bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain network modularity predicts changes in cortical thickness in children involved in a physical activity intervention
Authors: Chaddock‐Heyman Laura , Weng Timothy B. , Loui Psyche , Kienzler Caitlin , Weisshappel Robert , Drollette Eric S. , Raine Lauren B. , Westfall Daniel , Kao Shih‐Chun , Pindus Dominika M. , Baniqued Pauline , Castelli Darla M. , Hillman Charles H. , Kramer Arthur F. 
Published: July 2021

AbstractIndividual differences in brain network modularity at baseline can predict improvements in cognitive performance after cognitive and physical interventions. This study is the first to explore whether brain network modularity predicts changes in cortical brain structure in 8‐ to 9‐year‐old children involved in an after‐school physical activity intervention (N = 62), relative to children randomized to a wait‐list control group (N = 53). For children involved in the physical activity intervention, brain network modularity at baseline predicted greater decreases in cortical thickness in the anterior frontal cortex and parahippocampus. Further, for children involved in the physical activity intervention, greater decrease in cortical thickness was associated with improvements in cognitive efficiency. The relationships among baseline modularity, changes in cortical thickness, and changes in cognitive performance were not present in the wait‐list control group. Our exploratory study has promising implications for the understanding of brain network modularity as a biomarker of intervention‐related improvements with physical activity.
Aetiological analysis and diagnosis of reproductive disorders in male dromedary camels
Authors: Ali Ahmed , Derar Derar Refaat , Almundarij Tariq I. 
Published: July 2021

AbstractThe purpose of this paper was to analyse the aetiology and methods of diagnosing reproductive disorders in male dromedary camels. Male camel infertility manifests as one of three conditions: post‐coital infertility (IG), inability to copulate (IC) and lack of sexual desire (LSD). IG is mainly a testicular disorder that is linked to a deteriorated seminogram, arrested spermatogenesis, Sertoli cell‐only syndrome and testicular degeneration. For IG diagnosis, semen analysis, testicular biopsy and fine‐needle aspiration are gold standards. Testicular ultrasonography was generally inefficient. High serum FSH was found in IG camels with oligo‐ and azoospermia, implying primary spermatogenesis defects. The testis‐expressed protein (TEX101) and the epididymis‐expressed protein (ECM1) are reliable biomarkers for distinguishing between obstructive and non‐obstructive azoospermia. IC manifests in two forms: phimosis (PHI) and erectile dysfunction (ED). PHI is frequently linked to preputial and penile pathologies, as well as leucocytosis, neutrophilia and elevated nitric oxide metabolites. The majority of camels with ED have normal genital organs, and the condition is associated with an increase in cardiac troponin I. LSD is a rare disorder brought on by hormonal imbalances, high temperatures, stress and debilitating diseases. In conclusion, IG diagnosis necessitates semen analysis, testicular biopsy or fine‐needle aspiration, and FSH testing, whereas IC diagnosis requires preputial and penile examinations. Diagnostic aids include serum and seminal biomarkers.
Social‐cognitive risk for suicide and new relationship formation: False perception, self‐fulfilling prophecy, or both?
Authors: Jankowski Melissa S. , Erdley Cynthia A. , Schwartz‐Mette Rebecca A. 
Published: July 2021

AbstractObjectiveThis study examined the impact of social‐cognitive constructs associated with increased suicide risk (i.e., perceived burdensomeness and thwarted belongingness) on relationship formation during real‐time interactions of older adolescents with strangers in a dyadic context.MethodTwo hundred and seventy‐four older adolescents (61.9% female,Mage = 18.96 years) were paired with same‐gender strangers and completed a laboratory‐based interaction task. Both target participants and their partners answered questions about their interaction at three time points during the 45‐min session. Structural equation modeling was used to test hypothesized models.ResultsPerceived burdensomeness and thwarted belongingness predicted interpersonal consequences during the interaction. In the first model, thwarted belongingness led targets to inaccurately perceive their partners’ assessments of the interaction. This misperception negatively impacted the participants’ own desires for friendship. In the second model, thwarted belongingness predicted decreases in targets’ desire to continue the conversation, whereas perceived burdensomeness predicted higher levels of desire to continue the conversation. For females, thwarted belongingness in particular was related to new relationship formation in these models. Overall, those who desired to continue talking were more likely to like their partner at the end of the conversation.ConclusionsResults add to our understanding of how perceived burdensomeness and thwarted belongingness contribute to increased social alienation, which could serve to increase suicide risk.
In elderly Caucasian women, younger facial perceived age correlates with better forearm skin microcirculation reactivity
Authors: Guéré Christelle , Bigouret Armelle , Nkengne Alex , Vié Katell , Gélis Anthony , Dulong Joshua , Lamartine Jérôme , Fromy Bérengère 
Published: July 2021

