bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical care nurses’ knowledge and attitudes and their perspectives toward promoting advance directives and end-of-life care
Authors: Ho Mu-Hsing , Liu Hsiao-Chi , Joo Jee Young , Lee Jung Jae , Liu Megan F. 
Published: October 2022

Abstract
Background
End-of-life care can be a difficult and challenging process for critical care nurses in intensive care units (ICUs) due to the care plan shifts from providing life-sustaining measures to end-of-life care. The aims of this study were to assess critical care nurses' perceived knowledge and attitudes toward end-of-life care, as well as their perspectives on promoting advance directives and the associated factors.

Methods
A cross-sectional study was undertaken in an acute major metropolitan medical center in northern Taiwan between February and March 2020, and 250 critical care nurses were invited to participate in the study. Data on demographics, self-perceived knowledge of end-of-life care, attitudes toward end-of-life care, and perspectives of promoting advance directives were collected. A multiple linear regression model with stepwise selection was used to identify factors associated with their perspectives of promoting advance directives.

Results
The law related to end-of-life care was rated as the least familiar part of the self-perceived end-of-life care knowledge, while ‘I have sufficient knowledge to care for patients who have accepted end-of-life care’ was the lowest level of agreement in attitude scores among critical care nurses. Increased levels of perceived knowledge (β = 0.134; p = 0.045) and attitudes (β = 0.423; p < 0.001) toward end-of-life care were associated with the perspectives of promoting advance directives. Nurses who worked in cardiac (β = -0.234; p < 0.001) and respiratory ICUs (β = -0.135; p = 0.024) had less motivation to promote advance directives (F = 16.943; p < 0.001).

Conclusion
Given their important contributions to ICU care services, appropriate and meaningful support is required to optimize critical care nurses' involvement in end-of-life care. This study demonstrated a significant impact on perspectives of promoting advance directives of critical care nurse participants. Findings from this study can inform the design of effective nurse support programs to enhance the promotion of advance directives in intensive care settings.
Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review
Authors: Bozinoff Nikki , Tardelli Vitor Soares , Rubin-Kahana Dafna Sara , Le Foll Bernard 
Published: October 2022

AbstractBackground and AimsGiven the ongoing opioid crisis, novel interventions to treat severe opioid use disorder (OUD) are urgently needed. Injectable opioid agonist therapy (iOAT) with diacetylmorphine or hydromorphone is effective for the treatment of severe, treatment-refractory OUD, however barriers to implementation persist. Intravenous buprenorphine for the treatment of OUD (BUP iOAT) has several possible advantages over traditional iOAT, including a safety profile that might enable take-home dosing. We aimed to characterize injecting practices among real-world populations of persons who regularly inject buprenorphine, as well as associated adverse events reported in order to inform a possible future BUP iOAT intervention.MethodsWe conducted a systematic review. We searched MEDLINE, EMBASE, and PsycINFO from inception through July 2020 and used backwards citation screening to search for publications reporting on dose, frequency among persons who regularly inject the drug, or adverse events associated with intravenous use of buprenorphine. The review was limited to English language publications and there was no limitation on study type. Study quality and risk of bias was assessed using the Mixed Methods Appraisal Tool. Narrative synthesis was used in reporting the results.ResultsEighty-eight studies were included in our review. Regular injection of buprenorphine was identified across diverse settings world-wide. Daily dose of oral buprenorphine injected was < 1–12 mg. Frequency of injection was 0–10 times daily. Adverse events could be characterized as known side effects of opioids/buprenorphine or injection-related complications. Most studies were deemed to be of low quality.ConclusionsExtramedical, intravenous use of buprenorphine, continues to be documented. BUP iOAT may be feasible and results may inform the development of a study to test the efficacy and safety of such an intervention. Future work should also examine acceptability among people with severe OUD in North America. Our review was limited by the quality of included studies.
PGE2 promotes macrophage recruitment and neovascularization in murine wet-type AMD models
Authors: Zhan Pengfei , Cui Yuqing , Cao Yujuan , Bao Xun , Wu Meili , Yang Qian , Yang Jiahui , Zheng Haohan , Zou Jian , Xie Tianhua , Cai Jiping , Yao Yong , Wang Xiaolu 
Published: October 2022

