bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and outcome of intracardiac heartworms in dogs
Authors: Vila Jorge , Alost Elisabeth 
Published: April 2023

Abstract
Background
Intracardiac heartworm (IH) disease is a serious condition that can become life threatening if the patient develops caval syndrome. We aim to describe the management and outcome of IH in dogs evaluated by Medvet’s New Orleans cardiology service from November 2015 to December 2021.

Methods
Records of 27 dogs with IH were examined retrospectively. Follow-up information was obtained from phone conversations with referring veterinarians and owners.

Results
Nine of 27 dogs had a previous diagnosis of heartworm disease and were undergoing “slow kill” treatment; 12/27 dogs' heartworm disease was a new diagnosis, and 6/27 had either scheduled or started adulticide therapy. Nine dogs had heartworm extraction. No dogs died during the heartworm extraction procedure. Four of 9 dogs have died (survival time 1; 676; 1815 and 2184 days). One dog died the day after the procedure secondary to continued respiratory distress; the other three died of non-cardiac causes. Five of nine are alive (median follow-up 1062 (range 648–1831) days. Eleven dogs had IH resolution. In 7/11 this occurred while undergoing stabilization for heartworm extraction. In 4/11 heartworm extraction was not recommended because of low IH burden. All dogs with IH resolution were discharged from the hospital. Four of 11 have died (survival time 6; 22, 58 and 835 days), and 6/11 are alive (median follow-up 523 (range 268–2081) days. One was lost to follow-up after 18 days. Five dogs were medically managed. In one of five dogs, extraction was not recommended because of low IH burden. In four of five extraction was recommended but declined. One of five has died (survival 26 days), and four of five are alive (follow-up 155, 371, 935 and 947 days). Two dogs were killed at the time of diagnosis. Fifteen of 27 dogs were considered to have caval syndrome.

Conclusion
The results suggest that patients with IH resolution have a good long-term prognosis. Most often IH resolution occurred while the dog was undergoing stabilization for heartworm extraction. When IHs are present, heartworm extraction should still be considered the treatment of choice and recommended as first-line therapy whenever possible.

Graphical Abstract
Comparisons of treatment satisfaction and health-related quality of life in patients with rheumatoid arthritis treated with tofacitinib and adalimumab
Authors: Kim Seong-Kyu , Lee Sang-Heon , Sun Jiyu , Lee Soo Hyun , Jeon Ja-Young , Yoo Hyun-Jeong , Choe Jung-Yoon 
Published: April 2023

Abstract
Background
As significant advances in the field of treatment for rheumatoid arthritis (RA), there is a great need to identify the healthcare outcomes such as treatment satisfaction and health-related quality of life (HRQoL) of patients with various treatment options. This study aims to identify the difference in the treatment satisfaction and HRQoL of patients with RA using different treatment options, by comparing the treatment satisfaction and HRQoL in patients with RA treated with tofacitinib and adalimumab in real-world settings in Korea, using propensity score methods.

Methods
In this non-interventional, multicenter, cross-sectional study (NCT03703817), a total of 410 patients with RA diagnosis were recruited in 21 university-based hospitals throughout Korea. The treatment satisfaction and HRQoL were assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM) and EQ-5D questionnaires self-reported by the patients. This study compared outcomes between two drug groups in unweighted, greedy matching, and stabilized inverse probability of treatment weight (IPTW) samples using propensity score.

Results
In all three samples, tofacitinib group showed higher convenience domain of TSQM than that in the adalimumab group, but not effectiveness, side effects, and global satisfaction domains. Multivariable analysis using the covariates of demographic and clinical characteristics of the participants also showed consistent results in TSQM. No statistical difference in EQ-5D-based HRQoL was identified between two drug groups in all three samples.

Conclusions
This study identified that tofacitinib shows higher treatment satisfaction in the convenience domain of TSQM rather than adalimumab, suggesting that various factors such as drug formulation, route or frequency of administration, and storage can have an impact on the treatment satisfaction, especially the convenience domain. These findings may be useful to patients and physicians when determining treatment options.