AbstractBackgroundVisual and molecular changes occurring upon aging are rather well characterized. Still, aging signs show great significant inter‐individual variations, and little is known concerning the link between perceived age and cutaneous microcirculation.Materials and MethodsTo investigate this point, we recruited Caucasian women in their mid‐50's to mid‐70's and subsampled women looking older or younger than their age. We studied their facial skin color, as well as their microvascular reactivity to local heating assessed in the forearm skin. We also used skin biopsies from some of these women for gene expression or immunohistochemical analysis.ResultsClinical and instrumental analysis of skin color revealed that subjects who look 5 years younger differ only by a higher glowing complexion. Our most striking result is that subjects looking 5 years younger than their age present a higher microcirculation reactivity in forearm skin. Transcriptome comparison of skin samples from women looking older or younger than their age revealed 123 annotated transcripts differentially expressed, among which MYL9 relates to microcirculation. MYL9 is downregulated in the group of women looking younger than their real age. Microscopy shows that the labeling of MYL9 and CD31 are altered and heterogeneous with age, as is the morphology of microvessels.ConclusionTherefore, assessing generalized vascular reactivity in non‐photo‐exposed skin to focus on the intrinsic aging allows subtle discrimination of perceived age within elderly healthy subjects.
Eliminating hepatitis C in a rural Appalachian county: protocol for the Kentucky Viral Hepatitis Treatment Study (KeY Treat), a phase IV, single-arm, open-label trial of sofosbuvir/velpatasvir for the treatment of hepatitis C
Authors: Havens Jennifer R , Schaninger Takako , Fraser Hannah , Lofwall Michelle , Staton Michele , Young April M , Hoven Ardis , Walsh Sharon L , Vickerman Peter 
Published: July 2021

ObjectivesThe overall goal of the Kentucky Viral Hepatitis Treatment Study (KeY Treat) is to eliminate hepatitis C transmission from a county in Appalachian Kentucky by removing the barriers to accessing hepatitis C virus (HCV) treatment.Methods/analysisKeY Treat is a phase IV, open-label, single-arm clinical trial of sofosbuvir/velpatasvir (SOF/VEL) for the treatment of viraemic HCV infections. Those eligible for KeY Treat are at least 18 years of age, viraemic and are residents of the target county. Pregnant women are not eligible. Rapid HCV RNA screening is used to determine eligibility, and those with a quantifiable viral load (VL) consenting to participate initiate SOF/VEL on the same day. All pharmacologic treatment and related medical care is provided free of charge using a non-specialist provider model. Follow-up visits occur at 2, 6 and 12 weeks during treatment to assess medication adherence (measured via VL and self-report), side effects and engagement in risk behaviours. Post-treatment visits occur at 12 weeks (sustained virologic response (SVR12) visit), 6 months and 12 months post-treatment completion to assess re-infection. A control county has also been identified, and prevalence and incidence of chronic HCV infections will be compared with the target community longitudinally. The primary outcome to assess elimination is SVR12. However, several outcomes will be measured to assess the effectiveness of removing the barriers to HCV treatment, including treatment entry, completion and re-infection. Analyses will be conducted via a generalised linear model framework that can incorporate flexible covariate adjustment and multiple outcome types with a compatible link function. Mathematical modelling will be completed assessing the impact and cost-effectiveness of the intervention.Ethics and disseminationKeY Treat has been approved by the Institutional Review Board at the University of Kentucky. Results from KeY Treat will be presented at conferences and published in peer-reviewed journals.Trial registration numberNCT03949764.
Catheter to vein ratio and risk of peripherally inserted central catheter (PICC)-associated thrombosis according to diagnostic group: a retrospective cohort study
Authors: Sharp Rebecca , Carr Peter , Childs Jessie , Scullion Andrew , Young Mark , Flynn Tanya , Kirker Carolyn , Jackson Gavin , Esterman Adrian 
Published: July 2021