AbstractAge-related macular degeneration (AMD), a progressive chronic disease of the central retina, is a leading cause of blindness worldwide. Activated macrophages recruited to the injured eyes greatly contribute to the pathogenesis of choroidal neovascularization (CNV) in exudative AMD (wet AMD). This study describes the effects of cyclooxygenase-2 (COX2)/prostaglandin E2 (PGE2) signalling on the macrophage activation and CNV formation of wet AMD. In a mouse model of laser-induced wet AMD, the mice received an intravitreal injection of celecoxib (a selective COX2 inhibitor). Optical coherence tomography (OCT), fundus fluorescein angiography (FFA), choroidal histology of the CNV lesions, and biochemical markers were assessed. The level of PGE2 expression was high in the laser-induced CNV lesions. Macrophage recruitment and CNV development were significantly less after celecoxib treatment. E-prostanoid1 receptor (EP1R)/protein kinase C (PKC) signalling was involved in M2 macrophage activation and interleukin-10 (IL-10) production of bone marrow-derived macrophages (BMDMs) in vitro. In addition, IL-10 was found to induce the proliferation and migration of human choroidal microvascular endothelial cells (HCECs). Thus, the PGE2/EP1R signalling network serves as a potential therapeutic target for CNV of the wet-type AMD.
Graphical Abstract
Long term follow-up in two siblings with Sengers syndrome: Case report
Authors: Panicucci Chiara , Schiaffino Maria Cristina , Nesti Claudia , Derchi Maria , Trocchio Gianluca , Severino Mariasavina , Stagnaro Nicola , Priolo Enrico , Zara Federico , Santorelli Filippo M. , Bruno Claudio 
Published: October 2022

Abstract
Background
Sengers syndrome is characterized by congenital cataract, hypertrophic cardiomyopathy, mitochondrial myopathy, and lactic acidosis associated with mutations in AGK gene. Clinical course ranges from a severe fatal neonatal form, to a more benign form allowing survival into adulthood, to an isolated form of congenital cataract. Thus far few reported cases have survived the second decade at their latest examination, and no natural history data are available for the disease.

Case presentation
Here we provide a 20-year follow-up in two siblings with a benign form of Sengers syndrome, expanding the phenotypical spectrum of the disease by reporting a condition of ovarian agenesis.

Conclusion
To our knowledge, this report provides the first longitudinal data of Sengers syndrome patients.
Relationship between metabolically healthy obesity and the development of hypertension: a nationwide population-based study
Authors: Yuan Yue , Sun Wei , Kong Xiangqing 
Published: October 2022

AbstractBackgroundMetabolically healthy obesity (MHO), has been recognized as a transient phenotype with few cardiometabolic diseases; however, little is known regarding the development of hypertension in subjects with an absence of cardiometabolic abnormalities and general obesity evaluated by body mass index (BMI) or abdominal obesity evaluated by waist circumference (WC).MethodsA total of 4764 participants were enrolled from the China Health and Nutrition Survey and followed up from 2009 to 2015, whose fasting blood samples were collected in 2009. Obesity was classified as abdominal obesity (WC ≥ 90 cm in men and ≥ 80 cm in women) and general obesity (BMI ≥ 25.0 kg/m2). Logistic regression was used to analyze the relationship between MHO and prehypertension (120 < SBP < 140 mmHg or 80 < DBP < 90 mmHg) and hypertension (SBP ≥ 140 or DBP ≥ 90 mmHg). The age- and sex-specific impacts were further analyzed.ResultsThere were 412 (37.9%) participants with prehypertension and 446 (41.0%) participants with hypertension and metabolically healthy abdominal obesity (MHAO). The participants with the MHAO phenotype had significantly higher risks of prehypertension [odds ratio (OR) = 1.89 (1.51–2.36),p < 0.001] and hypertension [OR = 2.58 (2.02–3.30),p < 0.001] than those metabolically healthy but without abdominal obesity. Similar associations were observed in the subjects with metabolically healthy general obesity (MHGO) phenotype, particularly those aged under 64 years. Men with the MHAO phenotype seemed to have higher risks of prehypertension [2.42 (1.52–3.86) in men vs. 1.76 (1.36–2.29) in women] and hypertension [3.80 (2.38–6.06) in men vs. 2.22 (1.64-3.00) in women] than women, when compared with those metabolically healthy but without abdominal obesity.ConclusionThe MHO phenotype, regardless of the presence of general or abdominal obesity, showed a worse effect on the development of prehypertension and hypertension, particularly in young adults. Abdominal adiposity with a healthy metabolic state is significantly associated with incident hypertension in both men and women. These findings can guide the establishment of risk-stratified obesity treatments.
DNA methylation signatures on vascular differentiation genes are aberrant in vessels of human cerebral arteriovenous malformation nidus
Authors: Thomas Jaya Mary , Sasankan Dhakshmi , Abraham Mathew , Surendran Sumi , Kartha Chandrasekharan C. , Rajavelu Arumugam 
Published: October 2022

