bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological Complications of the Lower Extremities After Femoral Cannulated Extracorporeal Membrane Oxygenation: A Systematic Review
Authors: Johannes Frauke , Frohofer-Vollenweider Rahel , Teuschl Yvonne 
Published: November 2023

Background Femoral cannulated extracorporeal membrane oxygenation (ECMO) has been associated with neurologic complications in the lower extremity ipsilateral to the cannulation. There is uncertainty about the prevalence of these complications and their mechanisms of development. Objective Aim of this systematic review was to investigate the prevalence of neurological complications after ECMO and to describe possible underlying mechanisms. Method A systematic literature search was performed in Medline-Ovid, Embase, Cochrane Library, CINAHL, and PEDro until April 2021 for clinical trials in English or German language which quantified neurologic complications in the lower extremity ipsilateral to the ECMO cannulation of adults. The complications had to be delimitable to intensive care unit–acquired weakness. Methodological quality was assessed by 2 independent investigators using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. Results Eight observational studies were included in the synthesis. Study quality was good to fair in 88% of the papers. Overall, 47 of 202 patients (23.3%; ranging from 3% to 48% across studies) with femoral ECMO cannulation showed neurologic complications of the lower extremity ipsilateral to the cannulation. Peripheral ischemia and compression of nerves by the ECMO cannula are discussed as mechanisms of injury. Conclusion The occurrence of neurological complications after ECMO was common and can lead to long-term impairment. The mechanisms are largely unknown but currently there is no sufficient evidence for the involvement of ECMO. Standardized assessments are needed to systematically screen for neurological complications early after ECMO, to enable countermeasures and prevent further complications.
StigmaBeat: Collaborating With Rural Young People to Co-Design Films Aimed at Reducing Mental Health Stigma
Authors: Hine Rochelle , Gladstone Brenda , Reupert Andrea , O’Dea Lotti , Cuff Rose , Yates Scott , Silvén Hagström Anneli , McGaw Violette , Foster Kim 
Published: November 2023

Little is known about the experience and impact of intersectional stigma experienced by rural young people (15–25 years) who have a parent with mental health challenges. The StigmaBeat project employed a co-design approach to create short films to identify and challenge mental health stigma from the perspective of young people who have experienced this phenomenon. The aim of this paper is to describe the co-design methodological approach used in StigmaBeat, as an example of a novel participatory project. We describe one way that co-design can be employed by researchers in collaboration with marginalised young people to produce films aimed at reducing mental health stigma in the community. Through describing the processes undertaken in this project, the opportunities, challenges, and tensions of combining community development methods with research methods will be explored. Co-design with young people is a dynamic and engaging method of collaborative research practice capable of harnessing lived experience expertise to intervene in social issues and redesign or redevelop health services and policies. The participatory approach involved trusting and implementing the suggestions of young people in designing and developing the films and involved creating the physical and social environment to enable this, including embedding creativity, a critical element to the project’s methodological success. Intensive time and resource investment are needed to engage a population that is often marginalised in relation to stigma discourse.
Aggressive End-of-Life Treatments Among Inpatients With Cancer and Non-cancer Diseases Using a Japanese National Claims Database
Authors: Togashi Shintaro , Masukawa Kento , Aoyama Maho , Sato Kazuki , Miyashita Mitsunori 
Published: November 2023