ObjectivesDetermine the effect of the catheter to vein ratio (CVR) on rates of symptomatic thrombosis in individuals with a peripherally inserted central catheter (PICC) and identify the optimal CVR cut-off point according to diagnostic group.DesignRetrospective cohort study.Setting4 tertiary hospitals in Australia and New Zealand.ParticipantsAdults who had undergone PICC insertion.Primary outcome measureSymptomatic thrombus of the limb in which the PICC was inserted.Results2438 PICC insertions were included with 39 cases of thrombosis (1.6%; 95% CI 1.14% to 2.19%). Receiver operator characteristic analysis was unable to be performed to determine the optimal CVR overall or according to diagnosis. The association between risk of thrombosis and CVR cut-offs commonly used in clinical practice were analysed. A 45% cut-off (≤45% versus ≥46%) was predictive of thrombosis, with those with a higher ratio having more than twice the risk (relative risk 2.30; 95% CI 1.202 to 4.383; p=0.01). This pattern continued when only those with malignancy were included in the analysis, those with cancer had twice the risk of thrombosis with a CVR greater than 45%. Whereas the 33% CVR cut-off was not associated with statistically significant results overall or in those with malignancy. Neither the 33% or 45% CVR cut-off produced statistically significant results in those with infection or other non-malignant conditions.ConclusionsAdherence to CVR cut-offs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in individuals with cancer, the use of a CVR ≤45% should be considered to minimise risk of thrombosis. Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a non-malignant diagnosis.
Microablative fractional radiofrequency for the genitourinary syndrome of menopause: protocol of randomised controlled trial
Authors: Sarmento Ayane Cristine Alves , Fernandes Fabíola S , Costa Ana Paula Ferreira , Medeiros Kleyton Santos , Crispim Janaina Cristina , Gonçalves Ana Katherine 
Published: July 2021

IntroductionMenopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve. These changes have consequences: vaginal dryness, dyspareunia, discomfort, burning and irritation, vulvovaginal pruritus, dysuria and increased frequency of genitourinary infections. The therapy more suitable for vaginal symptoms in postmenopause yet is the use of a topical hormone. However, the prescription of topical oestrogens should also be avoided in women with a history of breast cancer, oestrogen-sensitive tumours and thromboembolism, emphasising the necessity of alternative treatments. Recently, physical methods, such as laser and radiofrequency (RF), in their non-ablative, ablative and microablative forms have been used in the vaginal mucosa to promote neocolagenesis and neoelastogenesis. This randomised study aims to compare the efficiency of microablative fractional RF (MAFRF) treatment with vaginal oestrogens and no treatment.Methods and analysesThis randomised, controlled clinical intervention trial with an open label design comparing the treatment of MAFRF with vaginal oestrogens and no treatment. Four important moments were considered to evaluate treatment results (T0, T1, T2 and T3). The primary outcome includes vulvovaginal atrophy (vaginal pain, burning, itching, dryness, dyspareunia and dysuria), and the secondary outcomes will be sexual function, vaginal health (epithelial integrity, vaginal elasticity, moisture, fluid volume and vaginal pH) and quality of life.Ethics and disseminationDue to the nature of the study, we obtained approval from the ethics committee. All participants must sign an informed consent form before randomisation. The results of this study will be published in peer-reviewed journals. The data collected will also be available in a public repository of data.Trial registration numberRBR-94DX93.
Point-of-care ultrasound-guided regional anaesthesia in older ED patients with hip fractures: a study to test the feasibility of a training programme and time needed to complete nerve blocks by ED physicians after training
Authors: Lee Jacques Simon , Bhandari Tina , Simard Robert , Emond Marcel , Topping Claude , Woo Michael , Perry Jeffrey , Eagles Debra , McRae Andrew D , Lang Eddy , Wong Charles , Sivilotti Marco , Newbigging Joseph , Borgundvaag Bjug , McLeod Shelley L , Melady Donald , Chernoff Lan , Kiss Alex , Chenkin Jordan 
Published: July 2021