AbstractArteriovenous malformation (AVM) is a tangle of arteries and veins, rupture of which can result in catastrophic hemorrhage in vulnerable sites such as the brain. Cerebral AVM is associated with a high mortality rate in humans. The causative factor or the stimulus at the artery-venous junction and the molecular basis of the development and progression of cerebral AVM remain unknown. While it is known that aberrant hemodynamic forces in the artery-vein junction contribute to the development of AVMs, the mechanistic pathways are unclear. Given that various environmental stimuli modulate epigenetic modifications on the chromatin of cells, we speculated that misregulated DNA methylome could lead to cerebral AVM development. To identify the aberrant epigenetic signatures, we used AVM nidus tissues and analyzed the global DNA methylome using the Infinium DNA methylome array. We observed significant alterations of DNA methylation in the genes associated with the vascular developmental pathway. Further, we validated the DNA hypermethylation by DNA bisulfite sequencing analysis of selected genes from human cerebral AVM nidus. Taken together, we provide the first experimental evidence for aberrant epigenetic signatures on the genes of vascular development pathway, in human cerebral AVM nidus.
Twelve Loci Associated With Bone Density in Middle-aged and Elderly Chinese: The Shanghai Changfeng Study
Authors: Zeng Hailuan , Ge Jieyu , Xu Wenjie , Ma Hui , Chen Lingyan , Xia Mingfeng , Pan Baishen , Lin Huandong , Wang Sijia , Gao Xin 
Published: October 2022

Abstract

Context
Previous genome-wide association studies (GWASs) of bone mineral density (BMD) were mainly conducted in Europeans.

Objective
To explore genetic variants that affect BMD and sex differences in a Chinese population.

Methods
A total of 5428 middle-aged and elderly Chinese were included. Dual-energy X-ray absorptiometry was used to measure BMD at the lumbar spine, and total and specific sites of the hip. A mixed linear model was used to analyze the associations between BMD and autosomal genetic variants, adjusting for age, age squared, sex, and menopausal women (model 1); model 2 was further adjusted for height and weight. A GWAS of osteoporosis in the Biobank Japan (BBJ) project was used for replication. GWAMA software was used to detect the statistical significance of sex differences of estimated effects. Gene annotation and pathway enrichment analysis were performed.

Results
Women lost BMD at earlier ages and faster than men. The 2 models identified a total of 12 loci that were associated with BMD at any site. Single nucleotide polymorphisms rs72354346, rs2024219, rs1463093, rs10037512, and rs5880932 were successfully replicated in the BBJ. Variations of rs79262027 G&gt;A (VKORC1L1) and rs4795209 A&gt;G (DDX52) were associated with BMD only in men, and rs1239055408 G&gt;GA (KCNJ2) was associated with BMD only in women. Gene enrichment analysis showed that BMD in a Chinese elderly population was mainly related to ossification, bone resorption, sex hormones, and kidney physiology.

Conclusion
The present GWAS identified 12 loci that were significantly associated with BMD at any site in a Chinese population, and 3 of them showed sex differences in their effects.
Globalization, Fertility, and Marital Behavior in a Lowest-Low Fertility Setting
Authors: Giuntella Osea , Rotunno Lorenzo , Stella Luca 
Published: October 2022

AbstractDeclines in marriage and fertility rates in many developed countries have fostered research debate and increasing policy attention. Using longitudinal data from the German Socio-Economic Panel, we analyze the effects of exposure to globalization on fertility and marital behavior in Germany, which was a lowest-low fertility setting until recently. We find that exposure to greater import competition from Eastern Europe led to worse labor market outcomes and lower fertility rates. In contrast, workers in industries that benefited from increased exports had better employment prospects and higher fertility. These effects are driven by low-educated individuals, married men, and full-time workers and reflect changes in the likelihood of having any child (the extensive margin). We find evidence of some fertility postponement and significant effects on completed fertility, but we see little evidence of a significant impact on marital behavior. Our results inform the public debate on fertility rates in settings with lowest-low fertility, such as Germany, during the period under investigation.
Three-Dimensional Modeling and Augmented and Virtual Reality Simulations of the White Matter Anatomy of the Cerebrum
Authors: Gurses Muhammet Enes , Gungor Abuzer , Gökalp Elif , Hanalioglu Sahin , Karatas Okumus Seda Yagmur , Tatar Ilkan , Berker Mustafa , Cohen-Gadol Aaron A. , Türe Uğur 
Published: October 2022

