bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teachers’ experiences with physically inactive children and their strategies to promote physical activity in early childhood education settings
Authors: Augustsson Christian , Högman Johan , Löfdahl Hultman Annica 
Published: September 2024

Objective: As an increasing number of children are identified as insufficiently physically active, the school environment has been targeted for efforts to promote physical activity (PA) among inactive children. While research has highlighted teachers’ role in promoting generic school-based daily PA, less is known about the early childhood education teachers’ experiences of physically inactive children and the strategies they use to promote PA. This study’s aim was to explore early childhood education teachers in Sweden’s experiences of physically inactive children and their strategies to promote PA among members of this group in their everyday school settings. Design: Qualitative interview study. Setting: Four small municipalities in Midwest Sweden. Method: Ten teachers working in early childhood education settings participated in individual semi-structured interviews. Data were analysed with a focus on teacher agency and the social, material and cultural resources teachers used to promote PA. Result: Findings indicated that teachers shoulder the worry and unarticulated responsibility for inactive children. This resulted in their use of strategies that varied and which were largely subjective in character. At the same time, teachers expressed how their agency was limited by insufficient resources. Conclusion: Teachers used social, material and cultural resources to promote PA, but their strategies were not informed by evidence or formal guidelines. None of the resources they used were specifically designed for inactive children. Instead, teachers used general resources which they adapted to inactive children’s interests and needs.
Advances in Psychiatry Training and Faculty Development in India
Authors: Narasimha Venkata Lakshmi , Suhas Satish , M Kishor  , Dixit Advait , Murthy Pratima 
Published: September 2024

Background: This review examines the historical developments, current state of training, existing challenges, and opportunities for undergraduate, postgraduate, and super specialty psychiatry education in India. Methods: For this narrative review, we examined information from the published literature, along with key documents from the Indian Psychiatric Society, the National Medical Commission, and other relevant sources. Conclusions: In India, psychiatry training has seen significant advancements since independence, particularly in the past decade, driven by the recommendations of the Indian Psychiatric Society and the introduction of competency-based medical education by the National Medical Commission. This transformation has redefined undergraduate and postgraduate training across all medical disciplines, including psychiatry. The shift has moved away from traditional, time-bound frameworks toward a focus on acquiring specific competencies essential for effective clinical practice. This approach ensures that trainees gain theoretical knowledge and develop practical skills and professional attitudes crucial for patient care. However, a major challenge highlighted in this review is the transition of senior residents to faculty roles without adequate training in teaching, research, academia, and leadership. Despite this, they are expected to excel in these areas upon assuming faculty positions. To address this gap, we emphasize the urgent need for a comprehensive faculty development program for early career faculty. Our proposed initiative aims to bridge these gaps and support the development of future leaders and educators in psychiatry. The recommendations outlined in this review seek to create a robust educational environment that will cultivate the next generation of psychiatrists in India.
Association between lifetime hallucinogen use and psychological distress varies by sexual identity in a nationally representative sample
Authors: Altman Blair , Magnus Manya 
Published: September 2024

Background: Clinical trials demonstrate that psychedelic-assisted therapy can improve mental health outcomes; however, few studies have recruited sexually diverse samples or reported information on sexual identity. Aims: The purpose of this analysis was to examine the relationship between hallucinogen use and mental health outcomes with respect to sexual identity. Methods: We conducted a cross-sectional analysis using data from the 2021 National Survey on Drug Use and Health to examine the relationship between hallucinogen use and psychological distress. Results: In a sample representative of 253,824,662 U.S. adults, the majority was heterosexual (92%), aged 50–64 (25%), women (51%), non-Hispanic White (62%), college educated (31%), and had an annual household income of $75,000 or higher (39%). The majority reported no lifetime hallucinogen use (82%) and no past month severe psychological distress (93%). Sexual identity modified the relationship between hallucinogen use and psychological distress. After stratifying by sexual identity and adjusting for covariates, hallucinogen use was associated with reduced odds of psychological distress in the heterosexual population (OR = 0.76, 95% CI: 0.59, 0.96) but the relationship was not significant in the sexual minority population. Conclusion: We found that in a nationally representative sample, psychedelic use was associated with reduced odds of psychological distress in heterosexual individuals only. Future research should investigate why hallucinogen use was not protective in sexual minority groups given their disproportionate burden of poor mental health outcomes.
Endovascular Grafting in Patients with Short Proximal Necks: An Analysis of Short-Term Results
Authors: Greenberg R. , Fairmman R. , Srivastava S. , Criado F. , Green R. 
Published: September 2024

