bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of arm position on the first pass success rates of ultrasound-guided infraclavicular axillary vein cannulation in spontaneously breathing patients: A randomised clinical trial
Authors: Nagalingam Saranya , T Sivashanmugam , Ravindran Charulatha , Ponnusamy Rani 
Published: February 2023

Background: Significant collapsibility during spontaneous respiration, deeper location, and smaller vein size are key challenging factors to safe infraclavicular axillary vein cannulation. Arm abduction reduces collapsibility, but interventional data supporting this observation is lacking. This study investigates the effect of neutral and abducted arm position on the first pass success rate of infraclavicular axillary vein cannulation in spontaneously breathing patients. Methods: One hundred and twelve patients were randomly assigned to two arm positions, neutral or abducted by 90° at the shoulder joint. Under ultrasound guidance, the infraclavicular axillary vein was cannulated using an in-plane approach. The primary outcome was the first pass success rate of guidewire placement in the infraclavicular axillary vein. The secondary outcome measures were the number of attempts for successful cannulation, failure rate, and catheter tip malposition. Results: Fifty-two patients in the neutral arm and fifty-six patients in the arm abduction group were compared according to the intention to treat analysis. The abducted arm position was associated with a higher first pass success rate (RR = 3.39, 95% CI = 1.47–7.85; p = 0.004) with fewer attempts ( p = 0.005), lower failure rate (RR = 1.37, 95% CI = 1.16–1.61; p = 0.000) and lower catheter tip malposition (1.5 vs 15.8%; p = 0.012) when compared to the neutral arm position. Conclusion: Abducted arm position resulted in a significantly higher first pass success rate with a lower failure rate and catheter tip malposition during ultrasound-guided infraclavicular axillary vein cannulation in spontaneously breathing patients.
Trimmed central venous catheters do not increase endothelial injury in an ovine model
Authors: Wang Hanjay , Williams Kiah M , Elde Stefan , Bulterys Philip L , Thakore Akshara D , Lucian Haley J , Farry Justin M , Mullis Danielle M , Zhu Yuanjia , Paulsen Michael J , Woo Y Joseph 
Published: February 2023

Introduction: Central venous catheters (CVCs) are often trimmed during heart transplantation and pediatric cardiac surgery. However, the risk of endothelial injury caused by the cut tip of the CVC has not been evaluated. We hypothesized that there is no difference in the degree of endothelial injury associated with trimmed CVCs versus standard untrimmed CVCs. Methods: In four adult male sheep, the left external jugular vein was exposed in three segments, one designated for an untouched control group, one for the trimmed CVC group, and one for the untrimmed CVC group. Trimmed and untrimmed CVC tips were rotated circumferentially within their respective segments to abrade the lumen of the vein. The vein samples were explanted, and two representative sections from each sample were analyzed using hematoxylin and eosin (H&E) staining, as well as with immunohistochemistry against CD31, von Willebrand factor (vWF), endothelial nitric oxide synthase (eNOS), and caveolin. Higher immunohistochemical stain distributions and intensities are associated with normal health and function of the venous endothelium. Data are presented as counts with percentages or as means with standard error. Results: H&E staining revealed no evidence of endothelial injury in 6/8 (75%) samples from the untouched control group, and no injury in 4/8 (50%) samples from both the trimmed and untrimmed CVC groups ( p = 0.504). In all remaining samples from each group, only mild endothelial injury was observed. Immunohistochemical analysis comparing trimmed CVCs versus untrimmed CVCs revealed no difference in the percentage of endothelial cells staining positive for CD31 (57.5% ± 7.2% vs 55.0% ± 9.2%, p = 0.982), vWF (73.8% ± 8.0% vs 62.5% ± 9.6%, p = 0.579), eNOS (66.3% ± 4.2% vs 63.8% ± 7.5%, p = 0.962), and caveolin (53.8% ± 5.0% vs 51.3% ± 4.4%, p = 0.922). There were no significant differences between the groups in the distributions of stain intensity for CD31, vWF, eNOS, and caveolin. Conclusion: Trimmed CVCs do not increase endothelial injury compared to standard untrimmed CVCs.
Applicability and feasibility of intraprocedural tip location of femorally inserted central catheters by transhepatic ultrasound visualization of the inferior vena cava in adult patients
Authors: Annetta Maria Giuseppina , Marche Bruno , Giarretta Igor , Pittiruti Mauro 
Published: February 2023

