bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between app usage and behaviour change in a m-health intervention to improve physical activity and sleep health in adults: secondary analyses from two randomised controlled trials
Authors: Murphy Leah L. , Dascombe Ben J. , Murawski Beatrice , Rayward Anna T. , Brown Wendy J. , Plotnikoff Ronald C. , Vandelanotte Corneel , Holliday Elizabeth G. , Duncan Mitch J. 
Published: February 2023

Abstract
Background
To examine associations between user engagement and activity-sleep patterns in a 12-week m-health behavioural intervention targeting physical activity and sleep.

Methods
This secondary analysis used data pooled from two Randomised Control Trials (RCT, [Synergy and Refresh]) that aimed to improve physical activity and sleep (PAS) among physically inactive adults with poor sleep. Both RCTs include a PAS intervention group (n = 190 [Synergy n = 80; Refresh n = 110]) and a wait list Control (CON n = 135 [Synergy n = 80; Refresh n = 55]). The PAS groups received a pedometer and accessed a smartphone/tablet “app” with behaviour change strategies, and email/SMS support. Activity-sleep patterns were quantified using the activity-sleep behaviour index (ASI) based on self-report measures. Intervention usage was quantified as a composite score of the frequency, intensity and duration of app usage during intervention (range: 0–30). Assessments were conducted at baseline, 3 and 6 months. Relationships between usage and ASI were examined using generalised linear models. Differences in ASI between the control group and intervention usage groups (Low [0–10.0], Mid [10.1–20.0], High [20.1–30.0]) were examined using generalised linear mixed models adjusted for baseline values of the outcome. Trial Registration: ACTRN12617000376347; ACTRN12617000680369.

Results
During the 3-month intervention, the mean (± sd) usage score was 18.9 ± 9.5. At 3 months (regression coefficient [95%CI]: 0.45 [0.22, 0.68]) and 6 months (0.48 [0.22, 0.74]) there was a weak association between usage score and ASI in the intervention group. At 3 months, ASI scores in the Mid (Mean [95%CI] = 57.51 [53.99, 61.04]) and High (60.09 [57.52, 62.67]) usage groups were significantly higher (better) than the control group (51.91 [49.58, 54.24]), but not the Low usage group (47.49 [41.87, 53.12]). Only differences between the high usage and control group remained at 6 months.

Conclusion
These findings suggests that while higher intervention usage is associated with improvements in behaviour, the weak magnitude of this association suggests that other factors are also likely to influence behaviour change in m-health interventions.
Trial registration number: ACTRN12617000376347; ACTRN12617000680369.
Genetic profiling analysis design of well-differentiated aggressive grade 2 and 3 gastroenteropancreatic neuroendocrine tumors in the phase III randomized controlled COMPOSE trial.
Authors: Halfdanarson Thorvardur Ragnar , Capdevila Jaume , Halperin Daniel M. , Herrmann Ken , Kong Grace , Leyden Simone , Mailman Josh , Reidy-Lagunes Diane , Srirajaskanthan Rajaventhan , Erdö Máté , Rotger Amanda , Thevenet Thomas 
Published: February 2023

TPS660 Background: Deeper comprehension of gastroenteropancreatic neuroendocrine tumor (GEP-NET) characteristics has led to development of therapeutic interventions such as targeted radionuclide therapies (TRT). In the prospective, randomized, controlled, open-label, multi-center, Phase III COMPOSE trial, the radiolabeled somatostatin analogue 177Lu-edotreotide will be compared to approved standard of care with everolimus, CAPTEM or FOLFOX in patients with well-differentiated aggressive grade 2 and 3 (Ki-67 index 15−55%), somatostatin receptor positive GEP-NETS. While TRT is advantageous, a key unmet need is to identify additional markers intended to guide patient selection for TRT. This is highly relevant as TRT is a therapy of growing interest likely to be broadly available for patients with variable phenotypes. Profiling analysis as part of COMPOSE plans to analyze the genetic signature of GEP-NETS through full exome sequencing and gene expression analysis of tumor histology and longitudinal blood samples. This analysis may guide detection of pathogenic mutations in NET patients, to potentially inform treatment and surveillance strategies. Methods: Whole exome analysis of tumor-suppressor- and proto-oncogenes included in several pan-cancer panels, upstream and downstream regulators, and novel candidate genes, will be studied. Following patient consent, historical tumor biopsy and blood samples will undergo genetic analysis. Genetic profiling analysis inclusion will not impact trial involvement or disease management. DNA will be assessed to determine the impact of different types of mutations; mRNA will be assessed to confirm and quantify these assumptions and compare gene expression at different treatment phases. Samples will be analyzed in a central pathology laboratory. The aim of this analysis is to develop software that would integrate genetic data with structural and functional imaging, histopathology and phenotype information for implementation into clinical practice. Clinical trial information: NCT04919226 .
Phase I study of PTM-101 as neoadjuvant therapy for borderline resectable or locally advanced pancreatic ductal adenocarcinoma: A trial in progress.
Authors: Pilgrim Charles , Smith Marty , Ban Jun , Ellis Sam , Zalcberg John Raymond , Markman Ben , Lashof-Sullivan Margaret , Indolfi Laura 
Published: February 2023

