bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding how community-dwelling persons with early dementia perceive health and community services: Informing the dementia strategy of Newfoundland and Labrador, Canada
Authors: Parsons Karen , Smith-Young Joanne , Pike April 
Published: September 2024

Background With an increased aging population, the number of individuals with dementia is expected to rise. The onset of dementia marks the start of negotiating access to a wide range of health and social services to find practical and emotional supports to deal with the management of changes and subsequent challenges that individual with dementia face. The toll of dementia goes beyond the health care system, affecting families and caregivers’ quality of life. This places more pressure on family caregivers and health care institutions to provide services for affected individuals. It is important to understand the service needs of this population to enable them to live at home longer, contribute to society and maintain a positive quality of life. Aim To increase understanding of how persons living at home with early dementia and their caregivers/significant others currently perceive and interact with health and community-based services and service providers. Methods A qualitative descriptive approach was used to explore the experiences of individuals with early dementia and care providers with health and community-based services using semi-structured interviews and content analysis. Results Participants included 16 individuals 50 years and older with mild/early dementia living at home, 22 informal caregivers of individuals with mild/early dementia, and 5 key community informants (community health nurses and social workers). Four thematic categories of barriers and two thematic categories of facilitators for access to and uptake of supportive services were identified. Five strategies to inform the development of an action plan to enhance access to, and uptake of, supportive services were determined. Conclusions Early recognition of dementia through education and publicity enhanced public awareness, attention, and social inclusion with dementia-friendly neighborhoods and facilities need to be considered to achieve effective dementia-related services. Inclusion and recognition of the wishes of persons with dementia is key.
Characterization and application of composite resin of natural rubber latex and polystyrene waste as a binder for water-resistant emulsion paint formulation
Authors: Osemeahon Sunday A , Akinterinwa Ayodele , Fasina Esther , Andrew Fartisincha P , Shagal Mohammed H , Kareem Semiu A , Reuben Usaku , Onyebuchi Patience U , Olubukola Adelagun R , Esenowo David , Aminu Amina 
Published: September 2024

Sustainable production of efficient and low-cost coating materials from recycled plastic wastes will have a significant impact on economic advancements in paints and coatings, as well as waste management. Polystyrene waste was reduced to a resin, which was further modified by blending with natural rubber latex (NRL). The recycled polystyrene resin (rPS) and NRL formed homogeneous composite resins (rPS-NRL) blends in various ratios, and the changes in some physicochemical properties of the resins were studied. The rPS-NRL blended in different ratios exhibited higher density (0.83–0.92 g/cm3), refractive index (1.401–1.438), viscosity (935–1287 cP), elongation (5–18 %), and melting point (184°C–217.5°C), as well as lower moisture uptake (1.1–0.88 %) and faster drying time (32–19 min), compared to the rPS resin. Changes in functional, structural, and morphological characteristics of the resins were studied using Fourier transformed infrared (FTIR) spectrometer, X-ray diffractometer (XRD), scanning electron microscope (SEM) and thermogravimetric analyzer (TGA-DTA). The results indicated molecular interactions between NRL and the rPS resin, which form the basis for the unique physicochemical properties of the composite resin compared with the pristine rPS and NRL resins. White (CaCO3) pigmented emulsion paint produced using the rPS-NRL composite resin as binder was tested in comparison with paint produced using the conventional polyvinyl acetate (PVA) binder, where the rPS-NRL paint exhibits superior properties, including outstanding resistance to water.
Experimental study on protective performance of ACF sandwich composites with different configurations in high-velocity impact
Authors: Yu Xu-Hua , Liu Wen-Wu , Huang Guo-Yang , Fang Yi-Qun , Xu Jia-Jun 
Published: September 2024