To describe aggressive treatments at end‐of‐life among inpatients with cancer and non-cancer diseases and to evaluate factors associated with these treatments using the Japanese national database (NDB). We conducted a retrospective cohort study among inpatients aged ≥ 20 years who died between 2012 and 2015 using a sampling dataset of NDB. The outcome was the proportion of aggressive treatments in the last 14 days of life. We considered the underlying causes of death as cancer, dementia/senility, and heart, cerebrovascular, renal, liver, respiratory, and neurodegenerative diseases. We analyzed 54,105 inpatients, with underlying cause of death distributed as follows: cancer, 24.9%; heart disease, 16.5%; respiratory disease, 12.3%; and cerebrovascular disease, 9.7%. The proportion of intensive care unit (ICU) admission was 9.7%, being the highest in heart disease (20.5%), followed by cerebrovascular diseases (12.6%), and least in dementia/senility (.6%). The proportion of cardiopulmonary resuscitation was 19.6%, being the highest in heart disease (38.1%), followed by renal diseases (19.5%), and least in cancer (6.2%). Multivariate logistic regression analysis revealed that having heart diseases, cerebrovascular diseases, younger age, less comorbidities, and shorter length of stay were associated with an increasing risk of aggressive treatments in the last 14 days of life. The proportion of aggressive treatments at the end-of-life varies depending on the disease; additionally, these treatments were associated with having heart diseases, younger age, less comorbidity, and shorter length of stay. Our findings may help develop and set benchmarks for quality indicators at the end‐of‐life for patients with non-cancer diseases.
Detection of Inflammatory Biomarker suPAR in COVID-19 Disease With CHORUS TRIO Instrument
Authors: Helena Cerutti , Giulia Tesi , Alessandra Cartocci , Roberto Guerranti , Caterina Silvestrini , Sabrina Gori , Simone Bianciardi , Tommaso Bandini , Alessandra Brogi , Roberto Leoncini 
Published: November 2023

Background: Deregulation in the urokinase-type plasminogen activator receptor (uPA/uPAR) system is reported in many diseases where the immune system is activated. During SARS-CoV-2 infection, a rise in soluble uPAR (suPAR) levels has been detected and its concentration above 6 µg/L predicts worsening to severe respiratory failure 14 days earlier, with a positive predictive value of 85.9%, and was the prerequisite for a treatment with anakinra, a recombinant IL-1 receptor antagonist that blocks the activity of both IL-1α and IL-1β. Objectives: To compare suPAR concentrations measured by CHORUS suPAR on CHORUS TRIO instrument of DIESSE with the commercially available suPARnostic (ViroGates) ELISA assay. Design: A single-centre, non-pharmacological, diagnostic study was performed. Results: A total of 522 serum samples from patients with COVID-19 were tested for suPAR. CHORUS suPAR resulted accurate and reliable, with a high grade of specificity (97.9%), accuracy (97.3%) and sensitivity (96.9%). The median concentration of suPAR, as determined with CHORUS suPAR, was 6.8 µg/L (interquartile range 4.5-9.7) in patients with moderate disease (n = 465) and 8.5 µg/L (interquartile range 5.4-10.6) in patients with severe disease. Among patients with moderate and severe disease, 60.6% and 71.9%, respectively, reached the cut-off concentration of suPAR ⩾6 µg/L, defining their illness severity and suggesting eligibility to anakinra treatment. Conclusion: CHORUS suPAR kit resulted as sensitive, specific, accurate and able to quantify suPAR concentrations in patients with moderate and severe COVID-19.
Assessing the Knowledge and Awareness Among Selected Tertiary Students in the Accra Metropolis on Zoonotic Infections
Authors: Barimah Antwi Joseph , Ofosua Tweneboah Yvonne , Addo Henry Ofosu , Agbomadzi Samuella Klenam , David Adom-Brobbey , Agyei Stephen Boakye , Eric Anin Amoateng 
Published: November 2023

