bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compliance to perioperative anticoagulation protocols in elderly patients undergoing elective orthopedic procedures: a retrospective observational cohort study on 548 patients
Authors: Munk Lizzie , van Essen Tom , van der Hoeven Casper , Nolte Peter A. , Becker Matthijs L. 
Published: April 2023

Abstract
Background
Compliance with perioperative anticoagulation guidelines is essential to minimize bleeding and thromboembolic risks in patients undergoing surgery. Compared to vitamin-K antagonists (VKAs), perioperative management of direct oral anticoagulants (DOACs) contains fewer steps. Therefore, we hypothesized that noncompliance with guidelines in VKA users is higher than in DOAC users. The primary aim of our study was to investigate the difference in noncompliance to perioperative anticoagulant management guidelines between elderly patients using VKAs versus those using DOACs. The secondary aim was to determine the difference in occurrence of conflicting information communicated to the patients and the difference in incidence of coagulation-related adverse events.

Methods
This retrospective non-controlled observational cohort study examined elderly patients undergoing elective orthopedic surgery in a teaching hospital in the Netherlands. All patients undergoing elective orthopedic surgery between 1 May 2016 and 1 January 2020, aged 70 years and over, using VKAs or DOACs were selected. Nonelective surgeries were excluded. The primary outcome was the noncompliance to perioperative anticoagulant management guidelines. Secondary outcomes were missing or conflicting information on anticoagulation management communicated to the patient and coagulation-related adverse events. For continuous data, the unpaired T-test was used and for categorical data, the chi-square test.

Results
In patients using VKAs, noncompliance to one of the steps of perioperative anticoagulation management was 81%, compared to 55% in patients using DOACs (p < 0.001). In most cases, VKAs or DOACs were interrupted for longer than recommended. In 13% of patients using a VKA with perioperative bridging, bridging was not conducted as recommended in the guidelines. In 13% of patients using a DOAC, a low-molecular-weight heparin (LMWH) was prescribed while a DOAC had already been restarted postoperatively. VKA users received conflicting information about perioperative anticoagulation management more often than DOAC users (33% versus 20%; p < 0.001). No difference was seen in postoperative coagulation-related complications.

Conclusion
Guidelines compliance in DOAC users is higher than in VKA users. Clinical decision support to help in selecting the right interruption interval in DOAC users, simplified standardized perioperative management, good coordination of instructions given to patients, and familiarity with updated guidelines are important in reducing noncompliance.
Voice activity detection in the presence of transient based on graph
Authors: Guo Xiao-Yuan , Gao Chun-Xian , Liu Hui 
Published: April 2023

AbstractVoice activity detection remains a significant challenge in the presence of transients since transients are more dominant than speech, though it has achieved satisfactory performance in quasi-stationary noisy environments. This paper studies the differences between speech and transients in nonlinear dynamic characteristics and proposes a new method for accurately detecting speech and transients. Limited by algorithm complexity, previous research has proposed few detectors to model speech and transients based on contextual information and thus failing to detect transient frames accurately. To address this challenge, our study proposes to map features of audio signals to a time series complex network, a kind of graph data, analyzed by the Laplacian and adjacency matrix of graphs, then classified by the support vector machine (SVM) classifier. The proposed algorithm can analyze a more extended speech period, allowing the full utilization of contextual information of preceding and following frames. The experimental results show that the performance of this method has obvious superiority over other existing algorithms.
Baby Steps: Communication Tips to Improve Physical Activity During Pregnancy
Authors: Buchanan Sabrina M. , Wilson Philip M. 
Published: April 2023

Apply It!
• Describe the use of motivational interviewing (MI) as a communication tool for exercise counseling with pregnant clients.
• Develop an understanding of core MI skills that exercise professionals can use to support exercise participation by pregnant client(s).
• Identify different MI techniques used for exercise counseling that can empower pregnant individuals to become more physically active.
Διαχείριση συγκρούσεων στην Πρωτοβάθμια Εκπαίδευση: Οι στρατηγικές των Διευθυντών- Έρευνα
Authors: ΤΡΙΑΝΤΗ ΠΑΡΘΕΝΑ ΔΗΜΗΤΡΙΟΣ 
Published: April 2023