Background: The ideal intraprocedural method for tip location during insertion of femorally inserted central catheters (FICCs) is still a matter of debate. When the catheter tip is meant to be in the right atrium or in the supradiaphragmatic inferior vena cava (IVC), tip location by either intracavitary electrocardiography or transthoracic echocardiography may be accurate and easy to perform. When the catheter tip is planned to be placed in the subdiaphragmatic IVC, fluoroscopy—though inaccurate and unsafe—has been regarded as the only option for intraprocedural tip location. Methods: We have investigated prospectively the applicability and feasibility of transhepatic ultrasound as intraprocedural method for assessing the location of the catheter tip in the subdiaphragmatic tract of IVC, during FICC insertion. Results: We enrolled 169 consecutive patients undergoing FICC insertion by ultrasound guided puncture of the superficial femoral vein. In 165 out of 169 patients, the subdiaphragmatic IVC was visualized by the transhepatic ultrasound view. In all cases of IVC visualization, the catheter tip could be identified by ultrasound, either directly (direct evidence of the tip inside the vein) or indirectly (enhanced visualization of the tip after “bubble test”). There was no immediate or early complication, and very few late complications. Conclusion: The intraprocedural method of tip location of FICCs by transhepatic ultrasound was applicable in 97.6% of cases and feasible in 100%. When the position of the catheter tip is planned to be in the subdiaphragmatic IVC, this method of tip location is accurate, safe, and inexpensive, and should be considered as an alternative to fluoroscopy.
Spanish subject pronoun expression among Bube speakers in Equatorial Guinea
Authors: Padilla Lillie 
Published: February 2023

Aims and Objectives: Spanish subject pronoun expression (SPE) among Bube speakers in Equatorial Guinea has hardly been examined. Thus, the paper aims to (a) examine the SPE rate (b) and the linguistic and social predictors of SPE in this variety. Methodology: The data for the present study were collected using sociolinguistic interviews. These interviews lasted between 45 minutes and an hour. Data and analysis: The audio recordings of 18 bilinguals of Bube and Spanish in Equatorial Guinea were transcribed and analyzed using the Rbrul mixed-effects statistical software. Findings: The overt SPE rate of these bilingual speakers is 17.9%. This pronoun rate is one of the lowest ever found among bilinguals. The significant factors are grammatical person and number, ambiguity, the lexical content, and gender. The insignificant predictors were reference, reflexivity, and education. Originality: This is the first variationist study on Spanish SPE among Bube speakers in Equatorial Guinea. In this study, switch reference, a usually robust predictor, is insignificant among bilingual speakers. Significance: This study expands on the scarce research conducted on Equatoguinean Spanish and opens new avenues for exploration.
Animal-assisted and robotic animal-assisted interventions within dementia care: A systematic review
Authors: Shoesmith Emily , Surr Claire , Ratschen Elena 
Published: February 2023

Background Animal-assisted interventions and robotic animal interventions are becoming increasingly popular to support the care of people with dementia and may have the potential to improve a range of psychosocial outcomes. This review aims to identify, describe, and compare animal-assisted and robotic animal interventions delivered to people with dementia, their characteristics, effectiveness, and the proposed mechanisms underlying any potential impact. Methods A systematic literature search was conducted in MEDLINE, AMED, EMBASE, PsycINFO, OVID Nursing, PubMed, CINAHL and Web of Science. Random-effects meta-analyses of randomised controlled trials (RCTs) were conducted to summarise studies that evaluated common outcomes (agitation, depression, quality of life). A narrative approach was used to synthesise other findings. Results Fifty-one studies were included: 18 RCTs; 12 non-randomised trials, 13 cohort studies, 7 qualitative studies and one mixed-methods study. Meta-analyses were conducted for a small number of RCTs, with effectiveness of animal-assisted interventions demonstrated for agitation. Narrative findings suggested animal-assisted and robotic animal interventions may be promising in improving depression, agitation, and quality of life. Three potential mechanisms of action were identified for both animal-assisted and robotic animal interventions, namely enhancing social connections, providing engaging and meaningful activities, and the affect-generating aspect of the human-animal bond. A fourth mechanism was identified for animal-assisted interventions only: promoting physical activity. Robotic animals appear to have a place in complex human-animal relationships, but a greater understanding of robotic animal interventions is required to harness the benefits that may be derived from their use. Conclusion Delivering these interventions appear promising in improving psychosocial outcomes for people with dementia. As most included studies had methodological limitations, these findings are preliminary, but contribute to the body of evidence providing an understanding in terms of intervention characteristics and mechanisms of action. When developing intervention guidance, attention should be given to potential mechanisms and fundamental characteristics such as session content, delivery format and facilitator role.
Esketamine Anesthetizes Mice With a Similar Potency to Racemic Ketamine
Authors: Ma Xiaofan , Peng Jiali , Chen Yelin , Wang Zeyi , Zhou Qiang , Yan Jia , Jiang Hong 
Published: February 2023

