bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of mechanical thrombectomy among stroke patients brought directly to a comprehensive stroke center versus transfer from a primary stroke center in upstate New York
Authors: Khazen Olga , Bao Jonathan , Gajjar Avi A , Entezami Pouya , Dalfino John C , Feustel Paul J , Paul Alexandra R 
Published: May 2023

Background Faster time to treatment for stroke is associated with improved outcomes. In cases of large vessel occlusion (LVO), standard of care treatment with thrombectomy can only be provided at a comprehensive stroke center (CSC). We examine the outcomes of patients who are directly brought to our center, a CSC, compared to those seen at a primary stroke center (PSC) and then transferred. Methods Patients with LVO presenting to our center from 1/1/2019 to 12/31/2019 were included. Cohorts of patients presenting first to a PSC and presenting first to a CSC were compared. Demographics and outcome metrics (Discharge Modified Rankin Scale (mRS) and National Institute of Health Stroke Severity Scale (NIHSS) scores) were obtained for all LVO patients. Imaging was also assessed. Results Of 864 stroke admissions, 346 had LVO (40%) with 183 (53%) transferring from a PSC and 163 (47%) presenting directly. Similar percentages of each cohort were taken for thrombectomy (25.1% transfer and 31.3% direct). However, as distance between PSC and CSC increased, likelihood of thrombectomy decreased. Transfer patients were more likely to be excluded from thrombectomy secondary to a large volume of complete stroke (p  =  0.0001). Direct presenters had lower discharge mRS scores than transfer patients (p < 0.01), however, severity of stroke upon admission was similar in the two groups. Conclusion Patients transferred from a PSC were more likely to have a worse outcome at time of discharge than those presenting directly to our center. Large volume of completed stroke was a frequent reason for exclusion from thrombectomy. Optimizing stroke protocols to CSC in cases of LVOs may result in better outcomes.
Service users’ and parents/carers’ experiences of a paediatric chronic fatigue service: A service evaluation
Authors: Hartley Gemma , Purrington Jack 
Published: May 2023

Objectives This service evaluation explored the experiences of families receiving care in a paediatric chronic fatigue service. The evaluation aimed to improve service provision across paediatric chronic fatigue services more widely. Methods Children and young people aged 7–18 years ( n  =  25) and parents/carers ( n  =  25) completed a postal survey exploring experiences of a paediatric chronic fatigue service. Quantitative data were analysed descriptively, and qualitative data were analysed using thematic analysis. Results Most service usersand parents/carers (88%) agreed that the service met their needs, that they felt supported by staff, and most notably, a large portion (74%) reported the team increased their activity levels. A small number disagreed (7%) with statements relating to positive links with other services, ease of talking to staff and suitability of appointment type. The thematic analysis revealed three themes: help managing chronic fatigue syndrome, experience of professional support and accessibility of service. Families reported benefiting from increased understanding of chronic fatigue syndrome, learning new strategies, the team linking with schools, feeling validated and mental health support. Accessibility was a particular problem including the service location, setup of appointments and difficulty contacting the team. Discussion The evaluation presents recommendations for paediatric Chronic Fatigue services to improve service user experiences.
Service user perspectives on social prescribing services for mental health in the UK: a systematic review
Authors: Cooper M , Flynn D , Avery L , Ashley K , Jordan C , Errington L , Scott J 
Published: May 2023

Aim: To thematically synthesise adult service users’ perspectives on how UK-based social prescribing services support them with their mental health management. Methods: Nine databases were systematically searched up to March 2022. Eligible studies were qualitative or mixed methods studies involving participants aged ⩾ 18 years accessing social prescribing services primarily for mental health reasons. Thematic synthesis was applied to qualitative data to create descriptive and analytical themes. Results: 51,965 articles were identified from electronic searches. Six studies were included in the review ( n = 220 participants) with good methodological quality. Five studies utilised a link worker referral model, and one study a direct referral model. Modal reasons for referral were social isolation and/or loneliness ( n = 4 studies). Two analytical themes were formulated from seven descriptive themes: (1) person-centred care was key to delivery and (2) creating an environment for personal change and development. Conclusions: This review provides a synthesis of the qualitative evidence on service users’ experiences of accessing and using social prescribing services to support their mental health management. Adherence to principles of person-centred care and addressing the holistic needs of service users (including devoting attention to the quality of the therapeutic environment) are important for design and delivery of social prescribing services. This will optimise service user satisfaction and other outcomes that matter to them.
Associations of increasing breast cancer incidence with the current drinking habits and the past smoking habits among Japanese women
Authors: Aoki Yuji , Niitsu Amane , Baba Hitomi , Nishizawa Yui 
Published: May 2023

