bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fundamental Rights and Necessary Implication
Authors: Meagher Dan 
Published: January 2023

AbstractThis article traces the manner in which the High Court’s recent legality jurisprudence has applied the ‘modern approach’ to interpretation in the context of fundamental rights. It is an approach which has exerted doctrinal pressure on the iconic and once authoritative conception of legality outlined in Coco v The Queen. Relevantly, the Court’s commitment to contextualism has extended to the interpretation of statutes which, on their ordinary meaning, implicate fundamental rights; and the important doctrinal shift which these cases seem to evidence is that the infringement of fundamental rights by necessary implication no longer has to satisfy the stringent — Coco — test. In Coco, the Court had stated that legality — the fundamental rights presumption — ‘may be displaced by an implication if it is necessary to prevent the statutory provisions from becoming inoperative or meaningless.’
Amyloid-PET of the white matter: Relationship to free water, fiber integrity, and cognition in patients with dementia and small vessel disease
Authors: Ottoy Julie , Ozzoude Miracle , Zukotynski Katherine , Kang Min Su , Adamo Sabrina , Scott Christopher , Ramirez Joel , Swardfager Walter , Lam Benjamin , Bhan Aparna , Mojiri Parisa , Kiss Alex , Strother Stephen , Bocti Christian , Borrie Michael , Chertkow Howard , Frayne Richard , Hsiung Robin , Laforce Robert Jr , Noseworthy Michael D , Prato Frank S , Sahlas Demetrios J , Smith Eric E , Kuo Phillip H , Chad Jordan A , Pasternak Ofer , Sossi Vesna , Thiel Alexander , Soucy Jean-Paul , Tardif Jean-Claude , Black Sandra E , Goubran Maged ,   for the Medical Imaging Trials Network of Canada (MITNEC) and Alzheimer’s Disease Neuroimaging Initiative (ADNI)
Published: January 2023

White matter (WM) injury is frequently observed along with dementia. Positron emission tomography with amyloid-ligands (Aβ-PET) recently gained interest for detecting WM injury. Yet, little is understood about the origin of the altered Aβ-PET signal in WM regions. Here, we investigated the relative contributions of diffusion MRI-based microstructural alterations, including free water and tissue-specific properties, to Aβ-PET in WM and to cognition. We included a unique cohort of 115 participants covering the spectrum of low-to-severe white matter hyperintensity (WMH) burden and cognitively normal to dementia. We applied a bi-tensor diffusion-MRI model that differentiates between (i) the extracellular WM compartment (represented via free water), and (ii) the fiber-specific compartment (via free water-adjusted fractional anisotropy [FA]). We observed that, in regions of WMH, a decrease in Aβ-PET related most closely to higher free water and higher WMH volume. In contrast, in normal-appearing WM, an increase in Aβ-PET related more closely to higher cortical Aβ (together with lower free water-adjusted FA). In relation to cognitive impairment, we observed a closer relationship with higher free water than with either free water-adjusted FA or WM PET. Our findings support free water and Aβ-PET as markers of WM abnormalities in patients with mixed dementia, and contribute to a better understanding of processes giving rise to the WM PET signal.
Evaluation of retinal vascular density and related factors using OCTA in children and adolescents with myopia without maculopathy
Authors: Lin Lingli , Zhang Xiaohan , Huang Cuiting , Zhang Zhaode 
Published: January 2023