Esketamine, the right-handed optical isomer of racemic ketamine, has recently become widely used for anesthesia and analgesia as a replacement for racemic ketamine. However, there are limited studies comparing the anesthetic and analgesic effects of esketamine and racemic ketamine in mice. This research was conducted to analyze the dose-dependent anesthetic and analgesic efficacy of esketamine in mice and to compare its potency with that of the racemate. We tested the anesthetic effects of different doses of esketamine and compared its potency with that of the racemate using righting reflex tests. Then, the acetic acid-induced pain model and formalin-induced pain model were used to investigate the analgesic effect. Compared with racemic ketamine, an equivalent dose of esketamine at 100 mg/kg was required to induce stable anesthesia. In contrast, 5 mg/kg esketamine was sufficient to provide analgesic effects similar to those of 10 mg/kg ketamine. Together, esketamine had a similar potency to racemic ketamine for anesthesia and a stronger potency for analgesia in mice.
Adapting international clinical trials during COVID-19 and beyond
Authors: Thriemer Kamala , Degaga Tamiru Shibiru , Alam Mohammad Shafiul , Adhikari Bipin , Tripura Rupam , Hossain Mohammad Sharif , Christian Michael , Ghanchi Najia K , Mnjala Hellen , Weston Sophie , Ley Benedikt , Rumaseb Angela , Tadesse Dagimawie , Teferi Tedla , Yilma Daniel , Lee Grant , Unger Holger , Sutanto Inge , Pasaribu Ayodhia Pitaloka , Ghimire Prakash , Beg Mohammad Asim , Price Ric N 
Published: February 2023

Background: The COVID-19 pandemic and resulting restrictions, particularly travel restrictions, have had significant impact on the conduct of global clinical trials. Our clinical trials programme, which relied on in-person visits for training, monitoring and capacity building across nine low- and middle-income countries, had to adapt to those unprecedented operational challenges. We report the adaptation of our working model with a focus on the operational areas of training, monitoring and cross-site collaboration. The new working model: Adaptations include changing training strategies from in-person site visits with three or four team members to a multi-pronged virtual approach, with generic online training for good clinical practice, the development of a library of study-specific training videos, and interactive virtual training sessions, including practical laboratory-focused training sessions. We also report changes from in-person monitoring to remote monitoring as well as the development of a more localized network of clinical trial monitors to support hybrid models with in-person and remote monitoring depending on identified risks at each site. We established a virtual network across different trial and study sites with the objective to further build capacity for good clinical practice–compliant antimalarial trials and foster cross-country and cross-study site collaboration. Conclusion: The forced adaptation of these new strategies has come with advantages that we did not envisage initially. This includes improved, more frequent engagement through the established network with opportunities for increased south-to-south support and a substantially reduced carbon footprint and budget savings. Our new approach is challenging for study sites with limited prior experience but this can be overcome with hybrid models. Capacity building for laboratory-based work remains difficult using a virtual environment. The changes to our working model are likely to last, even after the end of the pandemic, providing a more sustainable and equitable approach to our research.
Cognitive impairment after a stroke in young adults: A systematic review and meta-analysis
Authors: Weterings Rosemarije PC , Kessels Roy PC , de Leeuw Frank-Erik , Piai Vitória 
Published: February 2023

