bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value pluralism about sexual intimacy in residential care
Authors: Schouten Vanessa , Henrickson Mark , Cook Catherine M , MacDonald Sandra , Atefi Narges 
Published: February 2023

Background The existing literature on sexuality and intimacy in residential care tends to focus on either the question of rights, or the value of autonomy. Where the literature does reference values other than autonomy, such values are considered in the context of being a guide to whether or not a resident is autonomous, rather than being important values in their own right. Objective This paper draws on qualitative data gathered as part of a larger study in order to inform practice on how care workers respond to intimacy issues that arise with residents with dementia and to inform a general ethics of sex and sexuality, demonstrating that an approach which permits value pluralism can be appropriate in certain contexts. Research Design The qualitative data referred to in this paper was gathered from semi-structured interviews undertaken as part of a larger mixed-method research project. The interview text was analysed using Thorne’s methodological approach, interpretive description. Participants and research context The qualitative arm of the project consisted of semi-structured interviews conducted between October 2018 and October 2019 with participants (staff, residents and family members) recruited from 35 residential care homes in Aotearoa New Zealand. Ethical Considerations Participation was informed, voluntary and written consent was gained before interviews. The project was approved by the Massey University Human Ethics Committee (Northern), number NOR 18/25. Findings Analysis of the scenarios presented in this paper shows that decision-making around sexual intimacy involving people with dementia in a residential care setting is complex and requires recognizing and weighing the different values that may be a in play. Conclusion A focus on safety and consent to the exclusion of other values which matter morally in this context is a mistake which prevents care workers from providing appropriately person-centred care to residents, as policies which focus on the goal of care allow space for critical examination of issues which are likely to be highly context-sensitive.
Niche Roles for Dexmedetomidine in the Intensive Care Unit
Authors: Wiegand Alexandra , Behal Michael , Robbins Blake , Bissell Brittany , Pandya Komal , Mefford Breanne 
Published: February 2023

Objective: Review dexmedetomidine use in critically ill patients for niche indications including sleep, delirium, alcohol withdrawal, sepsis, and immunomodulation. Data Sources: Literature was sought using PubMed (February 2012-November 2022). Search terms included dexmedetomidine AND (hypnotics OR sedatives OR sleep OR delirium OR immunomodulation OR sepsis OR alcohol withdrawal). Study Selection and Data Extraction: Relevant studies conducted in humans ≥18 years published in English were included. Exclusion criteria included systematic reviews, meta-analyses, and studies evaluating oral dexmedetomidine or other alpha-2 agonists. Data Synthesis: A total of 231 articles were retrieved. After removal of duplicates, title and abstract screening, and application of inclusion criteria, 35 articles were included. Across the clinical conditions included in this review, varying clinical outcomes were seen. Dexmedetomidine may improve morbidity outcomes in delirium, sleep, and alcohol withdrawal syndrome. Due to limited human studies and poor quality of evidence, no conclusions can be drawn regarding the role of dexmedetomidine in immunomodulation or sepsis. Relevance to Patient Care and Clinical Practice: This review presents data for potential niche roles of dexmedetomidine aside from sedation in critically ill patients. This may serve as a guide for sedation selection in critically ill patients who may also benefit from the pleiotropic effects of dexmedetomidine due to a clinical condition discussed in this review. Conclusion: While further studies are needed, dexmedetomidine may provide benefit in other indications in critically ill patients including delirium, sleep, and alcohol withdrawal. Given the poor quality of evidence of dexmedetomidine use in immunomodulation and sepsis, no conclusions can be drawn.
Impact of Determinant Macro Economic Variables on Environmental Changes in Iran
Authors: Sepehrdoust Hamid , Tartar Mohsen , Mohtashami Sara 
Published: February 2023