The design of impact protective gear is crucial to human safety against high-velocity impacts from explosions. The rigid and flexible foam sandwich composites with ACF foam as the core and fiber-reinforced composite panels or high-performance fabrics as front/back panel materials were selected in this study. Hopkinson pressure bar experiment was conducted to assess the dynamic response, energy absorption, and dissipation rates of two types of composites in high-velocity impact. The effects of the number of structural layers, front/back panel thickness gradient, and panel material type on the protective performance were examined. The results demonstrated that the three-layer structure presented better protection and increased the energy absorption rate by 5% compared to the five-layer configuration in rigid and flexible composites. Thickness gradient and material type of panels had minimal impact on the protective performance of rigid composites compared to structural layers. Adding Kevlar layers to flexible composites improved protection, with 95.89% energy absorption and 31.82% energy dissipation at a core thickness of 8 mm. These insights guide the development of advanced impact protection materials to elevate personnel safety against high-velocity impacts.
Effectiveness of the Traditional Japanese Medicine Goshajinkigan in Preventing Paclitaxel-Induced Peripheral Neuropathy: A Multicenter Randomized Comparative Trial
Authors: Matsumura Yukiko , Futagami Masayuki , Baba Tsukasa , Soeda Shu , Watari Hidemichi , Terada Yukihiro , Tokunaga Hideki , Nagase Satoru , Nakanishi Toru , Kaiho Michiko , Yokoyama Yoshihito 
Published: September 2024

Objective: Development of chemotherapy-induced peripheral neuropathy (CIPN) poses significant challenges in cancer treatment, often leading to dose reductions or treatment discontinuation. Goshajinkigan (GJG), a traditional Japanese medicine, has shown promise for alleviating CIPN symptoms. This multicenter, randomized controlled trial aimed to prospectively examine the efficacy of GJG in preventing paclitaxel-induced peripheral neuropathy. Methods: This study enrolled 55 patients with ovarian cancer undergoing first-line chemotherapy using paclitaxel and carboplatin. The participants were randomized into Groups A (GJG initiation after onset of grade 2 neuropathy) and B (prophylactic administration of GJG from 1 week before chemotherapy). The primary endpoints were the proportion with a maximum sensory neuropathy grade and visual analog scale (VAS) scores. The secondary endpoints were the rate of chemotherapy completion and paclitaxel dose reduction due to neurotoxicity. Results: Prophylactic GJG administration (Group B) resulted in significant benefits. While both groups had a similar incidence of grade 2 sensory neuropathy, all patients in Group B with grade 2 neuropathy completed treatment without requiring additional analgesics. Group B exhibited lower VAS scores by the end of the study, reduced reliance on adjuvant analgesics (27.3% vs 66.7% in Group A), and significantly less frequent persistent CIPN 6 months post-chemotherapy (18.2% vs 55.6% in Group A). No differences were observed in the chemotherapy completion rates or CIPN-related changes between the groups. Conclusion: GJG, when administered prophylactically, showed potential for mitigating CIPN symptoms during paclitaxel chemotherapy. While promising, further research with placebo controls and objective measures is essential to comprehensively validate these findings.
Bow Hunter Phenomenon From Advanced Cerebrovascular Disease Treated With Subclavian Artery Stenting and Carotid Endarterectomy
Authors: Dong Henry W. , Ghahremani Jacob S. , Singh Rana S. Shamtej , Safran Brent A. , Lau David L. , Brewer Michael B. 
Published: September 2024

Bow Hunter syndrome (BHS) is a rare disorder characterized by mechanical occlusion of the vertebral artery (VA) during neck rotation, resulting in symptomatic, transient, and positional vertebrobasilar insufficiency. We describe a case of a 76-year-old female who presented with dizziness and right ear tinnitus triggered by right head rotation. Her symptoms would immediately resolve upon returning her head to the neutral position. CT angiogram showed 80% stenosis of the left subclavian artery origin, 50%–70% stenosis of the proximal right internal carotid artery (ICA), and near occlusive stenoses of the origins of the bilateral VAs. After failing conservative management, the patient was treated with left subclavian artery stenting, followed by a right carotid endarterectomy (CEA) 6 weeks later. Follow-up at 1 month showed resolution of paroxysmal symptoms and no neurological sequelae. To our knowledge, there have not yet been reported cases of patients with concurrent BHS, subclavian artery stenosis, and carotid artery stenosis. We suggest that global revascularization via subclavian artery stenting and CEA may be considered as treatment for patients with BHS complicated by other cerebrovascular disease secondary to stenoses of the ICA and subclavian artery. This approach obviates the need for more complex surgery or endovascular intervention of the VA.
Altered Corticospinal and Intracortical Excitability After Stroke: A Systematic Review With Meta-Analysis
Authors: Washabaugh Edward P. , Foley Sierra A. , Czopek Emily G. , Krishnan Chandramouli 
Published: September 2024