Background We have reported that age-specific incidence rates of breast cancer among Japanese women increased from 2005 to 2015 in a bimodal distribution pattern, with two peaks in the pre- and postmenopausal age groups. Objectives The present study aimed to assess the associations of the increasing age-specific breast cancer incidence or mortality with the prevalence of obesity and drinking and smoking habits, compared with those in uterine body, female and male colon and lung cancers. Methods Linear correlations of annual rates from 2005 to 2015 of the 10-year age-specific cancer incidence and mortality with the prevalence of obesity (body mass index, 25 and over) and drinking (alcohol, 20 g and over 3 times or more a week) and smoking habits were assessed by Pearson’s correlation coefficients during the same 10-year period (from 2005 to 2015) or the 10-year period 10 years before the cancer incidence and mortality were noted (from 1995 to 2005). Results Positive correlations (r>0.640) were found between the increasing breast cancer incidence and the drinking habit during the same period or the smoking habit during the period 10 years before. Similar but weaker correlations were found for the breast cancer mortality rate increasing with age. Positive correlations were found between the decreasing male lung cancer mortality rate and the smoking habit rate during the period 10 years before. Conclusions The present ecological study indicated that the breast cancer incidence was associated with the current drinking habits and the past smoking habits among Japanese women.
Flash pulmonary oedema associated with paroxysmal supraventricular tachycardia: report of two cases
Authors: Seddon Kathleen , Cerrada Serra Inmaculada , Seo Joonbum 
Published: May 2023

Case summary We describe two cats that had episodic tachypnoea and increased respiratory effort during periods of paroxysmal supraventricular tachycardia (SVT). Thoracic radiographs at the time of clinical signs were consistent with cardiogenic pulmonary oedema. Echocardiography following stabilisation revealed a hypertrophic cardiomyopathy phenotype with normal left atrial size in both cats. The first cat was initially treated with diltiazem, but this did not reduce the frequency of the clinical episodes. Diltiazem was switched to atenolol and the cat remained well without further recurrence. At the time of writing, the cat was reported to be well, 3 years after the initial diagnosis of SVT. The second cat was first managed with diltiazem and was then transitioned to atenolol due to recurrent clinical episodes. The episodes were less frequent with atenolol but still present. Therefore, atenolol was changed to sotalol. The cat remained well on sotalol for 2 years with only one recurrent episode during a painful event. The patient then suffered a sudden cardiac death, 5 years after the initial diagnosis of SVT. Relevance and novel information To our knowledge, this is the first report that describes flash pulmonary oedema developing secondary to episodic paroxysmal SVT in cats. Despite the severity and speed of respiratory compromise, prognosis may be good with an adequate arrhythmia control.
The BEM Program: An innovative online parenting program for socioeconomically disadvantaged caregiver–child dyads in Brazil
Authors: Solís-Cordero Katherine , Marinho Patricia , Camargo Patricia , Takey Silvia , Lerner Rogério , Fujimori Elizabeth 
Published: May 2023

