bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical techniques in veterinary dermatology: Dermoscopy
Authors: Burroughs Dylan L. , Diaz Sandra F. 
Published: December 2022

AbstractDermoscopy is a noninvasive, painless, easy‐to‐perform technique used in human and veterinary medicine for rapid and magnified in vivo observation of dermatological lesions and disease. Dermoscopy can lead to a swifter diagnosis and may eliminate the need to perform more invasive diagnostic testing such as skin biopsies. To perform dermoscopy, the clinician needs a dermoscope and a software program equipped with image capture for pattern identification. Two techniques exist for dermoscopy: standard contact, where the dermoscope is applied directly to the patient's skin with the use of a liquid interface, or noncontact, where there is no direct contact between the skin and the dermoscope. The most important criteria to be considered when using dermoscopy are the morphology/arrangement of vascular structures, scaling patterns, colours, follicular abnormalities and specific disease features. Application of dermoscopic findings should always be correlated with the patient's history, clinical signs and the morphology of the skin lesions. Dermoscopy does require an initial financial and time investment by the clinician, yet this technique can quickly and easily help to identify patterns of disease that correlate with clinical diagnosis of dermatological disease.
Assessment of survey radiography as a method of diagnosing bilateral laryngeal paralysis in dogs
Authors: Touzet Chloe , Hahn Harriet , Gomes Eymeric , Bismuth Camille , Le Boedec Kevin 
Published: December 2022

AbstractThe gold standard for diagnosis of laryngeal paralysis is laryngoscopy under light anesthesia. This prospective analytical cross‐sectional study aimed to determine whether a radiographic assessment of the larynx could be used as a non‐invasive screening tool for diagnosing laryngeal paralysis in non‐sedated animals, as the laryngeal ventricles may appear wider in affected animals. The laryngeal ventricles of 18 dogs with bilateral laryngeal paralysis composing the affected group and 25 non‐sedated dogs presenting no respiratory abnormality composing the control group were evaluated using right lateral radiography of the larynx. Three observers measured the ratios of the maximal ventricular length and surface to the body length of the third cervical vertebra (MVL/LC3 and VS/LC3, respectively). They also subjectively assessed the ventricular shape as either normal or rounded. The most accurate criterion was found to be MVL/LC3, as the respective areas under the ROC curves were 0.96 (95% confidence interval [CI]: 0.95–0.97), 0.89 (95% CI: 0.87–0.91), 0.80 (95% CI: 0.65–0.95) for MVL/LC3, VS/LC3, and ventricular shape evaluation, respectively. Based on ROC curve analysis, two thresholds of clinical interest were set for the MVL/LC3; bilateral laryngeal paralysis was very unlikely for values < 0.3 and very likely for values > 0.5. The findings of this study support the use of lateral laryngeal radiography as a screening tool for diagnosing bilateral laryngeal paralysis. However, further diagnostic tests remain required if MVL/LC3 lies between these threshold values or if clinically indicated. Further studies are warranted to explore the use of laryngeal radiography in unilateral paralysis and other laryngeal or oropharyngeal diseases.
Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia‐like syndrome
Authors: Winston John M. , Mann F. A. (Tony) , Dean Lauren 
Published: December 2022