Το θέμα που πραγματεύεται η παρούσα θεωρητική και ερευνητική μελέτη είναι η διαχείριση των σχολικών συγκρούσεων από τον διευθυντή. Βασικός σκοπός της εργασίας ήταν να καταγραφούν και να διερευνηθούν οι απόψεις των διευθυντών δημοτικών σχολείων σχετικά με τα είδη, τα αίτια και τις συνέπειες των συγκρούσεων, καθώς και με το ρόλο που αναλαμβάνουν οι ίδιοι στη διαχείριση και τις τεχνικές που χρησιμοποιούν. Μετά την εκτενή θεωρητική ανάλυση του θέματος, ακολούθησε η ερευνητική μελέτη με τη διεξαγωγή δέκα συνεντεύξεων από διευθυντές δημοτικών σχολείων των νομών Έβρου, Ξάνθης και Καβάλας. Η μεθοδολογία με την οποία έγινε η ανάλυση του ερευνητικού υλικού ήταν η ποιοτική ανάλυση περιεχομένου. Τα αποτελέσματα της έρευνας έδειξαν ότι συγκρούσεις συμβαίνουν συχνά στο σχολικό χώρο και μπορεί να είναι διαπροσωπικές, ομαδικές, ομάδων και ατόμων και της σχολικής κοινότητας με τους γονείς. Τα αίτια αυτών ποικίλουν και εξαρτώνται από την πληθυσμιακή ομάδα στην οποία προκύπτει η σύγκρουση. Υποστηρίχθηκε πως οι συγκρούσεις επιφέρουν αρνητικές συνέπειες σε όλα τα μέλη της σχολικής μονάδας, ωστόσο μέσω της κατάλληλης διαχείρισης μπορούν να μειωθούν οι συνέπειες αυτές και ενδέχεται να δημιουργηθούν και θετικές επιπτώσεις για τη σχολική μονάδα. Ο διευθυντής αναδείχθηκε ως το αρμόδιο πρόσωπο διαχείρισης συγκρούσεων στο χώρο του σχολείου και συνήθως αναλαμβάνει το ρόλο του διαμεσολαβητή. Ως παράγοντες που ενισχύουν τον διευθυντή στην αποτελεσματική αντιμετώπιση των συγκρούσεων παρουσιάστηκαν οι επικοινωνιακές, ηγετικές και διοικητικές δεξιότητες, η επιμόρφωση και η εμπειρία. Η επιλογή της τεχνικής διαχείρισης των συγκρούσεων εξαρτάται από το είδος, τα αίτια και τα μέλη της σύγκρουσης. Παρ’ όλα αυτά η τεχνική της συνεργασίας αναγνωρίστηκε ως η πιο εποικοδομητική μέθοδος αντιμετώπισης συγκρούσεων.
Use of angiotensin converting enzyme inhibitors in chronic kidney disease - a review of the literature
Authors: Sosnowski Jakub , Panek Eliasz , Jasłowski Damian , Rzeszutko Mateusz , Raczkiewicz Przemysław , Panasiuk Dominika , Skrętowicz Mateusz , Szponarowicz Patrycja , Snopkowski Bartosz , Korzec Tomasz 
Published: April 2023

Introduction: Chronic Kidney Disease (CKD) has become one of the most common chronic diseases of the XXI century and affects around 16% of the world's population. Despite the advancements of contemporary science and a range of therapeutic methods it considered a progressive and irreversible process. Nevertheless, use of ACEI halts the progression of the disease and postpones the necessity of renal replacement therapy and is the method of choice for this group of patients.
Purpose of the work: The article reviews current literature and writing regarding Chronic Kidney Disease (CKD) and the impact of ACEI on the progression of this condition.
Materials and methods: The sources available in the PubMed database have been analyzed using the keywords: “ACEI”, “angiotensin-converting-enzyme inhibitors”, ”chronic kidney disease”, “CKD”. Related publications to the topic of the work have been selected and utilized.
Description of the state of knowledge: Pharmacological therapy using ACEI is the main method of treatment for patients with CKD and should primarily serve to reduce proteinuria and control blood pressure. It inhibits the progression of the disease and delays the development of end-stage renal failure. However, the treatment of CKD using ACEI is controversial in cases of advanced stages of the disease.
Summary: ACEI inhibitors are one of the major advances in the treatment of patients dealing with CKD. Due to the increasing number of cases of the disease being observed, further research will be needed regarding the use of these drugs. Particularly ambiguous is the therapy for patients with advanced, just before end-stage renal failure, which will require a more in-depth analysis of these cases.
MOEDUM: QUEM (F)(S)OMOS O MACACO?
Authors: Cerqueira Correa Carolina , Vermelho Malandro 
Published: April 2023