Background Myopia is the most common ophthalmic condition worldwide with a rapidly increasing prevalence. This study aimed to compare the retinal microvasculature in the superficial capillary plexus (SCP) in children and adolescents with mild and moderate/high myopia using optical coherence tomography angiography, determine the relationship between retinal parameters and axial length (AL), and understand the occurrence and progression of myopia in microcirculation. Methods This prospective observational study included 39 participants with mild myopia and 33 participants with moderate/high myopia. Vessel density (VD) and perfusion density (PD) in the SCP, the foveal avascular zone (FAZ), and AL were compared between the groups and the relationship between these retinal parameters and AL was assessed. Results No difference in SCP VD or PD was observed between the two groups. The FAZ did not differ significantly between groups whereas significant differences in age, height, refractive status, and AL were observed. Significantly shorter AL was observed in participants with mild myopia compared with the moderate/high myopia group. Age was positively correlated with height (r = 0.852) and refractive status was negatively correlated with AL (r = −0.588). AL was positively correlated with VD (r = 0.317) and PD (r = 0.308) in the SCP and AL was negatively correlated with the FAZ (r = −0.434). Conclusions This study revealed that superficial foveal microvessel density was unaffected in children and adolescents without pathological myopia. However, myopia progression was associated with a change in AL, and an AL increase altered macular blood flow.
Prevalence and treatment of typical and atypical headaches in patients with Chiari I malformation: A meta-analysis and literature review
Authors: He Yunsen , Zhang Mengjun , Huang Caiquan , Qin Xiaohong , Zhang Zhou , Wang Yishuang , Guo Lili , Zheng Qiang , Bao Mingbin , Tao Ye , Wu Bo 
Published: January 2023

Objective A meta-analysis was conducted to analyze the incidence of typical and atypical headaches and outcomes following various treatments in patients with Chiari I malformation. Background Headache is the most common symptom of Chiari malformation, which can be divided into typical and atypical subgroups to facilitate management. Much controversy surrounds the etiology, prevalence and optimal therapeutic approach for both types of headaches. Method We identified relevant studies published before 30 July 2022, with an electronic search of numerous literature databases. The results of this study were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Result A total of 1913 Chiari malformation type I CIM patients were identified, 78% of whom presented with headache, within this group cephalgia was typical in 48% and atypical in 29% of patients, and migraine was the most common type of atypical headache. The ratio of typical/atypical headaches with international classification of headache disorders diagnosis was 1.53, and without international classification of headache disorders diagnosis was 1.56, respectively. The pooled improvement rates of typical headaches following conservative treatment, extradural decompression and intradural decompression were 69%, 88%, and 92%, respectively. The corresponding improvement rates for atypical headaches were 70%, 57.47%, and 69%, respectively. The complication rate in extradural decompression group was significantly lower than in intradural decompression group (RR, 0.31; 95% CI: 0.06–1.59, I2 = 50%, P = 0.14). Low reoperation rates were observed for refractory headaches in extradural decompression and intradural decompression groups (1%). Conclusion The International Classification of Headache Disorders can assist in screening atypical headaches. extradural decompression is preferred for typical headaches, while conservative therapy is optimal for atypical headaches. A definite correlation exists between atypical headaches and Chiari Malformation Type I patients with higher prevalence than in the general population. Importantly, decompression is effective in relieving headaches in this particular patient population.
Recurrent Painful Ophthalmoplegic Neuropathy: A case report with atypical features and a review of the literature
Authors: Furia Alessandro , Liguori Rocco , Donadio Vincenzo 
Published: January 2023

Introduction Recurrent Painful Ophthalmoplegic Neuropathy, previously known as Ophthalmoplegic Migraine, is a poorly characterized disorder mainly because there are few cases described. We report a new case of Recurrent Painful Ophthalmoplegic Neuropathy and a review of the literature to contribute to increasing the knowledge of the clinical features of this disorder. Case report and review of literature A 45-year-old woman presented with adult-onset recurrent attacks of abducens and oculomotor palsy associated with diplopia followed by headache. Most notably, pain always presented many days after oculomotor impairment, a feature never described in the literature. A diagnosis of possible Recurrent Painful Ophthalmoplegic Neuropathy was made after excluding other possible mimicking disorders. Symptoms usually resolved gradually with corticosteroid therapy, albeit without a clear-cut benefit. Clinical data collected from 1989 to 2022 showed that adult onset in Recurrent Painful Ophthalmoplegic Neuropathy is not uncommon. While III cranial nerve palsy is typical, VI and IV nerve palsy have also been described. Pathophysiology and diagnosis Several hypotheses have been proposed, including nerve compression, ischemia or inflammation/demyelination, but none has been completely accepted. Diagnosis remains of exclusion; magnetic resonance imaging and blood exams are key in differential diagnosis. Conclusions Our case gives us the possibility to expand the clinical features of Recurrent Painful Ophthalmoplegic Neuropathy, also contributing to updating the pathophysiological hypotheses.
The Prevalence and Predictors of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Registered Nurses in an Eastern Canadian Province: A Cross-Sectional Study
Authors: Maddigan Joy , Brennan Maureen , McNaughton Kelly , White Gerry , Snow Nicole 
Published: January 2023

