bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual Antiplatelet Therapy with Clopidogrel and Aspirin Versus Aspirin Monotherapy in Patients Undergoing Coronary Artery Bypass Graft Surgery
Authors: Qu Jianyu , Zhang Heng , Rao Chenfei , Chen Sipeng , Zhao Yan , Sun Hansong , Song Yunhu , Liu Sheng , Wang Liqing , Feng Wei , Wang Shuiyun , Hu Shengshou , Zheng Zhe 
Published: May 2021

Background
The optimal antiplatelet therapy after coronary artery bypass grafting remains unclear. We evaluated the association of dual antiplatelet therapy (DAPT) with clopidogrel plus aspirin and clinical outcomes among patients undergoing coronary artery bypass grafting.

Methods and Results

A total of 18 069 consecutive patients who underwent primary isolated coronary artery bypass grafting between 2013 and 2017 were identified from a contemporary registry, and 10 854 (60.1%) received DAPT with clopidogrel plus aspirin as determined by claimed prescriptions after surgery. Cox regression models with inverse probability of treatment weighting were used to examine the associations between DAPT and outcomes. Patients who received DAPT, compared with those who received aspirin monotherapy, had a lower incidence of a composite of all‐cause death, myocardial infarction, stroke, or repeat revascularization at 6 months (2.9% versus 4.2%; inverse probability of treatment weighting–adjusted hazard ratio [HR], 0.65; 95% CI, 0.55–0.77;
P
<0.001) as well as death (HR, 0.61; 95% CI, 0.41–0.90), myocardial infarction (HR, 0.55; 95% CI, 0.40–0.74), and stroke (HR, 0.58; 95% CI, 0.46–0.74). The incidence of major bleeding did not differ significantly between the 2 groups (HR, 1.11; 95% CI, 0.69–1.78). Similar results were noted across multiple subgroups as well as when using different analytic methods.

Conclusions
Among patients undergoing coronary artery bypass grafting, DAPT with clopidogrel plus aspirin as secondary prevention was associated with reduced risk of major adverse cardiovascular and cerebrovascular events within 6 months as compared with aspirin monotherapy, and there was no significant increase in major bleeding.
Differences in Preferences Between Clinicians and Patients for the Use and Dosing of Direct Oral Anticoagulants for Atrial Fibrillation
Authors: Rymer Jennifer A. , Webb Laura , McCall Debbe , Hills Mellanie T. , Wang Tracy Y. 
Published: May 2021

Background
Direct oral anticoagulants (DOACs) are effective in reducing the stroke risk for patients with nonvalvular atrial fibrillation if prescribed at the labeled dose, yet underdosing is frequent. Little is known about clinician knowledge and patient or clinician preferences for DOAC dosing.

Methods and Results

From April 2019 to March 2020, 240 clinicians and 343 patients with atrial fibrillation completed an assessment of anticoagulation knowledge/preferences. Clinician knowledge of DOAC dosing was tested with 4 hypothetical patient scenarios. Patients and clinicians were asked to grade the importance of 25 factors in anticoagulation decision making. Among clinicians, the median age was 55 years, and 23% were primary care clinicians. In scenarios of a patient indicated for full‐dose DOAC, 41.2% of clinicians underdosed apixaban and 17.6% underdosed rivaroxaban. In scenarios of a patient indicated for reduced‐dose DOAC, 64.6% and 71.7% of clinicians chose to use reduced‐dose apixaban and rivaroxaban, respectively. Only 35.0% of clinicians correctly answered all 4 scenarios with the label‐indicated dose; this knowledge gap was similar between clinicians who did and did not underdose. Among patients with atrial fibrillation, the median age was 65 years, and 89% were currently anticoagulated. Patients and clinicians ranked stroke prevention and avoiding severe bleeding as very important to anticoagulation decision making. Patients were more likely than clinicians to rank the ability to reduce anticoagulation dose if needed as very important (70.5% versus 43.6%;
P
<0.001).