Objectives: To evaluate the safety of endovascular graft placement in patients with short proximal aneurysm necks, and assess factors contributing to endoleak formation. Methods: 55 patients were enrolled over a two year period from five centers following the placement of a Talent® endograft with a suprarenal stent. Preoperative and 30-day post-implant CT scans were retrospectively analyzed in a blinded fashion by two physicians. Aortic measurements were obtained, the amount of thrombus was subjectively graded, and any extravasation of contrast into the aneurysm sac defined an endoleak. The data were analyzed using a t-test. Analyses compared patients with proximal necks < 10 mm (SN), n = 13) to those with longer necks (LN. n = 42), and then contrasted patients with endoleaks ( n = 12), to those without ( n = 43). Results: Endoleak rates were identical in the SN and LN groups (21 and 23%). Maximal aneurysm size was larger in the SN group (63 vs 56 mm, P < 0.05). Endoleaks were more frequently noted in larger aneurysms ( P < 0.05), but not related to SN ( P = 0.6). There was no correlation between endoleaks and the amount of thrombus, aneurysm length, proximal neck diameter or other morphologic characteristics. One of 12 endoleaks resulted from a problem with proximal fixation, nine were due to perfusing vessels, and two were undefined. The proximal neck diameter increased (0.9 mm) over the 30 days ( P < 0.005). Conclusions: Short-term proximal fixation can be achieved in proximal necks measuring less than 10 mm. The narrow margin of acceptable seal mandates careful follow-up. Larger aneurysms were associated with an increased incidence of endoleaks. SNs were associated with larger aneurysms, but not with an increased incidence of endoleaks. Proximal neck dilation was noted, but likely relates to the placement of an oversized endograft during this brief period of observation.
Long-Term Relative Survival following Surgery for Abdominal Aortic Aneurysm: A Review
Authors: Norman Paul E. , Semmens James B. , Lawrence-Brown Michael M.D. 
Published: September 2024

Background The literature reporting the long-term survival following surgery for abdominal aortic aneurysm (AAA) tends to be confusing. As a result, many clinicians looking after patients with AAA may be uncertain about the five-year survival of a given patient. This is in marked contrast to the situation for patients with malignant disease. With the current interest in population screening and endoluminal stenting for AAA, an understanding of long-term survival is increasingly important. Methods Thirty two publications in the English language over the last 20 years, containing data pertaining to five-year survival following routine elective surgery for AAA in unselected patients, were identified using Medline searches. Results and conclusions A range of important methodological differences were noted. The mean five-year crude survival was about 70% while the expected survival of a matched population was close to 80%. Survival was further reduced by about 10% in cases with significant coronary heart disease. Age alone is not a predictor of long-term relative survival with octogenarians who survive beyond 30 days surviving longer than an age-matched population.
Endovascular Treatment of type B Aortic Dissections
Authors: Lundbom J. , Wesche J. , Hatlinghus S. , Ødegaard A. , Aadahl P. , Tromsdal A. , Karevold A. , Kaspersen J.H. , Myhre H. O. 
Published: September 2024