BackgroundThe quality of Registered Nurses’ worklife is impacting nurses’ mental health, and the standard of care received by clients. Contributing factors to nurses’ stress are the trauma of continuous caring for those in great suffering, and adverse working conditions.Objectivesi) to explore the prevalence of work-related stress in a provincial sample of Registered Nurses; ii) to compare the levels of compassion satisfaction, burnout and secondary traumatic stress reported by nurses in hospital, community, non-direct care settings, and, iii) to identify factors that predict levels of nursing work stress.MethodsA descriptive, predictive study with a self-report survey containing demographic questions and the Professional Quality of Life Scale was emailed to over 3,300 Registered Nurses. The scale measured the prevalence of three worklife indicators, compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression identified factors that predicted the levels of the three indicators. A subgroup analysis explored the quality of worklife based on three practice environments.FindingsNurses (n  =  661) reported moderate compassion satisfaction, burnout, and secondary traumatic stress. The strongest predictor, satisfaction with one's current job, predicted high compassion satisfaction and lower burnout and secondary stress. The subgroup analysis identified hospital nurses as having the most work-related stress and the lowest level of compassion satisfaction.ConclusionInnovative, collaborative action can transform nurses’ practice environments. Organizational support is essential to bring about needed improvements.
Novel prepared nano potassium methyl siliconate as antioxidant for nitrile rubber
Authors: Mahmoud Doaa S , Elsayed AE , Reffaee AA , El-Nashar Doaa E 
Published: January 2023

In this work, novel potassium methyl siliconate (PMS) was employed as a new nano-type antioxidant for acrylonitrile-butadiene rubber (NBR). NBR/PMS composites were produced by incorporating various contents of the prepared compound as anti-ageing agents (PMS) to improve the heat resistance of these composites. Potassium methyl siliconate (PMS) was prepared, and its chemical structure was confirmed by different elemental analyses. The curing properties, filler dispersion, thermo-oxidative ageing test, mechanical properties, FTIR, and TGA of the NBR/PMS composites were evaluated. It was detected by TEM images of PMS. The particles had a rhombic shape, and the particle size ranged from 1.23 nm to 7.84 nm. PMS could successfully promote the interfacial interaction between rubber and filler and the uniform dispersion of silica particles into the NBR matrix. As a result, the mechanical characteristics of the NBR/PMS composites were significantly improved, and they were superior to those of the NBR/TMQ composites with similar filler contents. Furthermore, the crosslinking density of the NBR composites was reduced after adding PMS (an antioxidant), which had a great effect on the mechanical properties. The results exhibited that PMS dramatically enhanced the solvent extraction resistance and the thermo-oxidative ageing resistance of NBR/silica composites more efficiently than TMQ. Overall, this work extended the application scope of PMS to develop novel and effective antioxidants for elastomers.
A Qualitative Inquiry of Older Afghan Refugee Women’s Individual and Sociocultural Factors of Health and Health Care Experiences in the United States
Authors: Siddiq Hafifa , Alemi Qais , Lee Eunice 
Published: January 2023

Introduction: Approximately 132,000 Afghans have resettled in the United States since the 1980s and are now aging. As older adults, sociocultural factors influence health and health-related behaviors. This study aimed to explore older Afghan refugee women’s perceptions of individual and sociocultural factors of health and health care experiences. Methods: A focused ethnography methodology was conducted with 27 semi-structured interviews with older Afghan refugee women, family members, and community key informants in Southern California. Recorded interviews were transcribed and analyzed using inductive thematic analysis. Results: Five themes were identified as key to health promotion in the post-migration setting: (a) health promotion through Islam, (b) the centrality of family, (c) ongoing stressors that impact health, (d) needing support in navigating health services, and (e) miscommunication leading to mistrust of health care providers. Discussion: Health interventions should consider social and cultural contexts and faith-based and family-centered approaches when addressing older Afghan refugee women’s long-term health and well-being.
Substitution or addition: An observational study of a new primary care initiative in the Netherlands
Authors: van den Bogaart Esther HA , Spreeuwenberg Marieke D , Kroese Mariëlle EAL , Ruwaard Dirk 
Published: January 2023

