bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distal Perfusion With Modified Centrifugal Pump Circuit in Thoracic and Thoracoabdominal Aortic Aneurysm Repair
Authors: Ertugay Serkan , Apaydin Anil Z. , Karaca Sedat , Ergi Defne G. , Posacioglu Hakan 
Published: June 2022

Objective The left heart bypass is currently the most frequent adjunct to provide distal aortic perfusion during aortic clamping. However, closed-circuits cannot respond to sudden hemodynamic fluctuations during aortic clamping which may lead to complications. In this report, we aim to give the technical aspects of reservoir-added centrifugal pump circuit system, its implementation and the clinical outcomes. Methods Between 2002 and 2020, the data of 35 patients underwent aortic aneurysm repair with the use of modified pump circuit were analyzed. The mean age was 53.4 years (range 24-73) and 91.4% of all was male. Preoperative demographics, intraoperative pump data and postoperative clinical outcomes were reported. Results Thoracoabdominal incision was used in 22 patients (62.9%) and cerebrospinal fluid (CSF) drainage catheter was placed in 15 patients (42.9%). The left inferior pulmonary vein for outflow and the left femoral artery for inflow cannulation were used preferably. Median duration of pump support was 50 mins (13-121) in the cohort. The median transfusion of red packed cells was 2 units. Renal failure was observed in two patients and permanent paraplegia in one patient. Only one patient died in the elective group (1/34) and one patient in the emergent. Conclusions The reservoir-added centrifugal pump is an effective, practical, and flexible perfusion system which should be in the armamentarium of surgeons in order to solve difficult problems during open repair of descending and thoracoabdominal aortic aneurysms.
Concerns, beliefs and attitudes of pharmacists and pharmacy students on cannabis use in Canada
Authors: Vaillancourt Régis , Dhalla Rahim , Merks Piotr , Lougheed Taylor , Goldfield Gary , Mansell Holly , Cameron Jameason 
Published: June 2022

Background: Since cannabis has been legalized in Canada for medical and recreational use, there has been an increased demand on pharmacists for cannabis counselling. The objective of this study was to determine the concerns, beliefs and attitudes of Canadian pharmacists and pharmacy students towards using cannabis. Methods: An online survey was synthesized under 3 broad themes: concerns, beliefs and attitudes about cannabis, consisting of 27 questions capturing demographics and Likert scale responding to survey questions. We examined whether there were differences in responses by geographic location (i.e., Ontario, Quebec, Canada), sex or practice setting (i.e., community, hospital). Results: Across Canada, there were 654 survey respondents, with 399 in Ontario and 95 in Quebec. Approximately 24% indicated they had used cannabis since legalization, 69% indicated they believed cannabis should be available for medical and recreational use and 34% indicated their perceptions towards cannabis had become more positive since legalization. Relative to Quebec or the rest of Canada, respondents from Ontario were significantly more likely to be comfortable providing counselling to and answering questions of patients on the safety and efficacy of medical cannabis use. Examining sex differences across Canada, male respondents were more comfortable than female counselling patients on the safety and efficacy of medical cannabis. Conclusion: The current results reinforce the perceived need by pharmacists and pharmacy students for targeted education, and future research in cannabis education should consider potential gender differences in attitudes and beliefs surrounding cannabis therapy.
Early versus Late initiation of direct oral Anticoagulants in post-ischaemic stroke patients with atrial fibrillatioN (ELAN): Protocol for an international, multicentre, randomised-controlled, two-arm, open, assessor-blinded trial
Authors: Fischer Urs , Trelle Sven , Branca Mattia , Salanti Georgia , Paciaroni Maurizio , Ferrari Cecilia , Abend Stefanie , Beyeler Seraina , Strbian Daniel , Thomalla Götz , Ntaios George , Bonati Leo H , Michel Patrik , Nedeltchev Krassen , Gattringer Thomas , Sandset Else Charlotte , Kelly Peter , Lemmens Robin , Koga Masatoshi , Sylaja Padmavathy N , de Sousa Diana Aguiar , Bornstein Natan M , Gdovinova Zuzana , Seiffge David J , Gralla Jan , Horvath Thomas , Dawson Jesse 
Published: June 2022

