bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitudes, and behaviors toward fertility preservation in patients with breast cancer: A cross-sectional survey of physicians
Authors: Baek Soo Yeon , Lee Kyung-Hun , Kim Sung-Bae , Gomez Henry , Vidaurre Tatiana , Park Yeon Hee , Ahn Hee Kyung , Kim Yoo Seok , Park In Hae , Ahn Sung Gwe , Lee Jeeyeon , Jeong Jae Ho , Kim Seonok , Kim Hee Jeong 
Published: January 2023

BackgroundFertility is an important issue for young women with breast cancer, but studies about physicians’ knowledge, attitudes, and practices toward fertility preservation (FP) are largely based on Western populations and do not reflect recent international guidelines for FP. In this international study, we aimed to assess the knowledge, attitudes, and practices of physicians from South Korea, other Asian countries, and Latin America toward FP in young women with breast cancer, and identify the related barriers.MethodsThe survey was conducted anonymously among physicians from South Korea, other Asian countries, and Latin America involved in breast cancer care between November 2020 and July 2021. Topics included knowledge, attitudes, and perceptions toward FP; practice behaviors; barriers; and participant demographics. We grouped related questions around two main themes—discussion with patients about FP, and consultation and referral to a reproductive endocrinologist. We analyzed the relationships between main questions and other survey items.ResultsA total of 151 physicians completed the survey. Most participants’ overall knowledge about FP was good. More than half of the participants answered that they discussed FP with their patients in most cases, but that personnel to facilitate discussions about FP and the provision of educational materials were limited. A major barrier was time constraints in the clinic (52.6%). Discussion, consultations, and referrals were more likely to be performed by surgeons who primarily treated patients with operable breast cancer (FP discussion odds ratio [OR]: 2.90; 95% confidence interval [CI]: 1.24–6.79; FP consultation and referral OR: 2.98; 95% CI: 1.14–7.74). Participants’ knowledge and attitudes about FP were significantly associated with discussion, consultations, and referrals.ConclusionPhysicians from South Korea, other Asian countries, and Latin America are knowledgeable about FP and most perform practice behaviors toward FP well. Physicians’ knowledge and favorable attitudes are significantly related to discussion with patients, as well as consultation with and referral to reproductive endocrinologists. However, there are also barriers, such as limitations to human resources and materials, suggesting a need for a systematic approach to improve FP for young women with breast cancer.
Successful treatment discontinuation in CML patients with full-dose and low-dose TKI: Results from real-world practice
Authors: Chen Yilin , Zhao Huifang , Guo Jingming , Zou Jing , He Wenjuan , Han Danlei , Cheng Fanjun , Zhang Yanli , Li Weiming 
Published: January 2023

Background: In clinical studies, some patients who achieve deep molecular response (DMR) can successfully discontinue tyrosine kinase inhibitor (TKI). TKI dose reduction is also an important aspect of alleviating adverse effects and improving quality of life. This study aimed to explore the outcome after drug withdrawal in Chinese CML patients.Methods: We conducted a retrospective analysis of the outcome of 190 patients who stopped TKI. 27 patients experienced dose reduction before TKI discontinuation. The median duration of TKI treatment and MR4 before discontinuation was 82 months and 61 months.Results: With median follow-up after stopping TKI treatment of 17 months, the estimated TFR (Treatment Free Remission) were 76.9% (95%CI, 70.2%–82.4%), 68.8% (95%CI, 61.3%–75.2%), and 65.5% (95%CI, 57.4%–72.5%) at 6, 12 and 24 months. For full-dose and low-dose TKI groups, the TFR at 24 months was 66.7% and 55.8% (p = 0.320, log-rank). Most patients (56/57) quickly achieved MMR after restarting TKI treatment. Multivariable analysis showed that patients with TKI resistance had a higher risk of molecular relapse than patients without TKI resistance (p &lt; 0.001).Conclusion: TFR rates were not impaired in patients experiencing dose reduction before TKI discontinuation compared to patients with full-dose TKI. Our data on Chinese population may provide a basis for the safety and feasibility of TKI discontinuation, including discontinuation after dose reduction, in clinical practice.
Prolonged repolarization in the early phase of ischemia is associated with ventricular fibrillation development in a porcine model
Authors: Bernikova Olesya G. , Tsvetkova Alena S. , Gonotkov Mikhail A. , Ovechkin Alexey O. , Demidova Marina M. , Azarov Jan E. , Platonov Pyotr G. 
Published: January 2023