Background: Zoonotic infections are a serious threat to human health and a direct risk that could potentially be fatal. Animals both domestic and wild serve as reservoirs for zoonotic infections. Thus, frequent contact with animals might occasionally result in the transfer of infections from animals to people. Ghana is especially susceptible to the effects of zoonotic infections due to the increase in the household human-animal ratio. This study assessed the awareness and knowledge level of tertiary students in a selected tertiary institution on zoonotic infections. Methods: A quantitative research method was employed making use of a descriptive cross-sectional study design. The target population chosen for the research was mainly students from the University of Ghana. A stratified sampling technique was used in selecting participants for the study. 440 participants were selected for the study. The university’s four primary colleges served as the strata for the basis of data collection. Results: The study revealed a moderate knowledge level among students. The term “zoonoses” was understood by the majority (70%) of the respondents. Respondents knew at least one route of transmission of zoonotic infection. For the spread of zoonotic infections, close contact with infected animals and consumption of contaminated food were seen as ways of spread by a majority. Conclusion: Although the basic strategies required for the control and elimination of the zoonotic diseases in such tertiary institutions are well known and practiced as per the study findings, zoonoses still persists and this can be attributed to low education on the subject. Knowledge and awareness level on zoonoses especially in tertiary institutions such as the University of Ghana could be improved if relevant authorities create adequate enlightenment programs on improving the knowledge of zoonotic diseases through a variety of media including seminars, workshop, television, radio, newspaper and social media.
Thermomechanical devulcanization of butyl rubber using twin-screw extruder: Process parameters, viscoelastic and compatibility properties
Authors: Parsamanesh Maryam , Abbassi-Sourki Foroud , Karrabi Mohammad , Soltani Sedigheh 
Published: November 2023

Thermomechanical devulcanization of butyl rubber (BR1), bromobutyl rubber (BR2) vulcanizates, both prepared in laboratory, and a waste commercial butyl rubber (BR3) using a twin-screw extruder is reported. The commercial butyl rubber vulcanizate (BR3) was used as a tire curing bladder and the waste rubber received from a tire manufacturing company. The devulcanization process was carried out at various barrel temperatures and screw speeds (40, 80 and 120 r/min). The lowest sol fraction was obtained for devulcanized waste commercial butyl rubber (D-BR3). According to Horikx theory, devulcanized butyl rubber (D-BR1) presented mainly crosslink breakup while devulcanized bromobutyl rubber (D-BR2) and devulcanized waste commercial butyl rubber (D-BR3) showed a mixture of main chain and crosslink scission. As cure rheographs at 190°C indicated, the addition of devulcanized rubbers to the corresponding virgin ones influenced both scorch and optimal cure times. The tensile properties of devulcanized/virgin rubber blends changed depending on the blend type and virgin rubber. The stress relaxation experiment revealed that the addition of devulcanized rubber to virgin one mostly influenced short relaxation times and also decreased G0. BR1/D-BR3 blends exhibited higher elastic component than BR1/D-BR1 and BR2/D-BR2 samples. The Han plots revealed higher compatibility for BR2/D-BR2 blends.
Utilisation of the Scepter Mini dual-lumen balloon – An illustrative series
Authors: O’Reilly Sean Thomas , Hendriks Eef Jacobus , Itsekson Ze’ev , Alshahrani Rabab , Chung Emily , Radovanovic Ivan , Agid Ronit , Nicholson Patrick , Krings Timo 
Published: November 2023

Background Dual-lumen balloon microcatheters can aid in the safety and efficacy of endovascular embolisation of cerebrospinal vascular malformations. The Scepter Mini dual-lumen balloon is a novel device with a smaller profile than previous balloon microcatheters, opening up new indications not only in the treatment of cerebrospinal malformations but in various other neurovascular therapeutic and diagnostic scenarios. Methods Following institutional ethics review board approval, a retrospective review of our prospectively maintained database of cases employing the Scepter Mini dual-lumen microballoon catheter was conducted. Five cases in particular were highlighted, demonstrating utilisation of this device, which may be of interest to the Neurointerventionalist. Patient demographics, procedure details, complications and clinical outcome data were reviewed. Results Five cases employing the Scepter Mini dual-lumen microballoon catheter are presented; trans-arterial embolisation of cerebral AVM, pre-operative tumour embolisation, diagnostic angiography, trans-venous embolisation of cerebral AVM and trans-arterial embolisation of DAVF. No intraprocedural complications were recorded, one patient had a delayed haemorrhage. Conclusion Potential utilisation of the Scepter Mini lies not only in the trans-arterial embolisation of cerebrospinal vascular malformations, but in a range of other diagnostic and therapeutic indications as demonstrated.
Characterization of the Age-Related Differences in Porcine Acetabulum and Femoral Head Articular Cartilage
Authors: Fackler Nathan P. , Donahue Ryan P. , Bielajew Benjamin J. , Amirhekmat Arya , Hu Jerry C. , Athanasiou Kyriacos A. , Wang Dean 
Published: November 2023