AbstractObjectiveTo report the management and outcomes of dogs treated for lower esophageal sphincter achalasia‐like syndrome (LES‐AS) with modified Heller myotomy, Dor fundoplication, and with the use of a temporary gastrostomy tube.Study designRetrospective.Sample populationThirteen client‐owned dogs.MethodsMedical records and a client survey were used to assess frequency of vomiting/regurgitation, quality of life (QoL), bodyweight, and feeding modifications at the following time points: prior to referral, postoperatively from discharge to first recheck (4‐6 weeks), and from first recheck to survey (48 months). Postoperative and gastrostomy tube complications were surveyed and recorded. Pretreatment and 4‐6 weeks postoperative videofluoroscopic swallow studies (VFSS) were compared. Two‐sided t‐tests were used to compare outcomes between survey time points.ResultsPostoperative VFSS scores (available in 9 dogs) improved over preoperative scores in 6 dogs, and 12/13 dogs survived to discharge. One dog was euthanized 3 days postoperatively due to aspiration pneumonia. Postoperative gastrostomy tube complications occurred in half of the dogs that survived to discharge. According to the owners, scores assigned to vomiting/regurgitation improved by 180% (P = .004), QoL by 100% (P = .004), and bodyweight by 63% (P = .035).ConclusionModified Heller myotomy with Dor fundoplication and the use of a temporary gastrostomy tube improved clinical signs and owners' perceived quality of life in half of the dogs treated for LES‐AS in our clinical setting. Oral sildenafil therapy discontinued postoperatively suggests that surgery was equally efficacious.Clinical significanceModified Heller myotomy with Dor fundoplication and temporary gastrostomy tube is a treatment option with potentially sustained benefits for dogs that have LES‐AS.
Experiences of patients and their family members with metachromatic leukodystrophy, adrenoleukodystrophy, and Krabbe disease: a qualitative systematic review protocol
Authors: Koto Yuta , Ueki Shingo , Yamakawa Miyae , Sakai Norio 
Published: December 2022

Objective:
The objective of this review is to synthesize the experiences of patients with metachromatic leukodystrophy (MLD), adrenoleukodystrophy (ALD), and Krabbe disease and the experiences of their family members.

Introduction:
MLD, ALD, and Krabbe disease are rare disorders that are classified as lysosomal storage or peroxisomal disorders, with similar presentations as leukodystrophy. As these diseases cause cognitive and neurological decline due to the progression of leukodystrophy associated with demyelination, they have significant impact on the lives of patients and their families. It is important to identify the impact and challenges of these diseases on patients’ lives and on their families, as well as to synthesize qualitative studies regarding their experiences.

Inclusion criteria:
We will consider studies including patients with MLD, ALD, or Krabbe disease and their family members. These experiences will include the challenges, dissatisfactions, and frustrations with symptoms and treatments; complications of hematopoietic stem cell transplantation; and the increased caregiver burden with disease progression. This is important since the impacts of disease progression are experienced in a variety of settings beyond the hospital, such as in the community and at home.

Methods:
The search strategy will follow JBI methodology and be conducted in 3 steps: an initial limited search, a comprehensive database search, and a reference search of the included articles. MEDLINE, CINAHL Plus, PsycINFO, and Scopus will be searched with no restriction on language or publication dates. The study selection, critical appraisal, data extraction, and data synthesis will be performed according to JBI guidelines for systematic reviews of qualitative research. Final syntheses will be assessed using the ConQual approach.

Systematic review registration number:
PROSPERO CRD42022318805.
From Scan to Simulation—A Novel Workflow for Developing Bioinspired Heart Valves
Authors: Lee Aeryne , Farajikhah Syamak , Crago Matthew , Mosse Luke , Fletcher David Frederick , Dehghani Fariba , Winlaw David Scott , Naficy Sina 
Published: December 2022

AbstractCurrent heart valve replacements lack durability and prolonged performance, especially in pediatric patients. In part, these problems may be attributed to the materials chosen for these constructs, but another important contributing factor is the design of the valve, as this dictates hemodynamic performance and impacts leaflet stresses which may accelerate structural valve deterioration. Most current era bioprosthetic valves adhere to a fundamental design where flat leaflets are supported by commissural posts, secured to a sewing ring. This overall design strategy is effective, but functionality and durability can be improved by incorporating features of the native valve geometry. This paper presents a novel workflow for developing and analyzing bio-inspired valve designs computationally. The leaflet curvature was defined using a mathematical equation whose parameters were derived from the three-dimensional model of a native sheep pulmonary valve obtained via microcomputed tomography. Finite element analysis was used to screen the various valve designs proposed in this study by assessing the effect of leaflet thickness, Young's modulus, and height/curvature on snap-through (where leaflets bend against their original curvature), geometric orifice area (GOA) and the stress in the leaflets. This workflow demonstrated benefits for valve designs with leaflet thicknesses between 0.1 and 0.3 mm, Young's moduli less than 50 MPa, and elongated leaflets with higher curvatures. The proposed workflow brings substantial efficiency gains at the design stage, minimizing manufacturing and animal testing during iterative improvements, and offers a bridge between in vitro and more complex in silico studies in the future.
Eocene magmatism in the Himalaya: Response to lithospheric flexure during early Indian collision?
Authors: Ma Lin , Wang Qiang , Kerr Andrew C. , Li Zheng-Xiang , Dan Wei , Yang Ya-Nan , Zhou Jin-Sheng , Wang Jun , Li Cheng 
Published: December 2022