ObjectivesPoint-of-care ultrasound-guided regional anaesthesia (POCUS-GRA) provides safe, rapid analgesia for older people with hip fractures but is rarely performed in the emergency department (ED). Self-perceived inadequate training and time to perform POCUS-GRA are the two most important barriers. Our objective is to assess the feasibility of a proposed multicentre, stepped-wedge cluster randomised clinical trial (RCT) to assess the impact of a knowledge-to-practice (KTP) intervention on delirium.DesignOpen-label feasibility study.SettingAn academic tertiary care Canadian ED (annual visits 60 000).ParticipantsEmergency physicians working at least one ED shift per week, excluding those already performing POCUS-GRA more than four times per year.InterventionA KTP intervention, including 2-hour structured training sessions with procedure bundle and email reminders.Primary and secondary outcome measuresThe primary feasibility outcome is the proportion of eligible physicians that completed training and subsequently performed POCUS-GRA. Secondary outcome is the time needed to complete POCUS-GRA. We also test the feasibility of the enrolment, consent and randomisation processes for the future stepped-wedge cluster RCT (NCT02892968).ResultsOf 36 emergency physicians, 4 (12%) were excluded or declined participation. All remaining 32 emergency physicians completed training and 31 subsequently treated at least one eligible patient. Collectively, 27/31 (87.1%) performed 102 POCUS-GRA blocks (range 1–20 blocks per physician). The median (IQR) time to perform blocks was 15 (10–20) min, and reduction in pain was 6/10 (3–7) following POCUS-GRA. There were no reported complications.ConclusionOur KTP intervention, consent process and randomisation were feasible. The time to perform POCUS-GRA rarely exceeded 30 min, Our findings reinforce the existing data on the safety and effectiveness of POCUS-GRA, mitigate perceived barriers to more widespread adoption and demonstrate the feasibility of trialling this intervention for the proposed stepped-wedge cluster RCT.Trial registration numberClinicaltrials.gov #02892968
Transitional care of adolescents with Multiple Osteochondromas: a convergent mixed-method study ‘Patients’, parents’ and healthcare providers’ perspectives on the transfer process’
Authors: Amajjar Ihsane , Malik Romana , van Wier Marieke , Smeets Rob , Ham S John 
Published: July 2021

ObjectivesMultiple osteochondromas (MO) is a rare hereditary disease characterised by numerous benign bone tumours. Its chronic aspect requires a well-organised transition from paediatric care to adult care; however, little is known on organising this care specific for patients with MO. This study aims to gain insight on this topic.DesignConvergent mixed-method study.SettingThis study was conducted at the orthopaedic and paediatrics department of an MO-expertise centre in the Netherlands.Participants12 patients, 10 parents and 10 healthcare professionals were interviewed. An additional survey was completed by 20 young adults.Primary and secondary outcomesThe (1) themes on transition, identified through template analysis and (2) transfer experience and satisfaction assessed by an 18-item On Your Own Feet-Transfer Experience Scale (OYOF-TES, range: 18–90) and by Numeric Rating Scale (NRS, range: 1–10).ResultsThe following three key themes were identified in the qualitative analysis: (1) patient and parent in the lead can be encouraged by self-management tools, (2) successful transfers need interprofessional collaboration and communication and (3) how can we prepare patients for the transitional process? Stakeholders’ insights to improve transition were listed and divided into these three themes.Several important aspects were underlined, particularly within the first theme; speaking-up was difficult for patients especially when parents were not directly involved. Moreover, the high psychological impact of the disease requires coaching of self-management and psychological counselling to facilitate stakeholders in their changing roles.Twenty patients completed the quantitative survey. Mean satisfaction score with the transfer process was poor, which was assessed with the NRS (mean=5.7±2.1; range: 1–9) and the OYOF-TES (mean=56.3±14.2; range: 32–85). The OYOF-TES only showed a negative correlation (R2=0.25; p=0.026) with the number of surgical interventions in the past.ConclusionOverall, the transfer process was found unsatisfactory. Improvement can be achieved by supporting and guiding the patients to be in the lead of their care. Moreover, preparation for transfer and a multidisciplinary approach may enhance successful transition.
Work-related stress: the impact of COVID-19 on critical care and redeployed nurses: a mixed-methods study
Authors: Rattray Janice , McCallum Louise , Hull Alastair , Ramsay Pam , Salisbury Lisa , Scott Teresa , Cole Stephen , Miller Jordan , Dixon Diane 
Published: July 2021