The purpose is to describe our experience with endovascular treatment of type B aortic dissections. Five patients were treated for complications following type B dissections like, false channel aneurysm formation, rupture and arterial obstruction. They were treated in general anaesthesia using a ‘homemade’ endoprosthesis or a commercially available endoprosthesis (Excluder®) deployed during fluoroscopy. The patients have been followed at regular intervals with a median observation time of 18 months (range 12–36). One patient needed a secondary intervention due to dislodgement of the proximal stentgraft with haemorrhage into both the false and the true lumen. Otherwise there have been no early or late mortality or major complications in this series. Even if our experience with endovascular treatment of type B dissections is rather limited, the results so far are promising. Open surgery in many of these cases is complicated with high morbidity and mortality rate and the endovascular technique offers great advantages. A longer follow-up period is necessary to define the place of endovascular treatment.
CD40 Co-Stimulatory Molecule Expression by Dendritic Cells in Primary Atherosclerotic Lesions in Carotid Arteries and in Stenotic Saphenous Vein Coronary Artery Grafts
Authors: Ozmen J. , Bobryshev Y.V. , Lord R.S.A. 
Published: September 2024

We have previously identified dendritic cells in the intima of human large arteries and stenotic vein coronary bypass grafts. The mechanisms by which these dendritic cells might regulate immune responses in atherosclerotic lesions and stenotic vein grafts are unknown. The aim of the present study was to investigate whether dendritic cells in carotid plaques and in stenotic aortocoronary vein grafts express an immunoregulatory molecule CD40. Segments of wall from eight carotid arteries and three stenotic aortocoronary saphenous vein grafts were obtained at operation. CD40+ cells were detected in all specimens of both occluded and stenotic grafts and carotid plaques. Although CD40+ cells of various cell types were intermingled in most areas within the plaques and stenotic grafts, there were sites where CD40+ cells were located in small groups. Consecutive sections demonstrated that a small population of CD40+ cells stained positively for S100. These CD40+/S100+ cells were clustered within the intima but were also found in the media and adventitia. This suggests that dendritic cells, which accumulate within vessels affected by atherosclerosis and graft disease, express CD40 co-stimulatory molecule. The expression of CD40 molecule on the dendritic cells may be important in regulating T cell responses within atherosclerotic plaques and stenotic vein grafts.
Effect of Radial Artery Harvesting on Tissue Perfusion and Function of the Hand
Authors: Sadaba J. Rafael , Conroy Jonathan L. , Burniston Maria , Maughan Janice , Munsch Christopher 
Published: September 2024

This study was designed to measure the degree to which hand and forearm blood flow is reduced following harvesting of the radial artery in myocardial revascularization surgery and determine whether there is an effect on hand function. Twenty patients who had the radial artery used for myocardial revascularization underwent bilateral blood flow assessment of hands and forearms using Technetium-99m human serum albumin and clinical evaluation of hand function. Mean tissue perfusion in ml/100 ml/min ±SD was as follows: donor hand 21.9±5.6, non-donor hand 25.5±6.1 ( P = 0.00043), donor arm (hand and forearm) 17.5±3.7 and non-donor arm (hand and forearm) 21 ±5.1 ( P = 0.000681). No clinical evidence of hand claudication was detected. This study suggests that removal of the radial artery reduces the tissue perfusion of the hand and forearm but does not affect hand function in the short term. The use of radial artery grafts in patients at risk of developing peripheral vascular disease should be carefully considered
Effective Surgical Management of High-Risk Coronary Patients Using Preoperative Intra-Aortic Balloon Counterpulsation Therapy
Authors: Christenson J. T. , Schmuziger M. , Simonet F. 
Published: September 2024