Trial registration
ClinicalTrials.gov, NCT03703817.
3D printing exposure and perception in radiology residency: survey results of radiology chief residents
Authors: Chen David , Ganapathy Aravinda , Abraham Nihil , Marquis Kaitlin M. , Bishop Grace L. , Rybicki Frank J. , Hoegger Mark J. , Ballard David H. 
Published: April 2023

Abstract
Rationale and objectives
The purpose of this study is to summarize a survey of radiology chief residents focused on 3D printing in radiology.

Materials and methods
An online survey was distributed to chief residents in North American radiology residencies by subgroups of the Association of University Radiologists. The survey included a subset of questions focused on the clinical use of 3D printing and perceptions of the role of 3D printing and radiology. Respondents were asked to define the role of 3D printing at their institution and asked about the potential role of clinical 3D printing in radiology and radiology residencies.

Results
152 individual responses from 90 programs were provided, with a 46% overall program response rate (n = 90/194 radiology residencies). Most programs had 3D printing at their institution (60%; n = 54/90 programs). Among the institutions that perform 3D printing, 33% (n = 18/54) have structured opportunities for resident contribution. Most residents (60%; n = 91/152 respondents) feel they would benefit from 3D printing exposure or educational material. 56% of residents (n = 84/151) believed clinical 3D printing should be centered in radiology departments. 22% of residents (n = 34/151) believed it would increase communication and improve relationships between radiology and surgery colleagues. A minority (5%; 7/151) believe 3D printing is too costly, time-consuming, or outside a radiologist’s scope of practice.

Conclusions
A majority of surveyed chief residents in accredited radiology residencies believe they would benefit from exposure to 3D printing in residency. 3D printing education and integration would be a valuable addition to current radiology residency program curricula.
Importance of timing optimization for closed-loop applications of vagus nerve stimulation
Authors: Mylavarapu Ramanamurthy V. , Kanumuri Vivek V. , de Rivero Vaccari Juan Pablo , Misra Amrit , McMillan David W. , Ganzer Patrick D. 
Published: April 2023

AbstractIn recent decades, vagus nerve stimulation (VNS) therapy has become widely used for clinical applications including epilepsy, depression, and enhancing the effects of rehabilitation. However, several questions remain regarding optimization of this therapy to maximize clinical outcomes. Although stimulation parameters such as pulse width, amplitude, and frequency are well studied, the timing of stimulation delivery both acutely (with respect to disease events) and chronically (over the timeline of a disease’s progression) has generally received less attention. Leveraging such information would provide a framework for the implementation of next generation closed-loop VNS therapies. In this mini-review, we summarize a number of VNS therapies and discuss (1) general timing considerations for these applications and (2) open questions that could lead to further therapy optimization.
Impact of the COVID-19 pandemic on women’s contraceptive use: a mixed-methods study in South Africa and Zambia
Authors: Callahan Rebecca L. , Cartwright Alice F. , Beksinska Mags , Kasaro Margaret , Tang Jennifer H. , Milford Cecilia , Wong Christina , Velarde Marissa , Maphumulo Virginia , Fawzy Maria , Chinyama Manze , Chabu Esther , Mudenda Mayaba , Smit Jennifer 
Published: April 2023

