bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Retrospective Observational Study of Anticoagulation Practices in Critically ill Patients with Atrial Fibrillation Admitted to the Intensive Care Unit
Authors: Miller NHC , Johnston BW , Hampden-Martin A , AAC Waite , Waugh V , Welters ID 
Published: April 2022

Background Atrial Fibrillation (AF) is the most common arrhythmia in critically ill patients. AF precipitates thromboembolic (TE) events. International guidelines recommend long-term anticoagulation for AF patients dependent upon the risk of TE versus major bleeding events. The CHA2DS2VASc and HAS-BLED scores are used to calculate these risks, but have not been validated in intensive care. Little is known about the risk/benefit ratio of prescribing anticoagulation to patients with AF in the intensive care setting. Methods This observational study included patients who were admitted to intensive care and had AF episodes during admission. We aimed to 1) describe the anticoagulation strategies used in critically ill patients with AF, 2) determine the percentage of patients who received guideline-compliant anticoagulation and 3) compare anticoagulation strategies in patients with new onset AF (NOAF) and known AF. Demographic data was extracted from electronic health records. Therapeutic anticoagulation prescribed during AF episodes and outcomes were collected. CHA2DS2VASc and HAS-BLED scores were calculated and correlated with TE and bleeding events. Results The incidence of AF in our cohort was 13.8%. Anticoagulation was administered in 34.0% of patients. Anticoagulation use did not affect morbidity or mortality outcomes. Patients with pre-existing AF were anticoagulated more often compared to patients with NOAF. CHA2DS2VASc scores and TE events, and HAS-BLED scores and bleeding events did not correlate well. Conclusion AF is common in critical care. Current guidelines on anticoagulation in AF may not be directly transferable to the critical care setting.
Degradation of internal fixation materials based on antibacterial and absorbable silk containing different gentamicin concentrations
Authors: Shi Chenglong , Liao Xuqiang , Pu Xiaobing , Li Xiushi , Wu Ruihui , Deng Donghai , Zhou Yunfei , Huang Xingqiu 
Published: April 2022

Adding gentamicin to silk fibroin enhances both the antibacterial performance and degradation rate of silk-based materials. The increased material degradation rate can affect the strength of early internal fixation, resulting in internal fixation failure. This study sought to adjust the gentamicin concentration to control the material degradation rate, thereby better meeting clinical application requirements. The in vitro degradation, water absorption rate, and expansion rate of silk-based materials containing different gentamicin concentrations were studied. A gentamicin-loaded silk-based screw was implanted into the femurs of New Zealand rabbits. Micro-computed tomography was used to measure the screw diameter, which was then used to calculate the degradation rate. The specimens were stained with hematoxylin and eosin and Masson’s trichrome. The in vitro results revealed increasing material degradation rates with increasing gentamicin concentration but no significant differences in water absorption rates with different gentamicin concentrations. The degradation rates of gentamicin-loaded (4 mg/g) silk-based rod-like materials were approximately 11.08% at three months in vitro and 9.4% in the animal experiment. The time for complete degradation was predicted from the fitting curve to be approximately 16 months. No inflammatory hyperplasia was observed in bone or soft tissue. The degradation and biocompatibility of the material containing 4 mg/g gentamicin meet clinical application requirements, and previous experimental results demonstrate good antibacterial performance of materials containing this gentamicin concentration.
Mouse ovarian follicle growth in an amniotic membrane-based hydrogel
Authors: Haghshenas Mohammad , Tavana Somayeh , Zand Elnaz , Montazeri Leila , Fathi Rouhollah 
Published: April 2022