Sustainable economic development involves both improving the socio-economic quality of life in the present and improving environmental conditions for future generations. The main objective of the study was to investigate the impact of the determinant macroeconomic variables, including economic complexity, construction, energy consumption, and housing sector expenditures, on environmental changes in Iran over the period 1991 to 2019; using the autoregressive distributed lag (ARDL) model. The results show that at the macro level, an increase in the economic complexity index can reduce pollution in both the short and long term. The effects of further expansion of the housing sector and household energy consumption on pollution are positive and significant in both the short and long run. The error correction model (ECM = 0.65) shows that 65% of the imbalances in each period are corrected in the next period. Based on the obtained results, it is recommended to take serious measures to improve the structure of production and increase the country’s economic complexity index; in other words, to produce goods with higher knowledge and technology and apply policies to improve the level of household energy consumption leading to air pollution reduction. Jel: Q40, Q48, Q50, Q52
Hand and Upper Extremity Surgical Site Infection Rates Associated With Perioperative Corticosteroid Injection: A Review of the Literature
Authors: Light Jonathan J. , Pavlesen Sonja , Ablove Robert H. 
Published: February 2023

Background: Corticosteroid injection (CSI) has a relatively high benefit-to-risk ratio and is commonly administered to treat musculoskeletal conditions. However, perioperative CSI has been associated with an increased risk of postoperative infection. The literature suggests delaying surgery after CSI to minimize the risk of postoperative infection. We review the literature to summarize the most current knowledge on the association between perioperative CSI and infection rates for different hand and upper extremity procedures. Methods: Two independent reviewers conducted a literature search using PubMed and Web of Science databases (through October 1, 2022). The database searches used were (((injection) AND (infection)) AND (risk)) AND ((hand) OR (wrist) OR (elbow) OR (shoulder)). English-language articles were screened for infection rates associated with CSI given temporally around upper extremity surgery, focusing between 6 months preoperatively and 1 month postoperatively. Results: Nineteen articles including database queries and retrospective case-control or cohort studies were used after screening 465 articles. Most infection rates were increased in hand, wrist, elbow, and shoulder surgery between 3 months preoperatively and 1 month postoperatively. Intraoperative injection during elbow arthroscopy demonstrated increased infection rate relative to other upper extremity surgeries. Conclusions: Corticosteroid injection increased the risk of infection temporally around upper extremity surgeries; however, CSI provides benefits. The consensus regarding CSI timeline perioperatively has yet to be determined. The evidence supports an increased benefit-to-risk ratio when giving corticosteroids greater than 3 months preoperatively and greater than 1 month postoperatively for most upper extremity procedures, with relative contraindications within 1 month of upper extremity surgery.
A comparison of low- versus standard-dose bridging alteplase in acute ischemic stroke mechanical thrombectomy using indirect methods
Authors: Zheng Wei , Lei Hanhan , Ambler Gareth , Werring David J. , Lin Huiying , Lin Xiaojuan , Tang Yi , Wu Jing , Lin Zhaomin , Liu Nan , Du Houwei 
Published: February 2023

Background: Whether low-dose alteplase is similar to standard-dose bridging alteplase prior to endovascular mechanical thrombectomy in patients with acute ischemic stroke (AIS) remains uncertain. Aims: The aim of this study was to compare the efficacy and safety outcomes of low- versus standard-dose bridging alteplase therapy (BT) in patients with acute ischemic stroke (AIS) who are eligible for intravenous thrombolysis (IVT) within 4.5 h after onset. Methods: We conducted an indirect comparison of low- versus standard-dose bridging alteplase before mechanical thrombectomy in AIS of current available clinical randomized controlled trials (RCTs) that compared direct mechanical thrombectomy treatment (dMT) to BT. Primary efficacy outcomes were functional independence and excellent recovery defined as a dichotomized modified Rankin Scale (mRS) 0–2 and 0–1 at 90 days. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and any intracranial hemorrhage (ICH). Results: We included six RCTs of 2334 AIS patients in this analysis, including one trial using low-dose bridging alteplase ( n = 103) and five trials using standard-dose bridging alteplase ( n = 1067) against a common comparator (dMT). Indirect comparisons of low- to standard-dose bridging alteplase yielded an odds ratio (OR) of 0.84 (95% CI 0.47–1.50) for 90-day mRS 0–2, 1.18 (95% CI 0.65–2.12) for 90-day mRS 0–1, 1.21 (95% CI 0.44–3.36) for mortality, and 1.11 (95% CI 0.39–3.14) for successful recanalization. There were no significant differences in the odds for sICH (OR 1.05, 95% CI 0.32–3.41) or any ICH (OR 1.71, 95% CI 0.94–3.10) between low- and standard-dose bridging alteplase. Conclusion: Indirect evidence shows that the effects of low- and standard-dose bridging alteplase are similar for key efficacy and safety outcomes. Due to the wide confidence intervals, larger randomized trials comparing low- and standard-dose alteplase bridging therapy are required.
FIFA 11+ Kids: Challenges in implementing a prevention program
Authors: Franchina Méline , Turati Marco , Tercier Stéphane , Kwiatkowski Barbara 
Published: February 2023