Background: Information about cognitive functioning is vital in the management of stroke, but the literature is mostly based on data from individuals older than 50 years of age who make up the majority of the stroke population. As cognitive functioning is subject to change due to aging, it is unclear whether such cognitive impairment patterns from the general stroke literature apply to the growing population of younger people with a stroke. Aim: The aim of the study was to conduct a systematic review and meta-analysis of the proportion and severity of cognitive impairment in young-stroke patients. Summary of review: MEDLINE, Embase, PsycINFO, and Web of Science were systematically searched up to 11 October 2022. Studies were included if they reported on a population of young-stroke patients, evaluated cognitive functioning as an outcome measure, and reported original data. We estimated the pooled prevalence rates for cognitive impairment and for aphasia. In addition, we calculated the pooled estimates for the severity of impairment per cognitive domain in the chronic phase (defined as >6 months post-stroke). Six hundred thirty-five articles were identified, of which 29 were eligible for inclusion. The pooled prevalence of cognitive impairment was 44% ( k = 10; 95% confidence interval (CI): 34–54%) and of aphasia 22% ( k = 13; 95% CI: 12–39%). Young-stroke patients in the chronic phase performed worse than stroke-free healthy age-appropriate controls across all cognitive domains examined, with Hedges’ g effect sizes ranging from −0.49 to −1.64. Conclusion: Around half of all young-stroke patients present with cognitive impairment and around a quarter with aphasia. Our data suggest that patterns of impairment in young-stroke patients follow those in the general stroke literature.
Highly Miniaturized, Low-Power CMOS ASIC Chip for Long-Term Continuous Glucose Monitoring
Authors: Gudlavalleti Raja Hari , Xi Xiangyi , Legassey Allen , Chan Pik-Yiu , Li Jin , Burgess Diane , Giardina Charles , Papadimitrakopoulos Fotios , Jain Faquir 
Published: February 2023

Background: The objective of this work is to develop a highly miniaturized, low-power, biosensing platform for continuous glucose monitoring (CGM). This platform is based on an application-specific integrated circuit (ASIC) chip that interfaces with an amperometric glucose-sensing element. To reduce both size and power requirements, this custom ASIC chip was implemented using 65-nm complementary metal oxide semiconductor (CMOS) technology node. Interfacing this chip to a frequency-counting microprocessor with storage capabilities, a miniaturized transcutaneous CGM system can be constructed for small laboratory animals, with long battery life. Method: A 0.45 mm × 1.12 mm custom ASIC chip was first designed and implemented using the Taiwan Semiconductor Manufacturing Company (TSMC) 65-nm CMOS technology node. This ASIC chip was then interfaced with a multi-layer amperometric glucose-sensing element and a frequency-counting microprocessor with storage capabilities. Variation in glucose levels generates a linear increase in frequency response of this ASIC chip. In vivo experiments were conducted in healthy Sprague Dawley rats. Results: This highly miniaturized, 65-nm custom ASIC chip has an overall power consumption of circa 36 µW. In vitro testing shows that this ASIC chip produces a linear ( R2 = 99.5) frequency response to varying glucose levels (from 2 to 25 mM), with a sensitivity of 1278 Hz/mM. In vivo testing in unrestrained healthy rats demonstrated long-term CGM (six days/per charge) with rapid glucose response to glycemic variations induced by isoflurane anesthesia and tail vein injection. Conclusions: The miniature footprint of the biosensor platform, together with its low-power consumption, renders this CMOS ASIC chip a versatile platform for a variety of highly miniaturized devices, intended to improve the quality of life of patients with type 1 and type 2 diabetes.
Comparison of Intravenous, Topical, or Combined Routes of Tranexamic Acid in Primary Total Knee Arthroplasty
Authors: Bi Chunqiang , Wu Damei , Xie Fei , Song Xue , Yang Dawei 
Published: February 2023