Abstract
Eocene mafic magmatism in the Himalaya provides a crucial window for probing the evolution of crustal anatexis processes within the lower plate in a collisional orogen. We report geochemical data from the earliest postcollision ocean-island basalt–like mafic dikes intruding the Tethyan Himalaya near the northern edge of the colliding Indian plate. These dikes occurred coeval, and spatially overlap, with Eocene granitoids in the cores of gneiss domes and were likely derived from interaction between melts from the lithosphere-asthenosphere boundary and the Indian continental lithosphere. We propose that these mafic magmas were emplaced along lithospheric fractures in response to lithospheric flexure during initial subduction of the Indian continent and that the underplating of such mafic magmas resulted in orogen-parallel crustal anatexis within the Indian continent. This mechanism can explain the formation of coeval magmatism and the geologic evolution of a collisional orogen on both sides of the suture zone.
Preferential preservation of low-elevation biotas in the nonmarine fossil record
Authors: Holland Steven M. , Loughney Katharine M. , Cone Marjean 
Published: December 2022

AbstractModern coastal sedimentary basins typically lie at low elevations (&lt;600 m), whereas inland basins commonly occupy elevations as high as 4000–5000 m. Individual basins of all types typically preserve a narrower span of elevations, generally &lt;1000 m, and typically near 200–300 m in coastal basins. As a result, the nonmarine fossil record is expected to preserve mainly low-elevation habitats and a relatively narrow range of elevations. Because many of the basins that preserve high elevations are likely to undergo subsequent destruction via erosion or continental collision, the dominance of low-elevation habitats is likely to become stronger into deep time. This selective preservation of nonmarine communities from sedimentary basins, and specifically from low elevations, suggests that much or even most of ancient nonmarine biodiversity is not preserved. Given the occurrence of many modern biodiversity hotspots in regions of high elevation, long ghost lineages are likely common in the nonmarine fossil record, and divergence times estimated from the nonmarine fossil record may be systematically far too short. The spans of elevations that are preserved in sedimentary basins suggest that the fossil record may preserve gradients in community composition that are correlated with elevation, yet they have been largely undetected.
User-centred design for machine learning in health care: a case study from care management
Authors: Seneviratne Martin G , Li Ron C , Schreier Meredith , Lopez-Martinez Daniel , Patel Birju S , Yakubovich Alex , Kemp Jonas B , Loreaux Eric , Gamble Paul , El-Khoury Kristel , Vardoulakis Laura , Wong Doris , Desai Janjri , Chen Jonathan H , Morse Keith E , Downing N Lance , Finger Lutz T , Chen Ming-Jun , Shah Nigam 
Published: December 2022

ObjectivesFew machine learning (ML) models are successfully deployed in clinical practice. One of the common pitfalls across the field is inappropriate problem formulation: designing ML to fit the data rather than to address a real-world clinical pain point.MethodsWe introduce a practical toolkit for user-centred design consisting of four questions covering: (1) solvable pain points, (2) the unique value of ML (eg, automation and augmentation), (3) the actionability pathway and (4) the model’s reward function. This toolkit was implemented in a series of six participatory design workshops with care managers in an academic medical centre.ResultsPain points amenable to ML solutions included outpatient risk stratification and risk factor identification. The endpoint definitions, triggering frequency and evaluation metrics of the proposed risk scoring model were directly influenced by care manager workflows and real-world constraints.ConclusionsIntegrating user-centred design early in the ML life cycle is key for configuring models in a clinically actionable way. This toolkit can guide problem selection and influence choices about the technical setup of the ML problem.
Motivators and deterrents for early career female doctors applying to surgical training programmes in the UK National Health Service: a mixed-methods study
Authors: Ruparell Kajal , Barve Rajas , Tas Rukiye N , Chen Sihan , Mclaughlin Reed , Ravendren Andrew , Gupte Chinmay M 
Published: December 2022

