Construction and Demolition Waste in Flanders via Blockchain Technology: A Match Made in Heaven?
Authors: Voorter Jonas , Koolen Christof 
Published: December 2021

Abstract
The construction sector plays a crucial role in the transition to a circular economy and a more sustainable society. With this objective in mind, Flanders – the Dutch speaking part of Belgium – makes use of a traceability procedure for construction and demolition waste in order to guarantee that value can be derived from downstream waste processing activities. This article takes this traceability procedure as a legal case study and examines if the use of blockchain technology could lead to even stronger supply chains, better data management, and, more generally, a smoother transition to circular practices in the construction sector.
From Reform to Rights: The American Culture of the Citizen Soldier and the Transformation of the Crusading Metaphor, 1917–1945
Authors: Cross Graham 
Published: December 2021

Abstract
The “crusading” imagery attached to American soldiers in the 1917–1945 period performed an important function in assigning meaning to the wars of the United States. This was the result of a complex interplay between “official” and “vernacular” culture. The doughboys of the First World War at times fought a romantic “crusade” to reform the nation, world and themselves from a morally privileged position. In the post-war era, the romantic “crusade” survived but was more in tune with the conservative corporatism of Republican administrations. By the Second World War, gi s had become the agents of a very different “crusade”. Americans now embraced statist common effort in a realist prospective vision for human rights. This fundamental change in the meaning of “crusade” attached to the experiences of American soldiers suggests a protean nature to the metaphor and problematises notions of an ideologically cohesive American “crusade” in the world during the 20th century.
The Argo, Danaus, and Sesostris: On Allusions to Two First-Ship Traditions in Apollonius’s Argonautica
Authors: McPhee Brian D. 
Published: December 2021

Abstract
Against recent skepticism, this article proposes that Apollonius’s Argonautica alludes to the variant traditions that regarded either the Argo or the ship of Danaus as the first that ever sailed. Both variants predate Apollonius, and the poet nods to each at different points in his epic. Most novel is my argument that the rare word Δαναΐς (1.137) constitutes a subtle allusion to the tradition that Danaus’s ship, the “Danais” (Δαναΐς, scholium ad Argonautica 1.1–4e), was the world’s first ship. Neither tradition jibes with Apollonius’s mythological chronology, but Danaus’s voyage nevertheless provides a resonant Greco-Egyptian exemplar for the Argonautic expedition.
Deep learning nomogram for predicting lymph node metastasis using computed tomography image in cervical cancer
Authors: Li Peijun , Feng Bao , Liu Yu , Chen Yehang , Zhou Haoyang , Chen Yuan , Li Wenming , Long Wansheng 
Published: December 2021

Background Deep learning (DL) has been used on medical images to grade, differentiate, and predict prognosis in many tumors. Purpose To explore the effect of computed tomography (CT)-based deep learning nomogram (DLN) for predicting cervical cancer lymph node metastasis (LNM) before surgery. Material and Methods In total, 418 patients with stage IB-IIB cervical cancer were retrospectively enrolled for model exploration (n = 296) and internal validation (n = 122); 62 patients from another independent institution were enrolled for external validation. A convolutional neural network (CNN) was used for DL features extracting from all lesions. The least absolute shrinkage and selection operator (Lasso) logistic regression was used to develop a deep learning signature (DLS). A DLN incorporating the DLS and clinical risk factors was proposed to predict LNM individually. The performance of the DLN was evaluated on internal and external validation cohorts. Results Stage, CT-reported pelvic lymph node status, and DLS were found to be independent predictors and could be used to construct the DLN. The combination showed a better performance than the clinical model and DLS. The proposed DLN had an area under the curve (AUC) of 0.925 in the training cohort, 0.771 in the internal validation cohort, and 0.790 in the external validation cohort. Decision curve analysis and stratification analysis suggested that the DLN has potential ability to generate a personalized probability of LNM in cervical cancer. Conclusion The proposed CT-based DLN could be used as a personalized non-invasive tool for preoperative prediction of LNM in cervical cancer, which could facilitate the choice of clinical treatment methods.
Interior Environments in Long-Term Care Units From the Theory of Supportive Design
Authors: Bae Suyeon , Asojo Abimbola O. 
Published: December 2021

Aim: This study was designed to examine how residents in long-term care (LTC) units perceive their living environment based on the theory of supportive design. Background: Healthcare environments may cause a significant level of stress mainly due to patients’ lack of familiarity with such environments and patients’ poor health conditions. According to the theory, the healthcare environments providing a sense of control, social support, and positive distraction can promote wellness. This study was designed to learn how LTC residents perceive their current living environments. Method: This study collected data through qualitative interviews. A total of 48 residents living in two LTC units were asked the three interior environments they liked and they wanted to improve. Only the residents who lived in the current space for 1 month and communicate without any cognitive disabilities were able to participate. Most residents were female and lived in a private room. Results: The participants’ responses indicated the importance of perceived control, social support, and positive distraction in the environment. The most frequently mentioned interior environment that the residents liked was “window and view,” followed by “pictures and photos” and “TV,” while they wanted “bigger room and space,” followed by “improved privacy” and “more options for food.” In addition to the three elements, the participants considered other elements as important for them which can benefit the participants. Conclusion: More studies must be carried out to expand the theory, so that it can be applied to future studies with inclusive perspectives.
Neuroimaging cerebrovascular biomarkers in Parkinson’s disease
Authors: Alves Mariana , Pita Lobo Patrícia , Azevedo Kauppila Linda , Rebordão Leonor , Cruz M Manuela , Guerreiro Carla , Ferro José M , Ferreira Joaquim J , Reimão Sofia 
Published: December 2021