The proportion of high-risk coronary patients submitted to surgical myocardial revascularization (CABG) is steadily increasing. High-risk patients utilize more hospital resources and have a higher procedural cost than low—moderate risk CABG patients. An efficient management is essential to improve outcome and reduce costs. This report entails three study periods. In an initial retrospective study coronary high-risk criteria were established. At least two of the following factors were required: redo CABG, unstable angina, left main stem stenosis greater than 70%, preoperative left ventricular ejection fraction <0.30 and diffuse coronary artery disease. Poor preoperative cardiac performance was the major contributing factor for poor outcome. Intra-aortic balloon counterpulsation therapy (IABP) was introduced as preoperative therapy. During a second study period prospective randomized studies found preoperative IABP-therapy efficient, significantly improving both preoperative cardiac index ( P<0.0001), decreasing postoperative mortality ( P<0.0001) and morbidity, shorten intensive care unit stay as well as total hospital stay ( P<0.0001). Drug consumption was significantly reduced ( P<0.0001). Optimal timing was found to be 2 h prior to aortic cross-clamping and the therapy was found highly cost-beneficial with an average 36% reduction of the total procedural cost. During a third study period, well beyond any study protocol period, preoperative IABP therapy was again found highly effective with a close to 100% utilization rate in high-risk patients and continuous efficacy with excellent outcome, despite acceptance of sicker patients. During this post-study evaluation period 1/3 of the high-risk patients presented with 4 of the established risk factors. The use of preoperative IABP therapy is therefore highly recommended for high-risk coronary patients undergoing CABG.
The Hemashield Woven® Prosthesis in the Thoracic Aorta: A Prospective Computer Tomography Follow-Up Study
Authors: Vermeulen F. , Schepens M. , de Valois J. , Wijers L. , Kelder J. 
Published: September 2024

Background. Dacron prostheses in humans have been documented to present long-term fiber alterations, that may account for late graft dilatation. Late dilatation has been documented mainly in knitted prostheses, implanted in the abdominal and thoracic aorta. Dilatation of the collagen-impregnated Hemashield Woven® prosthesis has not been studied prospectively in the thoracic aorta. Methods. Twenty patients were prospectively included. The intraoperative performance of the graft and mid-term clinical behaviour were studied. The graft distensibility was evaluated by postoperative, 1 and 3 yr computed tomographic diameter follow-up. Results. There were no hospital deaths. Two graft-unrelated deaths occurred at 3 yr. The graft performance was excellent or good for most aspects. No significant changes in CT diameter occurred throughout the 3 yr follow-up. Conclusion. The collagen-impregnated Hemashield Woven® prosthesis is considered safe in replacements of the thoracic aorta. Future evaluation should focus on the very long-term behaviour in young adults.
Effect of α-Tocopherol, Taurine and Selenium on the Attenuation of Ischemia/Reperfusion Injury of Splanchnic Organs
Authors: Yoshida W. B. , Alasio T. , Mazziotta R. , Qin F. , Kashani M. , Lee S. , Dardik H. 
Published: September 2024

Background: Splanchnic artery occlusion shock is caused by increased capillary permeability and cellular injury precipitated by oxygen derived free radicals following ischemia and reperfusion of splanchnic organs. The purpose of this study was to assess the role of several well-known oxygen-derived free radical scavengers in ameliorating or preventing this syndrome. Study design: Anesthetized rats were subjected to periods of occlusion of the visceral arteries and reperfusion. Tocopherol, taurine, selenium or a ‘cocktail’ of these three agents was injected subcutaneously for 4 consecutive days prior to operation. Mean arterial blood pressure was measured throughout the experimental period. Fluorometry and technetium-99m pyrophosphate counting of the visceral organs were performed as well as a histologic grading system for intestinal viability. Results: Final mean arterial blood pressure associated with the ‘cocktail’ and selenium groups was 79.1 ± 27.4 mmHg and 83.6 ± 17.8 mmHg, respectively. These values were significantly higher than the control group, 40.8 ± 11.4 mmHg ( P < 0.05). Similar patterns of the benefit of selenium in contrast with the other groups were obtained with fluorescein perfusion, radioisotopic activity and histologic analysis. Conclusion: Pretreatment with selenium of splanchnic ischemia and reperfusion in the rat improves mean arterial blood pressure and microcirculatory visceral perfusion. Further analysis of the precise protective mechanism of selenium for reperfusion injury will enable visceral organs to withstand the consequences of increased capillary leakage and oxidant injury.
Bilateral Internal Carotid Artery Occlusion: Natural History and Surgical Alternatives
Authors: AbuRahma A. F. , Copeland S. E. 
Published: September 2024