Purpose: Soccer is a popular sport among children and adolescents that exposes to a high risk of injury. Several prevention programs, including the FIFA 11+ Kids program have been developed to decrease this injury rate. The aim of the study was to investigate the knowledge and use of the FIFA 11+ Kids program among soccer coaches of skeletally immature soccer players in a Swiss canton and analyze difficulties of implementing such a prevention program. Materials & methods: First, an online survey was sent to all soccer coaches involved in Swiss training programs for male players from 7 to 13 years of age. Coaches were identified through existing Swiss coaching networks. A total of 237 coaches completed the survey. Second, the FIFA 11+ Kids program was implemented in three soccer teams (players from 7 to 13 years of age) during 6 months in the same canton. Utilization of FIFA 11+ Kids program and compliance of coaches were recorded by the research staff. Results: Around 84% of the included coaches in the survey were certified. Of those, 59% had been taught injury prevention during their course(s). Only 14% of the included coaches knew one of the FIFA programs (11, 11+, 11+ Kids), of those, about one-third (10 out of 237) used the FIFA 11+ Kids program. After 6 months, none of the soccer coaches applied the entire FIFA 11+ Kids program twice a week. One coach had completely abandoned the program. The main reasons for their disapproval were the time and surveillance needed and the players’ lack of motivation. They stated, however, that the exercises were good if used occasionally. Conclusion: Injury prevention should be integrated in every soccer coach education courses. An adaptation of the FIFA 11+ Kids program should be considered, especially for the youngest players.
Osteochondritis dissecans of the knee in adolescents: How to treat them?
Authors: Cabral Joao , Duart Julio 
Published: February 2023

Background: Osteochondritis dissecans is an acquired condition of the joint that affects the articular surface and the subchondral bone. The juvenile form of osteochondritis dissecans presents in those aged 5–16 years with open growth plates. The causes of osteochondritis dissecans are unknown. Methods: The goals of treatment are to promote healing of the subchondral bone and prevent chondral collapse, subsequent fracture, osteochondral defect formation, and early joint degeneration. Treatment modality is influenced on clinical symptoms, skeletal maturity, as well as the size, stability, and location of the lesion. This article will review the treatment strategies of juvenile form of osteochondritis dissecans of medial femoral condyle and of atypical regions, such as lateral femoral condyle, patellofemoral joint, and tibial plateau. Level of evidence: level III.
Clinical considerations of anatomy and magnetic resonance imaging in pediatric meniscus tear, with imaging-based treatment options
Authors: Cabral Joao , Sinikumpu Jaakko 
Published: February 2023

Background: The incidence of meniscal tears in children has been increasing. Early sport specialization, more intense training activity, and increasing participation in competitive sports may have affected to that increasing trend. Diagnosing acute menisci tear in children is based on suggestive clinical and magnetic resonance imaging findings. There are special particulars in immature menisci, due to relatively good vascular supply. Furthermore, growing skeleton makes differences in injury pattern, and a clinician needs to recognize not only meniscus but also potential injuries in growth plates and ligaments, which are usual in connection with pediatric meniscus leasion. Clinical and imaging investigation prior to treatment is crucial, because non-operative care is considerable, to achieve spontaneous healing, especially in peripherial tears of younger children. Second, repair is preferred always as possible, in spite of resection due to high rate of long-term sequelae after partial meniscectomy. High standard preoperative imaging aid in preparing to the meniscus sparing arthroscopic intervention. Methods: In this current concept article, the clinical considerations of imaging the injured pediatric knee with a suspected meniscus tear and the treatment options by the imaging findings are reviewed. Level of evidence: level III.
Early arteriopathy in Aicardi–Goutières syndrome 5. Case report and review of literature
Authors: Markovic Ivana , Jocic-Jakubi Bosanka , Milenkovic Zoran 
Published: February 2023