Conclusions
There are considerable knowledge gaps regarding DOAC dosing in clinicians treating patients with atrial fibrillation, as well as significant differences in treatment dosing preferences between clinicians and patients.
Obéissance aux clercs et entre soi
Authors: Verdeil Chantal 
Published: May 2021

Résumé
Cet article se propose de considérer les institutions scolaires missionnaires comme un lieu où se forgent des masculinités. Il présente l’ idéal masculin que mettent en avant les missionnaires jésuites de la mission de Syrie à la fin du XIXe siècle et au début du XXe. Cet homme, qui appartient à une élite sociale, est avant tout un catholique soumis aux autorités religieuses, prêt à mourir pour sa foi et à lutter pour défendre sa patrie. Il est éduqué dans un entre soi masculin et intériorise une véritable ségrégation de l’ espace en fonction du sexe. Cette vision de la masculinité diffère d’ autres modèles en vogue à l’ époque, ce qui illustre aussi la diversité des modèles qui pouvaient alors circuler au Moyen-Orient.
Religieuses, laïques et travail social en Haute-Égypte
Authors: Mayeur-Jaouen Catherine 
Published: May 2021

Résumé
C’ est à partir du rôle des femmes catholiques missionnaires, religieuses et laïques, en Haute-Égypte, que l’ on abordera les enjeux du genre à la fin de la monarchie égyptienne et durant la période nassérienne, soit des années 1940 aux années 1970. Les religieuses catholiques européennes étaient très nombreuses à la fin de la monarchie égyptienne ; mais la période vit éclore des initiatives masculines pour appeler à un travail missionnaire féminin nouveau. Le jésuite égyptien Henry Ayrout recruta de jeunes laïques dans le cadre de l’ Association de Haute-Égypte (AHE) qu’ il avait fondée en 1940 pour mener un travail d’ alphabétisation et de soins médicaux. En 1960, la mission du Graal à Akhmīm, lancée par des laïques consacrées pour des femmes, marqua un tournant féministe dans l’ histoire des missions de Haute-Égypte. La conjonction des idées de Vatican II et de la politique développementaliste de l’ État nassérien permit à la fois la prise de pouvoir des laïcs et des laïques au sein de l’ Association de Haute-Égypte, et l’ essor des implantations de religieuses en Haute-Égypte dans les années 1960. Dans les années 1970, dans le mouvement « Justice et Paix », comme à l’ Association de Haute-Égypte, des religieuses et des femmes laïques, désormais en majorité égyptiennes, abordèrent la question de la contraception et la lutte contre l’ excision dans une politique déterminée de promotion de la femme.
Zur Phänomenologie der Aufforderungscharaktere
Authors: Borsato Andrea 
Published: May 2021

Abstract
The author will try to develop the notion of ‘valence’ (‘Aufforderungscharakter’), first introduced in psychology by the work of K. Lewin, from a phenomenological point of view. In a first approximation, an object has valence insofar as it prompts us to action. Valence is an important – although in contemporary philosophy of mind quite neglected – feature of our practical experience. Here we will concentrate on the consciousness of valence and its descriptive features. After distinguishing, on the one hand, ‘valence’ from ‘value’, and pointing out how, on the other hand, ‘valence’ should also not be confused with J.J. Gibson’s ‘affordance’, we will try to develop the implications of this notion beyond the original scope of Lewin’s experimental psychology: on the one hand, by introducing the idea of ‘passive valence’ and, on the other hand, by investigating the relation between valence and emotion and discussing the possibility of ‘emotional valence’.
Quantifying the potential of AQPI gap-filling radar network for streamflow simulation through a WRF-Hydro experiment
Authors: Ma Yingzhao , Chandrasekar V. , Chen Haonan , Cifelli Robert 
Published: May 2021