Background: Repolarization prolongation can be the earliest electrophysiological change in ischemia, but its role in arrhythmogenesis is unclear. The aim of the present study was to evaluate the early ischemic action potential duration (APD) prolongation concerning its causes, expression in ECG and association with early ischemic ventricular fibrillation (phase 1A VF).Methods: Coronary occlusion was induced in 18 anesthetized pigs, and standard 12 lead ECG along with epicardial electrograms were recorded. Local activation time (AT), end of repolarization time (RT), and activation-repolarization interval (ARIc) were determined as dV/dt minimum during QRS-complex, dV/dt maximum during T-wave, and rate-corrected RT–AT differences, respectively. Patch-clamp studies were done in enzymatically isolated porcine cardiomyocytes. IK(ATP) activation and Ito1 inhibition were tested as possible causes of the APD change.Results: During the initial period of ischemia, a total of 11 pigs demonstrated maximal ARIc prolongation &gt;10 ms at 1 and/or 2.5 min of occlusion (8 and 6 cases at 1 and 2.5 min, respectively) followed by typical ischemic ARIc shortening. The maximal ARIc across all leads was associated with VF development (OR 1.024 95% CI 1.003–1.046, p = 0.025) and maximal rate-corrected QT interval (QTc) (B 0.562 95% CI 0.346–0.775, p &lt; 0.001) in logistic and linear regression analyses, respectively. Phase 1A VF incidence was associated with maximal QTc at the 2.5 min of occlusion in ROC curve analysis (AUC 0.867, p = 0.028) with optimal cut-off 456 ms (sensitivity 1.00, specificity 0.778). The pigs having maximal QTc at 2.5 min more and less than 450 ms significantly differed in phase 1A VF incidence in Kaplan-Meier analysis (log-rank p = 0.007). In the patch-clamp experiments, 4-aminopyridine did not produce any effects on the APD; however, pinacidil activated IK(ATP) and caused a biphasic change in the APD with initial prolongation and subsequent shortening.Conclusion: The transiently prolonged repolarization during the initial period of acute ischemia was expressed in the prolongation of the maximal QTc interval in the body surface ECG and was associated with phase 1A VF. IK(ATP) activation in the isolated cardiomyocytes reproduced the biphasic repolarization dynamics observed in vivo, which suggests the probable role of IK(ATP) in early ischemic arrhythmogenesis.
High spatial and temporal resolution cerebrovascular reactivity for humans and large mammals: A technological description of integrated fNIRS and niABP mapping system
Authors: Sainbhi Amanjyot Singh , Froese Logan , Gomez Alwyn , Marquez Izzy , Amenta Fiorella , Batson Carleen , Stein Kevin Y. , Zeiler Frederick A. 
Published: January 2023

Introduction: The process of cerebral vessels maintaining cerebral blood flow (CBF) fairly constant over a wide range of arterial blood pressure is referred to as cerebral autoregulation (CA). Cerebrovascular reactivity is the mechanism behind this process, which maintains CBF through constriction and dilation of cerebral vessels. Traditionally CA has been assessed statistically, limited by large, immobile, and costly neuroimaging platforms. However, with recent technology advancement, dynamic autoregulation assessment is able to provide more detailed information on the evolution of CA over long periods of time with continuous assessment. Yet, to date, such continuous assessments have been hampered by low temporal and spatial resolution systems, that are typically reliant on invasive point estimations of pulsatile CBF or cerebral blood volume using commercially available technology.Methods: Using a combination of multi-channel functional near-infrared spectroscopy and non-invasive arterial blood pressure devices, we were able to create a system that visualizes CA metrics by converting them to heat maps drawn on a template of human brain.Results: The custom Python heat map module works in “offline” mode to visually portray the CA index per channel with the use of colourmap. The module was tested on two different mapping grids, 8 channel and 24 channel, using data from two separate recordings and the Python heat map module was able read the CA indices file and represent the data visually at a preselected rate of 10 s.Conclusion: The generation of the heat maps are entirely non-invasive, with high temporal and spatial resolution by leveraging the recent advances in NIRS technology along with niABP. The CA mapping system is in its initial stage and development plans are ready to transform it from “offline” to real-time heat map generation.
A comprehensive framework for evaluation of high pacing frequency and arrhythmic optical mapping signals
Authors: Ramlugun Girish S. , Kulkarni Kanchan , Pallares-Lupon Nestor , Boukens Bastiaan J. , Efimov Igor R. , Vigmond Edward J. , Bernus Olivier , Walton Richard D. 
Published: January 2023