TPS775 Background: While there have been tremendous advances in cancer treatment, critical challenges remain including limited ability of drugs to successfully reach the tumor, short half-life, and low retention rate on site. Local control of non-metastatic pancreatic adenocarcinoma (PDAC) remains a major challenge. Up to 40% of patients present with locally advanced and borderline resectable anatomy, for whom enhanced local downsizing of disease could improve symptoms and increase overall survival (OS). Targeted therapies with reduced systemic toxicity are needed for the treatment of PDAC since current therapies have not provided meaningful advances. PTM-101 is a paclitaxel-impregnated absorbable product which is designed for direct, sustained release of the therapeutic agent at the tumor site. Preclinical animal studies demonstrate that PTM-101 results in enhanced drug levels in the tumor compared with comparable systemic paclitaxel dosing leading to tumor reduction, metastasis inhibition and survival benefit (Indolfi et al, 2016). Large animal (i.e. pigs) and human cadaver studies show that PTM-101 can successfully be deployed to the peritumoral pancreatic surface by a standard laparoscopic procedure. Further, large animal studies show no evidence of neutropenia, pancreatitis, severe fibrosis or scarring, or infection after placement of PTM-101. Methods: This Phase I trial will assess the addition of PTM-101 prior to mFOLFIRINOX in 6 subjects with newly diagnosed borderline resectable or locally advanced PDAC. The primary objective is to assess the safety, toxicity and feasibility of a single administration of PTM-101. It is hypothesized that PTM-101 will be readily implanted during diagnostic laparoscopy and will result in clinically meaningful delivery of paclitaxel directly towards the tumor area with good tolerance and minimal local systemic exposure of drug. Patients enrolled and treated on study will be monitored closely for local and systemic toxicities as well as preliminary signals of efficacy. Enrollment is in progress and 3 patients have been enrolled and completed prospective follow up at the time of abstract submission. Clinical trial information: ACTRN12621000881831 .
Combined Arterial Hypertension and Ischemic Stroke Exaggerate Anesthesia-Related Hypotension and Cerebral Oxygenation Deficits: A Preclinical Study
Authors: Zhang Tracy , Thakkar Pratik , Emans Tonja W. , Fong Debra , Thampi Suma , Felippe Igor S. A. , Barrett Carolyn J. , Billing Robyn , Campbell Douglas , McBryde Fiona D. 
Published: February 2023

Background:
Intraoperative arterial hypotension (IOH) is a common side effect of general anesthesia (GA), associated with poor outcomes in ischemic stroke. While IOH is more prevalent with hypertension, it is unknown whether IOH may differ when GA is induced during ischemic stroke, versus other clinical settings. This is important given that many stroke patients receive GA for endovascular thrombectomy.

Methods:
We evaluate the cardiovascular responses to volatile GA (isoflurane in 100% o
2) before and during middle cerebral artery occlusion stroke in rats instrumented to record blood pressure (BP) and cerebral tissue oxygenation (po
2) in the projected penumbra, in clinically relevant cohorts of normotensive (Wistar rat, n = 10), treated hypertensive (spontaneously hypertensive [SH] + enalapril, n = 12), and untreated hypertensive (SH rat, n = 12).