Background and Purpose The cardiovascular risk in Parkinson’s disease (PD) remains uncertain and controversial. Some studies suggest PD patients present an increased risk of cerebrovascular disease. We aimed to study the prevalence of neuroimaging cerebrovascular biomarkers in PD patients compared to controls, using an accurate and complete magnetic resonance (MR) imaging evaluation. Material and Methods Neuroimaging sub-study within a larger cross-sectional case–control study. An enriched subgroup of PD patients (≤10 years since diagnosis) with at least a moderate cardiovascular mortality risk based on a Systematic COronary Risk Evaluation (SCORE) was compared to community-based controls regarding neuroimaging biomarkers. Patients underwent a high-resolution T1-weighted MR imaging sequence at 3.0 T to visualize neuromelanin. A 3D SWI FFE, sagittal 3D T1-weighted, axial FLAIR and diffusion-weighted image sequences were obtained. Results The study included 47 patients, 24 with PD and 23 controls. PD patients presented a reduced area and signal intensity of the substantia nigra and locus coeruleus on neuromelanin-sensitive MR. The median SCORE was 5% in both groups. No significant differences regarding white matter hyperintensities (OR 4.84, 95% CI 0.50, 47.06), lacunes (OR 0.43, 95% CI 0.07, 2.63), microbleeds (OR 0.64, 95% CI 0.13, 3.26), or infarcts (0.95, 95% CI 0.12, 7.41) was found. The frequency of these neuroimaging biomarkers was very low in both groups. Conclusion The present study does not support an increased prevalence of neuroimaging cerebrovascular biomarkers in PD patients.
COVID-19 Care Clinic in a Medical Center: Lessons Learned
Authors: Tulledge-Scheitel Sidna M. , Billings Thomas A. , Fischer Karen M. , Homme Jason H. , Miller Jennifer M. , North Frederick , Sanderson Rachael L. , Schroeder Darrell R. , Vaughan Marvin A. , Croghan Ivana T. 
Published: December 2021

Objective: The purpose of this report is to describe the elements of a Covid-19 Care Clinic (CCC), patient demographics, and outcomes. Methods: Descriptive statistics were used to describe demographics, clinical characteristics, and outcomes. This report is based on 4934 unique patients seen in the CCC who provided research authorization within a 10-month period of time (April 1, 2020-January 31, 2021). The CCC infection control processes consisted of a rooming process that mitigated SARS-COV-2 transmission, preparing examination rooms, using PPE by staff, in room lab drawing, and escorting services to minimize the time in clinic. Results: Of the 4934 unique patients seen (age range newborn-102 years), 76.8% were tested for COVID-19. Of those tested, 11.8% were positive for SARS-CoV-2. Ninety-two percent of the patients with the reason for the visit documented had COVID-19 type symptoms. Cough, shortness of breath, and chest pain were the most common presenting symptom in those with COVID-19. At the time of the visit in the CCC, 5.8% of the patients were actively contagious. Thirty days after being seen in the CCC, 9.1% of the patients were seen in the emergency department (ED) and 0.2% died. During the 10-month period there were no known occupationally related COVID-19 infections. Conclusion: The COVID-19 Care Clinic provided face-to-face access for all ages with COVID-19 type symptoms. A minority of patients had COVID-19 who were seen in the clinic. The clinic provided an additional venue of care outside of the ED. The infectious control measures employed were highly effective in protecting the staff. Lessons learned allow for decentralization of COVID-19 symptom care to the primary care practices employing the infection control measures.
Robot for Ligament Tensioning and Assessment of Spinal Stability
Authors: McAfee Paul C. , Eisermann Lukas , Mullinix Kenneth 
Published: December 2021

Study Design An in vitro human cadaveric biomechanics study. Objective A proof-of-concept study to quantify whether or not differences in segmental mobility associated with spinal instability could be detected by a robotic distraction system. Methods Testing was performed in fresh human cadaveric tissue. A prototype Robotic Middle Column Distractor was attached unilaterally to the pedicles of L3-4. Distraction forces up to 150 N were applied first in the intact state, and following discectomy of L3-4. Motions were recorded by time-indexed visual and fluoroscopic images, and analyzed to measure actual motions achieved. Functions of the robot unit were monitored during the procedure and evaluated qualitatively. Results A difference of 2.5 mm in z-axis motion was detected at 150 N load between the intact and post-discectomy states. The robot coupled with the image analysis method was able to clearly detect the difference between the intact (“stable”) and post-discectomy (“unstable”) spine. Data analysis of fluoroscopic images taken during the procedure showed greater motion than perceived by the investigators from qualitative review of visual data. All monitored robot functions performed within design parameters without error. Conclusion The study demonstrates the feasibility and utility of utilizing an intraoperative robotic distractor to measure the amount of spinal mobility present at a level. This could lead to an important clinical tool for both diagnostic functions as well as operative assist functions.
Anatomy and cell wall ultrastructure of sunflower stalk rind
Authors: Wang Lizhen , Ren Hao , Zhai Shengcheng , Zhai Huamin 
Published: December 2021