Aicardi–Goutières syndrome (AGS) is an autosomal recessive disease that mimics congenital viral infection and mainly affects the brain, immune system, and skin. The dominant clinical symptom is the subacute onset of severe encephalopathy, which manifests as irritability, loss of ability, slowing of head growth, and poor nutrition. Arteriopathy in AGS is an uncommon manifestation usually associated with mutations in the SAMHD1 gene. We present a rare case of a 3-year-old male due to failure to thrive, global developmental delay, microcephaly, poor vision, upper and lower limbs spasticity, and gastroesophageal reflux disease (GERD), who harbored early stenotic lesions of the large and medium intracranial arteries with ischemic sequelae in the early postnatal life. Performed genetic testing confirmed homozygous gene mutation, SAMHD1 associated with AGS type 5. By reviewing the available literature, we were able to find only one patient whose arterial lesions were diagnosed after 6 months.
Study protocol for a multicenter randomized controlled trial of personalized exercise therapy and self-management support for people with multimorbidity: The MOBILIZE study
Authors: Skou Søren T , Nyberg Mette , Dideriksen Mette , Overgaard Jan A , Bodilsen Christine , Soja Anne MB , Attarzadeh Amir P , Bieder Manuel J , Dridi Nadia P , Heltberg Andreas , Gæde Peter H , Reventlow Johan L , Arnfred Sidse , Bodtger Uffe , Thygesen Lau C , Jäger Madalina , Bricca Alessio 
Published: February 2023

Background Despite the great individual and societal burden associated with multimorbidity, little is known about how to effectively manage it. Objective The aim of this multicenter randomized controlled trial (RCT) is to investigate the 12-month effects of a personalized exercise therapy and self-management support program in addition to usual care in people with multimorbidity. Design This is a protocol for a pragmatic, parallel-group (1:1 ratio), superiority RCT conducted at five intervention sites (two hospitals, a private practice physiotherapy clinic and two municipal rehabilitation centers) in Region Zealand, Denmark. A total of 228 persons with multimorbidity aged 18 years or older, will be randomly allocated to one of two groups. Both groups will receive usual care, defined as routine care for multimorbidity at the discretion of the treating doctor, while the intervention group will also participate in a 12-week exercise therapy and self-management support program tailored to people with multimorbidity at one of the intervention sites. The primary outcome will be the between-group difference in change in EQ-5D-5L from baseline to the follow-up at 12 months. Secondary outcomes include objectively-measured physical function and physical activity, inflammatory markers, disease and treatment burden, anxiety, depression, stress, sleep, pain and other self-reported parameters. In parallel with the RCT, an observational cohort will follow persons aged ≥18 years with multimorbidity not adhering to all eligibility criteria, as well as people fulfilling all eligibility criteria, but unwilling to participate in the RCT. This study was approved by the Regional Committee on Health Research Ethics for Region Zealand (SJ-857) and results will be communicated in scientific papers, at relevant conferences and to a broader audience. Discussion Exercise therapy and self-management support is safe and effective in people with single conditions. However, it is still unclear whether this holds true for individuals with multimorbidity. This pragmatic, multicenter RCT will provide high-quality evidence on the benefits and harms of exercise therapy and self-management support and, if the results support it, lead to the development of a plan for implementation in clinical practice.
Thrombogenic potential of picomolar coagulation factor XIa is mediated by thrombin wave propagation
Authors: Parunov Leonid A. , Liang Yideng , Lu Qijin , Shibeko Alexey M. , Tucker Erik I. , Lee Timothy K. , Ataullakhanov Fazoil I. , Scott Dorothy E. , Ovanesov Mikhail V. 
Published: February 2023