Three-dimensional cultures of follicles on ECM-based scaffolds can be an approach for women who become infertile after cancer treatments. Human amniotic membrane (HAM) is extensively employed in tissue engineering because of its unique properties. We cultured mouse pre-antral follicles in a hydrogel derived from decellularized amniotic membrane (DAM) combined with alginate (ALG) to improve ovarian follicle culture. HAM was decellularized. Quantitative (nuclear contents, collagen, glycosaminoglycan [GAG]) and qualitative (DAPI, H&E, Masson’s trichrome, Alcian blue, scanning electron microscopy assessments were performed. Then, we created an amniotic membrane-based hydrogel (AMBH) and conducted AMBH characterization assays (rheology, MTS, degradation rate). Isolated mouse pre-antral follicles were cultured in 15 mg/mL AMBH (AMBH15), 30 mg/mL AMBH (AMBH30), or 45 mg/mL AMBH (AMBH45). ALG hydrogel was the control group. Follicular diameters, estradiol hormone secretion rate, follicular morphology, and the follicle antral and degeneration rate were examined. Quantitative and qualitative assays indicated successful decellularization. AMBH characterization assays showed that the ALG hydrogel had more appropriate gelation and slower degradation than AMBH. There was a statistically higher antral follicle formation rate in the AMBH45 group ( p < .05) compared to the AMBH30 and AMBH15 groups and less ( p < .05) degenerated follicles. There was no significant difference with the ALG group. Diameter and estradiol hormone secretion in the AMBH45 group were not significantly higher than the ALG group. Although decellularization was confirmed and the viscoelastic parameters of AMBH support follicle culture, there was no significant effect on ovarian follicle maturation compared to the ALG control group.
Synthesis and properties of polyarylene ether nitrile random copolymer containing naphthalene and biphenyl structure
Authors: Zhu Ying , Tong Lifen , Liu Xiaobo 
Published: April 2022

A novel series of polyarylene ether nitrile (PEN) random copolymers with a higher Tg and better mechanical and electrical properties were synthesized through nucleophilic substitution polycondensation. In the means of adjusting mole ratio of 4,4′-dihydroxybiphenyl (BP) to 2,7-naphthalenediol (ND), the performance of PEN random copolymer could be controlled. The FTIR, SEM, DSC, TGA, AR, intrinsic viscosity, and electrical and mechanical properties were performed on the samples. All the samples exhibited excellent thermal performance with Tg over 210°C, Td5% over 520°C, and heat conduction higher than 0.4 W/m·k. The PEN copolymers when the molar ratio of ND was 15% had the best comprehensive performances, whose Tg was 215°C, Td5% was up to 554.31°C, thermal conductivity was 0.4430 W/m·k, tensile strength was 113.27 MPa, and stable dielectric constant (at frequency from 103 Hz to 106 Hz) was lower than 4. As a result, this PEN copolymer obtained in this paper could provide practical value and possibility in further application in the filed including machine manufacture industry, electronic materials, and automotive industry.
Arteriovenous fistula creation with VasQTM device: A feasibility study to reveal hemodynamic implications
Authors: Bozzetto Michela , Soliveri Luca , Poloni Sofia , Brambilla Paolo , Curtò Diego , Condemi Giuseppina Carmela , Cefalì Pietro , Spina Irene , Villa Alessandro , Caroli Anna , Remuzzi Andrea 
Published: April 2022

Background: Arteriovenous fistula (AVF) is the preferred vascular access (VA) for hemodialysis, but it is still affected by high non-maturation and early failure rates due to stenosis development. Increasing evidence suggests that the presence of turbulent-like flow may play a key role, therefore, to stabilize the flow in the venous segment, an external support device (VasQTM) has been designed. The aim of this study was to provide preliminary evidence of VasQTM impact on AVF hemodynamics as compared to AVFs created with conventional surgery. Methods: In this pilot single-center prospective randomized study six patients were enrolled, three in the VasQ group and three in the control group. Contrast-free magnetic resonance imaging (MRI) scans were acquired at 3 days, 3 months and 1 year after AVF surgery and were used to generate 3D patient-specific models. Computational fluid dynamic (CFD) simulations were performed using pimpleFoam, imposing patient-specific flow waveforms derived from ultrasound (US) examinations at the inlet of the proximal and distal artery, and a traction-free condition at the venous outflow. Morphologic and hemodynamic changes occurring over time were compared between VasQ and control AVFs. Results: Our MRI protocol provided high-quality images suitable for reliable segmentation and reconstruction of patient-specific 3D models of AVFs at all three timepoints in four out of six patients. The VasQTM device maintained the angle between the artery and the vein almost unchanged over time, with a more stable flow in the AVFs supported by the device. In contrast, one of the AVFs of the control group evolved to an extreme dilatation of the vein and highly disturbed flow, while the other developed a stenosis in the juxta-anastomotic region. Conclusions: This study demonstrated the feasibility of characterizing the morphological and hemodynamic changes occurring over time in AVFs created using the VasQTM device and provided preliminary evidence of the potential hemodynamic benefits of its use.
Household Water Treatment Practice and Associated Factors in Rural Households of Sodo Zuria District, Southern Ethiopia: Community-Based Cross-Sectional Study
Authors: Admasie Amha , Abera Kefelegn , Feleke Fentaw Wassie 
Published: April 2022