Results:
During baseline induction of GA, IOH was similar in normotensive, treated hypertensive, and untreated hypertensive rats during the induction phase (first 10 minutes) (–24 ± 15 vs −28 ± 22 vs −48 ± 24 mm Hg; P > .05) and across the procedure (−24 ± 13 vs −30 ± 35 vs −39 ± 27 mm Hg; P > .05). Despite the BP reduction, cerebral po
2 increased by ~50% in all groups during the procedure. When inducing GA after 2 hours, all stroke groups showed a greater magnitude IOH compared to baseline GA induction, with larger falls in treated (−79 ± 24 mm Hg; P = .0202) and untreated(−105 ± 43 mm Hg; P < .001) hypertensive rats versus normotensives (−49 ± 21 mm Hg). This was accompanied by smaller increases in cerebral po
2 in normotensive rats (19% ± 32%; P = .0144 versus no-stroke); but a decrease in cerebral po
2 in treated (−11% ± 19%; P = .0048) and untreated (−12% ± 15%; P = .0003) hypertensive rats. Sham animals (normotensive and hypertensive) showed similar magnitude and pattern of IOH when induced with GA before and after sham procedure.

Conclusions:
Our findings are the first demonstration that ischemic stroke per se increases the severity of IOH, particularly when combined with a prior history of hypertension; this combination appears to compromise penumbral perfusion.
Anesthetic Considerations for Second-Trimester Surgical Abortions
Authors: Ozery Elizabeth , Ansari Jessica , Kaur Simranvir , Shaw Kate A. , Henkel Andrea 
Published: February 2023

Although most abortion care takes place in the office setting, anesthesiologists are often asked to provide anesthesia for the 1% of abortions that take place later, in the second trimester. Changes in federal and state regulations surrounding abortion services may result in an increase in second-trimester abortions due to barriers to accessing care. The need for interstate travel will reduce access and delay care for everyone, given limited appointment capacity in states that continue to support bodily autonomy. Therefore, anesthesiologists may be increasingly involved in care for these patients.
There are multiple, unique anesthetic considerations to provide safe and compassionate care to patients undergoing second-trimester abortion. First, a multiday cervical preparation involving cervical osmotic dilators and pharmacologic agents results in a time-sensitive, nonelective procedure, which should not be delayed or canceled due to risk of fetal expulsion in the preoperative area. In addition, a growing body of literature suggests that the older anesthesia dogma that all pregnant patients require rapid-sequence induction and an endotracheal tube can be abandoned, and that deep sedation without intubation is safe and often preferable for this patient population through 24 weeks of gestation. Finally, concomitant substance use disorders, preoperative pain from cervical preparation, and intraoperative management of uterine atony in a uterus that does not yet have mature oxytocin receptors require additional consideration.
Anesthesiology Resident Knowledge of Transfusion Medicine: Results From the Anesthesiology Transfusion Education Study
Authors: Connelly Neil Roy , Adler Adam C. , Vanderberg Laura E. , Conlin Frederick , Mitchell John D. , Goldstein Sheldon , Haspel Richard L. ,   the ATEST Collaborators
Published: February 2023

BACKGROUND:
Transfusion of blood products is a common practice in anesthesiology. Inadequate transfusion medicine knowledge may lead to inappropriate transfusion practices and patient risk. Using a validated assessment tool modified for anesthesiology, we conducted a survey of anesthesiology residents in the United States to assess transfusion medicine knowledge.

METHODS:
A validated transfusion medicine examination and accompanying survey were forwarded by program directors to residents for anonymous completion on May 5 and closed on June 30, 2021. The outcome of interest was the mean examination score. Secondary areas of interest were performance by year of training and previous educational experience in transfusion reported by the trainees. Rasch analysis was performed on the examination quality and individual question performance. Kruskal-Wallis H tests were used to identify differences between mean scores. Post hoc comparisons were used to assess specific pairwise differences between mean test scores by survey variable.

RESULTS:
Four hundred twenty-three anesthesiology residents in 37 programs completed the examination. The mean score was 45.5% ± 12.6%. There was a significant difference in mean cumulative examination scores between different resident training levels (P < 0.001). There was a significant difference in scores between clinical anesthesia (CA)-1 and CA-2 residents (P = 0.011) and CA-1 and CA-3 residents (P = 0.012). No significant difference in examination scores was observed between CA-2 and CA-3 residents (P = 0.95). All these subgroups scored below 50% on the examination. Significant differences between the residency training programs and cumulative scores were identified (P < 0.001).