AbstractIt remains a challenge to provide accurate and timely flood warnings in many parts of the western United States. As part of the Advanced Quantitative Precipitation Information (AQPI) project, this study explores the potential of using the AQPI gap-filling radar network for streamflow simulation of selected storm events in the San Francisco Bay Area under a WRF-Hydro modeling system. Two types of watersheds including natural and human-affected among the most flood-prone region of the Bay Area are investigated. Based on the high-resolution AQPI X-band radar rainfall estimates, three basic routing configurations, including Grid, Reach, and National Water Model (NWM), are used to quantify the impact of different model physics options on the simulated streamflow. It is found that the NWM performs better in terms of reproducing streamflow volumes and hydrograph shapes than the other routing configurations when reservoirs exist in the watershed. Additionally, the AQPI X-band radar rainfall estimates (without gauge correction) provide reasonable streamflow simulations, and they show better performance in reproducing the hydrograph peaks compared with the gauge-corrected rainfall estimates based on the operational S-band Next Generation Weather Radar network. Also, sensitivity test reveals that surficial conditions have a significant influence on the streamflow simulation during the storm: the discharge increases to a higher level as the infiltration factor (REFKDT) decreases, and its peak goes down and lags as surface roughness coefficient (Mann) increases. The time delay analysis of precipitation input on the streamflow at the two outfalls of the surveyed watersheds further demonstrates the link between AQPI gap-filling radar observations and streamflow changes in this urban region.
‘It’s almost superstition: If I don’t think about it, it won’t happen’. Public knowledge and attitudes towards advance care planning: A sequential mixed methods study
Authors: McIlfatrick Sonja , Slater Paul , Bamidele Olufikayo , Muldrew Deborah , Beck Esther , Hasson Felicity 
Published: May 2021

Background: Internationally, participation in advance care planning is low. Whilst a community action approach is advocated, what the public know and understand about advance care planning is unknown. Aim: To assess public awareness, knowledge and attitudes towards advance care planning and identify strategies to raise awareness within a public health framework. Design: Sequential mixed methods comprising a cross-sectional survey and focus group/interviews. Setting/participants: A random representative sample of adults from one region of the United Kingdom ( n = 1201; response rate 56%) completed a face-to-face survey. Twenty-five participants consented to an additional focus group/interview held in a secure accessible location or via telephone. Results: Most participants (78.7%) acknowledged the benefits of advance care planning conversations, however, two thirds did not want to think about advance care planning or find out more at present. Respondents were reluctant to broach advance care planning as it was linked to end of life care and funeral plans, and they did not wish to cause distress to their loved one. Respondents trusted their family to respect their wishes and they considered having an advance care plan in place would be of assistance in the future. Top-down leadership, normalisation, and increased education were identified as potential approaches to overcome barriers. Conclusions: Advance care planning was recognised as important despite limited awareness, lack of knowledge and misperceptions. Whilst a community action approach to enhance understanding and engagement was supported, a ‘one size fits all’ approach will not work; rather bespoke targeting is required with educational and media messaging aligned.
Pregnancy-related sacroiliac joint findings in females with low back pain: a four-year magnetic resonance imaging follow-up study
Authors: Kiil Rosa Marie , Arnbak Bodil Al-Mashhadi , Zejden Anna , Schiøttz-Christensen Berit , Hendricks Oliver , Jurik Anne Grethe 
Published: May 2021

Background Pregnancy-related pain may be associated with sacroiliac joint (SIJ) changes, detectable by magnetic resonance imaging (MRI). Purpose To analyze the prevalence and course of SIJ MRI and clinical findings in women referred with low back pain and relate these to pregnancy. Material and Methods A retrospective follow-up study from a longitudinally collected cohort comprising 328 women. Results Women reporting debut of pain in relation to a pregnancy (PP group) tended to have a higher baseline prevalence of all investigated MRI findings, cumulated positive SIJ tests, and a potential fulfilment of the spondyloarthritis diagnosis compared to remainders. The prevalence of subchondral bone marrow edema (BME), any SIJ MRI finding, and potential fulfilment of the spondyloarthritis diagnosis were significantly higher in the PP group compared to women who had not been pregnant. In the total study group, the prevalence of ≥1 MRI finding increased over the four-year study period from 34% to 47% ( P<0.001), driven by increasing prevalence of BME (25% to 32%; P=0.008) and fatty marrow deposition (FMD) (20% to 25%; P=0.020). In addition, the BME volume score increased. Over time, the PP group had persisting high prevalence of buttock pain and total MRI findings and their FMD volume score increased, but there were no between-group differences in MRI variables at follow-up. Conclusion Overall, the prevalence of MRI findings increased over time. Although the PP group had different clinical and SIJ MRI characteristics cross-sectional at baseline compared to remainders, longitudinal analyses revealed that these diminished over time.
Functional repair of the great saphenous vein by external valvuloplasty reduces the vein's diameter: 6-month results of a multicentre study
Authors: Mühlberger Dominic , Brenner Erich , Frings Norbert , Geier Bruno , Mumme Achim , Reich-Schupke Stefanie , Steffen Horst-Peter , Stenger Dietmar , Stücker Markus , Hummel Thomas 
Published: May 2021