Objective To describe the BEM Program, an innovative online parenting program for socioeconomically disadvantaged caregiver–child dyads in Brazil. Methods The Template for Intervention Description and Replication checklist was used to describe the BEM Program in detail. Results The BEM Program (an acronym for Brincar Ensina Mudar in Portuguese, “Play Teaches Change” in English) refers to the change in adult, child, and dyad outcomes that can be observed through incorporating playful interactions between the caregiver and their child into their daily household chores. Content consisting of 8 videos and 40 text and audio messages was sent entirely online through WhatsApp®. Thus, the Program could be accessed wherever caregivers wanted, if they had their smartphone and Internet access. Conclusions The detailed description of an innovative online parenting program focused on caregiver–child interaction and child development contributes to the scarce evidence on this type of programs. Adherence to the program continues to represent one of the main challenges to overcome.
Biomechanical Evaluation of TensionLoc Versus the Double Spike Plate for ACL Graft Tibial Fixation
Authors: Jernick Michael , Borden Peter S. , Seager Andorra , McGarry Michelle H. , Adamson Gregory J. , Lee Thay Q. 
Published: May 2023

Background: The optimal tibial fixation of anterior cruciate ligament (ACL) reconstruction (ACLR) grafts remains controversial. Purpose/Hypothesis: The purpose of this study was to compare the biomechanical characteristics of the TensionLoc (TL) cortical fixation device with the Double Spike Plate (DSP) fixation device for ACL tibial fixation using both bone–patellar tendon–bone (BTB) and quadriceps grafts. It was hypothesized that there would be no differences in biomechanical characteristics between the fixation devices regardless of graft type. Study Design: Controlled laboratory study. Methods: ACLR was performed on 14 matched-pair cadaveric knee specimens—7 pairs using quadriceps grafts (n = 3 male cadaveric knee specimens; n = 4 female cadaveric knee specimens; age, 51 ± 8 years) and 7 pairs using BTB grafts (n = 3 male cadaveric knee specimens; n = 4 female cadaveric knee specimens; age, 50 ± 7 years). One side of each pair was randomized to receive DSP fixation, and the contralateral side received TL fixation. Specimens underwent cyclic ramp loading (10 cycles each at 50-100 N, 50-250 N, and 50-400 N), followed by load-to-failure testing, with the tensile force in line with the tibial tunnel. Results between the 2 fixation types were compared with a paired t test. Results: For the quadriceps graft, there were no significant differences in cyclic loading or load-to-failure characteristics between fixation types ( P≥ .092 for all parameters). For the BTB graft, TL fixation resulted in higher stiffness than DSP at all cyclic testing cycles except for cycle 1 during 100-N loading and had lower displacement at 250-N loading (3.4 ± 0.1 vs 5.4 ± 0.3 mm; P = .045). For load to failure, TL fixation resulted in higher stiffness than DSP fixation (232 ± 3.1 vs 188.4 ± 6.4 N/mm; P = .046); however, all other load-to-failure parameters were not statistically different ( P≥ .135 for all parameters). Conclusion: With the quadriceps tendon graft, there were no significant differences in biomechanical characteristics between TL and DSP ACL tibial fixations; however, with BTB grafts, the TL tibial fixation demonstrated greater biomechanical integrity than the DSP tibial fixation. Clinical Relevance: The TL fixation device may provide an alternative ACL tibial fixation option for BTB and soft tissue grafts.
Comparision of efficacy and safety of 0.03% and 0.1% tacrolimus ointment in children with vernal keratoconjunctivitis
Authors: Saha Bhawesh Chandra , Kumari Rashmi , Ambasta Anita 
Published: May 2023