IntroductionWe need to understand the impact of COVID-19 on critical care nurses (CCNs) and redeployed nurses and National Health Service (NHS) organisations.Methods and analysisThis is a mixed-methods study (QUANT-QUAL), underpinned by a theoretical model of occupational stress, the Job Demand-Resources Model (JD-R). Participants are critical care and redeployed nurses from Scottish and three large English units.Phase 1 is a cross-sectional survey in part replicating a pre-COVID-19 study and results will be compared with this data. Linear and logistic regression analysis will examine the relationship between antecedent, demographic and professional variables on health impairment (burnout syndrome, mental health, post-traumatic stress symptoms), motivation (work engagement, commitment) and organisational outcomes (intention to remain in critical care nursing and quality of care). We will also assess the usefulness of a range of resources provided by the NHS and professional organisations.To allow in-depth exploration of individual experiences, phase 2 will be one-to-one semistructured interviews with 25 CCNs and 10 redeployed nurses. The JD-R model will provide the initial coding framework to which the interview data will be mapped. The remaining content will be analysed inductively to identify and chart content that is not captured by the model. In this way, the adequacy of the JD-R model is examined robustly and its expression in this context will be detailed.Ethics and disseminationEthics approval was granted from the University of Aberdeen CERB2020101993. We plan to disseminate findings at stakeholder events, publish in peer-reviewed journals and at present at national and international conferences.
Tissue stress from laparoscopic grasper use and bowel injury in humans: establishing intraoperative force boundaries
Authors: Khan Amanda Farah , MacDonald Matthew Kenneth , Streutker Catherine , Rowsell Corwyn , Drake James , Grantcharov Teodor 
Published: July 2021

ObjectivesWe aim to determine what threshold of compressive stress small bowel and colon tissues display evidence of significant tissue trauma during laparoscopic surgery.DesignThis study included 10 small bowel and 10 colon samples from patients undergoing routine gastrointestinal surgery. Each sample was compressed with pressures ranging from 100 kPa to 600 kPa. Two pathologists who were blinded to all study conditions, performed a histological analysis of the tissues. Experimentation: November 2018–February 2019. Analysis: March 2019–May 2020.SettingAn inner-city trauma and ambulatory hospital with a 40-bed inpatient general surgery unit with a diverse patient population.ParticipantsPatients were eligible if their surgery procured healthy tissue margins for experimentation (a convenience sample). 26 patient samples were procured; 6 samples were unusable. 10 colon and 10 small bowel samples were tested for a total of 120 experimental cases. No patients withdrew their consent.InterventionsA novel device was created to induce compressive “grasps” to simulate those of a laparoscopic grasper. Experimentation was performed ex-vivo, in-vitro. Grasp conditions of 0–600 kPa for a duration of 10 s were used.ResultsSmall bowel (10), M:F was 7:3, average age was 54.3 years. Colon (10), M:F was 1:1, average age was 65.2 years. All 20 patients experienced a significant difference (p<0.05) in serosal thickness post-compression at both 500 and 600 kPa for both tissue types. A logistic regression analysis with a sensitivity of 100% and a specificity of 84.6% on a test set of data predicts a safety threshold of 329–330 kPa.ConclusionsA threshold was discovered that corresponded to both significant serosal thickness change and a positive histological trauma score rating. This “force limit” could be used in novel sensorized laparoscopic tools to avoid intraoperative tissue injury.
An Unusual Case of a Pharyngeal Fistula to the Cervical Spine Causing Osteomyelitis
Authors: Harris Kevin B. , Singh Achintya D. , Burkey Brian B. , Bhatt Amit , Vargo John J. , Baggott Brian B. 
Published: July 2021

Significance Statement Pharyngeal fistulas to the cervical spine resulting in vertebral osteomyelitis are a rare, yet clinically important, complication of total laryngectomy performed in conjunction with chemoradiotherapy or radiation therapy. This complication is likely underdiagnosed and can have a high mortality rate. It is very important that clinicians are aware of this complication as early diagnosis and management may improve patient outcomes.