Purpose and background: Bilateral internal carotid artery occlusion is an extremely rare entity, therefore, studies of the natural history of this disease are lacking in the English literature. The purpose of this study is to analyze the natural history and surgical alternatives for patients with bilateral internal carotid artery occlusion. Patient population and methods: Twenty-one patients with bilateral internal carotid artery occlusion were encountered with a mean age of 61 years (range of 48–73 years). Their clinical presentations included eight with hemispheric transient ischemic attacks, three with amaurosis fugax, five with strokes and five with non-hemispheric transient ischemic attack. Diagnosis was confirmed using carotid duplex ultrasound and angiography. The majority of patients had more than one risk factor for atherosclerosis: smoking in 100%. hyperlipidemia in 14/21 (67%), hypertension in 17/21 (81%), coronary artery disease in 15/21 (71%) and diabetes mellitus in 7/21 (33%). In addition to the usual medical treatment, 13 patients underwent surgical intervention: eight had an external carotid endarterectomy, four had a carotid—subclavian bypass (to increase external carotid or vertebral flow for tight stenosis or occlusion of the common carotid or subclavian artery) and one patient had an ascending aorta to innominate artery bypass. At a mean follow-up of 6 years (range 1–11 years), the overall mortality rates were 11/21 (52%). in the surgical group it was 5/13 (38%) and 6/8 (75%) in the medical group. The causes of death included seven myocardial infarctions (four in the surgical group and three in the medical group) and four strokes (one in the surgical group and three in the medical group). In the surgical group, 2/13 (15%) had late neurological deficits (one hemispheric transient ischemic attack and one stroke), in contrast to 6/8 (75%. three strokes and three hemispheric transient ischemic attacks) in the medical group. Conclusions: Bilateral internal carotid artery occlusions have grave prognoses and should be considered a marker for severe systemic disease. Various cerebrovascular reconstructive procedures, if feasible, may be beneficial for some of these patients.
Effects of Slow Breathing Exercises on Cardiac Autonomic Functions in Anxiety Disorder—A Randomised Control Trial
Authors: Kavitha Natarajan , Pal Pravati , Pal Gopal Krushna , Bharadwaj Balaji , Nanda Nivedita 
Published: September 2024

Background Anxiety disorders are commonly associated with a higher risk of fatal cardiovascular diseases (CVD). Anxiety disorders lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, thus weakening the key neuronal components of the autonomic nervous system (ANS) that are involved in cardiovascular functions, leading to increased cardiovascular risk. Purpose Impaired ANS activity, as reduced parasympathetic tone is strongly associated with an increased risk of CVD in anxiety disorders. Slow pranayama influences the ANS by activating the parasympathetic tone and deactivating the sympathetic tone in healthy volunteers and various diseased conditions. Therefore, we aimed to study the effects of slow pranayama and savasana on cardiac autonomic function tests in anxiety disorder patients. Methods Anxiety disorder patients (N = 140) of either sex between the age group 18 and 40 years attending the psychiatry outpatient department (OPD) in JIPMER were recruited for the study and were randomly assigned into the pranayama group and control group. The Pranayama group practised slow pranayama and savasana for 8 weeks along with routine psychiatric care, while the control group continued with routine psychiatric care only. Outcome measures were heart rate variability (HRV), baroreflex sensitivity (BRS), 30:15 ratio during lying to standing, E: I ratio during deep breathing, and ∇DBP during isometric handgrip, which were assessed before and after the intervention period. Results After 8 weeks in the Pranayama group, the HRV parameters showed significant improvement towards the parasympathetic domain. Also, there was a significant increase in parasympathetic reactivity with a decrease in sympathetic reactivity and significant improvement in BRS. Conclusion Slow pranayama and savasana practice in anxiety disorder patients as an adjunct to routine psychiatric care effectively improves cardiac autonomic function with a shift towards parasympathetic predominance, with significant improvements in cardiovascular parameters. Slow pranayamas with savasana may be incorporated into the routine care of these patients to enhance their cardiovascular health.