bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Dilatational Tracheostomy Performed by Anaesthesiologist in a Low Resource Setting: Preliminary Report on 19 Patients
Authors: Antwi-Kusi A. , Boakye G. , Sam-Awortwi W. , Konney A. 
Published: July 2023

Background: Percutaneous dilatational tracheostomy (PDT) is an established alternative to surgical tracheostomy in intensive care patients deemed to require prolonged ventilation. The procedure is simple, cheap and is associated with less complication. Even though PDT is the preferred technique of tracheostomy in ICU’s in low resource countries like Ghana little is known about this technique. PDT using the percutwist set became available in the ICU of the Komfo Anokye Teaching Hospital recently and we report on 19 consecutive cases done so far.Objective: To determine the outcome of 19 percutaneous dilatational tracheostomy done under bronchoscopic guidance by anaesthesiologists in an Intensive Care Unit.Design: Retrospective study.
Setting: Intensive Care Unit of the Komfo Anokye Teaching Hospital, Kumasi, GhanaSubjects and Methods: Nineteen consecutive patients who underwent percutaneous dilatational tracheostomy at the bedsideusing the percutwist set under bronchoscopy guidance. Using the admission/discharge books and the Nurses report book in the ICU, patients’ records were retrieved. The number and success of tracheostomies, and the complications were assessed.Results: There were 19 patients who underwent PDT during the period. 17 (95.24%) of the tracheostomies done were successful with easy ventilation of the lungs In one patient (4.76%) PDT was unsuccessful and was converted to surgical tracheotomy. One patient had a problem with ventilation after the tracheostomy tube was inserted. It was detected that the tube was short and was therefore replaced with a normal endotracheal tube. There was bleeding from the incision site in two of the patients (9.5%). This was controlled with pressure dressing.Conclusion: In a low resource country like Ghana where there is a limited number of ENT surgeons, PDT performed by the anaesthesiologist in the ICU can be an alternative technique to surgical tracheostomy. It is safe and success rate is high if done by skilled Anaesthesiologist in the appropriate patient.
Anxiety and Depression Among Breast Cancer Patients in A Tertiary Hospital in Ghana
Authors: Calys-Tagoe B.N.L. , Senaedza N.A.H. , Arthur C.A. , Clegg-Lamptey J.N. 
Published: July 2023

Background: Breast cancer is the second most common cancer globally and the most frequent cancer among women. It is associated with significant psychological morbidity including anxiety and depression. The extent of this burden has however not been documented in the Ghanaian setting. This study aimed at determining the prevalence of anxiety and depression amongst patients with breast cancer at the Korle Bu Teaching Hospital (KBTH).Design and Subjects: A cross-sectional study was carried out among 120 breast cancer patients using a structured questionnaire to obtain socio-demographic characteristics of patients. The hospital anxiety and depression scale (HADS) was used to assess fordepression and anxiety in these patients. Results: The overall prevalence of depression was 84.2%, while that for anxiety was 92.5%. Forty-four percent of the study participants had both anxiety and depression. There was no significant difference in depression (p=0.796) and anxiety (p=0.999) prevalencebetween post-menopausal (82.9% and 92.1% respectively) and pre-menopausal (86.4% and 93.2% respectively) patients. A significant difference in prevalence of depression alone (p=0.033) and depression in combination with anxiety (0.025) was found between those living with their partners and those living without their partners. Average monthly income was found to be significantly associated withanxiety alone (p=0.014) as well as anxiety and depression combination (p=0.032) but not with depression alone (p=0.101).Conclusion: The prevalence of anxiety and depression are quite high among breast cancer patients at the Korle Bu Teaching Hospital. Anxiety was significantly associated with the average monthly income while depression was associated with the marital status ofpatients. The high prevalence of both anxiety and depression among breast cancer patients makes it imperative for psychotherapy to be incorporated as an integral part of the management of breast cancer patients for the entire duration of the illness but moreespecially during the period immediately following diagnosis
Calcium Supplementation For The Prevention Of Pregnancy Induced Hypertension/Preeclampsia
Authors: Omonua K.I. , Akaba G.O. , Isah A.Y. , Offiong R.A. , Ekele B.A. 
Published: July 2023