Introduction: High pacing frequency or irregular activity due to arrhythmia produces complex optical mapping signals and challenges for processing. The objective is to establish an automated activation time-based analytical framework applicable to optical mapping images of complex electrical behavior.Methods: Optical mapping signals with varying complexity from sheep (N = 7) ventricular preparations were examined. Windows of activation centered on each action potential upstroke were derived using Hilbert transform phase. Upstroke morphology was evaluated for potential multiple activation components and peaks of upstroke signal derivatives defined activation time. Spatially and temporally clustered activation time points were grouped in to wave fronts for individual processing. Each activation time point was evaluated for corresponding repolarization times. Each wave front was subsequently classified based on repetitive or non-repetitive events. Wave fronts were evaluated for activation time minima defining sites of wave front origin. A visualization tool was further developed to probe dynamically the ensemble activation sequence.Results: Our framework facilitated activation time mapping during complex dynamic events including transitions to rotor-like reentry and ventricular fibrillation. We showed that using fixed AT windows to extract AT maps can impair interpretation of the activation sequence. However, the phase windowing of action potential upstrokes enabled accurate recapitulation of repetitive behavior, providing spatially coherent activation patterns. We further demonstrate that grouping the spatio-temporal distribution of AT points in to coherent wave fronts, facilitated interpretation of isolated conduction events, such as conduction slowing, and to derive dynamic changes in repolarization properties. Focal origins precisely detected sites of stimulation origin and breakthrough for individual wave fronts. Furthermore, a visualization tool to dynamically probe activation time windows during reentry revealed a critical single static line of conduction slowing associated with the rotation core.Conclusion: This comprehensive analytical framework enables detailed quantitative assessment and visualization of complex electrical behavior.
Determining factors for compensatory movements of the left arm and shoulder in violin playing
Authors: Margulies Oliver , Nübling Matthias , Verheul William , Hildebrandt Wulf , Hildebrandt Horst 
Published: January 2023

IntroductionDespite a large number of available ergonomic aids and recommendations regarding instrument positioning, violin players at any proficiency level still display a worrying incidence of task-specific complaints of incompletely understood etiology. Compensatory movement patterns of the left upper extremity form an integral part of violin playing. They are highly variable between players but remain understudied despite their relevance for task-specific health problems.MethodsThis study investigated individual position effects of the instrument and pre-existing biomechanical factors likely determining the degree of typical compensatory movements in the left upper extremity: (1) left elbow/upper arm adduction (“Reference Angle α”, deviation from the vertical axis), (2) shoulder elevation (“Coord x”, in mm), and (3) shoulder protraction (“Coord y”, in mm). In a group of healthy music students (N = 30, 15 m, 15 f, mean age = 22.5, SD = 2.6), “Reference Angle α” was measured by 3D motion capture analysis. “Coord x” and “Coord y” were assessed and ranked by a synchronized 2D HD video monitoring while performing a pre-defined 16-s tune under laboratory conditions. These three primary outcome variables were compared between four typical, standardized violin positions varying by their sideward orientation (“LatAx-CSP”) and/or inclination (“LoAx-HP”) by 30°, as well as the players’ usual playing position. Selected biomechanical hand parameter data were analyzed as co-factors according to Wagner’s Biomechanical Hand Measurement (BHM).ResultsMean “Reference Angle α” decreased significantly from 24.84 ± 2.67 to 18.61 ± 3.12° (p &lt; 0.001), “Coord x” from 22.54 ± 7.417 to 4.75 ± 3.488 mm (p &lt; 0.001), and “Coord y” from 5.66 ± 3.287 to 1.94 ± 1.901) mm (p &lt; 0.001) when increasing LatAx-CSP and LoAx-HP by 30°. Concerning the biomechanical co-factors, “Reference Angle α”, “Coord y”, but not “Coord x”, were found to be significantly increased overall, with decreasing passive supination range (r = −0.307, p = &lt;0.001 for “Passive Supination 250 g/16Ncm”, and r = −0.194, p = &lt;0.001 for “Coord y”). Compensatory movements were larger during tune sections requiring high positioning of the left hand and when using the small finger.DiscussionResults may enable to adapt individually suitable instrument positions to minimize strenuous and potentially unhealthy compensation movements of the left upper extremity.
Becoming a mother when suffering from a chronic illness
Authors: Riazuelo Hélène 
Published: January 2023

