bluuebunny/crossref_metadata_2025_split huggingface dataset:
Grundlagen zur Anwendung von Andexanet
Authors: Koscielny J. , Birschmann I. , Bauersachs R. , Trenk D. , Langer F. , Möhnle P. , Beyer-Westendorf J. 
Published: October 2023

Zusammenfassung
Hintergrund Für lebensbedrohliche oder unkontrollierbare Blutungen steht bei einer Assoziation mit dem Thrombin-Inhibitor Dabigatran das monoklonale Antikörperfragment Idarucizumab und bei einer Assoziation mit den direkten Faktor-Xa-Inhibitoren Rivaroxaban oder Apixaban das modifizierte rekombinante FXa-Protein Andexanet für eine Antagonisierung zur Verfügung. Diese spezifischen Antidote stellen Notfallpräparate dar, die typischerweise nur bei Notwendigkeit einer Antagonisierung neben oder nach der Durchführung leitlinienkonformer multimodaler Maßnahmen eingesetzt werden.
Methoden Eine interdisziplinäre Gruppe erfahrener Experten aus den Bereichen Angiologie, Hämatologie, Innerer Medizin, klinischer Pharmakologie, Labormedizin, Transfusionsmedizin, Anästhesiologie, Intensivmedizin und Hämostaseologie hat auf Basis der aktuellen wissenschaftlichen Datenlage praxisrelevante Informationen und Empfehlungen erarbeitet.
Ergebnisse Eine Antagonisierung oraler Antikoagulanzien sollte in folgenden Situationen erfolgen: (1) lebensbedrohliche Blutungen oder refraktärer hämorrhagischer Schock, (2) intrazerebrale Blutungen, oder (3) gastrointestinale endoskopisch unstillbare Blutungen. Nach erfolgreicher Blutstillung sollte die Antikoagulation (z.B. direktes orales Antikoagulanz, Vitamin-K-Antagonist, Heparin) unter Berücksichtigung des individuellen Blutungs- und Thromboembolierisikos wieder zeitnah fortgeführt werden.
Diskussion Diese Zusammenstellung soll allen beteiligten medizinischen Disziplinen helfen, den Umgang mit Andexanet zu erleichtern und damit eine optimale Versorgung der Patienten mit lebensbedrohlichen oder unkontrollierbaren Blutungen zu gewährleisten.
Recurrence, Reoperation, and Patient-Reported Outcomes after Wrist Ganglion Excision
Authors: Lans Jonathan , George Keith M. , Hazewinkel Merel , Eberlin Kyle R. , Chen Neal C. , Garg Rohit 
Published: October 2023

Abstract
Background Ganglion excision is performed for pain, functional impairment, or cosmetic reasons, with recurrence rates ranging between 9 and 20%. The aim of this study was to evaluate the recurrence and reoperation rates after ganglion excision, along with assessing patient-reported outcomes.
Methods Retrospectively, 1,076 patients, with 1,080 wrist ganglia, were identified who underwent open excision (n = 1,055) and arthroscopic excision (n = 25). The ganglia were predominantly dorsal (59%) and volar (37%). Additionally, 149 patients who underwent open excision and all who underwent arthroscopic excision were contacted to complete a questionnaire on recurrence and reoperation, the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and the Patient-Rated Wrist Evaluation (PRWE). Seventy-seven patients responded at a median of 4 years postoperatively. A matched case-control analysis was performed to identify factors associated with reoperation, along with a bivariate analysis to assess what factors influence patient-reported outcomes.
Results The reoperation rate was 3.3%, with no factors statistically associated with reoperation in case-control analysis. Among the contacted patients, 13% reported a recurrence, of which 2.6% reported reoperation. The median QuickDASH score was 2.3 (interquartile range [IQR]: 0–12), the median PRWE score was 0 (IQR: 0–12), and the median pain score was 0 (IQR: 0–3), with female sex being associated with higher scores.
Conclusion The reoperation rate after ganglion excision is low (3.3%) and is mostly performed within 3 years. The self-reported ganglion recurrence is higher (13%), but only one-fifth of these patients reported a repeat excision. After surgery, patients report good functional scores, with little persistent pain.
A - 22 Preliminary Outcomes on Depression Symptoms in a Randomized Controlled Trial of High-Definition Transcranial Direct Current Stimulation in Alzheimer’s Dementia
Authors: Helphrey Jessica , Cabrera Hannah , Neaves Stephanie , Ahmed Danyah , Chiang Hsueh-Sheng , Thakkar Vishal , Peters Matthew , McClintock Shawn , Hart John , LoBue Christian 
Published: October 2023

Abstract

Objective
New treatments to manage emotional and cognitive symptoms of Alzheimer’s Dementia (ad) are needed. High-definition transcranial direct current stimulation (HD-tDCS) is a non-invasive neuromodulation technology with potential as a new treatment for improving neuropsychiatric symptoms. The dorsal anterior cingulate cortex (dACC) is a region found to play an important role in emotional processes and is vulnerable to degeneration in ad. As such, we conducted a pilot study investigating the effect of HD-tDCS applied over the dACC on depression symptoms in ad patients.