Introduction: In Ethiopia, access to safe drinking water is very low, and even safe water at the point of distribution is subjected to frequent and substantial contamination during collection, transport, and storage. The purpose of this study was to assess the level of household water treatment practices and associated factors in rural households of the Sodo Zuria district, southern Ethiopia. Methods: A community-based cross-sectional study was conducted in 836 households using a multistage sampling technique. A structured and pre-tested questionnaire was used. Binary and multivariate logistic regression analysis was used. Results: The household water treatment practice was 44.1%. Households having a higher estimated monthly income, AOR = 1.5 (1.23, 3.47), older age greater than 45 years, AOR = 1.69 (1.08, 2.64), fetching water twice a day, AOR = 2.8 (1.21, 9.17), weekly washing of the water storage container, AOR = 0.3 (0.11, 0.83), and using the dipping technique to draw water from the collection jar, AOR = 1.67 (1.14, 2.42) were significant factors in the practice of household water treatment in the study. Conclusions: The household water treatment practice was low. Higher estimated monthly income, older household heads, fetching water twice per day, washing the water storage container weekly, and dipping techniques to draw water from water storage containers were significant factors of household water treatment practices. Thus, proper hygiene of water storage, and engaging the community in income-generating activities were recommended.
Expression and Prognostic Significance of c-Myc, ALK, ROS1, BRAF, and PD-L1 Among Patients With Non-Small Cell Lung Cancer
Authors: Sunpaweravong Patrapim , Thongwatchara Patcharaporn , Chotipanvithayakul Rassamee , Sangkhathat Surasak , Thongsuksai Paramee 
Published: April 2022

Background: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer death worldwide, for which better knowledge in molecular prognostic factors is needed to improve clinical outcome. This study aimed to investigate the clinical significance of c-Myc, ALK, ROS1, BRAF, and PD-L1 in NSCLC patients. Methods: Formalin-fixed paraffin-embedded tissue specimens were obtained from 124 NSCLC patients. Of these, 66 matched specimens of normal respiratory epithelial and tumor tissue from patients with stages I-III, who underwent surgical resection, and 58 NSCLC specimens from stage IV patients were recruited into this analysis. Immunohistochemistry staining along with semiquantitative criteria were used to evaluate the expression of the interested proteins. Results: Of the 66 patients with stages I-III, positive expression of c-Myc was detected in 12 specimens (18.2%) of NSCLC tissue, whereas none of the normal respiratory epithelial tissue was found to have c-Myc expression ( P < .001). Of the 66 NSCLC patients, 28 (43.8%) had PD-L1-positive staining on 1%-49% tumor cells and 7 (10.9%) patients expressed PD-L1 in ⩾50% tumor cells. One (2.3%) adenocarcinoma patient was found to have ROS1 rearrangement. Patients with no expression of c-Myc and PD-L1 (co-negative expression) tended to have a better prognosis than other subgroups. Conclusions: NSCLC tissue significantly expressed more c-Myc and PD-L1, compared with the matched normal respiratory epithelium, emphasizing the important role of these key drivers in tumorigenesis. Therapeutic approach to precisely inhibit the targetable molecular pathways should be considered on an individual patient basis to improve survival outcome.
Reflections of Buddhist priests who started a dementia carers’ café in Japan
Authors: Okamura Tsuyoshi , Ura Chiaki , Shimmei Masaya , Takase Akinori , Shoji Ryosho , Ogawa Yukan 
Published: April 2022