Rationale: Direct oral anticoagulants (DOAC) are highly effective in preventing ischaemic strokes in people with atrial fibrillation (AF). However, it is unclear how soon they should be started after acute ischaemic stroke (AIS). Early initiation may reduce early risk of recurrence but might increase the risk of haemorrhagic complications. Aim: To estimate the safety and efficacy of early initiation of DOACs compared to late guideline-based initiation in people with AIS related to AF. Methods and design: An international, multicentre, randomised (1:1) controlled, two-arm, open, assessor-blinded trial is being conducted. Early treatment is defined as DOAC initiation within 48 h of a minor or moderate stroke, or at day 6–7 following major stroke. Late treatment is defined as DOAC initiation after day 3–4 following minor stroke, after day 6–7 following moderate stroke and after day 12–14 following major stroke. Severity of stroke is defined according to imaging assessment of infarct size. Sample size: ELAN will randomise 2000 participants 1:1 to early versus late initiation of DOACs. This assumes a risk difference of 0.5% favouring the early arm, allowing an upper limit of the 95% confidence interval up to 1.5% based on the Miettinen & Nurminen formula. Outcomes: The primary outcome is a composite of symptomatic intracranial haemorrhage, major extracranial bleeding, recurrent ischaemic stroke, systemic embolism or vascular death at 30 ± 3 days after randomisation. Secondary outcomes include the individual components of the primary outcome at 30 ± 3 and 90 ± 7 days and functional status at 90 ± 7 days. Discussion: ELAN will estimate whether there is a clinically important difference in safety and efficacy outcomes following early anticoagulation with a DOAC compared to late guideline-based treatment in neuroimaging-selected people with an AIS due to AF.
Maternal age affects equine day 8 embryo gene expression both in trophoblast and inner cell mass
Authors: Derisoud Emilie , Jouneau Luc , Dubois Cédric , Archilla Catherine , Jaszczyszyn Yan , Legendre Rachel , Daniel Nathalie , Peynot Nathalie , Dahirel Michèle , Auclair-Ronzaud Juliette , Wimel Laurence , Duranthon Véronique , Chavatte-Palmer Pascale 
Published: June 2022

Abstract
Background
Breeding a mare until she is not fertile or even until her death is common in equine industry but the fertility decreases as the mare age increases. Embryo loss due to reduced embryo quality is partly accountable for this observation. Here, the effect of mare’s age on blastocysts’ gene expression was explored. Day 8 post-ovulation embryos were collected from multiparous young (YM, 6-year-old, N = 5) and older (OM, > 10-year-old, N = 6) non-nursing Saddlebred mares, inseminated with the semen of one stallion. Pure or inner cell mass (ICM) enriched trophoblast, obtained by embryo bisection, were RNA sequenced. Deconvolution algorithm was used to discriminate gene expression in the ICM from that in the trophoblast. Differential expression was analyzed with embryo sex and diameter as cofactors. Functional annotation and classification of differentially expressed genes and gene set enrichment analysis were also performed.

Results
Maternal aging did not affect embryo recovery rate, embryo diameter nor total RNA quantity. In both compartments, the expression of genes involved in mitochondria and protein metabolism were disturbed by maternal age, although more genes were affected in the ICM. Mitosis, signaling and adhesion pathways and embryo development were decreased in the ICM of embryos from old mares. In trophoblast, ion movement pathways were affected.

Conclusions
This is the first study showing that maternal age affects gene expression in the equine blastocyst, demonstrating significant effects as early as 10 years of age. These perturbations may affect further embryo development and contribute to decreased fertility due to aging.
“Your heart keeps bleeding”: lived experiences of parents with a perinatal death in Northern Uganda
Authors: Arach Anna Agnes Ojok , Kiguli Juliet , Nankabirwa Victoria , Nakasujja Noeline , Mukunya David , Musaba Milton W. , Napyo Agnes , Tumwine James K. , Ndeezi Grace , Rujumba Joseph 
Published: June 2022

Abstract
Background
Worldwide, two million babies are stillborn and 1.8 million babies die before completing seven days of life. Approximately 4% of pregnant women in Uganda experience perinatal death. The response following a perinatal death tends to be socio-culturally constructed. Investigating the unique personal experiences of parents from a low-income setting with unique cultural beliefs and practices is crucial for the design and implementation of appropriate interventions.