Background Intracortical inhibitory/faciliatory measures are affected after stroke; however, the evidence is conflicting. Objective This meta-analysis aimed to investigate the changes in motor threshold (MT), motor evoked potential (MEP), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF), and identify sources of study variability using a machine learning approach. Methods We identified studies that objectively evaluated corticospinal excitability and intracortical inhibition/facilitation after stroke using transcranial magnetic stimulation. Pooled within- (ie, affected hemisphere [ AH] vs unaffected hemisphere [ UH]) and between-subjects (ie, AH and UH vs Control) standardized mean differences were computed. Decision trees determined which factors accurately predicted studies that showed alterations in corticospinal excitability and intracortical inhibition/facilitation. Results A total of 35 studies (625 stroke patients and 328 healthy controls) were included. MT was significantly increased and MEP was significantly decreased (ie, reduced excitability) in the AH when compared with the UH and Control ( P < .01). SICI was increased (ie, reduced inhibition) for the AH when compared with the UH, and for the AH and UH when compared with Control ( P < .001). ICF was significantly increased (ie, increased facilitation) in the AH when compared with UH ( P = .016) and decreased in UH when compared with Control ( P < 0.001). Decision trees indicated that demographic and methodological factors accurately predicted (73%-86%) studies that showed alterations in corticospinal and intracortical excitability measures. Conclusions The findings indicate that stroke alters corticospinal and intracortical excitability measures. Alterations in SICI and ICF may reflect disinhibition of the motor cortex after stroke, which is contrary to the notion that stroke increases inhibition of the affected side.
Robot-Assisted Minimally Invasive Coronary Artery Bypass Grafting: Total Arterial Revascularization Using the Double-Docking Technique
Authors: Yusuf Meeranghani Mohammed , Bansal Varun , Venkatesh Ashwin , Chandrasekharan Ganapathy Arumugam , Vora Minal , Mahesh Kumar Aishwarya 
Published: September 2024

Objective: The right internal mammary artery is considered to be the second choice for arterial conduits for coronary artery bypass grafting (CABG). However, the widespread use of bilateral internal mammary artery (BIMA) grafting is limited owing to increased technical demands, lengthy procedure, and high incidence of sternal wound complications. We compared the early clinical outcomes of a novel robot-assisted double-docking technique (DDT) with an open sternotomy technique for total arterial revascularization using BIMA. Methods: Between June 2019 and June 2023, 445 patients with multivessel coronary artery disease underwent open sternotomy CABG using BIMA grafting and 145 patients underwent robot-assisted BIMA grafting using DDT. Comparative analysis of 104 pairs of matched patients obtained using propensity score matching was performed. Procedural characteristics, postoperative 30-day mortality, and composite outcome (major adverse cardiac and cerebrovascular events) at a median follow-up of 1.5 years were evaluated. Results: Preprocedural characteristics were well balanced between the groups after propensity matching. The number of distal anastomoses performed in the conventional group was statistically higher than that performed using DDT ( P < 0.001). The durations of postsurgical ventilation, intensive care unit stay, and in-hospital stay were significantly lower with the DDT than with conventional CABG ( P < 0.001). There was no significant difference in all-cause mortality or major adverse cardiac events between the DDT and conventional CABG groups at a median follow-up of 1.5 years. Conclusions: The DDT is feasible and efficacious for revascularization of multiple coronary targets in select individuals. It is equivalent to open sternotomy in terms of early clinical outcomes and superior to open sternotomy with regard to rates of sternal infection and intensive care unit and in-hospital stay.
Cost Analysis of Robot-Assisted Versus On-Pump and Off-Pump Coronary Artery Bypass Grafting: A Single-Center Surgical and 30-Day Outcomes Comparison
Authors: Gianoli Monica , de Jong Anne R. , van der Harst Pim , van der Kaaij Niels P. , Jacob Kirolos A. , Suyker Willem J. L. 
Published: September 2024