CONCLUSIONS:
This examination highlights gaps in transfusion medicine knowledge within US anesthesiology residents. Targeted education may improve knowledge in this area and patient care.
Failure to Rescue and Mortality Differences After Appendectomy in a Low-Middle-Income Country and the United States
Authors: Rosero Eric B. , Eslava-Schmalbach Javier , Garzón-Orjuela Nathaly , Buitrago Giancarlo , Joshi Girish P. 
Published: February 2023

BACKGROUND:
Major disparities in complications and mortality after appendectomy between countries with different income levels have not been well characterized, as comparative studies at patient level between countries are scant. This study aimed to investigate variations in postoperative complications, mortality, and failure to rescue after appendectomy between a high-income country and a low-to-middle–income country.

METHODS:
Hospital discharges on adult patients who underwent appendectomy were extracted from administrative databases from Colombia and 2 states of the United States (Florida and New York). Outcomes included major postoperative complications, in-hospital mortality, and failure to rescue. Univariate analyses were conducted to compare outcomes between the 2 countries. Multivariable logistic regression analyses were conducted to examine the independent effect of country on outcomes after adjustment for patient age, sex, comorbidity index, severity of appendicitis, and appendectomy route (laparoscopic/open).

RESULTS:
A total of 62,338 cases from Colombia and 57,987 from the United States were included in the analysis. Patients in Colombia were significantly younger and healthier but had a higher incidence of peritonitis. Use of laparoscopy was significantly lower in Colombia (5.9% vs 89.4%; P < .0001). After adjustment for covariates, multivariable logistic regression analyses revealed that compared to the United States, Colombia had lower complication rates (2.8% vs 6.6%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.39–0.44; P < .0001) but higher mortality (0.44% vs 0.08%; OR, 8.92; 95% CI, 5.69–13.98; P < .0001) and failure to rescue (13.6% vs 1.0%; OR, 17.01; 95% CI, 10.66–27.16; P < .0001).

CONCLUSIONS:
Despite lower rates of postoperative complications, in-hospital mortality after appendectomy was higher in Colombia than in the United States. This difference may be explained by higher rates of failure to rescue in the low-to-middle–income country (ie, decreased ability of Colombian hospitals to rescue patients from complications).
Postoperative Outcomes in Elderly Patients Undergoing Cardiac Surgery With Preoperative Cognitive Impairment: A Systematic Review and Meta-Analysis
Authors: Au Emily , Thangathurai Gowtham , Saripella Aparna , Yan Ellene , Englesakis Marina , Nagappa Mahesh , Chung Frances 
Published: February 2023

BACKGROUND:
Older patients with preoperative cognitive impairment are at risk for increased postoperative complications after noncardiac surgery. This systematic review and meta-analysis aimed to determine the association between preoperative cognitive impairment and dementia and postoperative outcomes in older surgical patients after cardiac surgery.

METHODS:
Eight electronic databases were searched from inception to January 4, 2022. Inclusion criteria were cardiac surgery patients ≥60 years of age; preoperative cognitive impairment; ≥1 postoperative complication reported; comparator group with no preoperative cognitive impairment; and written in English. Using a random-effects model, we calculated effect sizes as odds ratio (OR) and standardized mean differences (SMDs). Risk of random error was assessed by applying trial sequential analysis.

RESULTS:
Sixteen studies (62,179 patients) were included. Preoperative cognitive impairment was associated with increased risk of delirium in older patients after cardiac surgery (70.0% vs 20.5%; OR, 8.35; 95% confidence interval [CI], 4.25–16.38; I2, 0%; P < .00001). Cognitive impairment was associated with increased hospital length of stay (LOS; SMD, 0.36; 95% CI, 0.20–0.51; I2, 22%; P < .00001) and intensive care unit (ICU) LOS (SMD, 0.39; 95% CI, 0.09–0.68; I2, 70%; P = .01). No significant association was seen for 30-day mortality (1.7% vs 1.1%; OR, 2.58; 95% CI, 0.64–10.44; I2, 55%; P = .18).

CONCLUSIONS:
In older patients undergoing cardiac surgery, cognitive impairment was associated with an 8-fold increased risk of delirium, a 5% increase in absolute risk of major postoperative bleeding, and an increase in hospital and ICU LOS by approximately 0.4 days. Further research on the feasibility of implementing routine neurocognitive testing is warranted.
The Angiographic and Clinical Follow-up Outcomes of the Wide-Necked and Complex Intracranial Aneurysms Treated With LVIS EVO–Assisted Coiling
Authors: Aydin Kubilay , Puthuran Mani , Onal Yilmaz , Barburoglu Mehmet , Chandran Arun , Berdikhojayev Mynzhylky , Gravino Gilbert , Senturk Yunus Emre , Aygun Serhat , Velioglu Murat , Sencer Serra 
Published: February 2023

BACKGROUND:
The Low Profile Visible Intraluminal Support EVO (LVIS EVO) is a self-expandable braided stent, which was recently introduced for the treatment of intracranial aneurysms. Full visibility of the stent and a relatively high metal coverage ratio are the unique features of the LVIS EVO.