IntroductionThe critical period of early motherhood when facing serious health problems constitutes a major public health issue. The disease may interfere with, influence, and compound the difficulties experienced over the course of pregnancy and during the parenthood processes. These processes are to be understood as a passage involving so many changes and fraught with difficulties leading to a series of psychological mobilizations. Illness also needs to be considered as a moment of transition, sometimes of severance, marking the lives of the people concerned in a more or less lasting way. Various developments are possible, some of which can be envisaged as leading to more positive outcomes, while others appear as if blocked or doomed to failure.Clinical data and methodThis clinical study is the result of twelve analytically oriented psychotherapeutic follow-ups. The sessions took place weekly over periods ranging from 1 to 6 years. Some of the patients we met had become pregnant while they had a declared but not yet chronic nephropathy. The other patients were already on dialysis and had become mother before starting dialysis. There is also one instance of a pregnant patient on dialysis. In the background, there are also many women who talked about giving up fertility and motherhood. After an in-depth study of each follow-up, a cross-sectional study was conducted to identify the main themes.Results and discussionMain considerations on the psychotherapeutic treatment: We regularly observe people who find it impossible to muster the internal resources that would enable them to deal with the trials they undergo in such situations. For the psychologist, there is a need to listen to archaic remnants. Gradually, in the space of psychotherapeutic work, possibilities of “reanimation” of the psyche emerge, an internal space that renews fantasmatic activity as it begins to be able to project into the external space and into the space of the sessions.
CpH methylome analysis in human cortical neurons identifies novel gene pathways and drug targets for opioid use disorder
Authors: Nagamatsu Sheila T. , Rompala Gregory , Hurd Yasmin L. , Núñez-Rios Diana L. , Montalvo-Ortiz Janitza L. ,   Traumatic Stress Brain Research Group
Published: January 2023

IntroductionDNA methylation (DNAm), an epigenetic mechanism, has been associated with opioid use disorder (OUD) in preclinical and human studies. However, most of the studies have focused on DNAm at CpG sites. DNAm at non-CpG sites (mCpHs, where H indicates A, T, or C) has been recently shown to have a role in gene regulation and to be highly abundant in neurons. However, its role in OUD is unknown. This work aims to evaluate mCpHs in the human postmortem orbital frontal cortex (OFC) in the context of OUD.MethodsA total of 38 Postmortem OFC samples were obtained from the VA Brain Bank (OUD = 12; Control = 26). mCpHs were assessed using reduced representation oxidative bisulfite sequencing in neuronal nuclei. Differential analysis was performed using the “methylkit” R package. Age, ancestry, postmortem interval, PTSD, and smoking status were included as covariates. Significant mCpHs were set at q-value &lt; 0.05. Gene Ontology (GO) and KEGG enrichment analyses were performed for the annotated genes of all differential mCpH loci using String, ShinyGO, and amiGO software. Further, all annotated genes were analyzed using the Drug gene interaction database (DGIdb).ResultsA total of 2,352 differentially methylated genome-wide significant mCpHs were identified in OUD, mapping to 2,081 genes. GO analysis of genes with differential mCpH loci showed enrichment for nervous system development (p-value = 2.32E-19). KEGG enrichment analysis identified axon guidance and glutamatergic synapse (FDR 9E-4–2.1E-2). Drug interaction analysis found 3,420 interactions between the annotated genes and drugs, identifying interactions with 15 opioid-related drugs, including lofexidine and tizanidine, both previously used for the treatment of OUD-related symptoms.ConclusionOur findings suggest a role of mCpHs for OUD in cortical neurons and reveal important biological pathways and drug targets associated with the disorder.
Outcomes after fixation of rib fractures sustained during cardiopulmonary resuscitation: A retrospective single center analysis
Authors: van Veelen Nicole Maria , Buenter Lea , Kremo Valérie , Peek Jesse , Leiser Alfred , Kestenholz Peter , Babst Reto , Paulus Beeres Frank Joseph , Minervini Fabrizio 
Published: January 2023