BACKGROUND:
An understanding of the anatomy of white matter tracts and their 3-dimensional (3D) relationship with each other is important for neurosurgical practice. The fiber dissection technique contributes to this understanding because it involves removing the brain's white matter tracts to reveal their anatomic organization. Using this technique, we built freely accessible 3D models and augmented and virtual reality simulations of white matter tracts.

OBJECTIVE:
To define the white matter tracts of cadaveric human brains through fiber dissection and to make 2-dimensional and 3D images of the white matter tracts and create 3D models and augmented and virtual reality simulations.

METHODS:
Twenty cadaveric brain specimens were prepared in accordance with the Klingler method. Brain hemispheres were dissected step-by-step from lateral-to-medial and medial-to-lateral directions. Three-dimensional models and augmented reality and virtual reality simulations were built with photogrammetry.

RESULTS:
High-resolution 3D models and augmented reality and virtual reality simulations of the white matter anatomy of the cerebrum were obtained. These models can be freely shifted and rotated on different planes, projected on any real surface, visualized from both front and back, and viewed from various angles at various magnifications.

CONCLUSION:
To our knowledge, this is the first detailed study integrating various technologies (3D modeling, augmented reality, and virtual reality) for high-resolution 3D visualization of dissected white matter fibers of the entire human cerebrum.
Technical Assessment of Microvascular Decompression for Trigeminal Neuralgia Using a 3-Dimensional Exoscope: A Case Series
Authors: Herta Johannes , Rössler Karl , Dorfer Christian 
Published: October 2022

BACKGROUND:
Detailed anatomic visualization of the root entry zone of the trigeminal nerve is crucial to successfully perform microvascular decompression surgery (MVD) in patients with trigeminal neuralgia.

OBJECTIVE:
To determine advantages and disadvantages using a 3-dimensional (3D) exoscope for MVD surgery.

METHODS:
A 4K 3D exoscope (ORBEYE) was used by a single surgical team for MVD in a retrospective case series of 8 patients with trigeminal neuralgia in a tertiary center. Clinical and surgical data were collected, and advantages/disadvantages of using the exoscope for MVD were recorded after each surgery. Descriptive statistics were used to summarize the data.

RESULTS:
Adequate MVD of the trigeminal nerve root was possible in all patients by exclusively using the exoscope. It offered bright visualization of the cerebellopontine angle and the root entry zone of the trigeminal nerve that was comparable with a binocular operating microscope. The greatest advantages of the exoscope included good optical quality, the pronounced depth of field of the image for all observers, and its superior surgeon ergonomics. Disadvantages were revealed with overexposure at deep surgical sites and the lack of endoscope integration. In 6 patients, facial pain improved significantly after surgery (Barrow Neurological Institute pain intensity score I in 5 and III in 1 patient), whereas it did not in 2 patients (Barrow Neurological Institute score IV and V). No complications occurred.

CONCLUSION:
Utilization of a 3D exoscope for MVD is a safe and feasible procedure. Surgeons benefit from better ergonomics, excellent image quality, and an improved experience for observers.
Pushing the Limits of the Prone Position in the Intraoperative MR Suite
Authors: Winter Fabian , Herta Johannes , Niederle Martin , Furtner Julia , Rentenberger Colleen , Hedrich Cora , Roessler Karl , Dorfer Christian 
Published: October 2022

BACKGROUND:
Patient positioning is an integral part of surgical planning, and numerous variations have been suggested to optimize the prone position. So far, however, little attention has been given to address the restrictions and special needs in an intraoperative MRI suite.

OBJECTIVE:
To share our experience of transforming the modified prone position from the conventional operating room to the intraoperative MRI suite.

METHODS:
Two-room 3T intraoperative MRI suite. Detailed description of the technical pearls is provided.