Objectives External valvuloplasty (eVP) is a reconstructive surgical method to repair the function of the terminal and preterminal valves. We evaluated the 6-month outcomes of eVP regarding the diameter of the great saphenous vein (GSV). Methods Patients from five vein centres were included in this observational study. Follow-up involved detailed duplex sonography of the GSV. The venous clinical severity score (VCSS) and the C class of the clinical, aetiologic, anatomic and pathophysiologic (CEAP) classification were recorded. Results We enrolled 210 patients, with a follow-up rate of 58%; eVP was sufficient in 95.24% of the patients. The GSV diameters decreased significantly from 4.4 mm (standard deviation (SD): 1.39) to 3.9 (SD: 1.12), 4 cm distal to the saphenofemoral junction (SFJ); from 3.7 mm (SD: 1.10) to 3.5 mm (SD: 1.02) at the mid-thigh; from 3.6 mm (SD: 1.14) to 3.3 mm (SD: 0.94) at the knee and from 3.1 mm (SD: 0.99) to 2.9 mm (SD: 0.78) at the mid-calf. VCSS decreased significantly from 4.76 (SD: 2.13) preoperatively to 1.77 (SD: 1.57) 6 months postoperatively. Conclusions GSV function can be restored by eVP; diameters over the total length of the GSV decreased significantly.
Demarcation of arteriopulmonary segments: a novel and effective method for the identification of pulmonary segments
Authors: Gao Huijie , Liu Chao 
Published: May 2021

Objective Each pulmonary segment is an anatomical and functional unit. However, it is fundamentally difficult to precisely distinguish every pulmonary segment using the conventional pulmonary intersegmental planes from computed tomography images. Building arteriopulmonary segments is likely to be an effective way to identify pulmonary segments. Methods The thoracic computed tomography images of 40 patients were collected. The anatomic structures of interest were extracted in the transverse, sagittal, and coronal planes using the semi-automated segmentation tools provided by Amira software. The intrapulmonary vessels were subsequently segmented and reconstructed. The distributions of the pulmonary arteries, veins, and bronchi were observed. In patients with pulmonary masses, the mass was also reconstructed. Results The three-dimensional reconstructed images showed the branches of the pulmonary artery ramified up to their eighth order covering the entire lung as well as evident intersegmental gaps without pulmonary arteries. The segmental artery was closely accompanied by the segmental bronchi in 486 pulmonary segments (90% of total number of segments). The size and spatial location of the pulmonary mass within a pulmonary segment were also clearly visible. Conclusions Demarcation of arteriopulmonary segments can be used to precisely distinguish every pulmonary segment and provide its detailed anatomical structure before pulmonary segmentectomy.
Quantitative assessment and determinants of foveal avascular zone in healthy volunteers
Authors: Zhou Lijun , Wang Fengqun , Wang Ling , Shen Peiyang , Cao Yi , He Yushen , Yan Shigang , Kong Xiangbin , Lu Xiaohe 
Published: May 2021

Objectives To evaluate the foveal avascular zone (FAZ) area in healthy volunteers using optical coherence tomography angiography (OCTA) and identify factors that influence the FAZ. Methods This single-center cross-sectional study included 526 eyes of 263 healthy volunteers who underwent macular scanning by Zeiss OCTA. A linear mixed model was used to investigate the effects of systemic factors (age, sex, blood pressure, height, and weight) and ocular factors (intraocular pressure, biometric parameters, and central macular thickness) on FAZ. Results In total, 520 eyes of 262 healthy volunteers were included in the analysis. The mean volunteer age was 38.59 ± 22.03 years (range, 5–84 years); 124 volunteers were male (47.33%) and 138 volunteers were female (52.67%). The mean FAZ area was 0.30 ± 0.03 mm2 (95% confidence interval [CI], 0.29–0.31 mm2). Univariate analysis showed that FAZ area was associated with age (β = 0.0011), anterior chamber depth (β = −0.0513), and axial length (β = −0.0202). Multivariate analysis showed that FAZ area was negatively correlated with axial length (β = −0.0181). Conclusions The mean FAZ area in healthy volunteers, measured using Zeiss OCTA, was 0.30 ± 0.03 mm2. Furthermore, FAZ area was negatively associated with axial length; this relationship should be considered in clinical practice.
Expertise is crucial to prolong survival in average risk medulloblastoma: long-term results of a retrospective study
Authors: Franceschi Enrico , Minichillo Santino , Tosoni Alicia , Mascarin Maurizio , Mura Antonella , Di Battista Monica , Di Nunno Vincenzo , Gatto Lidia , Lodi Raffaele , Bartolini Stefania , Brandes Alba Ariela 
Published: May 2021