Objective In 2014, the Primary Care Plus (PC+) model was introduced in the Netherlands to shift low-complex specialised care from the hospital to the primary care setting. While positive effects of PC+ have been documented at individual patient level concerning health-related quality of life, perceived quality of care and care costs, its impacts on service use at the population level remain uncertain. Methods In this observational study, we used retrospective health insurance reimbursement claims data from the largest health insurer in the intervention region to determine service use. We assessed PC+ and secondary care insurance claims (i.e. claims of the regional hospital and claims of other secondary care settings in and outside the region visited by patients from the intervention region) from 2015 to 2018 and compared these to the national level. Results The total number of claims related to low-complex specialised care in the intervention region showed an increase over time. The increase in claims was related to PC+. The number of claims related to the regional hospital and other secondary care settings decreased over time. During the same period, a declining trend in claims at the national level was observed. Conclusion The introduction of the PC+ model in one region in the Netherlands was associated with an increase in the use of low-complex specialised care. This suggests that the ability of the PC+ model to substitute for specialist care at population level may be limited. Going forward, it will be important to continue monitoring and evaluating service use as substitution effects may materialise only over a longer timeframe.
Predictors of poor outcomes after lower extremity revascularization for acute limb ischemia
Authors: Juneja Amandeep , Garuthara Melissa , Talathi Sonia , Rao Amit , Landis Gregg , Etkin Yana 
Published: January 2023

Objectives Acute lower extremity ischemia is one of the most common emergencies in vascular surgery and is a cause of considerable morbidity and mortality. The goal of this study was to evaluate outcomes of revascularization for acute lower extremity ischemia and to determine factors associated with perioperative morbidity and mortality. Methods A total of 354 patients underwent urgent revascularization for acute lower extremity ischemia at an academic medical center between 2014 and 2019. A retrospective review of patients’ demographics, comorbidities, etiology and severity of limb ischemia, and procedural characteristics was recorded. Outcomes, including postoperative complications, perioperative limb loss, and mortality, were analyzed. Results The mean patient age was 69 ± 17 years, and 52% were females. 50% of patients presented with Rutherford Class IIb ischemia. Arterial embolization was the most common cause of limb ischemia, seen in 33% of cases. Open surgical revascularization was performed in 241 (68%) patients, while endovascular and hybrid approaches were utilized in 53 (15%) and 60 (17%) cases, respectively. Postoperative adverse events occurred in 44% of patients, including wound complications (11%), cardiac (5%) and pulmonary (16%) complications, strokes (4%), UTIs (10%), renal failure (14%), bleeding (5%), and compartment syndrome (3%). The rate of unplanned return to the operating room was 21%. Major adverse cardiovascular events were seen in 103 (29%) patients and major adverse limb events were seen in 57 (16%) patients. The median length of stay was 10 days (IQR = 4); 49% patients were discharged to skilled nursing facility and 19% were readmitted within 30 days. The rate of amputation during index admission was 10%, and perioperative mortality was 20%. Gender, tibial runoff, and etiology of limb ischemia were independent predictors of limb loss. Women had lower risk of limb loss than men (OR, 0.11; 95% CI, 0.023, 0.38). Poor tibial runoff (one-vessel or absence of flow below the knee) was a significant predictor of limb loss as compared to three-vessel runoff (OR, 14.92; 95% CI, 1.92, 115.88). Aneurysmal disease (OR, 38.35; 95% CI, 3.54, 42.45) and traumatic injuries (OR, 108.08; 95% CI, 8.21, 159.06) were the strongest predictors of amputation as compared to other etiologies of limb ischemia. Multivariate model identified ESRD (OR, 9.2; 95% CI, 1.8–46.3), degree of ischemia (class IIb or higher vs class IIa; OR, 3.5; 95% CI, 1.2–10.6), and age (OR, 1.5; 95% CI 1.1–2.0 for every 10 years) as independent predictors of perioperative mortality. Conclusions Urgent revascularization for management of acute limb ischemia is associated with high morbidity and mortality. Elderly patients with ESRD presenting with severely threatened limbs have especially high risk of perioperative mortality and may not be ideal candidates for limb salvage.
Low Radiation Protocol for Intraoperative Robotic C-Arm Can Enhance Adolescent Idiopathic Scoliosis Deformity Correction Accuracy and Safety
Authors: Tanaka Masahiro , Schol Jordy , Sakai Daisuke , Sako Kosuke , Yamamoto Kazuyuki , Yanagi Kensuke , Hiyama Akihiko , Katoh Hiroyuki , Sato Masato , Watanabe Masahiko 
Published: January 2023

