bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcome of Aortic Valve Replacement in the Elderly
Authors: Chiappini Bruno , Bergonzini Marcello , Gallieri Simona , Pacini Davide , Pierangeli Angelo , Bartolomeo Roberto Di , Marinelli Giuseppe 
Published: September 2022

Since elderly patients are being referred for surgery in increasing numbers, we reviewed the clinical outcome of 459 consecutive patients aged 70 to 89 years, who had aortic valve replacement between 1993 and 2000. We subdivided the study population into three groups: in Group 1 we included patients aged 70–74 years old; in Group 2 patients aged 75–79 years old; and in Group 3 patients aged 80 years old or older. An isolated AVR was performed in 289 patients (63%), concomitant coronary artery bypass graft (CABG) in 168 patients (36.6%), an isolated ventricular septal defect (VSD) closure in one patient (0.2%) and an isolated atrial septal defect (ASD) closure in one patient (0.2%). The overall perioperative mortality rate was 7% (32 patients), without significant differences among the three groups ( P= 0.88). Our study confirms the good outcome of aortic valve replacement in elderly patients even in octagenarians and only concomitant CABG procedures increase the operative risk, reducing long-term survival ( P < 0.05).
Intermittent Warm Blood Cardioplegia Induces the Expression of Heat Shock Protein-72 by Ischemic Myocardial Preconditioning
Authors: Chello M. , Mastroroberto P. , Patti G. , D'Ambrosio A. , Sciascio G. Di , Covino E. 
Published: September 2022

Objective: Recent studies have demonstrated that the induction of heat shock protein-72 (HSP72) by different stimuli preserves the heart function after cardioplegic arrest. Based on these findings, we investigated whether intermittent warm blood cardioplegia would induce changes in the myocardial expression of HSP72. Methods: Forty patients scheduled for aortocoronary bypass were randomly assigned to receive either cold or warm intermittent blood cardioplegia. In all patients HSP72 and HSP72 mRNA were assayed in biopsies from the right atrium at baseline, and during the reperfusion period. Plasma CK-MB and troponin-T, and myocardial oxygen extraction and lactate release were also measured. Results: In both groups, myocardial expression of HSP72 increased throughout the reperfusion period, but the values of HSP72 band lengths were significantly higher in the warm group. Correspondingly, HSP72 mRNA levels increased progressively in both groups, with significant difference between groups observed in biopsies at the reperfusion. Warm blood cardioplegia was associated with lower levels of CK-MB and troponin-T. Myocardial oxygen extraction and lactate release were higher during intermittent warm cardioplegia, indicating a more profound ischemic anaerobic metabolism in the warm group. Conclusions: Intermittent warm blood cardioplegia induces an increased expression of HSP72 and it is associated with a better myocardial protection, by a mechanism involving a variant of the classical ischemic preconditioning model.
Routine β-Blockade in Vascular Surgery
Authors: Torella Francesco , de Cossart Linda , Dimitri Sameh K. , Edwards Paul R. 
Published: September 2022

We have evaluated the safety and efficacy of routine β-blockade for the prevention of cardiac complications in a comprehensive series of patients undergoing major vascular surgery and amputation for atherosclerotic arterial disease. From 1 December 2001 to 31 May 2002, patients received perioperative β-blockade by atenolol. Outcomes in this period were compared to the immediately antecedent 6 months. The main outcome measure was the occurrence of cardiac complications. Fifty-three patients underwent surgery in the first period and 54 in the second. After introduction of routine β-blockade, only one patient suffered cardiac complications compared to 10 in the first period ( P = 0.01). There were eight deaths in the first and two in the second period ( P = 0.052). On multivariate analysis, treatment with β-blockers was the only variable significantly associated with a decrease in cardiac morbidity (OR = 0.12; 95% Cl = 0.002–0.66; P = 0.014). Two patients suffered bronchospasm leading to discontinuation of atenolol. Routine perioperative β-blockade was safe and reduced the occurrence of cardiac complications after vascular surgery.
Norepinephrine-Induced Delayed Cardioprotection against Stunning is at the Expense of a Higher Postishemic Arrhythmia Rate
Authors: Marktanner Ralph , Nacke Peter , Feindt Peter , Hohlfeld Thomas , Gams Emmeran 
Published: September 2022