Background: The COVID-19 pandemic affected global access to health services, including contraception We sought to explore effects of the pandemic on family planning (FP) service provision and use in South Africa and Zambia, including on implant and intrauterine device (IUD) users’ desire and ability to obtain removal. Methods: Between August 2020 and April 2021, we conducted surveys with 537 women participating in an ongoing longitudinal contraceptive continuation study. We also carried out in-depth interviews with 39 of the survey participants and 36 key informants involved in FP provision. We conducted descriptive analysis of survey responses and thematic analysis of interviews. Results: Contraceptive use changed minimally in this sample with the emergence of COVID-19. Fewer than half of women (n=220) reported attempting to access FP since the start of the pandemic, the vast majority using short-acting methods. Among those who sought services, 95% obtained their preferred method. The proportion of women not using a method before and after pandemic start did not change in Zambia (31%); in South Africa, the proportion increased from 8% to 10%. Less than 7% of implant or IUD users in either country reported wanting removal. Among those who sought removal (n=22), 91% (n=10) in Zambia and 55% (n=6) in South Africa successfully obtained removal. In qualitative interviews, women with challenges accessing FP services mentioned long queues, deprioritization of contraceptive services, lack of transportation, stock-outs, and fear of contracting COVID-19 at a facility. Key informants reported stock-outs, especially of injectables, and staff shortages as barriers. Conclusions: We did not find a substantial impact of COVID-19 on contraceptive access among this sample; however, providers and others involved in service provision identified risks to continuity of care. As the COVID-19 pandemic wanes, it continues to be important to monitor people’s ability to access their preferred contraceptive methods.
A MODULAÇÃO DE EFEITOS EM MATÉRIA TRIBUTÁRIA E OS SEUS PARÂMETROS: A SEGURANÇA JURÍDICA E O EXCEPCIONAL INTERESSE SOCIAL / THE PROSPECTIVE EFFECTS IN TAX MATTERS AND ITS PARAMETERS: LEGAL CERTAINTY AND EXCEPTIONAL SOCIAL INTEREST
Authors: Faria Luiz Alberto Gurgel de , González Thiago Holanda 
Published: April 2023

Resumo: O artigo examina os requisitos da segurança jurídica e do excepcional interesse social na modulação de efeitos das decisões em matéria tributária. Inicialmente, são discutidos os seus fundamentos legais, problematizando-se a abertura semântica dos requisitos autorizadores. Em seguida, analisa-se como a doutrina e a jurisprudência têm enfrentado a possibilidade de o Estado ser beneficiário das modulações de efeitos na seara tributária e em que medida são observados argumentos consequencialistas na fundamentação dos votos, tomando-se como base os acórdãos do Supremo Tribunal Federal proferidos na ADI 5.469/DF e no RE 574.706 ED/PR. Investiga-se, por fim, como as regras processuais podem contribuir para a observância de parâmetros legítimos para as decisões que aplicam a técnica modulatória e para sua adequada utilização. O estudo baseia-se em pesquisa bibliográfica e documental. Os resultados apresentados são qualitativos.Palavras-chave: Direito tributário. Modulação de efeitos. Segurança jurídica. Interesse social. Princípio do contraditório.Abstract: The article examines the requirements of legal certainty and exceptional social interest in the prospective effects of judicial decisions in tax matters. Initially, its legal foundations are discussed, problematizing the semantic openness of the requirements. Next, we analyze how the doctrine and case law have faced the possibility of the State being a beneficiary of prospective effects in tax cases and to what extent consequentialist arguments are observed in the reasoning of theopinions, taking as a basis the judgments of the Supreme Court rendered in ADI 5.469/DF and RE 574.706 ED/PR. Finally, we investigate how procedural rules can contribute to the observance of legitimate parameters for the decisions that apply the prospective effects and for its adequate use. The study is based on bibliographic and documentary research. The results presented are qualitative.Keywords: Tax law. Prospective effects. Legal certainty. Social interest. Adversarial principle.
Inequalities in provision of hip and knee replacement surgery for osteoarthritis by age, sex, and social deprivation in England between 2007–2017: A population-based cohort study of the National Joint Registry
Authors: Lenguerrand Erik , Ben-Shlomo Yoav , Rangan Amar , Beswick Andrew , Whitehouse Michael R. , Deere Kevin , Sayers Adrian , Blom Ashley W. , Judge Andrew 
Published: April 2023

Background
While the United Kingdom National Health Service aimed to reduce social inequalities in the provision of joint replacement, it is unclear whether these gaps have reduced. We describe secular trends in the provision of primary hip and knee replacement surgery between social deprivation groups.