RESULTS:
Ten procedures in 9 consecutive patients (2 female and 7 male) were performed. The median age was 8 years ranging from 4 to 71 years. We experienced no complication from patient positioning. Neither size (range 104-182 cm) nor weight (range 18-98 kg) of the patients was a limiting factor. In none of them, the surgeon experienced an adverse event from inadequate patient positioning and the surgical goals could be achieved without restrictions. An intraoperative MRI could be acquired in all of them with the same image quality as observed for standard positions.

CONCLUSION:
A transition of the modified prone position from the conventional operating room to the intraoperative MRI suite is feasible, if some crucial steps are considered. We provide a detailed technical description that could be used as a guide by others.
Applying 3-Dimensional Printing and Modeling for Preoperative Reconstruction and Instrumentation Placement Planning in Complex Deformity Surgery
Authors: Caruso James P. , Kafka Benjamin R. , Traylor Jeffrey I. , Wilson Remi A. , El Ahmadieh Tarek , Nassif Rabih Bou , Caldwell Christie , Palmisciano Paolo , Al Tamimi Mazin , Olson Daiwai M. , Dahdaleh Nader S. , Bagley Carlos A. , Aoun Salah G. 
Published: October 2022

BACKGROUND:
Advances in three-dimensional (3D) printing technology have enabled the development of customized instrumentation and surgical training platforms. However, no existing studies have assessed how patient-specific 3D-printed spine models can facilitate patient education and operative planning in complex spinal deformity correction.

OBJECTIVE:
To present a cost-effective technique for constructing personalized 3D-printed spine models for patients with severe spinal deformities and to outline how these models can promote informed consent, trainee education, and planning for instrumentation placement and alignment correction.

METHODS:
We present 2 patients who underwent surgical correction of progressive thoracolumbar deformities. Full-scale 3D-printed models of each patient's spine were produced preoperatively and used during clinic evaluations, surgical planning, and as intraoperative references.

RESULTS:
Each model took 9 days to build and required less than 60 US dollars of material costs. Both patients were treated with a posterior approach and contiguous multilevel osteotomies. Postoperatively, their alignment parameters and neurological deficits improved.

CONCLUSION:
Personalized 3D-printed spine models can aid in patient education, surgical training, visualization, and correction of complex spinal deformities.
SOFIA Nonwire Advancement techniKE 35 Technique: A Minimalist Approach to Stroke Thrombectomy
Authors: Colasurdo Marco , Gabrieli Joseph Domenico , Cester Giacomo , Edhayan Gautam , Simonato Davide , Pieroni Alessio , De Cassai Alessandro , Geraldini Federico , Baracchini Claudio , Causin Francesco 
Published: October 2022

BACKGROUND:
The Soft Torqueable Catheter Optimized for Intracranial Access (SOFIA) is a catheter designed to enable intracranial access, allowing for advancement, at least partially, without a microcatheter by a technique called SOFIA Nonwire Advancement techniKE (SNAKE). We propose a variation of this technique, called SOFIA Nonwire Advancement techniKE 35 (SNAKE35), in which the catheter is navigated by the intracatheter support of a 0.035-inch guidewire, allowing for rapid, distal intracranial access through a biaxial technique.

OBJECTIVE:
To assess the performance of a modified navigation technique in the setting of acute stroke thrombectomy.

METHODS:
Consecutive patients who underwent a thrombectomy procedure between January 2017 and February 2019 were retrospectively identified at our institution. The primary end point was defined as successful positioning of the catheter at the proximal end of the occlusion with the sole use of the SNAKE35 technique. Secondary end points were defined as complications, reperfusion times, and thrombolysis in cerebral infarction scores.

RESULTS:
Among 140 patients, SNAKE35 was attempted in 79 patients (SNAKE35 group), while traditional navigation was used in the remaining 61 patients (conventional group). Of the total 79 cases, SNAKE35 was successful in positioning the catheter at the proximal end of the occlusion in 66 cases (84%). Of these, 54 cases were completed solely with aspiration techniques. Groin puncture to revascularization time averaged 26 minutes in the SNAKE35 group and 37 minutes in the conventional group (P < .05), despite older age (P < .001) and increased use of conscious sedation (P < .001) in the SNAKE35 group.

CONCLUSION:
SNAKE35 is an effective and safe technique for SOFIA navigation up to the site of intracranial occlusion in the anterior circulation leading to significant decrease of procedural times.