Objective: Throughout Europe, the interest in implementing robot-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB) has been growing. However, concerns about additional costs have emerged concurrently. In this analysis, we aim to provide a comparison of the cumulative perioperative costs of RA-MIDCAB, on-pump coronary artery bypass grafting (CABG), and off-pump CABG (OPCAB). Methods: We conducted a propensity score–matched analysis comparing patients undergoing RA-MIDCAB with those undergoing CABG or OPCAB at our institution from January 2016 to December 2021. After matching, we analyzed the combined intraoperative surgical costs and 30-day postoperative costs. We first compared RA-MIDCAB costs to CABG and then to OPCAB separately. Violin plots illustrated the cost distribution among individual patients. Total cost uncertainty was estimated using 1,000 bootstrapping iterations. Results: Seventy-nine RA-MIDCAB patients were matched to 158 CABG patients, and 80 RA-MIDCAB patients were matched to 149 OPCAB patients. Considering both surgical and clinical outcomes, RA-MIDCAB yielded an average cost of €17,121 per patient (€16,781 to €33,294), CABG was €16,571 per patient (€16,664 to €41,860), and OPCAB was €15,463 per patient (€10,895 to €57,867). After bootstrap iterations, RA-MIDCAB was found to be €472 (2.8%) and €1,599 (10.3%) more expensive per patient than CABG and OPCAB, respectively. Conclusions: In The Netherlands, the adoption of RA-MIDCAB did not show a significant economic impact on hospital resources. The additional robotic costs for the surgery were almost entirely offset by the cost savings during the postoperative hospital stay. However, these comparisons may differ when considering hybrid coronary revascularization with its additional percutaneous coronary intervention costs.
Lower Recurrence Rate After Surgical Treatment for Primary Spontaneous Pneumothorax Using a Digital Chest Drainage System
Authors: Yu Peter Sze-Yuen , Chan Kin Wai , Lim Kevin , Siu Ivan Chi Hin , Wong Randolph Hung Leung , Wan Innes Yuk Pui 
Published: September 2024

Objective: This study assessed the impact of digital chest drainage systems for patients undergoing video-assisted thoracoscopic surgery (VATS) pleurodesis for primary spontaneous pneumothorax (PSP) as compared with conventional chest drainage. Methods: A retrospective analysis of patients who underwent VATS pleurodesis for PSP was conducted. The primary outcome was pneumothorax recurrence, while secondary outcomes included time to mobilization, degree of lung expansion, drainage duration, and length of hospital stay. These measures were expressed as average treatment effect and subsequently compared after propensity score adjustment. Results: In total, 125 consecutive patients over a 64-month period were analyzed, with 55 patients in the digital drainage system group and 70 patients in the conventional drainage system group. After propensity score adjustment, the use of a digital drainage system was significantly associated with earlier mobilization (−2.22 days, P < 0.001) and lower rate of recurrence (−11.2%, P = 0.049). Conclusions: The digital drainage system facilitated earlier postoperative free mobilization and resulted in lower pneumothorax recurrence rates.
The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy
Authors: Elawady Sameh Samir , Kasem Rahim Abo , Matsukawa Hidetoshi , Cunningham Conor , Sowlat Mohamed Mahdi , Nawabi Noah Lee , Orscelik Atakan , Venegas Joshua M , Isidor Julio , Loulida Hasna , Maier Ilko , Jabbour Pascal , Kim Joon-Tae , Wolfe Stacey Quintero , Rai Ansaar , Starke Robert M , Psychogios Marios-Nikos , Samaniego Edgar A , Goyal Nitin , Yoshimura Shinichi , Cuellar Hugo , Howard Brian , Alawieh Ali , Alaraj Ali , Ezzeldin Mohamad , Romano Daniele G , Tanweer Omar , Mascitelli Justin , Fragata Isabel , Polifka Adam , Siddiqui Fazeel , Osbun Joshua , Grandhi Ramesh , Crosa Roberto , Matouk Charles , Park Min S , Levitt Michael R , Brinjikji Waleed , Moss Mark , Daglioglu Ergun , Williamson Richard , Navia Pedro , Kan Peter , De Leacy Reade , Chowdhry Shakeel , Altschul David J , Spiotta Alejandro M , Al Kasab Sami 
Published: September 2024