AbstractThe anatomy and ultrastructure of sunflower stalk rind are closely related to its conversion and utilization. We studied systematically the anatomy and ultrastructure of the stalk rind using light, scanning electron, transmission electron and fluorescence microscopy. The results showed that the stalk rind consisted of phloem fibers (PF), xylem fibers (XF), vessel elements (V), ground parenchyma cells (GPC), axial parenchyma cells (APC), xylem ray parenchyma cells (XRPC), and pith ray parenchyma cells (PRPC). These cell walls were divided into the middle lamella, primary wall, and secondary wall (S). It was found that the S of PF, XF and V was further divided into three layers (S1–S3), while the S of APC, GPC, XRPC and PRPC showed a non-layered cell wall organization or differentiated two (S1, S2) to seven layers (S1–S7). Our research revealed the plasmodesmata characteristics in the pit membranes (PMs) between parenchyma cells (inter-GPCs, inter-XRPCs, and inter-PRPCs). The morphology of the plasmodesmata varied with the types of parenchyma cells. The thickness and diameter of PMs between the cells (inter-Vs, V–XF, V–APC, and V–XRPC) were greater than that of PMs between parenchyma cells. The cell corners among parenchyma cells were intercellular space. The lignification degree of vessels was higher than that of parenchyma cells and fibers. The results will provide useful insights into the biological structure, conversion and utilization of sunflower stalk rind.
Coin Paradox Spin–Orbit Interaction Enhances Magneto-Optical Effect and Its Application in On-Chip Integrated Optical Isolator
Authors: Hu Hao , Qi Jiwei , Wu Qiang , Fu Xianhui , Wu Hongjin , Zhang Sihao , Chen Zongqiang , Chen Jing , Yao Jianghong , Yu Xuanyi , Sun Qian , Xu Jingjun 
Published: December 2021

AbstractWe designed a simple on-chip integrated optical isolator made up of a metal–insulator–metal waveguide and a disc cavity filled with magneto-optical material to enhance the transverse magneto-optical effect through the coin paradox spin–orbit interaction (SOI). The simulation results of the non-reciprocal transmission properties of this optical structure show that a high-performance on-chip integrated optical isolator is obtained. The maximum isolation ratio is greater than 60 dB with a corresponding insertion loss of about 2 dB. The great performance of the optical isolator is attributed to the strong transverse magneto-optical effect, which is enhanced by the coin paradox SOI. Moreover, the enhancement of the transverse magneto-optical effect through the coin paradox SOI is more substantial for smaller azimuthal mode number n. Benefiting from this, the transverse magneto-optical effect remains strong in a wide wavelength range. Additionally, a smaller cavity has a stronger transverse magneto-optical effect in the same wavelength range. Our research provides a new perspective for creating highly integrated magneto-optical devices.
A CT-based technique to predict optimal projection for self-expanding TAVI in patients with different aortic valve anatomies
Authors: Wang Xi , Chen Fei , Xiong Tian-Yuan , Li Yi-Jian , Ou Yuan-Weixiang , Li Qiao , Peng Yong , Wei Jia-Fu , He Sen , Chen Mao , Feng Yuan 
Published: December 2021

Abstract
Background
Optimal projection is essential for valve deployment during transcatheter aortic valve implantation (TAVI). The purpose of this study was to propose an approach to predict optimal projection in TAVI candidates with different aortic valve anatomies.

Methods
331 patients undergoing self-expanding TAVI were included and the so-called non-coronary cusp (NCC)-parallel technique was utilized, which generated the predicted projection by connecting NCC commissures on the transverse plane on the pre-procedural computed tomography images.

Results
37.8% of the study cohort were bicuspid aortic valve (BAV) patients. Around 80% of both NCC-parallel views and final views were in the right anterior oblique (RAO) and caudal (CAU) quadrant. There was less than 5° change required from the NCC-parallel view to the final implanted view in 79% of tricuspid aortic valve (TAV) patients but only in 27% (13/48) of type 0 BAV patients with coronary arteries originated from the different cusps. After excluding the above mentioned BAV patients, 62.3% (48/77) of BAV patients needed less than 5° change to achieve optimal projection and only in 8 patients, the angular change was larger than 10° in either left/right anterior oblique or cranial/caudal direction.

Conclusions
The NCC-parallel technique provides reliable prediction for optimal projection in self-expanding TAVI in all TAV and most BAV patients, with a vast majority of views in the RAO and CAU quadrant.