OBJECTIVE:
To assess the safety, efficacy, and midterm durability of LVIS EVO stent-assisted coiling for the treatment of wide-necked intracranial aneurysms.

METHODS:
The endovascular databases were reviewed to identify patients treated with LVIS EVO–assisted coiling. The technical success and immediate clinical/angiographic outcomes were assessed. Periprocedural and delayed complications were evaluated. The follow-up angiographic/clinical outcomes were investigated. The preprocedural/follow-up neurological statuses were assessed with the modified Rankin Scale.

RESULTS:
One hundred three aneurysms in 103 patients (63 females) with a mean age of 54.9 ± 11.3 years were included. The mean maximum sac diameter was 6.2 ± 2.9 mm. The procedural technical success rate was 100%. Immediate postprocedural angiography showed complete occlusion in 77.7%. The mean duration of the angiographic follow-up was 8.8 ± 3.6 months. Follow-up angiography showed complete aneurysm occlusion in 89% of the 82 patients with angiographic follow-up. Recanalization was observed in 7.3% of 82 patients. Two patients (2.4%) required retreatment. In addition, 8.7% of the patients had at least 1 complication, and 2.9% of the patients developed a permanent morbidity. All patients had mRS scores ≤2.

CONCLUSION:
The results of this study demonstrate that SAC with LVIS EVO is a relatively safe, efficient, and durable treatment for wide-necked and complex intracranial aneurysms.
The visible subtitler: Blockchain technology towards right management and minting
Authors: Orero Pilar , Fernandez Torner Anna , Oncins Estel·la 
Published: February 2023

Background: Subtitles are produced through different workflows and technologies: from fully automatic to human in open source web editors or in-house platforms, and increasingly through hybrid human-machine interaction. There is little agreement regarding subtitle copyright beyond the understanding that it is a derivative work. While same language verbatim subtitles may have little room for creativity, interlingual subtitling is heavily dependent on the subtitler skills to translate, prioritise, and condense information. These days creative subtitles are increasingly being used as one more aesthetic element in audiovisual narrative. Though they may be in the same language, the visual attributes that contribute to the narrative development make creative subtitles one more element that should be acknowledged and copyright protected. Methods: The paper will present a short introduction to subtitling copyright. It will then describe centralised and decentralised copyright management — where blockchain technology can be applied to aid subtitler identification. A focus group with expert professional subtitlers was organised, and feedback is reported. Conclusions: Subtitle copyright is country dependent, still subtitling working practices and media asset distribution have no geographical borders. Blockchain technology -as a concept- could aid subtitle traceability. This can be useful beyond financial and moral right management and work towards media sustainability, allowing for reuse and repurpose of existing media assets.
ALEXITHYMIA AND THE ANXIETY FACTOR IN ADOLESCENTS
Authors: Zaitseva Olga I. , Kolodyazhnaya Tatyana A. , Zaitseva Ghanna G. , Ignatova Irina A. 
Published: February 2023

Aim. To study the level of alexithymia and anxiety in adolescents depending on age and gender, to identify relationships.
Materials and methods. A survey of clinically healthy adolescents was carried out using the Toronto alexithymic scale (TAS-26) and the scale of situational and personal anxiety Ch.D. Spielberger – Yu. L. Khanin.
Results. Among practically healthy adolescents, over 60% have signs of alexithymia, and half of them are adolescents with a pronounced level of alexithymia. “Vulnerable” for alexithymia are adolescent girls, and by age - younger adolescents. For practically healthy students, the normal level of situational and personal anxiety is natural. With an increase in the symptoms of alexithymia, the presence of high situational and personal anxiety in adolescents is characteristic. A positive correlation was found between the level of alexithymia and the degree of situational (r=0.40; p<0.001; n=507) and personal (r=0.35; p<0.001; n=507) anxiety.
Conclusion. Dentification among adolescents of a group of individuals with a risk of developing alexithymia and the presence of signs of alexithymia, with an altered level of situational and personal anxiety, will allow for early prevention and necessary therapeutic interventions.