o a(u)toretrato nos torna um y 3. singulares y plurais, humanos y não-humanos (co(auto))criamos. no fogo do Monkey, múltiplo afronorteamericano de Exu, transsignificamos o animal-mundo-nós.experimentamos com palavras, chaves, abstracts, imagens, resumos, words y keys. destruímos pra nos refazer. desobedientes y libertados.prestamos respeito ao fogo que nos transforma. girando y cruzando com mon-key
‘Sinta-se em casa mas lembre-se que não está’
Authors: Casagrande Mariana Ferreira 
Published: April 2023

O ensaio parte do conceito Das Unheimlich (o infamiliar), de Sigmund Freud, para analisar a relação sujeito-casa ao longo da pandemia de 2020. Utilizando como referência o texto psicanalítico, investigamos como a arte contemporânea brasileira e as manifestações oníricas podem simbolizar o angustiante convívio com espaço doméstico durante o enfrentamento do coronavírus.
Measuring spiritual uncertainty for hospice and palliative care providers
Authors: Stephenson Pam , Sheehan Denice , Petrinec Amy , Hansen Dana , Mayo Murray 
Published: April 2023

Background: Spiritual uncertainty is a new construct for end-of-life care that focuses on the questions, worries and doubts people have with end-of-life spirituality. Spiritual uncertainty can contribute to spiritual distress for patients and families dealing with the end of life, as well as lead healthcare providers to avoid spiritual care methods. Aims: This article reports on the item construction of a new survey design to measure the spiritual uncertainty of healthcare providers. Methods: Items were constructed from qualitative data gathered from five focus groups (with a total of 23 interdisciplinary hospice and palliative care providers being surveyed). Data were developed through three rounds of item construction, selection/refinement and assessment. Findings: A final pool of 42 items was constructed to measure the spiritual uncertainty of healthcare providers. Expert validity was obtained by 16 interdisciplinary hospice and palliative care providers. Conclusion: This survey is the first to measure spiritual uncertainty of healthcare providers. Additional research is needed to assess the psychometric properties of survey items.
Development of a core outcome set for open lower limb fracture
Authors: Aquilina Alexander L. , Claireaux Henry , Aquilina Christian O. , Tutton Elizabeth , Fitzpatrick Ray , Costa Matthew L. , Griffin Xavier L. 
Published: April 2023

AimsOpen lower limb fracture is life-changing, resulting in substantial morbidity and resource demand, while inconsistent outcome-reporting hampers systematic review and meta-analysis. A core outcome set establishes consensus among key stakeholders for the recommendation of a minimum set of outcomes. This study aims to define a core outcome set for adult open lower limb fracture.MethodsCandidate outcomes were identified from a previously published systematic review and a secondary thematic analysis of 25 patient interviews exploring the lived experience of recovery from open lower limb fracture. Outcomes were categorized and sequentially refined using healthcare professional and patient structured discussion groups. Consensus methods included a multi-stakeholder two-round online Delphi survey and a consensus meeting attended by a purposive sample of stakeholders, facilitated discussion, and voting using a nominal group technique.ResultsThematic analysis and systematic review identified 121 unique outcomes, reduced to 68 outcomes following structured discussion groups. Outcomes were presented to 136 participants who completed a two-round online Delphi survey. The Delphi survey resulted in 11 outcomes identified as consensus ‘in’ only. All outcomes were discussed at a consensus meeting attended by 15 patients, 14 healthcare professionals, 11 researchers, and one patient-carer. Consensus was achieved for a four-core outcome set: ‘Walking, gait and mobility’, ‘Being able to return to life roles’, ‘Pain or discomfort’, and ‘Quality of life’.ConclusionThis study used robust consensus methods to establish a core outcome set that should be measured in all future research studies and audits of clinical practice without precluding the measurement of additional outcomes.Cite this article: Bone Joint Res 2023;12(4):294–305.
Municipal officials’ perspectives on policymaking for addressing obesity and health equity
Authors: Parks Renee G. , Thomas Fanice , Morshed Alexandra B. , Dodson Elizabeth A. , Tian Ruiyi , Politi Mary C. , Eyler Amy A. , Thomas Ian , Brownson Ross C. 
Published: April 2023