Background: Pregnancy induced hypertension (PIH) and preeclampsia (PE) contribute significantly to maternal and perinatal morbidity and mortality. The role of calcium supplementation towards preventing PIH/PE however remains unclear.Objective: To assess the efficacy of calcium supplementation in prevention of PIH and PE. Materials and methods: An open label, randomized controlled trial conducted at the antenatal clinic of University of Abuja Teaching Hospital between July 2014 and June 2015. A total of 484 nulliparous women 16 weeks or less gestation and with normal bloodpressures were randomly assigned to either receive 1200mg of calcium tablet daily (N=242) or not to receive calcium tablets (N=242) from 16weeks until delivery. Primary outcome measure was development of PIH or PE and secondary outcome measure was preterm birth.Results: The incidence of PIH was 7.7% among the intervention group compared to 13.7% in the control, p=0.039 and calcium supplementation reduced the risk of PIH (RR=0.56 (95% CI: 0.32-0.98)), but not PE. It also prolonged the duration of pregnancy in women who developed PIH (p=0.02). Incidence of preeclampsia was not significant, RR-0.56 (95% CI: 0.21-1.52) so also was the incidence of preterm delivery between the two groups (RR-0.65 (95% CI: 0.32-1.31)). No serious maternal side effects of treatment were recorded.Conclusion: Calcium supplementation during pregnancy reduced the risk of PIH and thus may have a role in the prevention of PIH amongst nulliparous women. Its role in the absolute prevention of PE was not demonstrated in this study.
Emergency Laparoscopic Appendectomy In Ghana: The 37 Military Hospital Method
Authors: Asumanu E. , Yeboah R. , Boadi B. , Opae – Tetteh I. , Teteyfio – Koney C. , Antwi A.A. , Adiali B. , Ayebge V.A. , Idan P. 
Published: July 2023

Summary: Emergency laparoscopic appendectomy is evolving as the method of preference for the management of acute appendicitis. Appendicitis is one of the common causes of acute abdomen diagnosed in the emergency unit in Ghana and open appendectomyhas been the preferred method for most surgeons. Increasing patient preference for laparoscopy in Ghana will soon require an increase in the practice of emergency laparoscopic appendectomy in many centres. The number and sizes of ports as well as thesite of placement, together with the technique of appendectomy, determines the uniqueness of the method of laparoscopic appendectomy. A simplified easy to apply method of laparoscopic appendectomy is needed to encourage its use in emergency centres.Methods: The paper describes a 3-port method of laparoscopic appendectomy which combines the principles of open appendectomy and basic laparoscopy. Patient positioning and the operative removal of the appendix is similar to what as is done in open appendectomy. Pneumoperitoneum is achieved by open access through the umbilicus. Two additional ports are placed below the iliac crest for a good cosmetic effect. The amount of consumable used usage is comparable to that of open appendectomy. Discusion: The question of a gold standard procedure for laparoscopic appendix still persists. The key criteria in the choice of any method should be the success rate, affordability, resource availability and suitability. The method described meets the above criteria in a low resource environment. It offers opportunity for the practice of laparoscopic appendectomy in institutions that practice open appendectomy. The sites of port placement makes the method especially suitable for population that are keloid prone. The use of the same principle for mesappendix and appendix excision as in open appendectomy helps improve the learning curve. Modifying the 10mm port into a retrieval bag at the end of the procedure presents gives the same effect as a conventional retrieval bag without an additional risk of infection.Conclusion: The method has an inherent easy learning curve and is expected to help scale up the conversion from open to laparoscopic appendectomy.
Honteux, désarmés, décidés !
Authors: Wormser Gérard 
Published: July 2023

Une honte totale nous envahit, à proportion de la stupeur du 24 février dernier. Quatre millions de personnes, surtout des femmes et des enfants, ont fui le risque mortel et connaissent les affres de l’exil. Six millions d’Ukrainiens de plus durent abandonner leur maison pour un lieu moins menacé du territoire national. La Russie a gagné : l’Ukraine détruite a perdu sa souveraineté, le temps des zones d’influence et des pactes militaires est de retour. La nouvelle guerre froide sera arbitrée par les puissances asiatiques, tandis que les soutiens dévoyés à la Russie de Poutine devront ravaler leurs inepties criminelles.
La relecture sensible : vers une conscientisation du « savoir‑lire éditorial » ?
Authors: Tréhondart Nolwenn 
Published: July 2023