Purpose: Medulloblastoma is a rare tumor in adults and the use of adjuvant chemotherapy in average risk patients is debated. Methods: Patients included in our study were ⩾16 years of age, had histologically confirmed medulloblastoma, and underwent adjuvant radiotherapy with or without chemotherapy. Average risk was defined according to the Chang classification. Results: We included 48 average-risk patients. Median follow-up was 151.5 months (95% confidence interval, 124.5–178.5). Both progression-free survival (PFS) and overall survival (OS) were significantly influenced by adjuvant chemotherapy (PFS: hazard ratio [HR], 0.334, p = 0.05; OS: HR, 0.187, p = 0.017) and by receiving the treatment in a referral center (PFS: HR, 0.250, p = 0.008; OS: HR, 0.295, p = 0.038). Conclusions: Treating patients with average-risk medulloblastoma in a referral center improves both PFS and OS, does adding adjuvant chemotherapy.
Occupational therapy interventions in child and adolescent mental health to increase participation: A mixed methods systematic review
Authors: Brooks Rob , Bannigan Katrina 
Published: May 2021

Introduction Mental health disorders and low levels of mental well-being can have a lasting effect on life satisfaction and contribution to society for children and adolescents, yet the effectiveness of occupational therapy interventions is unknown. Methods A mixed methods systematic review was conducted including studies with children and adolescents aged 5–16 years, who had mental health difficulties, that evaluated occupational therapy interventions and focused on participation in everyday occupations as an outcome. Results The nine included studies were generally very low quality. The results could not be pooled due to heterogeneity. For children with Asperger’s syndrome, the Cognitive Orientation to Daily Occupational Performance intervention had clinically significant improvements on occupational performance and social skills. For children with attention deficit hyperactivity disorder, the Ultimate Guide to Play, Language and Friendship intervention improved playfulness and the Cognitive–Functional intervention had a statistically significant improvement on occupational performance and behaviour. Conclusion One intervention used by occupational therapists with children with Asperger’s syndrome and two interventions used with children with attention deficit hyperactivity disorder had some evidence of effect. No evidence was identified for the effectiveness of occupational therapy interventions for children and adolescents with other common mental health conditions.
Evolution of professional identity in Iranian occupational therapy students and new graduates: A comparative study
Authors: Derakhshanrad Seyed Alireza , Piven Emily F , Zeynalzadeh Ghoochani Bahareh 
Published: May 2021

Introduction The development of professional attitude evolves over time and contributes to the formation of professional identity. This study tracked formation of professional identity by comparing professional attitudes of three cohorts: new graduates, final-year, and first-year students of occupational therapy. Method The online survey, including a 5-point Likert scale 17-item questionnaire and one qualitative inquiry using an incomplete statement, revealed the perception and future career prospects of 144 novice practitioners and students of occupational therapy. Written statements were compared to each other to provide insight about the participants’ perspectives during the three time periods. Findings One-way ANOVA indicated that there were significant differences in professional attitudes among the three cohorts (F (2, 141) = 14.32, p < 0.0001), demonstrating a downward trend in professional identity formation. The comparison analysis of statements confirmed the quantitative results and highlighted an issue of negative professional identity through indicating great concerns over the future career prospects. Conclusion Despite increased awareness of occupational therapy over time, these participants seemed to have had trouble developing a sound sense of professional identity. Possible sources and solutions for this issue were discussed, to better facilitate a clear sense of professional identity in occupational therapy students and practitioners.