Method
Ten participants (M age = 71.50, SD = 9.80) with clinically diagnosed mild-to-moderate ad were randomized to receive sham (0 milliamps [mA]; n = 2), 1 mA (n = 5), or 2 mA (n = 3) HD-tDCS for ten daily 20-minute sessions across two weeks. The Beck Depression Inventory-2 (BDI-2) was administered before and after ten treatments. A one-tailed analysis of covariance (ANCOVA) was conducted to examine differences in post-treatment scores between HD-tDCS groups, adjusting for pre-treatment scores.

Results
Baseline BDI-2 scores were similar for the groups receiving 1 mA (M = 7.00; SD = 3.10), 2 mA (M = 4.70; SD = 8.10), and sham (M = 9.00; SD = 7.10) Statistically significant differences were found between groups on depression scores after HD-tDCS, F(2) = 3.55, p = 0.048, ηp2 = 0.54), driven by the depression scores in the 1 mA group being lower than the sham group.

Conclusions
Our pilot results suggest that HD-tDCS may be associated with a reduction in depression symptoms in ad, though determining the minimum clinically important difference for a decrease needs further evaluation. Future research having larger samples with ad and long-term follow up is also warranted to examine clinical efficacy.
A - 60 How a Celebrity’s Disclosures of Aphasia and Dementia Impacted Online Searches Regarding Dementia Screening, Prevention, and Treatment: a Big Data Analysis
Authors: Schaefer Lynn A , Bekerman Elizabeth H , Levin Veronica P 
Published: October 2023

Abstract

Objective
Celebrity disclosure of medical conditions may lead to online searches into prevention and treatment. There are no studies examining this effect on dementia screening, prevention, and treatment and, if so, the effects’ length.

Data Selection
Bruce Willis announced diagnoses of aphasia on 3/30/2022 and frontotemporal dementia on 2/16/2023. U.S. Google search trends (GT) from 3/1/2022–3/1/2023 were accessed for: Bruce Willis, aphasia, and dementia. Wikipedia Pageviews (WP) for 1-week before, week of, and 1-week after each announcement were accessed for: dementia, aphasia; neuropsychological test, neuroimaging; dementia prevention, brain training, nootropics; donepezil, galantamine, and rivastigmine. ANOVAs and Tukey post-hocs were conducted of WP data.

Data Synthesis
Visual inspection of GT suggested announcement-related pulse effects. Relative search volume (RSV) for aphasia = 100 the week of 3/27/2022, and spiked for dementia the week of 2/12/2023, with RSV = 19, 3x the previous week. Week of 3/30/2022, ANOVAs revealed a significant increase for aphasia (p = 0.050) and a trend toward significance for dementia (p = 0.086) searches; there was a trend for neuroimaging (p = 0.083) the following week. Aphasia searches dropped 1-week after, but remained 9x higher than pre-announcement. Week of 2/16/2023, there were significant increases in searches for dementia (p = 0.030), aphasia (p = 0.036), and prevention of dementia (p = 0.028), but no other screening or treatments. Each returned to pre-announcement levels 1-week after, according to post-hoc trends.

Conclusions
Willis’s announcements prompted searches for dementia and prevention in general, but not specific screening, treatment, or prevention. The effect was short-lived, as has been seen regarding cancer. For more influential public impact, media could report information including screening and prevention.
A haemorrhagic pericardial cyst compressing the right side of the heart: a case report
Authors: Elhakim Abdelrahman , Boguschewski Andrea , Zamzow Piet , Saad Mohammed 
Published: October 2023

Abstract

Background
Pericardial cysts are rare and represent the third most common cystic mass of the mediastinum. The majority are asymptomatic and detected as incidental findings; however, they can be symptomatic and associated with life-threatening complications such as bronchial compression, congestive heart failure, cardiac tamponade, or even sudden death.