Methods and findings
We used the National Joint Registry to identify all hip and knee replacements performed for osteoarthritis from 2007 to 2017 in England. The Index of Multiple Deprivation (IMD) 2015 was used to identify the relative level of deprivation of the patient living area. Multilevel negative binomial regression models were used to model the differences in rates of joint replacement. Choropleth maps of hip and knee replacement provision were produced to identify the geographical variation in provision by Clinical Commissioning Groups (CCGs).
A total of 675,342 primary hip and 834,146 primary knee replacements were studied. The mean age was 70 years old (standard deviation: 9) with 60% and 56% of women undergoing hip and knee replacements, respectively. The overall rate of hip replacement increased from 27 to 36 per 10,000 person-years and knee replacement from 33 to 46. Inequalities of provision between the most (reference) and least affluent areas have remained constant for both joints (hip: rate ratio (RR) = 0.58, 95% confidence interval [0.56, 0.60] in 2007, RR = 0.59 [0.58, 0.61] in 2017; knee: RR = 0.82 [0.80, 0.85] in 2007, RR = 0.81 [0.80, 0.83] in 2017). For hip replacement, CCGs with the highest concentration of deprived areas had lower overall provision rates, and CCGs with very few deprived areas had higher provision rates. There was no clear pattern of provision inequalities between CCGs and deprivation concentration for knee replacement.
Study limitations include the lack of publicly available information to explore these inequalities beyond age, sex, and geographical area. Information on clinical need for surgery or patient willingness to access care were unavailable.

Conclusions
In this study, we found that there were inequalities, which remained constant over time, especially in the provision of hip replacement, by degree of social deprivation. Providers of healthcare need to take action to reduce this unwarranted variation in provision of surgery.
Psychological safety in European medical students’ last supervised patient encounter: A cross-sectional survey
Authors: Thyness Cathinka , Grimstad Hilde , Steinsbekk Aslak 
Published: April 2023

Objective
To investigate the association between European medical students’ psychological safety in and experiences from their last supervised patient encounter.

Materials and methods
A cross-sectional online survey among European medical students. Bivariable and multivariable linear regression was used to explore the associations between the dependent variable psychological safety and independent variables concerning students’ experiences from their last supervised patient encounter.

Results
A total of 886 students from more than 25 countries participated. The variables most strongly associated with psychological safety were supervisor coaching and modelling behaviour, adjusted beta 0.4 (95%CI 0.3 to 0.5) and 0.1 (95%CI 0.1 to 0.2) per unit respectively on a one-to-five-point scale, and studying in Northern Europe, adjusted beta 0.4–0.5 compared to other regions. There was a weak negative association (reduced score on psychological safety) for being supervised by a medical doctor with <5 years’ experience and a positive association for student confidence. Student gender, student seniority, speciality, whether peers were present, number of previous encounters with the supervisor and supervisor articulation and exploration behaviour were not associated in multivariable analysis.

Conclusion
Coaching might be a good primary focus to improve supervision practices, as participation with feedback is known to be beneficial for learning and coaching was strongly associated with psychological safety. Supervisors in western, eastern, and southern Europe might have to work harder to create psychological safety than their northern colleagues.
Natural History of Anal Ulcerations in Pediatric-Onset Crohn's Disease: Long-Term Follow-Up of a Population-Based Study
Authors: Mortreux Perrine , Leroyer Ariane , Dupont Claire , Ley Delphine , Bertrand Valérie , Spyckerelle Claire , Guillon Nathalie , Wils Pauline , Gower-Rousseau Corinne , Savoye Guillaume , Fumery Mathurin , Turck Dominique , Siproudhis Laurent , Sarter Hélène 
Published: April 2023

INTRODUCTION:
Anal ulcerations are frequently observed in Crohn's disease (CD). However, their natural history remains poorly known, especially in pediatric-onset CD.

METHODS:
All patients with a diagnosis of CD before the age of 17 years between 1988 and 2011 within the population-based registry EPIMAD were followed retrospectively until 2013. At diagnosis and during follow-up, the clinical and therapeutic features of perianal disease were recorded. An adjusted time-dependent Cox model was used to evaluate the risk of evolution of anal ulcerations toward suppurative lesions.