ObjectivesTo perform a mixed-methods study identifying motivators and deterrents to female doctors interested in core surgical training (CST). To provide tangible implementations based on the findings.DesignThis study used quantitative (questionnaires) and qualitative (semistructured interviews (SSIs)) analyses. Participants completed online questionnaires on Qualtrics and SSIs were conducted remotely on Microsoft Teams. Questions were derived from previous studies and a novel term, the gender impact rating (GIR), was coined to assess the impact of gender on opportunities available during CST application.SettingParticipants were working in the UK National Health Service and data collected from December 2020 to January 2021.ParticipantsA total of 100 female surgical trainees in the UK ranging from Foundation Year 2 to Core Training Year 2.Main outcome measuresParticipants ranked factors by their influence on their CST application. Of the 100 trainees, 21 were randomly selected for an SSI to explore their questionnaire responses. Statistical analyses were performed using MATLAB and SPSS, alongside a thematic analysis of the interviews.ResultsA total of 44 out of 100 questionnaire respondents ranked early exposure to surgery as the most influential motivator, while 43% selected work-life balance as the greatest deterrent and 33% suggested mentoring schemes to encourage women to apply to CST. The median GIR was 3 out of 5, indicating a moderate perceived impact of gender on opportunities available during CST application. Qualitative analysis found four overarching themes: institutional factors (including mentorship schemes), organisational culture (including active engagement), social factors and personal factors.ConclusionThematic analysis suggested that seniors involving women in theatre and a supportive work environment would encourage entry of more female surgeons. Therefore, the proposed implementations are the active engagement of women in theatre and destigmatising less than full-time training. Further research into ethnicity and personality on motivations to enter surgery is advised.
Determination of biomarkers associated with neoadjuvant treatment response focusing on colibactin-producingEscherichia coliin patients with mid or low rectal cancer: a prospective clinical study protocol (MICARE)
Authors: Taoum Christophe , Carrier Guillaume , Jarlier Marta , Roche Gwenaelle , Gagniere Johan , Fiess Catherine , De forges Helene , Chevarin Caroline , Colombo Pierre-Emmanuel , Barnich Nicolas , Rouanet Philippe , Bonnet Mathilde 
Published: December 2022

IntroductionThe management of mid and low rectal cancer is based on neoadjuvant chemoradiotherapy (CRT) followed by standardised surgery. There is no biomarker in rectal cancer to aid clinicians in foreseeing treatment response. The determination of factors associated with treatment response might allow the identification of patients who require tailored strategies (eg, therapeutic de-escalation or intensification). Colibactin-producingEscherichia coli(CoPEC) has been associated with aggressive colorectal cancer and could be a poor prognostic factor. Currently, no study has evaluated the potential association between intestinal microbiota composition and tumour response to CRT in mid and low rectal cancer. The aim of this study is to assess the association between response to neoadjuvant CRT and faecal intestinal microbiota composition and/or CoPEC prevalence in patients with mid or low rectal cancer.Methods and analysisThis is a non-randomised bicentric prospective clinical study with a recruitment capacity of 200 patients. Three stool samples will be collected from participants with histological-proven adenocarcinome of mid or low rectum who meet eligibility criteria of the study protocol: one before neoadjuvant treatment start, one in the period between CRT end and surgery and one the day before surgery. In each sample, CoPEC will be detected by culture in special media and molecular (PCR) approaches. The global microbiota composition will be also assessed by the bacterial 16S rRNA gene sequencing. Neoadjuvant CRT response and tumour regression grade will be described using the Dworak system at pathological examination. Clinical data and survival outcomes will also be collected and investigated.Ethics and disseminationMICARE was approved by the local ethics committee (Comité de Protection des Personnes Sud-Est II, 18 December 2019. Reference number 2019-A02493-54 and the institutional review board. Patients will be required to provide written informed consent. Results will be published in a peer reviewed journal.Trial registration numberNCT04103567.
Practical Anemia Bundle for Sustained Blood Recovery (PABST-BR) in critical illness: a protocol for a randomised controlled trial
Authors: Warner Matthew A , Go Ronald S , Schulte Phillip J , Beam William B , Charnin Jonathan E , Meade Laurie , Droege Kim A , Anderson Brenda K , Johnson Matthew L , Karon Brad , Cheville Andrea , Gajic Ognjen , Kor Daryl J 
Published: December 2022