Objective
To describe the lived experiences of parents following perinatal death in Lira district, Northern Uganda.

Methods
A qualitative study was carried out drawing on the tenets of descriptive phenomenology. We conducted 32 in-depth interviews in Lira district, Northern Uganda between August 2019 and September 2020 with 18 women and 14 men who had experienced a stillbirth or an early neonatal death within the preceding 2 years. Participants were selected from different families and interviewed. A local IRB approved the study. All in-depth interviews were audio-recorded, transcribed, translated, and data were analysed using a content thematic approach. Key findings were discussed based on Worden’s Four Tasks of Mourning theory.

Results
The themes that emerged from the analyses included reaction to the perinatal loss and suggestions for support. The participants’ immediate reactions were pain, confusion, and feelings of guilt which were aggravated by the unsupportive behaviour of health care providers. Men cumulatively lost financial resources in addition to facing multiple stressful roles. Delayed reactions such as pain and worries were triggered by the sight of similar-age-babies, subsequent pregnancy losses, and marital challenges. Participants recommended emotional support and management of postnatal complications for parents faced with perinatal loss.

Conclusion
Losing a baby during the perinatal period in a resource-constrained setting negatively affected both gender. In addition, men suffered the loss of financial resources and the burden of multiple stressful roles. Acknowledging the pain and offering support to the grieving parents reinforce their coping with a perinatal loss. In addition to family and community members, health care providers need to provide emotional support and postnatal care to parents who experience perinatal death.
Experiences of young Australian mothers with infant feeding
Authors: Buckland Christa , Hector Debra , Kolt Gregory S. , Thepsourinthone Jack , Arora Amit 
Published: June 2022

Abstract
Background
Despite the overwhelming evidence of health and other benefits of breastfeeding and recommendations to breastfeed by peak health bodies, breastfeeding rates are significantly lower than recommended in Australia and globally. Young mothers are identified as being at high risk of not breastfeeding their infants according to infant feeding recommendations. This study aimed to gain an in-depth understanding of young Australian mothers’ experiences of infant feeding, and to explore the factors which facilitated or hindered adherence to recommended breastfeeding practices.

Methods
Purposive and snowball sampling were used to recruit young mothers in Australia (n = 17) aged 18–25 years who had given birth to their first child within the last two years. Data were collected through semi-structured interviews via online videoconferencing. Interviews were audio-recorded, transcribed verbatim, coded, and subsequently analysed. Thematic analysis was conducted using Quirkos, a qualitative data management and analysis software.

Results
Four major themes were identified: Breastfeeding is challenging; Feeling judged about infant feeding choices; Experiences with breastfeeding support; and Experiences and views on breastfeeding education. Most mothers reported experiencing breastfeeding challenges, particularly those arising from lactation difficulties, yet many were able to overcome these challenges through their determination to breastfeed. Many mothers expressed perceiving judgement from others for breastfeeding in public. Some mothers who were bottle feeding their infants, whether with expressed breast milk or infant formula, felt that they were being judged for using a bottle. Many mothers reported professional, partner, family, and peer support as critical facilitators to the continuation of breastfeeding. Most mothers shared positive experiences of attending breastfeeding education sessions, but indicated the need for community education to reduce judgement toward mothers’ infant feeding decisions.

Conclusions
The barriers and enablers to infant feeding experienced by young mothers are similar to those experienced by mothers of all ages. Young mothers experience significant breastfeeding challenges and need support from partner, family, peers, and professionals to continue breastfeeding in line with recommendations. Breastfeeding campaigns to support young mothers should be aimed at the wider community to increase awareness of breastfeeding challenges, reduce stigma associated with breastfeeding in public, and to support mothers in their infant feeding decisions.
Parents’ perceptions of functional electrical stimulation as an upper limb intervention for young children with hemiparesis: qualitative interviews with mothers
Authors: Swaffield Emma , Yang Jaynie F. , Manns Patricia , Chan Katherine , Musselman Kristin E. 
Published: June 2022

Abstract
Background/objective
To explore parents’ perceptions of an upper extremity (UE) intervention using functional electrical stimulation (FES) for young children with hemiparesis.