Background: Topical immunosuppressants such as tacrolimus in different concentrations are a breakthrough in the management of recalcitrant vernal keratoconjunctivitis (VKC); however, there is a lacks of comparative studies to guide their use in VKC management. Objective: To compare the efficacy and safety of tacrolimus 0.03% and 0.1% eye ointment in the treatment of recalcitrant VKC. Design: A retrospective comparative single-centre observational study. Method: We reviewed records of a total of 48 recalcitrant VKC patients treated with two different strengths of tacrolimus ointment between April 2016 and March 2017. Of these, 39 fulfilled the inclusion criteria and were categorized into two groups, A and B, depending on the use of strength of tacrolimus (0.03% and 0.1%) used, respectively. Group A had 18 patients, while group B had 21 patients. Thirty-six patients, 18 from each group, were finally analysed and compared. Records of patients were explored for the subjective symptoms and objective sign score of the patient at baseline and at each time point. The main outcome measures were composite scoring and comparison of total subjective symptom scores (TSSSs) and total objective sign scores (TOSSs) within and between the groups at each follow-up. Percentage of patient with significant reduction in symptom and sign scores as compared with baseline was considered success of treatment. Chi-square and t-tests were used for comparison of outcomes between both groups Results: Mixed variety was most commonly encountered type of VKC. The signs and symptoms were significantly reduced in patients with treatment in both groups ( p = 0.001) in all types of VKC. However, in group B, there was significant improvement in the size of papillae ( p = 0.04) as compared baseline in contrast to group A. Side effects like burning and stinging in group B were significantly higher as compared with group A. Conclusions: Both strengths of tacrolimus (0.03% and 0.1%) are effective in all forms of recalcitrant VKC. Papillary component of VKC responds better with higher strength (0.1%) but is associated with more significant side effects. Different strengths of tacrolimus can be used strategically depending upon the severity and clinical type of VKC to intensify outcome and minimize side effects.
Repair of the Medial Ulnar Collateral Ligament of the Elbow With Internal Brace Augmentation
Authors: Nauert Richard F. , Yu Kristin E. , Camp Christopher L. 
Published: May 2023

Background: The medial ulnar collateral ligament (MUCL) is the primary restraint to valgus force across the elbow during throwing. The incidence of MUCL continues to rise, and injuries are common in overhead throwing athletes often leading to elbow pain and instability. While MUCL reconstruction remains the gold standard for high-level throwing athletes with midsubstance tears, MUCL repair remains an option for select athletes and affords good functional outcomes with quicker return to sport compared with reconstruction. Indications: Indications for MUCL repair include acute injuries, proximal or distal avulsions, young and lower demand athletes, non-throwing athletes, or older athletes who may be nearing retirement. Technique Description: An incision is made over the medial elbow from the medial epicondyle to the sublime tubercle. Dissection is carried down to fascia which is split in line with its fibers. The flexor pronator muscle group is bluntly divided, and the ligament exposed. Care is taken to identify and dissect the native ligament. The avulsed portion of the ligament is secured with a 0 FiberWire suture in a running locked whipstitch fashion. The footprint of the avulsed ligament is gently debrided and prepared using a scalpel. The 0-FiberWire suture tails are then loaded onto a suture anchor preloaded with suture tape. This is then secured at the footprint of the ligament. The FiberWires are cut, and the suture tape is then pulled back over the native ligament and fixed at the other attachment site for the ligament. 0-Vicryl sutures are then used to suture the internal brace to the underlying ligament so the construct would move as a single unit. Results: Biomechanical testing has demonstrated that MUCL repair with internal brace augmentation has similar time-zero failure strength when compared with the original Jobe reconstruction technique while also having greater resistance to gapping. In addition, recent literature has shown that well-selected patients can have excellent functional outcomes and quicker return to sport with MUCL repair as opposed to reconstruction. Discussion: Medial ulnar collateral ligament repair with internal brace augmentation can be a successful treatment in the appropriately indicated athlete to allow for good functional results and quicker return to sport. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
The hops (Humulus lupulus) genome contains a mid-sized terpene synthase family that shows wide functional and allelic diversity
Authors: Chen Xiuyin , Wang Mindy Y. , Deng Cecilia H. , Beatson Ron A. , Templeton Kerry R. , Atkinson Ross G. , Nieuwenhuizen Niels J. 
Published: May 2023