Case summary
We present a rare case of a haemorrhagic pericardial cyst with subtotal compression of the right side of the heart. A symptomatic male patient was referred due to progressive dyspnoea, signs of congestive heart failure for four months, and a transthoracic echocardiogram showing subtotal compression of the right heart side; the diagnosis was confirmed with thoracic computer tomography imaging and was removed surgically.

Discussion
Pericardial cysts are asymptomatic and benign in the majority of cases; however, they can be associated with life-threatening complications. Thus, regular follow-up is recommended, and in a minority of cases, minimal invasive intervention or surgery could be imperative.
Navigating concepts of social-ecological resilience in marine fisheries under climate change: shared challenges and recommendations from the northeast United States
Authors: Maltby K M , Mason J G , Cheng H , Fay G , Selden R L , Williams L , Alves C L 
Published: October 2023

Abstract
Climate change is increasingly impacting marine fisheries worldwide. Concurrently, scientific interest has grown to understand how these systems can cope and adapt, with research shifting from examining vulnerability to assessing risks to focusing on determining and operationalizing resilience. As fisheries-climate-resilience researchers and practitioners navigating a sea of frameworks, toolkits, strategies, policy goals, and management desires, we take stock to ask: what does resilience mean to us? Drawing on our experiences in the northeast United States, we discuss the challenges and ambiguity we encounter in concepts of social-ecological resilience and explore implications for research and implementation. We bring together perspectives to discuss various approaches to resilience, highlighting shared and unique challenges we face. We outline three key considerations as we move forward in resilience research and practice: (1) the need for greater transparency and reflexivity among researchers regarding how they frame and approach resilience; (2) the value of increasing coordination and communication among fisheries groups working on these topics; and (3) the use of co-developed and co-produced resilience research and strategies. We urge for greater centring of communities in these discussions and to explicitly consider how resilience interacts with equity outcomes.
New and revised taxa of Neotropical Diplotaxini (Coleoptera: Melolonthidae): do they change the existing relationships? Revisiting systematics with morphological and molecular data
Authors: Cherman Mariana A , Basílio Daniel S , Clarkson Bruno , Agostinis André O , Smith Andrew B T , Vaz-De-Mello Fernando Z , Almeida Lúcia M 
Published: October 2023

Abstract
The relationships among the Neotropical Diplotaxini and homology of revised and new taxa are revisited with parsimony analyses based on morphological characters, and probabilistic analyses based on concatenated ITS2 and COI genes. Neotropical Diplotaxini is now composed of five monophyletic genera: Pacuvia, Pachrodema, Homalochilus, Liogenys, and Careocallus gen. nov.. Pseudodiplotaxis is here transferred to incertae sedis of Melolonthinae. Careocallus is the sister genus of Liogenys and is composed of Careocallus tehuelche sp. nov. and Careocallus densicollis sp. nov. Sister phylogenetic relationship between Homalochilus and the rest of genera except Pacuvia is revealed. Homalochilussensu nov. is comprised by Homalochilus punctatostriatus and Homalochilus nigripennis sp. nov. This genus recovered its monophyly by transferring Homalochilus niger to Liogenys, as Liogenys nigercomb. nov. and this name is also synonymized with L. morio. The type species of Homalochilus is emended to be H. punctatostriatus. A neotype (Liogenys morio) and lectotypes (H. punctatostriatus, H. niger) are designated. Dichotomious key to Neotropical Diplotaxini genera and to species of Homalochilus and Careocallus are presented. Sequences and phylogenetic signals for Neotropical melolonthines are reported for the first time.
Quality Assessment of Online Resources for Gender-affirming Surgery
Authors: Berry Charlotte E. , Fazilat Alexander Z. , Churukian Andrew A. , Abbas Darren B. , Griffin Michelle , Downer Mauricio , Januszyk Micheal , Momeni Arash , Morrison Shane D. , Wan Derrick C. 
Published: October 2023

Background:
As visibility of the transgender patient population and utilization of online resources increases, it is imperative that web-based gender-affirming surgery (GAS) materials for patients are readable, accessible, and of high quality.

Methods:
A search trends analysis was performed to determine frequency of GAS-related searches over time. The top 100 most common results for GAS-related terms were analyzed using six readability formulas. Accessibility of patient-facing GAS sources was determined by categorizing types of search results. Frequency of article types was compared in low- and high-population dense areas. Quality was assigned to GAS web-based sources using the DISCERN score.