Methods
Parents of children aged 3–6 years with a history of perinatal stroke, impaired UE function, and participation in a 12-week FES intervention delivered at a hospital were included in this exploratory qualitative study. Nine mothers participated in a semi-structured interview < 1 week after their child completed the FES intervention (MyndMove®, MyndTec Inc.) targeting the hemiparetic UE. Open-ended questions queried parents’ goals, perceived benefits, and challenges of the FES intervention. Interviews were audio recorded and transcribed verbatim. Qualitative conventional content analysis was used to analyze the transcripts.

Results
Five themes were identified. 1) Parents’ expectations for the FES intervention. Mothers described setting functional, exploratory, and realistic goals, yet feeling initial apprehension towards FES. 2) Perceived improvement. Physical, functional, and psychological improvements were observed with FES; however, there was still room for improvement. 3) Factors influencing the FES intervention. Program structure, therapist factors, and child factors influenced perceived success. 4) Lack of access to intensive therapy. Mothers noted that FES is not provided in mainstream therapy; however, they wanted access to FES outside of the study. They also highlighted socioeconomic challenges to accessing FES. 5) Strategies to facilitate participation. The mothers provided suggestions for program structure and delivery, and session delivery.

Conclusions
Mothers perceived the FES intervention to have physical, functional and psychological benefits for their children. Interest in continuing with FES highlights a need to improve access to this therapy for young children.
Using a multi-module web-app to prevent substance use among students at a Hispanic Serving Institution: development and evaluation design
Authors: Rainisch Bethany K. W. , Dahlman Linn , Vigil Jorge , Forster Myriam 
Published: June 2022

Abstract
Background
Despite effective strategies to prevent substance use and substance use disorders among college students, challenges remain. As young adults’ preference for and comfortability with web-based technology continues to increase, leveraging innovative approaches to rapidly evolving mHealth technology is critical for the success of lowering the risk for substance use and related consequences in college populations, and especially those at Hispanic Serving Institutions. Therefore, the present study describes the rationale, development, and design of iSTART, a novel web-app to prevent substance use among students.

Methods
The web-app was developed following the intervention mapping protocol, and in collaboration with numerous stakeholders, including a community-based partner specializing in substance abuse prevention and treatment. A 30-day multi-module web-app intervention was developed based on key theoretical constructs, behavior change strategies, and practical module components: attitudes (knowledge), perceived susceptibility (risk perceptions), subjective norms (normative re-education), and self-efficacy (refusal skills). This intervention will be evaluated via a time series design using a sample of 600 students randomly assigned to either the intervention, comparison, or control condition at a public institution in southern California.

Discussion
The iSTART web-app is an innovative and sustainable program ideal for college campuses with diverse student populations. If this prevention web-app is successful, it will significantly contribute to the evidence of effective substance use interventions in the college setting, and identify the benefits of mHealth programs to prevent future substance use.

Trial registration
NCT05362357 retrospectively registered on May 4, 2022 on clinicaltrials.gov.
Automated detection of anterior cruciate ligament tears using a deep convolutional neural network
Authors: Minamoto Yusuke , Akagi Ryuichiro , Maki Satoshi , Shiko Yuki , Tozawa Ryosuke , Kimura Seiji , Yamaguchi Satoshi , Kawasaki Yohei , Ohtori Seiji , Sasho Takahisa 
Published: June 2022

Abstract
Background
The development of computer-assisted technologies to diagnose anterior cruciate ligament (ACL) injury by analyzing knee magnetic resonance images (MRI) would be beneficial, and convolutional neural network (CNN)-based deep learning approaches may offer a solution. This study aimed to evaluate the accuracy of a CNN system in diagnosing ACL ruptures by a single slice from a knee MRI and to compare the results with that of experienced human readers.

Methods
One hundred sagittal MR images from patients with and without ACL injuries, confirmed by arthroscopy, were cropped and used for the CNN training. The final decision by the CNN for intact or torn ACL was based on the probability of ACL tear on a single MRI slice. Twelve board-certified physicians reviewed the same images used by CNN.

Results
The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the CNN classification was 91.0%, 86.0%, 88.5%, 87.0%, and 91.0%, respectively. The overall values of the physicians’ readings were similar, but the specificity was lower than the CNN classification for some of the physicians, thus resulting in lower accuracy for the human readers.