Aim Faith-based organizations are a potential global resource; however, details of their activities have not been fully explored in the academic literature. In Japan, little is known about delivering support for dementia caregivers in a faith-based setting. In this study, we spoke with priests who started carers’ cafés to support people who have dementia and people who care for them. These “carers’ cafés” are set up in temples and this movement is slowly expanding. The aim of this study was to (1) provide a detailed description of a carers’ café and (2) report the reflections of the Buddhist priests who have been involved in the project from the beginning. Methods We conducted in-depth interviews with five Buddhist priests who pioneered the carers’ café movement, and conducted a thematic analysis of the transcripts using a qualitative descriptive approach. Results Six prominent themes were identified: “A carers’ café aligns with Buddhist doctrine,” “...reveals the strengths of Buddhism and its temples,” “...facilitates priests’ personal growth,” and “...introduces viewpoints from outside of Buddhism.” Conclusions Carers’ cafés set up in temples have a positive impact on the Buddhist priests who are involved and on the visitors. One possible reason for this is that the relationship between the temple and the local residents has a long history and thus provides a sense of security for those who are suffering from the realities related to dementia. To create a more inclusive society, it is necessary for secular entities to support this new movement.
Complex and Successful Management of a Symptomatic Isolated Abdominal Aortic Aneurysm in a Pregnant Woman with Marfan Syndrome
Authors: Ruben-Castillo Christopher , Mier y Teran-Ellis Santiago , Anaya-Ayala Javier E. , Contreras-Jimenez Emmanuel , Lopez-Peña Gabriel , Luna Lizeth , Arzola Luis H. , Silerio Ernesto , Guerrero-Hernández Manuel , Hinojosa Carlos A. 
Published: April 2022

Aortopathies associated to Marfan syndrome (MFS) are important causes of maternal death during pregnancy. We present a 27-year-old and 24-week pregnant MFS woman who arrived to the emergency department with increasing abdominal pain; an obstetric ultrasound showed an Abdominal Aortic Aneurysm (AAA), a multislice computed tomography angiography (CTA) confirmed and demonstrated a 7.3 centimeter (cm) infrarenal AAA without evidence of dissection. A multidisciplinary committee determined that an open repair would lead to a significantly high maternal-fetal morbidity and mortality. Although endovascular repair (EVAR) in MFS patients remains controversial, an urgent bridge therapy was considered to be the best option. She was transferred to the angiography suite for EVAR to prevent AAA rupture and ensure a satisfactory pregnancy. The patient and fetus presented no complications during the procedure and were discharged 3 days later. She continued her pregnancy without eventualities and an elective C-section was performed on week 36. A CTA imaging at 12 months revealed type 1A and 3 endoleaks, we decided to perform endograft explant and a definitive open repair, there were no complications during the procedure, the patient is currently asymptomatic. Our case illustrates a complex decision and management that successfully avoid morbidity and mortality of a MFS mother and her product; additionally, this experience reinforces the need for lifelong and close surveillance in these patients.
Characterization of Near-Infrared Imaging and Indocyanine-Green Use Amongst General Surgeons: A Survey of 263 General Surgeons
Authors: Verhoeff Kevin , Mocanu Valentin , Fang Breanna , Dang Jerry , Sun Warren , Switzer Noah J. , Birch Daniel W. , Karmali Shahzeer 
Published: April 2022

Background Near-infrared fluorescence imaging (NIRFI) is an increasingly utilized imaging modality, however its use amongst general surgeons and its barriers to adoption have not yet been characterized. Methods This survey was sent to Canadian Association of General Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons members. Survey development occurred through consensus of NIRFI experienced surgeons. Results Survey completion rate for those opening the email was 16.0% (n = 263). Most respondents had used NIRFI (n = 161, 61.2%). Training, higher volumes, and bariatric, thoracic, or foregut subspecialty were associated with use (P < .001). Common reasons for NIRFI included anastomotic assessment (n = 117, 72.7%), cholangiography (n = 106, 65.8%), macroscopic angiography (n = 66, 41.0%), and bowel viability assessment (n = 101, 62.7%). Technical knowledge, training and poor evidence were cited as common barriers to NIRFI adoption. Conclusions NIRFI use is common with high case volume, bariatric, foregut, and thoracic surgery practices associated with adoption. Barriers to use appear to be lack of awareness, low confidence in current evidence, and inadequate training. High quality randomized studies evaluating NIRFI are needed to improve confidence in current evidence; if deemed beneficial, training will be imperative for NIRFI adoption.
The failing endograft-A systematic review of aortic graft explants and associated outcomes
Authors: de Boer Madeleine , Qasabian Raffi , Dubenec Steven , Shiraev Timothy 
Published: April 2022