S’il est en plein essor aux États‑Unis, le métier desensitivity readerest encore marginal en France. À partir d’entretiens semi‑directifs menés avec 14 professionnel·le·s concerné·e·s (relecteur·trice·s sensibles, éditeur·trice·s, agent·e·s littéraires), nous proposons dans cet article de mieux cerner les spécificités de cette activité émergente du point de vue de celles et ceux qui sont amené·e·s à l’exercer ou qui la promeuvent. Nous montrons les interrogations concernant l’émergence d’un « savoir‑lire éditorial » spécifique, où le vécu discriminatoire et l’affirmation d’un « savoir situé » sont au centre de l’expertise. Nous concluons sur le rôle d’intermédiaire de l’éditeur·trice, qui cherche à promouvoir une pratique encore invisibilisée dans les maisons d’édition.
Reading for Normal: Young People and YA Fiction in the Time of Covid‑19
Authors: Waller Alison , Dashwood Rita J. 
Published: July 2023

The Reading for Normal project discussed in this article sought to
interrogate some of the assumptions about “normality” that underpin everyday life,
and to understand how reading fictional representations of ordinary life might help
young readers better manage periods of uncertainty and instability. Using data from
a small‑scale UK‑based reading group project that ran from December 2020 to
May 2021, we explore the affordances of authenticity, belonging, and connection that
emerged when teens were offered opportunities for a “common dwelling in fictional
ordinariness with a generational cohort”. We consider the ways in which reading and
talking about young adult (YA) fiction helps teenage readers address questions about
the changing world around them.
Effect of Internet-Delivered Emotion Regulation Individual Therapy for Adolescents With Nonsuicidal Self-Injury Disorder
Authors: Bjureberg Johan , Ojala Olivia , Hesser Hugo , Häbel Henrike , Sahlin Hanna , Gratz Kim L. , Tull Matthew T. , Claesdotter Knutsson Emma , Hedman-Lagerlöf Erik , Ljótsson Brjánn , Hellner Clara 
Published: July 2023

ImportanceNonsuicidal self-injury is prevalent in adolescence and associated with adverse clinical outcomes. Effective interventions that are brief, transportable, and scalable are lacking.ObjectiveTo test the hypotheses that an internet-delivered emotion regulation individual therapy for adolescents delivered adjunctive to treatment as usual is superior to treatment as usual only in reducing nonsuicidal self-injury and that improvements in emotion regulation mediate these treatment effects.Design, Setting, and ParticipantsThis 3-site, single-masked, randomized superiority trial enrolled participants from November 20, 2017, to April 9, 2020. Eligible participants were aged between 13 and 17 years and met diagnostic criteria for nonsuicidal self-injury disorder; they were enrolled as a mixed cohort of consecutive patients and volunteers. Parents participated in parallel to their children. The primary end point was at 1 month after treatment. Participants were followed up at 3 months posttreatment. Data collection ended in January 2021.InterventionsTwelve weeks of therapist-guided, internet-delivered emotion regulation individual therapy delivered adjunctive to treatment as usual vs treatment as usual only.Main Outcomes and MeasuresPrimary outcome was the youth version of the Deliberate Self-harm Inventory, both self-reported by participants prior to treatment, once every week during treatment, and for 4 weeks posttreatment, and clinician-rated by masked assessors prior to treatment and at 1 and 3 months posttreatment.ResultsA total of 166 adolescents (mean [SD] age, 15.0 [1.2] years; 154 [92.8%] female) were randomized to internet-delivered emotion regulation therapy plus treatment as usual (84 participants) or treatment as usual only (82 participants). The experimental intervention was superior to the control condition in reducing clinician-rated nonsuicidal self-injury (82% vs 47% reduction; incidence rate ratio, 0.34; 95% CI, 0.20-0.57) from pretreatment to 1-month posttreatment. These results were maintained at 3-month posttreatment. Improvements in emotion dysregulation mediated improvements in self-injury during treatment.Conclusions and RelevanceIn this randomized clinical trial, a 12-week, therapist-guided, internet-delivered emotion regulation therapy delivered adjunctive to treatment as usual was efficacious in reducing self-injury, and mediation analysis supported the theorized role of emotion regulation as the mechanism of change in this treatment. This treatment may increase availability of evidence-based psychological treatments for adolescents with nonsuicidal self-injury.Trial RegistrationClinicalTrials.gov Identifier: NCT03353961
Management of Down Syndrome–Associated Leukemias
Authors: Verma Anupam , Lupo Philip J. , Shah Nirali N. , Hitzler Johann , Rabin Karen R. 
Published: July 2023