Objective The use of porcine animal models for cartilage injury has increased recently due to their similarity with humans with regard to cartilage thickness, limited intrinsic healing of chondral defects, and joint loading biomechanics. However, variations in the mechanical and biochemical properties of porcine hip articular cartilage among various tissue ages and weightbearing (WB) regions are still unknown. This study’s aim was to characterize the mechanical and biochemical properties of porcine hip articular cartilage across various ages and WB regions. Methods Articular cartilage explants were harvested from WB and non-weightbearing (NWB) surfaces of the femoral head and acetabulum of domesticated pigs ( Sus scrofa domesticus) at fetal (gestational age: 80 days), juvenile (6 months), and adult (2 years) ages. Explants underwent compressive stress-relaxation mechanical testing, biochemical analysis for total collagen and glycosaminoglycan (GAG) content, and histological staining. Results Juvenile animals consistently had the highest mechanical properties, with 2.2- to 7.6-time increases in relaxation modulus, 1.3- to 2.3-time increases in instantaneous modulus, and 4.1- to 14.2-time increases in viscosity compared with fetal cartilage. Mechanical properties did not significantly differ between the WB and NWB regions. Collagen content was highest in the NWB regions of the juvenile acetabulum (65.3%/dry weight [DW]) and femoral head (75.4%/DW) cartilages. GAG content was highest in the WB region of the juvenile acetabulum (23.7%/DW) and the WB region of the fetal femoral head (27.5%/DW) cartilages. Histological staining for GAG and total collagen content followed the trends from the quantitative biochemical assays. Conclusion This study provides a benchmark for the development and validation of preclinical porcine models for hip cartilage pathologies.
The consequences of Dental trauma
Authors: Gladwin Lorna , Darcey James 
Published: November 2023

Traumatic dental injuries pose a variety of complex ongoing issues to the dental practitioner. As dental injuries are commonly experienced at a young age, the treatment often takes place during adolescence or early in adulthood years at crucial development stages and very early in the life of the permanent successor. Therefore, the ability to correctly diagnose the injury, and follow an appropriate management plan should increase practitioners’ ability to improve both the outcomes of dental trauma and long-term prognosis of the tooth. The consequences of dental trauma can be explored by taking into consideration the type of injury, which enables an assessment of the degree of insult to the pulpal tissues, neurovascular bundle, periodontal ligament and cemental cells. This has a direct influence on post-trauma complications. Early intervention, where indicated, and appropriate follow-up utilising international guidelines is imperative to identify changing diagnoses and act accordingly. This review paper will discuss the classification of traumatic injuries and their associated outcomes with management strategies for emerging disease including potential endodontic and restorative complexities and when to refer to secondary care.
Alignment Among Patient, Caregiver, and Health Care Provider Perspectives on Hemodialysis Vascular Access Decision-Making: A Qualitative Study
Authors: Schneider Angela R. , Ravani Pietro , King-Shier Kathryn M. , Quinn Robert R. , MacRae Jennifer M. , Love Shannan , Oliver Matthew J. , Hiremath Swapnil , James Matthew T. , Ortiz Mia , Manns Braden R. , Elliott Meghan J. 
Published: November 2023