Conclusions
The trained CNN automatically detected the ACL tears with acceptable accuracy comparable to that of human readers.
Prevalence rates of metabolic health and body size phenotypes by different criteria and association with insulin resistance in a Maltese Caucasian population
Authors: Agius Rachel , Fava Marie Claire , Pace Nikolai Paul , Fava Stephen 
Published: June 2022

Abstract
Introduction
Hyperinsulinemia and insulin resistance are known to be associated with increased cardiovascular morbidity and mortality. A metabolically unhealthy phenotype is frequently used as a surrogate marker for insulin resistance. The aims of the current study were to compare the prevalence of the body size phenotypes using different definitions of metabolic health and to investigate which one of them is most strongly associated with insulin resistance in men and women.

Methods
We conducted a cross-sectional study in a middle-aged cohort of Maltese Caucasian non-institutionalized population. Metabolic health was defined using the various currently used definitions.

Results
There were significant differences in the prevalence of body size phenotypes according to the different definitions. We also found significant sex differences in the predictive value of the various definitions of the metabolically unhealthy phenotype to predict insulin resistance. The strongest association was for the definition of having >2 NCEP-ATPIII criteria to characterize the metabolic unhealthy phenotype in women (odds ratio of 19.7). On the other hand, the Aguilar-Salinas et al. definition had the strongest association in men (odds ratio of 18.7).

Conclusions
We found large differences in the prevalence of the various body size phenotypes when using different definitions, highlighting the need for having standard criteria. Our data also suggest the need for sex-specific definitions of metabolic health.
Peripheral blood CD4posCD25posFoxP3pos cells and inflammatory cytokines as biomarkers of response in rheumatoid arthritis patients treated with CTLA4-Ig
Authors: Gremese Elisa , Tolusso Barbara , Petricca Luca , Di Mario Clara , Gigante Maria Rita , Ferraccioli Gianfranco , Alivernini Stefano 
Published: June 2022

Abstract
Background
Prognostic biomarkers of treatment response to distinct biologic disease-modifying anti-rheumatic drugs (b-DMARDs) are still lacking within the management of rheumatoid arthritis (RA).

Methods
Thirty-four b-DMARDs naive RA patients, divided by disease duration into early (cohort 1) and long standing (cohort 2), received CTLA4-Ig. At study entry, and every 3 months for 1 year, each patient underwent peripheral blood (PB)-derived CD4pos cell subpopulation assessment by flow cytometry, STAT3 and STAT5 expression by RT-PCR and IL-6, IL-12p70, TGFβ, and IL-10 serum levels by ELISA. The DAS and CDAI remission was assessed at 6 and 12 months.

Results
DAS- and CDAI-defined remission within 12 months was achieved by 16 (47.1%) and 8 (23.5%) RA patients, respectively. Considering the whole RA cohort, CTLA4-Ig induced a significant decrease of IL-6 serum levels from baseline to 6 and 12 months, as well as of PB CD4posCD25posFoxP3pos cells at 6 and 12 months, and of CD4posIL17pos cells after 12 months. PB CD4pos cells of RA patients showed higher STAT3 and STAT5 expression than healthy controls, which remained unchanged within 12 months of treatment. At study entry, RA patients achieving DAS remission had significantly lower IL-6 serum levels than RA patients not achieving this outcome. In particular, having baseline IL-6 serum levels ≤ 8.4 pg/ml, significantly identified naïve to b-DMARDs RA patients more likely to achieve DAS-remission under CTLA4-Ig at 6 months (66.7%) compared to RA patients with baseline IL-6 serum levels > 8.4 pg/ml [15.4%, OR (95%Cis) 11.00 (1.75–55.82)]. Moreover, having CD4posCD25posFoxP3pos cells rate ≥ 6.0% significantly identifies naïve to b-DMARDs early RA patients more likely to achieve DAS remission at 6 months (83.3%) compared to RA patients with baseline CD4posCD25posFoxP3pos cells < 6.0% [16.7%, OR (95% Cis) 25.00 (1.00–336.81)].

Conclusions
Baseline IL-6 serum levels and peripheral blood-derived CD4pos subpopulations are putative novel prognostic biomarkers of CTLA4-Ig response in RA patients.