ImportanceDown syndrome (DS), caused by an extra copy of material from chromosome 21, is one of the most common genetic conditions. The increased risk of acute leukemia in DS (DS-AL) has been recognized for decades, consisting of an approximately 150-fold higher risk of acute myeloid leukemia (AML) before age 4 years, and a 10- to 20-fold higher risk of acute lymphoblastic leukemia (ALL), compared with children without DS.ObservationsA recent National Institutes of Health-sponsored conference, ImpacT21, reviewed research and clinical trials in children, adolescents, and young adults (AYAs) with DS-AL and are presented herein, including presentation and treatment, clinical trial design, and ethical considerations for this unique population. Between 10% to 30% of infants with DS are diagnosed with transient abnormal myelopoiesis (TAM), which spontaneously regresses. After a latency period of up to 4 years, 20% to 30% develop myeloid leukemia associated with DS (ML-DS). Recent studies have characterized somatic mutations associated with progression from TAM to ML-DS, but predicting which patients will progress to ML-DS remains elusive. Clinical trials for DS-AL have aimed to reduce treatment-related mortality (TRM) and improve survival. Children with ML-DS have better outcomes compared with non-DS AML, but outcomes remain dismal in relapse. In contrast, patients with DS-ALL have inferior outcomes compared with those without DS, due to both higher TRM and relapse. Management of relapsed leukemia poses unique challenges owing to disease biology and increased vulnerability to toxic effects. Late effects in survivors of DS-AL are an important area in need of further study because they may demonstrate unique patterns in the setting of chronic medical conditions associated with DS.Conclusions and RelevanceOptimal management of DS-AL requires specific molecular testing, meticulous supportive care, and tailored therapy to reduce TRM while optimizing survival. There is no standard approach to treatment of relapsed disease. Future work should include identification of biomarkers predictive of toxic effects; enhanced clinical and scientific collaborations; promotion of access to novel agents through innovative clinical trial design; and dedicated studies of late effects of treatment.
Objectively Measured Visual Impairment and Dementia Prevalence in Older Adults in the US
Authors: Killeen Olivia J. , Zhou Yunshu , Ehrlich Joshua R. 
Published: July 2023

ImportanceEstimates of the association between visual impairment (VI) and dementia in the US population are based on self-reported survey data or measures of visual function that are at least 15 years old. Older adults are at high risk of VI and dementia so there is a need for up-to-date national estimates based on objective assessments.ObjectiveTo estimate the association between VI and dementia in older US adults based on objective visual and cognitive function testing.Design, Setting, and ParticipantsThis secondary analysis of the 2021 National Health and Aging Trends Study (NHATS), a population-based, nationally representative panel study, included 3817 respondents 71 years and older. Data were analyzed from January to March 2023.InterventionIn 2021, NHATS incorporated tablet-based tests of distance and near visual acuity and contrast sensitivity (CS) with habitual correction.Main Outcomes and MeasuresVI was defined as distance visual acuity more than 0.30 logMAR, near visual acuity more than 0.30 logMAR, and CS more than 1 SD below the sample mean. Dementia was defined as scoring 1.5 SDs or more below the mean in 1 or more cognitive domains, an AD8 Dementia Screening Interview Score indicating probable dementia, or diagnosed dementia. Poisson regression estimated dementia prevalence ratios adjusted for covariates.ResultsOf 2967 included participants, 1707 (weighted percentage, 55.3%) were female, and the median (IQR) age was 76.9 (77-86) years. The weighted prevalence of dementia was 12.3% (95% CI, 10.9-13.7) and increased with near VI (21.5%; 95% CI, 17.7-25.3), distance VI (mild: 19.1%; 95% CI, 13.0-25.2; moderate, severe, or blind: 32.9%; 95% CI, 24.1- 41.8), and CS impairment (25.9%; 95% CI, 20.5-31.3). Dementia prevalence was higher among participants with near VI and CS impairment than those without (near VI prevalence ratio: 1.40; 95% CI, 1.16-1.69; CS impairment prevalence ratio: 1.31; 95% CI, 1.04-1.66) and among participants with moderate to severe distance VI or blindness (prevalence ratio: 1.72; 95% CI, 1.26-2.35) after adjustment for covariates.Conclusions and RelevanceIn this survey study, all types of objectively measured VI were associated with a higher dementia prevalence. As most VI is preventable, prioritizing vision health may be important for optimizing cognitive function.
An adaptive cascade predictive control strategy for connected and automated vehicles
Authors: Landolfi Enrico , Natale Ciro 
Published: July 2023