Introduction: The optimal route and dosing regimen of tranexamic acid (TXA) in primary total knee arthroplasty (TKA) remains unclear. This study aims to explore if there was a synergistic effect of intravenous (IV) and topical TXA on blood loss and risk of complications. Materials and methods: From Jan 2019 to June 2021, medical records of patients aged 65 years or older who underwent primary unilateral TKA for primary osteoarthritis were retrospectively reviewed. The included patients were divided into 3 groups according to the methods of TXA application: Intravenous (IV) group, topical group, or combined group. Propensity-score match was used to reduce the bias and imbalance of confounding variables. The primary outcome was total blood loss. Results: The total blood loss, hidden blood loss, and the reduction of Hb concentration in the combined group were significantly lower than in the IV group and topical group (all P < .01). There is no significant difference in the transfusion rate, length of hospital stay, and incidence of thromboembolic events (both P > .05). Conclusions: Combined administration of IV and topical TXA is the most effective approach to decrease blood loss and postoperative Hb drop in the treatment of TKA without increasing any risk of complications.
Assessment of level of heavy metals in cosmetics
Authors: Dinake Pogisego , Motswetla Obakeng , Kereeditse Tsotlhe T , Kelebemang Rosemary 
Published: February 2023

Background: Toxic metals in cosmetic products can lead to serious health problems among consumers. Skin lightening cosmetics are popular among women who may be unaware of prevalence of toxic metals in such products. Purpose: This study assessed the content of toxic metals in cosmetic products imported into Botswana. There are currently no regulations in Botswana governing maximum contaminants limits for contaminants such as metal ions in cosmetic products. Research Design: Sample analysis was carried out using inductively coupled plasma optical emission spectrometry after microwave-assisted acid sample digestion. Results: Total concentrations of metals were in the order Pb > Ni > Cr > As. The concentrations of metals analysed were in the range of 45.75–193.60; 2.99–9.50; 3.32–7.41 and 1.95–4.52 mg/kg for Pb, Ni, Cr and As respectively. The concentrations of Pb in all 14 samples exceeded the maximum impurity level of 10 mg/kg in cosmetics as per the United States Food and Drug Administration (US FDA). Concentrations of Ni, As and Cr were also higher than the set US FDA limits in some cosmetic samples under study. A human health risk assessment was conducted using hazard quotient, average daily intake and health risk index. A hazard quotient of greater than one was determined for Pb (HQ ∼ 177.0–749.2) in all 14 cosmetic samples investigated indicating potential adverse effects to human health. Conclusion: Overall results of total concentration and health risk assessment indicate that cosmetic products imported into Botswana are harmful to consumers. Therefore, quality control measures should be enforced to ensure metal concentrations in facial cosmetic products do not exceed regulatory limits.
Classification of long-term condition patterns in rheumatoid arthritis and associations with adverse health events: a UK Biobank cohort study
Authors: McLoone Philip , Jani Bhautesh D , Siebert Stefan , Morton Fraser R , Canning Jordan , Macdonald Sara , Mair Frances S , Nicholl Barbara I 
Published: February 2023

Purpose We aimed to classify individuals with RA and ≥2 additional long-term conditions (LTCs) and describe the association between different LTC classes, number of LTCs and adverse health outcomes. Methods We used UK Biobank participants who reported RA (n=5,625) and employed latent class analysis (LCA) to create classes of LTC combinations for those with ≥2 additional LTCs. Cox-proportional hazard and negative binomial regression were used to compare the risk of all-cause mortality, major adverse cardiac events (MACE), and number of emergency hospitalisations over an 11-year follow-up across the different LTC classes and in those with RA plus one additional LTC. Persons with RA without LTCs were the reference group. Analyses were adjusted for demographic characteristics, smoking, BMI, alcohol consumption and physical activity. Results A total of 2,566 (46%) participants reported ≥2 LTCs in addition to RA. This involved 1,138 distinct LTC combinations of which 86% were reported by ≤2 individuals. LCA identified 5 morbidity-classes. The distinctive condition in the class with the highest mortality was cancer (class 5; HR 2.66 95%CI (1.91-3.70)). The highest MACE (HR 2.95 95%CI (2.11-4.14)) and emergency hospitalisations (rate ratio 3.01 (2.56-3.54)) were observed in class 3 which comprised asthma, COPD & CHD. There was an increase in mortality, MACE and emergency hospital admissions within each class as the number of LTCs increased. Conclusions The risk of adverse health outcomes in RA varied with different patterns of multimorbidity. The pattern of multimorbidity should be considered in risk assessment and formulating management plans in patients with RA.