Objective The prominent use of endovascular stent grafts in the management of abdominal aortic aneurysms is associated with increased descriptions of late complications such as graft infection and endoleaks, which can confer significant morbidity and mortality. Failed endovascular management of late complications often requires open conversion and graft explantation. This systematic review sought to highlight the peri- and post-operative course of patients undergoing aortic graft explants to inform readers of the associated morbidity and mortality of patients undergoing this procedure. Methods The review was conducted in accordance with PRISMA guidelines. A search of the PubMed, Google Scholar and Ovid MEDLINE databases from January 1995 to April 2021 was performed with a combination of MeSH terms pertaining to endovascular aneurysm repair and open conversion. Articles were screened and included based on pre-determined selection criteria. Results A total of 818 studies were identified, with 41 meeting inclusion criteria. These studies examined a total of 1324 patients, 84.3% of whom were male with a mean age of 74 years at explantation. Mean time to graft explantation was 36 months, with a mean aneurysm size of 66 mm. The majority of aortic explants were performed for persistent endoleaks (68%), and 10% for infection. There was high morbidity with the procedure, with high rates of post-operative complications (mean, 37%) and 30-day mortality (11%). The most common complications included renal (15%), respiratory (12%) and cardiac (9%). Most explanted grafts were first-generation endografts. Morbidity and mortality rates were reduced in patients undergoing elective explants compared to emergent procedures (3.3% compared to 43.4%). Conclusion Aortic graft explant remains a highly co-morbid procedure, with high rates of peri- and post-operative complications and mortality. The number of explant procedures reported over the past 25 years has increased, reflecting the prominent use of EVAR in the management of AAAs. Whilst remaining a highly co-morbid procedure, patients undergoing elective explants had markedly reduced rates of mortality and morbidity compared to emergent explants. Thus, clinical focus should be on identifying patients who require graft explantation early to perform these procedures in an elective setting.
Retinal parameters, cortical cerebral microinfarcts, and their interaction with cognitive impairment
Authors: Hilal Saima , Cheung Carol Y , Wong Tien Yin , Schmetterer Leopold , Chen Christopher 
Published: April 2022

Background: Quantitative changes in retinal vessels and thinning of optic nerves have been associated with subclinical (atherosclerosis, inflammation) and clinical age-related brain pathologies (stroke and neurodegeneration). However, data on the association between both retinal vascular and neuronal parameters with cortical cerebral microinfarcts (CMIs) and how these factors jointly influence cognition are lacking. Aim: We investigated the association of retinal vascular and neuronal changes with CMIs on 3 T MRI and explored their interaction with cognitive impairment in a memory-clinic population. Methods: A total of 538 participants were included. Retinal vascular parameters (caliber, tortuosity, and fractal dimension) were measured from retinal fundus photographs using a semi-automated computer-assisted program. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thicknesses were obtained from optical coherence tomography. Cortical CMIs were defined as hypointense on T1-weighted MRI, <5 mm in diameter and restricted to the cortex. Cognition was assessed using Clinical Dementia Rating Sum-of-Boxes (CDR-SoB) score and detailed neuropsychological test. Multivariable regression analysis was conducted adjusting for age, sex, hypertension, hyperlipidemia, diabetes mellitus, smoking, diagnosis, white matter hyperintensities volume, lacunes, and cerebral microbleeds. Results: Larger venular caliber (Rate ratios (RR): 1.15, 95% CI: 1.01–1.38, p = 0.014), increased venular fractal dimension (RR: 1.58, 95% CI: 1.31–1.91, p ⩽ 0.001), increased venular tortuosity (RR: 1.54, 95% CI: 1.35–1.75, p ⩽ 0.001), and thinner GC-IPL (RR: 1.24, 95% CI: 1.13–1.36, p ⩽ 0.001) were associated with CMI counts. Among individuals in highest tertile of retinal parameters, a significant interaction was observed between venular tortuosity (RR: 1.12, 95% CI: 1.02–1.22, p-interaction = 0.014) and GC-IPL (RR: 1.05, 95% CI: 1.01–1.11, p-interaction < 0.001) with CMIs on CDR-SoB. Conclusion: Retinal vascular and neuronal parameters are associated with cortical CMIs, and persons with both pathologies are likely to have cognitive impairment. Further studies may be warranted to evaluate the clinical utility of retinal parameters and CMI in risk prediction for cognitive dysfunction.