SummaryConnectivity is a key element enabling intelligent vehicles to communicate with each other and the Smart Road. In general, the connectivity is allowed by an On‐Board Unit enabling the Vehicle to Everything communication. This paper proposes an innovative unit acting not only as a device allowing connectivity but also as an intelligent electronic control unit to perform advanced and adaptive control strategies able to give reference trajectories and actuator set‐points to the low‐level control systems of power‐train and vehicle dynamics. In particular, based on a cascade model predictive control, an adaptive control strategy is proposed, considering time‐varying parameters and information related to vehicle kinematics and dynamics. Such a strategy allows the vehicle to follow a certain origin‐destination path in the inertial frame, based on an upper controller that considers a vehicle kinematic model so as to give speed references and target values for the steering angle at the wheels to the inner predictive control loop acting on both longitudinal and lateral vehicle dynamics. To check the effectiveness of the proposed approach, a comparison is made with existing cascade control strategies. The results show better safety and lane‐keeping performance. Then, using Hardware‐In‐the‐Loop testing for the proposed Intelligent On‐Board Unit, the considered approach demonstrates robustness against parametric variations, signal delay and noise both in the Global Positioning System and in the yaw rate sensor. The achieved results show good robustness properties, safety performances and confirm the real‐time execution of the cascade control strategy, paving the way to future developments necessary before tests in a real road scenario.
Sonoactivated Cascade Fenton Reaction Enhanced by Synergistic Modulation of Electron–Hole Separation for Improved Tumor Therapy
Authors: Zhang Su‐Ling , Liu Cong , Li Zhi‐Xiang , Guan Ying‐Hua , Ge Lin , Sun Qijun , Liu Jun‐An , Lin Yong‐Jun , Yang Zi‐Xin , Qiao Zeng‐Ying , Wang Hao 
Published: July 2023

AbstractChemodynamic therapy (CDT) is an emerging targeted treatment technique for tumors via the generation of highly cytotoxic hydroxyl radical (·OH) governed by tumor microenvironment‐assisted Fenton reaction. Despite high effectiveness, it faces limitations like low reaction efficiency and limited endogenous H2O2, compromising its therapeutic efficacy. This study reports a novel platform with enhanced CDT performance by in situ sono‐activated cascade Fenton reaction. A piezoelectric g‐C3N4 (Au‐Fe‐g‐C3N4) nanosheet is developed via sono‐activated synergistic effect/H2O2 self‐supply mediated cascade Fenton reaction, realizing in situ ultrasound activated cascade Fenton reaction kinetics by synergistic modulation of electron–hole separation. The nanosheets consist of piezoelectric g‐C3N4 nanosheet oxidizing H2O to highly reactive H2O2 from the valence band, Fe3+/Fe2+ cycling activated by conduction band to generate ·OH, and Au nanoparticles that lower the bandgap and further adopt electrons to generate more 1O2, resulting in improved CDT and sonodynamic therapy (SDT). Moreover, the Au–Fe–g‐C3N4 nanosheet is further modified by the targeted peptide to obtain P–Au–Fe–g‐C3N4, which inhibits tumor growth in vivo effectively by generating reactive oxygen species (ROS). These results demonstrated that the sono‐activated modulation translates into a high‐efficiency CDT with a synergistic effect using SDT for improved anti‐tumor therapy.