AbstractBackgroundHops (Humulus lupulusL.) are a dioecious climbing perennial, with the dried mature “cones” (strobili) of the pistillate/female inflorescences being widely used as both a bittering agent and to enhance the flavour of beer. The glandular trichomes of the bract and bracteole flowering structures of the cones produce an abundance of secondary metabolites, such as terpenoids, bitter acids and prenylated phenolics depending on plant genetics, developmental stage and environment. More knowledge is required on the functional and allelic diversity of terpene synthase (TPS) genes responsible for the biosynthesis of volatile terpenes to assist in flavour-directed hop breeding.ResultsMajor volatile terpene compounds were identified using gas chromatography–mass spectrometry (GC–MS) in the ripe cones of twenty-one hop cultivars grown in New Zealand. All cultivars produced the monoterpene β-myrcene and the sesquiterpenes α-humulene and β-caryophyllene, but the quantities varied broadly. Other terpenes were found in large quantities in only a smaller subset of cultivars, e.g. β-farnesene (in seven cultivars) and α-pinene (in four). In four contrasting cultivars (Wakatu™, Wai-iti™, Nelson Sauvin™, and ‘Nugget’), terpene production during cone development was investigated in detail, with concentrations of some of the major terpenes increasing up to 1000-fold during development and reaching maximal levels from 50–60 days after flowering. Utilising the publishedH. lupulusgenome, 87 putative full-length and partial terpene synthase genes were identified. Alleles corresponding to seven TPS genes were amplified from ripe cone cDNA from multiple cultivars and subsequently functionally characterised by transient expressionin planta. Alleles of the previously characterisedHlSTS1produced humulene/caryophyllene as the major terpenes.HlRLSalleles produced (R)-(-)-linalool, whilst alleles of two sesquiterpene synthase genes,HlAFS1andHlAFS2produced α-farnesene. Alleles ofHlMTS1,HlMTS2andHlTPS1were inactive in all the hop cultivars studied.ConclusionsAlleles of four TPS genes were identified and shown to produce key aroma volatiles in ripe hop cones. Multiple expressed but inactive TPS alleles were also identified, suggesting that extensive loss-of-function has occurred during domestication and breeding of hops. Our results can be used to develop hop cultivars with novel/improved terpene profiles using marker-assisted breeding strategies to select for, or against, specific TPS alleles.
Efficacy and safety of remimazolam tosilate versus propofol in patients undergoing day surgery: a prospective randomized controlled trial
Authors: Luo Wenchen , Sun Minli , Wan Jie , Zhang Zhenyu , Huang Jian , Zhang Jinlin , Xiong Wanxia , Xia Lirong , Xu Peiyao , Miao Changhong , Zhang Xuesong , Liu Mingyue , Zhong Jing 
Published: May 2023

Abstract
Background
Remimazolam tosilate (RT) is a novel short-acting GABA (A) receptor agonist that has a rapid recovery from procedural sedation and can be fully reversed by flumazenil. To date, there have been relatively few articles comparing RT and propofol for general anesthesia. This study aimed to assess the efficacy and safety of RT with or without flumazenil compared with propofol in general anesthesia for day surgery.

Methods
115 patients scheduled for day surgery were randomized into three groups: RT (n = 39), RT + flumazenil (n = 38) and propofol (n = 38). The primary endpoints were anesthesia induction time and time until fully alert. Anesthesia success rate, bispectral index (BIS) values, injection pain, opioid and vasopressor dosages, postoperative recovery profiles and perioperative inflammatory and cognitive changes were assessed. Any adverse events were recorded.

Results
Induction times were similar among the three groups (P = 0.437), but the median time until fully alert in patients treated with RT was longer than that of the propofol or RT + flumazenil groups (17.6 min vs. 12.3 min vs. 12.3 min, P < 0.001). The three groups had comparable postoperative recovery quality and inflammatory and cognitive state changes (P > 0.05). Smaller percentages of patients who received RT (26.3%) and RT + flumazenil (31.6%) developed hypotension during anesthesia maintenance compared with propofol (68.4%), and consequently less ephedrine (P < 0.001) and phenylephrine (P = 0.015) were needed in the RT group. Furthermore, serum triglyceride levels were lower (P < 0.001) and injection pain was much less frequent in the RT with or without flumazenil groups compared with the propofol group (5.3% vs. 0% vs. 18.4%).

Conclusion
RT permits rapid induction and comparable recovery profile compared with propofol in general anesthesia for day surgery, but has a prolonged recovery time without flumazenil. The safety profile of RT was superior to propofol in terms of hypotension and injection pain.

Trial registration
The study was registered at Chinese Clinical Trial Registry http://www.chictr.org.cn/ (Registration date: 19/7/2021; Trial ID: ChiCTR2100048904).