Background:
Obesity evidence-based policies (EBPs) can make a lasting, positive impact on community health; however, policy development and enactment is complex and dependent on multiple forces.
Aims and objectives:
This study investigated key factors affecting municipal officials’ policymaking for obesity and related health disparities.
Methods:
Semi-structured interviews were conducted with 20 local officials from a selection of municipalities with high obesity or related health disparities across the United States between December 2020 and April 2021.
Findings:
Policymakers follow a general decision-making process with limited distinction between health and other policy areas. Factors affecting policymaking included: being informed about other local, state, and federal policy, conducting their own research using trustworthy sources, and seeking constituent and stakeholder perspectives. Key facilitators included the need for timely, relevant local data, and seeing or hearing from those impacted. Key local policymaking barriers included constituent opposition, misinformation, controversial issues with contentious solutions, and limited understanding of the connection between issues and obesity/health. Policymakers had a range of understanding about causes of health disparities, including views of individual choices, environmental influences on behaviours, and structural factors impacting health. To address health disparities, municipal officials described: a variety of roles policymakers can take; limitations based on the scope of government; challenges with intergovernmental collaboration or across government levels; ability of policymakers and government employees to understand the problem; and the challenge of framing health disparities given the social-political context.
Discussion and conclusion:
Understanding factors affecting the uptake of EBPs can inform local-level interventions that encourage EBP adoption.
Rare CIDEC coding variants enriched in age-related macular degeneration patients with small low-luminance deficit cause lipid droplet and fat storage defects
Authors: Kim Sehyun , Stockwell Amy , Qin Han , Gao Simon S. , Sagolla Meredith , Stoilov Ivaylo , Wuster Arthur , Lai Phillip , Yaspan Brian L. , Jeanne Marion 
Published: April 2023

Background
The basis of Age-related macular degeneration (AMD) genetic risk has been well documented; however, few studies have looked at genetic biomarkers of disease progression or treatment response within advanced AMD patients. Here we report the first genome-wide analysis of genetic determinants of low-luminance vision deficit (LLD), which is seen as predictive of visual acuity loss and anti-VEGF treatment response in neovascular AMD patients.

Methods
AMD patients were separated into small- and large-LLD groups for comparison and whole genome sequencing was performed. Genetic determinants of LLD were assessed by common and rare variant genetic analysis. Follow-up functional analysis of rare coding variants identified by the burden test was then performed in vitro.

Results
We identified four coding variants in the CIDEC gene. These rare variants were only present in patients with a small LLD, which has been previously shown to indicate better prognosis and better anti-VEGF treatment response. Our in vitro functional characterization of these CIDEC alleles revealed that all decrease the binding affinity between CIDEC and the lipid droplet fusion effectors PLIN1, RAB8A and AS160. The rare CIDEC alleles all cause a hypomorphic defect in lipid droplet fusion and enlargement, resulting in a decreased fat storage capability in adipocytes.

Conclusions
As we did not detect CIDEC expression in the ocular tissue affected by AMD, our results suggest that the CIDEC variants do not play a direct role in the eye and influence low-luminance vision deficit via an indirect and systemic effect related to fat storage capacity.
Extrauterine growth restriction in very low birth weight infants according to different growth charts: A retrospective 10 years observational study
Authors: Starc Meta , Giangreco Manuela , Centomo Giacomo , Travan Laura , Bua Jenny 
Published: April 2023