Study design Retrospective case-series study Objectives To assess (1) low cone beam CT (CBCT) mediated intraoperative navigation to limit radiation exposure without compromising surgical accuracy, and (2) the potential of intraoperative C-arm CBCT navigation to augment pedicle screw (PS) placement accuracy in AIS surgery compared to pre-surgery CT-based planning. Methods The first part involved a prospective phantom study, comparing radiation doses for conventional CT, and standard (6sDCT) and a low dose (5sDCT) Artis Zeego®-imaging. Next, 5sDCT- and 6sDCT-navigation were compared on PS accuracy and radiation exposure during AIS correction. The final part compared surgical AIS deformity correction through intraoperative 5sDCT navigation to a matched cohort treated using conventional pre-surgery CT-scans for navigation. Outcome parameters included operation time, skin dose (SD), dose area product (DAP), intraoperative blood loss, postoperative complications, and PS deviation rates. Results The phantom study demonstrated a reduction in radiation for the 5sDCT protocol. Moreover, 5sDCT-imaged patients (n = 15) showed a significantly lower SD (-27.41%) and DAP (-30.92%), without compromising PS accuracy compared with 6sDCT-settings (n = 15). Finally, AIS correction through intraoperative CBCT C-arm navigation (n = 27) significantly reduced screw deviation rates (6.83% versus 10.75%, P = .016) without increasing operation times, compared with conventional CT (n = 37). Conclusions Intraoperative navigation using a CBCT C-arm system improved the accuracy of PS insertion and reduced surgery time. Moreover, it reduced radiation exposure compared with conventional CT, which was further curtailed by adapting the low-dose 5sDCT protocol. In short, our study highlights the benefits of intraoperative CBCT navigation for PS placement in AIS surgery.
Collagen Scaffold Application in Arthroscopic Reconstruction of Osteochondral Lesions of the Talus With Autologous Cancellous Bone Grafts
Authors: Gorgun Baris , Gamlı Alper , Duran Mehmet Emin , Bayram Berhan , Ulku Tekin Kerem , Kocaoglu Baris 
Published: January 2023

Background: Single-step all-arthroscopic techniques have gained popularity recently in the treatment of osteochondral lesions of the talus (OLT). Concomitant subchondral bone defects led surgeons to add autologous bone grafting to the surgical procedures. Collagen scaffolds have been used widely for stabilization of the reconstruction and regeneration of the articular surface. Purpose: To compare single-step all-arthroscopic treatment of OLT consisting of debridement, microfracture, autologous bone grafting, and application of fibrin sealant in 2 patient groups: with versus without collagen scaffold. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 94 patients who underwent single-step all-arthroscopic treatment for OLT. Autologous bone grafting was applied to 48 patients (BG group), while autologous bone grafting plus collagen scaffold was applied to 46 patients (BG+S group). A fibrin sealant was applied to both groups. Clinical outcomes were assessed with the American Orthopaedic Foot & Ankle Society (AOFAS) score and the visual analog scale (VAS) for pain. Radiological outcomes were evaluated with the magnetic resonance observation of cartilage repair tissue score. The mean follow-up time was 69.3 ± 20.7 months. Results: Patients in both groups showed statistically significant improvement in pre- to postoperative AOFAS and VAS scores ( P < .001 for all), with no difference between groups in AOFAS and VAS score improvement. Complete healing with or without hypertrophy was achieved in 42 patients in the BG group (87.5%) and 38 patients in the BG+S group (82.6%). Conclusion: The treatment of bone lesions in OLT may be the ultimate goal to obtain successful outcomes, in which case using a collagen scaffold besides grafting may not affect clinical and radiological outcomes.