Results:
Search engine trend data demonstrates increasing occurrence of searches related to GAS. Readability scores of the top 100 online sources for GAS were discovered to exceed recommended levels for patient proficiency. Availability of patient-facing online information related to GAS was found to be 60%, followed by information provided by insurance companies (17%). Differences in availability of online resources in varying dense cities were found to be minimal. The average quality of sources determined by the DISCERN score was found to be 3, indicating “potential important shortcomings.”

Conclusions:
Despite increasing demand for web-based GAS information, the readability of online resources related to GAS was found to be significantly greater than the grade level of proficiency recommended for patients. A high number of nonpatient-facing search results appear in response to GAS search terms. Quality sources are still difficult for patients to find, as search results have a high incidence of low-quality resources.
A New Technique for Pelvic and Vaginal Reconstruction in Abdominoperineal Rectal Excision: Combination of Gluteus Maximus Flap and Fasciocutaneous Flap
Authors: Assi Hanin , Guné Henrik , Buchwald Pamela , Lagergren Jakob , Lydrup Marie-Louise , Öberg Martin 
Published: October 2023

Summary:
Resection of advanced rectal cancer might result in significant tissue loss, including pelvic floor and parts of the vaginal wall. Pelvic floor reconstruction using a musculocutaneous flap offers optimized healing abilities and the possibility of vaginal reconstruction. In Skåne University Hospital, two different flap techniques are used to reconstruct the perineum: the vertical rectus abdominis musculocutaneous flap and the gluteus maximus (GM) flap. A combination of a GM flap and a fasciocutanous flap, referred to locally as a GM special (GMS) flap, is used for posterior vaginal wall reconstruction in women undergoing abdominoperineal resections including parts of or the total posterior vaginal wall. The GMS flap was introduced through a national collaboration in Sweden in 2013. The aim of this article is to offer a detailed description and illustrations of the surgical technique used to construct the GMS flap, focusing on the posterior vaginal wall reconstruction. In our experience, the GMS flap is a resilient and cosmetically appealing choice that is technically easily harvested. The flap has acceptable morbidity and long-term results with adequate neovaginal measurements. Collaborative work is further encouraged.
A Systematic Review of the State of Preclinical Mentorship Programs in Plastic and Reconstructive Surgery
Authors: Dzubara Bryce , Bajestani Nojan , Paras Stephanie , Min Eric , Sharma Shuchi , Katta Juhi , Ueno Cristiane 
Published: October 2023

Background:
Plastic and reconstructive surgery is consistently one of the most competitive medical specialties in the match. The recent United States Medical Licensing Examination score reporting switch to pass-fail led to a change in metrics by which applicants are evaluated by plastic surgery programs. Applicant research productivity and the demand for plastic surgery mentorship will continue to rise. Given the competitive nature of the residency match and shift in metrics emphasis after the change in STEP 1 scoring, early exposure to plastic surgery and mentoring relationships are paramount to applicant success. However, most medical students are not exposed to plastic surgery until they begin clinical rotations.

Methods:
A literature review of plastic surgery mentorship programs available during preclinical years was conducted to identify preclinical mentorship opportunities in plastic surgery. Sixty-eight references were identified, but only two studies met the inclusion criteria of addressing mentorship programs in preclinical years.

Results:
Examination of the included studies indicated that preclinical medical students achieve self-identified goals and generate longitudinal benefits in plastic surgery by participating in early and focused mentorship programs.

Conclusions:
The limited number of studies in this review highlights a lack of available, studied preclinical mentorship programs in plastic surgery and reveals a knowledge gap concerning the creation of successful preclinical mentorship programs. Early exposure to plastic surgery, combined with the development of structured preclinical mentorship programs, can potentially replicate successful outcomes seen in other surgical subspecialties’ mentorship programs while addressing the lack of formalized mentorship opportunities for preclinical students in plastic surgery.
A Phase 1, Open-label, Dose-Ascending Study to Evaluate the Safety and Tolerability of the Therapeutic Radiopharmaceutical 131I-MIP-1095 for the Treatment of Metastatic Castration-Resistant Prostate Cancer
Authors: Laccetti Andrew L. , Bodei Lisa , O'Donoghue Joseph A. , Weber Wolfgang A. , Morris Michael J. 
Published: October 2023

Purpose

131I-MIP-1095 is a targeted radiotherapeutic that contains 131I, a β-particle emitter, and MIP-1095, a urea-based ligand for prostate-specific membrane antigen. We report the first phase 1, dose-escalation study of 131I-MIP-1095 in patients with metastatic castration-resistant prostate cancer (mCRPC).