BackgroundExtrauterine growth restriction (EUGR) is common among very low birth weight (VLBW) infants and associated with poor neurodevelopmental outcomes. There are two types of EUGR definitions (cross-sectional and longitudinal) and many growth charts for monitoring postnatal growth. Aims of our study were 1) to compare the rate of small for gestational rate (SGA) and EUGR in a population of VLBW infants, both according to different growth charts (Fenton, INeS charts and Intergrowth-21) and different definitions; 2) to identify risk factors for EUGR.MethodsThis is a single centre retrospective observational study, including all VLBW infants born between January 2009 and December 2018. Anthropometric measures were obtained at birth and at discharge and presented as z-scores according to three growth charts (Fenton, INeS charts, Intergrowth-21). Maternal, clinical and nutritional data were retrieved from clinical records.Results228 VLBW were included. Percentage of SGA did not change significantly according to the three different growth charts (Fenton 22.4%, INeS charts 22.8%, Intergrowth 28.2%, p 0.27). Prevalence of EUGR was significantly higher when INeS and Fenton charts were used, compared to Intergrowth charts regardless of EUGR-definition (cross sectional-EUGR: Fenton 33.5%, INeS charts 40.9%, Intergrowth-21 23.8%, p 0.001;longitudinal-EUGR (loss of 1SDS): Fenton 15%, INeS charts 20.4%, Intergrowth 4%, p <0.001). In our population a longer time to reach 100 ml/kg/day of enteral feeding increased of 18% the risk of longitudinal EUGR. Late onset sepsis and retinopathy of prematurity were associated with an increased risk of longitudinal EUGR, although not significantly, while having a preeclamptic mother was associated with a reduced risk.ConclusionsWe confirmed a wide variability of EUGR rates when using different charts and definitions, highlighting that Intergrowth-21 charts identify less EUGR when compared to INeS and Fenton charts. Standardized criteria for defining EUGR are warranted in order to facilitate comparisons between studies and to improve the nutritional management of VLBW infants.
Treatment outcome of patients with prosthetic stuck valves at the Cardiac Center of Ethiopia
Authors: Tadesse Kefelegn Dejene , Gebru Meron , Tekleab Atnafu Mekonnen 
Published: April 2023

Background
Prosthetic Valve Thrombosis (PVT) is rare but life threatening condition which requires urgent intervention. Patient treatment outcome is not well studied in resource limited settings and the current study aims to explore the treatment outcome of patients with PVT at the Cardiac Center of Ethiopia.

Methods
The study was conducted at the Cardiac Center of Ethiopia which provides heart valve surgery. All patients who were diagnosed and managed for PVT in the center during the period July 2017 to March 2022 were included in the study. Data were collected through chart abstraction by using a structured questionnaire. Data analysis was done using SPSS version 20.0 for windows software.

Result
Eleven patients (13 episodes of stuck valve) with PVT were included in the study and nine of them were female. The median age was 28 years old (IQR 22.5–34.0) with the youngest and oldest patients being 18 and 46 years old respectively. All the patients had bi-leaflet prosthetic mechanical valves (10 at mitral valve, two at aortic and mitral and one at aortic positions). The median duration of valve replacement before having PVT was 36 months (IQR 5–72). All patients reported good adherence to anticoagulant therapy; yet only five had optimal INR value. Nine patients presented with failure symptoms. Eleven patients received thrombolytic therapy and nine of them responded to it. One patient operated for failed thrombolytic therapy. Two patients responded to heparinization and optimization of anticoagulant therapy. Of the ten patients who received streptokinase, two of them developed fever and one patient developed bleeding as a complication of the treatment. All the patients survived hospital discharge.

Conclusion
Prosthetic valve thrombosis was accompanied by sub-optimal anticoagulant therapy. Most patients responded to medical therapy alone.
Dlaczego jest tak źle, skoro jest tak dobrze? O demokracji w Polsce w opiniach respondentów i pewnej tendencji do wyrazistej władzy
Authors: Scheffs Łukasz 
Published: April 2023

Refleksja nad demokracją w ogóle, jak i konkretnym jej przypadkiem, zawsze nastręcza wielu problemów. Rozpoczynają się one już na etapie próby odpowiedzi na pytanie: o jakiej w zasadzie demokracji myślimy? Jaki fundament aksjo-normatywny znajduje się u podstaw systemu, który w naszej (zapewne subiektywnej) ocenie spełnia kryteria demokracji sui generis?
Każda z intelektualnych prób uchwycenia fenomenu demokratycznego tylko w jakiejś mierze odpowiada na nurtujące nas pytania o: sens, znaczenie, przyszłość i potencjalny upadek systemu. Przedłożony tu szkic jest jedynie próbą prezentacji opinii badanych grup respondentów nt. systemu i determinant ustroju demokratycznego w Polsce oraz konfrontacji występujących w przywoływanych tu analizach opinii z ogólną koncepcją dekapilaryzacji władzy.
Zawarte w tym opracowaniu spostrzeżenia pozostają efektem rekonstrukcji dokonanej na podstawie dostępnej literatury przedmiotu i danych wtórnych, pochodzących z badań prowadzonych przez innych autorów, najczęściej w ramach szerszych programów (projektów) badawczych. W tym znaczeniu praca ma charakter przyczynkarski, deskryptywny, a same jej rozważania mieszczą się w nurcie konstruktywistycznym współczesnych nauk społecznych, ze szczególnym uwzględnieniem nauk o polityce i administracji.