BackgroundHistorically rib fractures have been typically treated non-operatively. Recent studies showed promising results after osteosynthesis of rib fractures in trauma patients with flail segments or multiple rib fractures. However, there is a paucity of data on rib fixation after cardiopulmonary resuscitation (CPR). This study evaluated the outcomes of patients who received rib fixation after CPR.MethodsAdult patients who received surgical fixation of rib fractures sustained during CPR between 2010 and 2020 were eligible for inclusion in this retrospective study. Outcome measures included complications, quality of life (EQ 5D 5L) and level of dyspnea.ResultsNineteen patients were included with a mean age of 66.8 years. The mean number of fractured ribs was ten, seven patients additionally had a sternum fracture. Pneumonia occurred in 15 patients (74%), of which 13 were diagnosed preoperatively and 2 post-operatively. Six patients developed a postoperative pneumothorax, none of which required revision surgery. One patient showed persistent flail chest after rib fixation and required additional fixation of a concomitant sternum fracture. One infection of the surgical site of sternal plate occurred, while no further surgery related complications were reported. Mean EQ-5D-5L was 0.908 and the average EQ VAS was 80. One patient reported persisting dyspnea.ConclusionTo date, this is the largest reported cohort of patients who received rib fixation for fractures sustained during CPR. No complications associated with rib fixation were reported whereas one infection after sternal fixation did occur. Current follow-up demonstrated a good long-term quality of life after fixation, warranting further studies on this topic. Deeper knowledge on this subject would be beneficial for a wide spectrum of physicians.
Analysis of patterns of livestock movements in the Cattle Corridor of Uganda for risk-based surveillance of infectious diseases
Authors: Hasahya Emmanuel , Thakur Krishna , Dione Michel M. , Kerfua Susan D. , Mugezi Israel , Lee Hu Suk 
Published: January 2023

IntroductionThe knowledge of animal movements is key to formulating strategic animal disease control policies and carrying out targeted surveillance. This study describes the characteristics of district-level cattle, small ruminant, and pig trade networks in the Cattle Corridor of Uganda between 2019 and 2021.MethodologyThe data for the study was extracted from 7,043 animal movement permits (AMPs) obtained from the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) of Uganda. Most of the data was on cattle (87.2%), followed by small ruminants (11.2%) and pigs (1.6%). Two types of networks representing animal shipments between districts were created for each species based on monthly (n = 30) and seasonal (n = 10) temporal windows. Measures of centrality and cohesiveness were computed for all the temporal windows and our analysis identified the most central districts in the networks.ResultsThe median in-degree for monthly networks ranged from 0–3 for cattle, 0–1 for small ruminants and 0–1 for pigs. The highest median out-degrees for cattle, small ruminant and pig monthly networks were observed in Lira, Oyam and Butambala districts, respectively. Unlike the pig networks, the cattle and small ruminant networks were found to be of small-world and free-scale topologies.DiscussionThe cattle and small ruminant trade movement networks were also found to be highly connected, which could facilitate quick spread of infectious animal diseases across these networks. The findings from this study highlighted the significance of characterizing animal movement networks to inform surveillance, early detection, and subsequent control of infectious animal disease outbreaks.