Background: Updates to the Kidney Disease Outcomes Quality Initiative Clinical Practice Guideline for Vascular Access emphasize the “right access, in the right patient, at the right time, for the right reasons.” Although this implies a collaborative approach, little is known about how patients, their caregivers, and health care providers engage in vascular access (VA) decision-making. Objective: To explore how the perspectives of patients receiving hemodialysis, their caregivers, and hemodialysis care team align and diverge in relation to VA selection. Design: Qualitative descriptive study. Setting: Five outpatient hemodialysis centers in Calgary, Alberta. Participants: Our purposive sample included 19 patients receiving maintenance hemodialysis, 2 caregivers, and 21 health care providers (7 hemodialysis nurses, 6 VA nurses, and 8 nephrologists). Methods: We conducted semi-structured interviews with consenting participants. Using an inductive thematic analysis approach, we coded transcripts in duplicate and characterized themes addressing our research objective. Results: While participants across roles shared some perspectives related to VA decision-making, we identified areas where views diverged. Areas of alignment included (1) optimizing patient preparedness—acknowledging decisional readiness and timing, and (2) value placed on trusting relationships with the kidney care team—respecting decisional autonomy with guidance. Perspectives diverged in the following aspects: (1) differing VA priorities and preferences—patients’ emphasis on minimizing disruptions to normalcy contrasted with providers’ preferences for fistulas and optimizing biomedical parameters of dialysis; (2) influence of personal and peer experience—patients preferred pragmatic, experiential knowledge, whereas providers emphasized informational credibility; and (3) endpoints for VA review—reassessment of VA decisions was prompted by access dissatisfaction for patients and a medical imperative to achieve a functioning access for health care providers. Limitations: Participation was limited to individuals comfortable communicating in English and from urban, in-center hemodialysis units. Few informal caregivers of people receiving hemodialysis and younger patients participated in this study. Conclusions: Although patients, caregivers, and healthcare providers share perspectives on important aspects of VA decisions, conflicting priorities and preferences may impact the decisional outcome. Findings highlight opportunities to bridge knowledge and readiness gaps and integrate shared decision-making in the VA selection process.
Co-design of a theory-based implementation plan for a holistic eHealth assessment and decision support framework for people with dementia in care homes
Authors: Gillam Juliet , Evans Catherine , Aworinde Jesutofunmi , Ellis-Smith Clare , Ross Jamie , Davies Nathan 
Published: November 2023

Background Despite positive findings around the use of eHealth in dementia care, it is rarely translated into routine practice. This can be facilitated by early involvement of end-users in the development of an implementation plan. This study aimed to co-design strategies to implement an eHealth intervention, the EMBED-Care Framework, to support assessment and decision-making for people with dementia in care homes. Methods A qualitative co-design method was applied through a series of workshops. Participants included family carers and health and social care practitioners. People with dementia were included through a series of stakeholder engagement meetings. The workshops focused on co-developing strategies in response to identified determinants of implementation. A codebook thematic analytic approach was taken, guided by the Normalisation Process Theory (NPT). Results Three workshops were conducted from July 2021 to November 2021, attended by 39 participants. Three overarching phases of implementation were identified which aligned with the constructs of the NPT: (a) incentivising adoption of the Framework, which requires promotion of its benefits and alignment with recommendations for good quality dementia care to engage stakeholders, relating to ‘coherence’ and ‘cognitive participation’ constructs; (b) enabling its operation, which requires ensuring compatibility with care home processes, provision of training and support from ‘champions’, relating to ‘collective action’; (c) sustaining use of the Framework, which requires monitoring of implementation and appraisal of its effects, relating to ‘reflexive monitoring’. Conclusions We have developed a multi-strategy, theoretically driven plan to implement eHealth to support assessment and decision-making for people with dementia in care homes. Successful implementation requires incentivisation to adopt, ability to operate and motivation to sustain use of eHealth. The plan is strengthened through collaborating with end-users to increase its value, credibility and real-world relevance. The theoretically informed strategies target mechanisms of the NPT, demonstrated to shape the implementation process and outcomes, ready for testing.