Methods
This study enrolled men with mCRPC refractory to second-generation antiandrogen(s) and taxane chemotherapy. Dosimetry/biodistribution assessments were performed. Safety and tolerability were determined in subjects who qualified for therapeutic administration of 131I-MIP-1095 with maximum tolerated activity examined in a dose-ascending manner (3 + 3 design methodology). Disease outcomes including prostate-specific antigen (PSA) change, tumor response, survival, and circulating tumor cell concentration were assessed.

Results
A total of 9 subjects with mCRPC were included in this study. On the basis of dosimetry results, 5 of 9 patients were treated: 3 in cohort 1 (50 mCi) and 2 in cohort 2 (75 mCi). Accrual stopped at the cohort 2 activity level in response to the US Food and Drug Administration mandate for 131I-MIP-1095 manufacturing concerns. Parotid/salivary glands (3.5 Gy/Bq), liver (2.2 Gy/Bq), kidneys (1.3 Gy/Bq), and spleen (0.7 Gy/Bq) demonstrated the greatest extent of 131I-MIP-1095 exposure. There were no deaths, serious adverse events, or drug discontinuations due to treatment-emergent adverse events. Grade 1–2 thrombocytopenia, anemia, leukopenia, and dry mouth most commonly occurred. One subject (33.3%) exhibited maximum decline for the PSA response of 50% or greater.

Conclusion

131I-MIP-1095 demonstrated favorable dosimetry, biodistribution, and safety, as well as a modest PSA response supporting further investigation for treatment of men with mCRPC.
Clinical Trial Registration: ClinicalTrials.gov identifier: NCT03030885, Registered January 25, 2017 (https://clinicaltrials.gov/ct2/show/NCT03030885).
Patient education about breathlessness
Authors: Williams Marie T. 
Published: October 2023

Purpose of the reviewEffective education enables people to modify the distress and impact of breathlessness by integrating evidence-informed breathlessness-related behaviours (knowledge, skill, attitude) into everyday life. This review considers recent studies of educational approaches focussed on chronic breathlessness as a modifiable, noxious and debilitating multidimensional experience.Recent findingsSystematic assessments of text-based patient education materials and mobile phone applications specific to breathlessness indicate that while these resources are readily available, issues continue to persist with quality, readability, usefulness and availability of non-English language versions. Various forms of educational interventions for breathlessness have proven feasible and valued by people living with breathlessness and their significant others (uptake/completion, personal benefit, ripple effect on health professionals). Health professional knowledge about the impact of chronic breathlessness and effective management can be altered through structured, educational interventions.SummaryEmpiric studies of patient education for breathlessness are scarce despite persistent calls for better breathlessness education for people living with or providing care for someone living with this noxious symptom. In clinical practice, it is highly likely that there are effective and ineffective educational practices, both of which, if publicly disseminated, would inform future educational strategies to advance breathlessness self-management.
A novel taxonomy to assess dressing activity in chronic stroke
Authors: Fokas Emily E. , Ahmed Zuha , Parnandi Avinash R. , Venkatesan Anita , Pandit Natasha G. , Nilsen Dawn M. , Schambra Heidi M. 
Published: October 2023

AbstractUpper-body dressing (UBD) is a key aspect of motor rehabilitation after stroke, but most individuals with stroke require long-term dressing assistance. Having a measurement approach that captures the quantity and quality of dressing movements during training could support more targeted strategies. As the basis of an approach, we modified our previously developed motion taxonomy, which categorizes elemental motions into classes of functional primitives (e.g.reaches, transports, stabilizations). Three expert coders examined videos of two healthy subjects performing dressing tasks, and expanded the taxonomy to account for the unique arm and trunk motions of UBD. An expert and a trained coder then applied the expanded taxonomy to dressing videos of five chronic stroke subjects. We examined the interrater reliability (IRR) for classifying primitives. Using the expanded taxonomy, IRR for identifying primitives in UBD was overall low (k = 0.52) but varied by primitive class: IRR was moderate forreach(k = 0.75),transport(k = 0.63), andidle(k = 0.68), lower forreposition(k = 0.58), and negligible forstabilization(k = -0.02). IRR increased with increasing UE-FMA score (ρ=1, p<0.0001), indicating that the reliability of primitive classification improved with less impaired movement. With additional modification, the expanded taxonomy could support the measurement of training doses and impaired motion during dressing activities.