Background The benefit of intravenous thrombolysis (IVT) is well established. We aim to study the benefits of IVT in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) who underwent unsuccessful mechanical thrombectomy (MT). Methods We included AIS patients who underwent MT for anterior circulation LVO with failed recanalization (modified treatment in cerebral ischemia [mTICI] score ≤ 2A). Patients who received IVT prior to MT were compared to those who received MT alone. Propensity score matching using demographic, clinical, radiographic and procedural variables was used to match patients with and without IVT. The primary outcome was favorable 90-day good functional outcome (defined as modified Rankin scale of 0–2), and secondary outcomes included intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality. Results Totally, 610 AIS patients with unsuccessful MT were included. After propensity matching, 219 patients were identified in each group. Median age was 70 years and 73 years in the IVT + MT and MT alone groups, respectively. In the IVT + MT group, final mTICI scores of 0, 1, and 2A were achieved in 92 (42.0%), 33 (15.1%), and 94 (42.9%) patients, respectively, versus 76 (34.7%), 29 (13.2%), and 114 (52.1%) in the MT alone group. The IVT + MT group had greater odds of 90-day good functional outcome (adjusted odds ratio 2.54, 95% confidence interval 1.53–4.32). There were no significant differences in secondary outcomes. Conclusions IVT is associated with improved functional outcomes in AIS patients with LVO despite unsuccessful MT.
Perfecting the pour: A novel co-axial technique with sequential injections for optimising cement delivery during sacroplasty
Authors: Nasralla Mehran , Alfalahi Afra , Hendriks Eef J , Murphy Kieran , Smith Roger 
Published: September 2024

Background Percutaneous sacroplasty is an effective treatment for painful sacral fractures and tumours, however there is no accepted optimal technique for performing this procedure. This study investigated a novel approach to sacroplasty combining co-axial sacral access, sequential cement injections and hypothermic cement manipulation to improve cement delivery. Methods This retrospective study analysed 11 patients who underwent co-axial sacroplasty between April 2023 and March 2024 for treatment of painful insufficiency fractures ( n = 5) or malignant sacral tumours ( n = 6). All cases were performed using biplane fluoroscopy with conebeam CT navigation for planning and monitoring percutaneous access. Procedural details, technical outcomes, and clinical outcomes including Numerical Rating Scale (NRS) pain and analgesic utilisation on a six-point scale were analysed pre-procedure and at follow-up. Results Technical success of was achieved in all cases using this technique. The mean injected cement volume was 20.5 ± 6.4 ml. Median pre-procedural NRS pain scores of 8 (IQR 7.25–8) significantly decreased to 0 (IQR, 0–0.25) at follow-up ( p <.01). The median preprocedural analgesic utilisation score reduced from 3 (IQR, 2–3) to 0 (IQR, 0–2.5) at follow-up ( p <.01). Cement leakage occurred during two cases without associated adverse clinical sequelae. There were no major adverse events. Conclusion Co-axial sequential injection sacroplasty is a safe and effective technique which allows facilitates controlled delivery of cement. Improved control of cement delivery, including around high-risk structures for cement leakage, offers a potential safety advantage over conventional sacroplasty techniques. Further research comparing technical and clinical outcomes to conventional techniques is warranted.