AbstractInhibitors of coagulation factor XIa (FXIa) are currently being investigated as potential anticoagulant therapies. We hypothesize that circulating FXIa could be a potential target for these therapies. Using previous analyses of FXIa impurities in immune globulin products involved in thrombotic adverse events, we estimated that picomolar levels of FXIa can be thrombogenic. In an in vitro clot-growth assay, 0.1-3 pM of FXIa did not, by itself, activate clotting but increased the size of growing clots. Spatio-temporal reconstruction of thrombin activity inside the clot revealed that FXIa’s effect was limited to the clot-plasma interface, in which FXIa produced a taller than standard wave of thrombin. Factor-depleted plasma and a panel of selective anti-FXIa antibodies showed that exogenous FXIa effects are (1) blocked by anti-FXIa antibodies, (2) independent of FXI activation inside the clot, and (3) larger than the contribution of in situ FXIa. In a thrombin generation (TG) assay, picomolar FXIa did not initiate TG but rather promoted TG triggered by tissue factor or thrombin, suggesting that the effect of FXIa on the thrombin wave is mediated by the elevation of thrombin-triggered TG. In circulating bovine blood, low doses of human FXIa did not initiate clotting but increased the size of stenosis-triggered thrombi. FXIa injection in mice enhanced TG in plasma for at least 6 hours ex vivo, confirming the persistence of circulating FXIa. Our findings suggest that picomolar levels of circulating FXIa may not be able to initiate thrombosis but can facilitate thrombus growth through the facilitation of TG inside the clot.
Olutasidenib (FT-2102) induces durable complete remissions in patients with relapsed or refractory IDH1-mutated AML
Authors: de Botton Stéphane , Fenaux Pierre , Yee Karen , Récher Christian , Wei Andrew H. , Montesinos Pau , Taussig David C. , Pigneux Arnaud , Braun Thorsten , Curti Antonio , Grove Carolyn , Jonas Brian A. , Khwaja Asim , Legrand Ollivier , Peterlin Pierre , Arnan Montserrat , Blum William , Cilloni Daniela , Hiwase Devendra K. , Jurcic Joseph G. , Krauter Jürgen , Thomas Xavier , Watts Justin M. , Yang Jay , Polyanskaya Olga , Brevard Julie , Sweeney Jennifer , Barrett Emma , Cortes Jorge 
Published: February 2023

Abstract
Olutasidenib (FT-2102) is a potent, selective, oral, small-molecule inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1). Overall, 153 IDH1 inhibitor–naive patients with mIDH1R132 relapsed/refractory (R/R) acute myeloid leukemia (AML) received olutasidenib monotherapy 150 mg twice daily in the pivotal cohort of this study. The median age of participants was 71 years (range, 32-87 years) and the median number of prior regimens received by patients was 2 (1-7). The rate of complete remission (CR) plus CR with partial hematologic recovery (CRh) was 35%, and the overall response rate was 48%. Response rates were similar in patients who had, and who had not, received prior venetoclax. With 55% of patients censored at the time of data cut-off, the median duration of CR/CRh was 25.9 months. The median duration of overall response was 11.7 months, and the median overall survival was 11.6 months. Of 86 patients who were transfusion dependent at baseline, a 56-day transfusion independence was achieved in 29 (34%), which included patients in all response groups. Grade 3 or 4 treatment-emergent adverse events (≥10%) were febrile neutropenia and anemia (n = 31; 20% each), thrombocytopenia (n = 25; 16%), and neutropenia (n = 20; 13%). Differentiation syndrome adverse events of special interest occurred in 22 (14%) patients, with 14 (9%) grade ≥3 and 1 fatal case reported. Overall, olutasidenib induced durable remissions and transfusion independence with a well-characterized and manageable side effect profile. The observed efficacy represents a therapeutic advance in this molecularly defined, poor-prognostic population of patients with mIDH1 R/R AML. This trial was registered at www.clinicaltrials.gov as #NCT02719574.