IntroductionAnaemia is highly prevalent in critical illness and is associated with impaired outcomes during and after hospitalisation. However, the impact of interventions designed to attenuate or treat anaemia during critical illness on post-hospitalisation haemoglobin recovery and functional outcomes is unclear.Methods and analysisThe Practical Anemia Bundle for Sustained Blood Recovery (PABST-BR) clinical trial is a pragmatic, open-label, parallel group, single-centre, randomised clinical trial assessing the impact of a multifaceted anaemia prevention and treatment strategy versus standard care for improvement of haemoglobin concentrations and functional outcomes after critical illness. The intervention, which will be delivered early in critical illness for those with moderate-to-severe anaemia (ie, haemoglobin <100 g/L), includes three components: (1) optimised phlebotomy, (2) clinical decision support and (3) pharmacological anaemia treatment directed at the underlying aetiology of anaemia. In-person assessments will occur at 1 and 3 months post-hospitalisation for laboratory evaluations and multidimensional functional outcome assessments. The primary outcome is differences in haemoglobin concentrations between groups, with secondary endpoints of anaemia-related fatigue, physical function, cognition, mental health, quality of life, phlebotomy volumes and frequency, transfusions, readmissions and mortality through 1-year post-hospitalisation.Ethics and disseminationThe study has been approved by the Institutional Review Board of the Mayo Clinic in Minnesota, USA. A Data Safety Monitoring Plan has been created in accordance with the policies of the Institutional Review Board and the study funder, the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH). The study will comply with NIH data sharing and dissemination policies. Results will be presented at national and international meetings and published in peer-reviewed journals. Designing and testing strategies to optimise haemoglobin recovery and improve functional outcomes after critical illness remain important research gaps. The PABST-BR trial will inform the development of a larger multicentre clinical trial.Trial registration numberNCT05167734.
COVID-19 in a tertiary paediatric centre in Portugal: a single-centre
retrospective study
Authors: Silva Tiago Milheiro , Garcia Ana Margarida , Gouveia Catarina , Candeias Flora , Brito Maria João 
Published: December 2022

Objective
To describe the demographic, clinical, laboratory and imaging
features of the first 300 SARS-CoV-2-infected children presenting to a
tertiary paediatric centre in Portugal.

Design
Single-centre, retrospective, descriptive study of paediatric
patients who had a confirmed SARS-CoV-2 infection from 7 March to 20
September 2020.

Setting
Tertiary paediatric referral centre (Hospital Dona Estefânia,
Lisbon, Portugal).

Patients
18 years or younger.

Main outcome measures
Incidence, mortality, age of infection, clinical characteristics,
treatment prescribed and outcome.

Results
Three hundred patients with confirmed COVID-19 presented to the
centre. One hundred and seventeen (39%) patients were admitted to the
hospital: 69 with COVID-19 and 48 for other reasons. The most common
symptoms in children admitted with COVID-19 were fever (49) and cough
(38). Six patients required intensive care. Two children died and seven
reported short-term sequelae.

Conclusions
COVID-19 is usually a mild disease in children, but a small
proportion of patients develop severe and critical disease. Fatal
outcomes were rare and only occurred in children with severe previous
medical conditions.