RESULTS:
Among the 1,005 included patients (females, 450 [44.8%]; median age at diagnosis 14.4 years [interquartile range 12.0–16.1]), 257 (25.6%) had an anal ulceration at diagnosis. Cumulative incidence of anal ulceration at 5 and 10 years from diagnosis was 38.4% (95% confidence interval [CI] 35.2–41.4) and 44.0% (95% CI 40.5–47.2), respectively. In multivariable analysis, the presence of extraintestinal manifestations (hazard ratio [HR] 1.46, 95% CI 1.19–1.80, P = 0.0003) and upper digestive location (HR 1.51, 95% CI 1.23–1.86, P < 0.0001) at diagnosis were associated with the occurrence of anal ulceration. Conversely, ileal location (L1) was associated with a lower risk of anal ulceration (L2 vs L1 HR 1.51, 95% CI 1.11–2.06, P = 0.0087; L3 vs L1 HR 1.42, 95% CI 1.08–1.85, P = 0.0116). The risk of fistulizing perianal CD (pCD) was doubled in patients with a history of anal ulceration (HR 2.00, 95% CI 1.45–2.74, P < 0.0001). Among the 352 patients with at least 1 episode of anal ulceration without history of fistulizing pCD, 82 (23.3%) developed fistulizing pCD after a median follow-up of 5.7 years (interquartile range 2.8–10.6). In these patients with anal ulceration, the diagnostic period (pre vs biologic era), exposure to immunosuppressants, and/or anti–tumor necrosis factor did not influence the risk of secondary anoperineal suppuration.

DISCUSSION:
Anal ulceration is frequent in pediatric-onset CD, with nearly half of patients presenting with at least 1 episode after 10 years of evolution. Fistulizing pCD is twice as frequent in patients with present or past anal ulceration.
Lifelong learning of property managers in enabling sustainable and energy efficient residential buildings: experiences of care project in Tampere region
Authors: Tammi Kalle , Väisälä Pekka , Murtomaa Petri , Juvela Jussi-Pekka , Hietakangas Jani , Lähteenmäki Timo , Vuopponen Silva 
Published: April 2023

The existing building stock causes 40% of the total energy consumption in the European Union. The high energy consumption together with ageing buildings put strong pressure on renovation of buildings and lowering of CO2 emissions. The Directives on Energy Performance of Buildings (EPBD) and Energy Efficiency (EED) were established to urge and steer the activities in the EU member countries.There are about 90,000 housing companies in Finland. They consist of 1,7 million apartments and 2,7 million residents, which makes housing companies a significant energy consumer. Around 50 % of the building stock in Finland was built between 1960s and 1980s. The average level of technical building systems is decent. Measures are still needed to tackle the increasing maintenance backlog and energy consumptionobjectives.Management of housing companies consists of the general meeting of apartment owners and a board elected by the general meeting. In addition, a vast majority of housing companies have a professional property manager whose role corresponds to CEO. The property manager’s expertise plays an essential role in planning and execution of maintenance and energy efficiency.The role of the property manager calls for multidisciplinary competencies and continuous learning. The CARE - Resource efficient caretaking of residential buildings project implemented flexible courses and training for property managers to enhance their technical understanding of energy efficient renovations and retrofit of new energy solutions.
La prevención de la radicalización violenta como método más eficaz contra el terrorismo internacional
Authors: Jalloul Muro Hana 
Published: April 2023

Los procesos de radicalización en relación con la violencia y la violencia terrorista acontecen tanto en grupos de extrema derecha, izquierda, etnonacionalistas y separatistas, en los movimientos políticos-religiosos y en aquellos motivados por un motivo concreto.
Comprender los procesos de radicalización recíproca, el social milieu de las personas que viven en tornos donde se pueden producir los procesos de radicalización es fundamental, así como la relevancia que tienen las redes sociales; todo ello, además de otros factores, juega un papel importante a la hora de analizar los procesos de radicalización y prevención de estos.
Este artículo se centra en el análisis de los procesos de radicalización que llevan a la violencia terrorista, analizando las distintas medidas que se han llevado a cabo en este campo; y haciendo propuestas que pensamos necesarias para prevenir las fases previas que conllevan a la comisión de un acto terrorista centrándonos más en radicalización hacia la violencia en agrupaciones islamistas radicales violentas yihadistas.