Objective α1-adrenoceptor activation confers myocardial protection from ischemic injury. We tested whether norepinephrine mediates delayed cardioprotection against stunning and whether this alters postischemic arrhythmias. Methods New Zealand White rabbits were assigned to three groups: Control-group ( n = 7): no drugs. Norepinephrine-group ( n = 7): 75 μg norepinephrine/kg bodyweight (bw). Norepinephrine/prazosin-group ( n = 7):75 μg norepinephrine and 15 μg prazosin/kg bw. After 24 h, hearts were excised, perfused with buffer and subjected to 20 min of ischemia followed by 120 min of reperfusion. Results (a) Developed pressures (dP) ( Psyst– Pdiast) at the end of reperfusion: C: 51.2 ± 5.0%, NE: 71.7 ± 5.1% ( p < 0.05 vs. C), NEP: 50.7 ± 5.0%. (b) Ventricular extra beats (vebs) were detected throughout the experiments. C: 0.41 ± 0.15 vebs/min, NE: 1.06 ± 0.18 vebs/min ( p < 0.05 vs. C), NEP: 1.17 ± 0.3 vebs/min. Conclusion Norepinephrine confers delayed preconditioning against myocardial stunning via an α1-adrenoceptor mediated pathway. Norepinephrine-mediated preconditioning involves a beneficial effect towards stunning, but at the expense of a higher rate of postischemic ventricular arrhythmia.
Prospective Clinical and Biological Comparison of Three Blood Cardioplegia Techniques in Low-Risk CABG Patients: Better is Worse than Good Enough
Authors: Baron Olivier , Roussel Jean-Christian , Delaroche Odile , Péron Stéphanie , Duveau Daniel 
Published: September 2022

Objective Three myocardial protection techniques were evaluated in a prospective, randomised trial during coronary artery bypass grafts in 69 patients. Material and method Twenty seven patients received intermittent hyperkalaemic undiluted warm blood anterograde cardioplegia (AC), 21 received continuous hyperkalaemic undiluted warm blood retrograde cardioplegia (RC) and 21 received intermittent, hyperkalaemic, diluted cold blood (15 °C), anterograde cardioplegia (CC). Assessment criteria were clinical, laboratory and haemodynamic. Results Groups were homogeneous in terms of age, sex, cardiovascular risk factors, severity of coronary disease, preoperative ejection fraction, and number of bypass grafts performed. The oxygen extraction coefficient, and lactate and troponin production in the coronary sinus on aortic unclamping was not significantly different between the three groups. The base excess was −0.19 ± 0.13 in the RC group, −0.18 ± 0.52 in the AC group and −2.67 ± 0.59 in the CC group ( P < 0.01 CC vs. AC and CC vs. RC). The priming volume was 1485 ± 64 ml (CC), 1317 ± 44 ml (RC) and 1318 ± 30 ml (AC) ( P < 0.05 CC vs. AC and CC vs. RC). The haematocrit during CPB was 28.9 ± 0.9 (CC), 32.5 ± 0.8 (RC) and 32 ± 0.7 (AC) ( P < 0.05 CC vs. AC and CC vs. RC). The volume of crystalloid delivered was 735 ± 85 ml (CC), 362 ± 67 ml (RC) and 357 ± 105 ml (AC) ( P < 0.05 CC vs. AC and CC vs. RC). The incidence of ventricular fibrillation on aortic unclamping was 61.9% (CC), 9.5% (RC) and 0% (AC) ( P < 0.01 CC vs. AC and CC vs. RC). The transfusion rate, duration of intubation, postoperative troponin level, complication rate and mortality were not significantly different between the three groups. Haemodynamic parameters at H2, H4, H8 did not vary significantly between the three groups. Conclusion These three techniques appear to be comparable in terms of myocardial protection. Anterograde cardioplegia ensures an identical degree of security to retrograde cardioplegia regardless of the coronary lesions, apart from redo lesions. CC requires greater haemodilution of the patients during CPB.
Depth of focus of four novel extended range of vision intraocular lenses
Authors: Schmid Ruediger , Fuchs Christin , Luedtke Holger , Borkenstein Andreas F. 
Published: September 2022

Purpose To assess the depth of focus of four latest non-diffractive extended range of vision IOLs on the optical bench. Such comparison had not been done before. Methods We assessed and compared the through focus modulation transfer function (MTF) of the following novel IOLs with a nominal power of 22 D: Acrysof Vivity, LuxSmart Crystal, RayOne EMV and Tecnis Eyhance. An ISO-2 model eye was applied with apertures of 3 and 4.5 mm with monochromatic light of 546 nm. Measurements were done on OptiSpheric IOL PRO 2 optical bench. Results For the aperture of 3 mm, Eyhance and RayOne EMV showed the most pronounced peak in MTF with only little enlarged depth of power. Vivity and LuxSmart showed two peaks of about 1.7 D respectively 1.3 D depth of focus, yet reduced MTF and with maxima differently located. For 4.5 mm, MTF values for Eyhance and particularly for RayOne EMV dropped. For Vivity and LuxSmart, only the peak for the secondary focus decreased. Conclusion Vivity and LuxSmart showed a larger depth of focus for our measuring conditions than Eyhance and RayOne EMV. Correspondingly, the peak MTF was best for Eyhance and RayOne ERV with small aperture. With the larger aperture, RayOne EMV considerably lost performance.
Combined intense pulsed light and low-level light therapy for the treatment of refractory Meibomian gland dysfunction
Authors: Meduri Alessandro , Oliverio Giovanni William , Tedesco Giovanni , Aragona Pasquale 
Published: September 2022

Purpose To evaluate the efficacy of combined Intense Pulsed Light (IPL) and Low-Level Light Therapy (LLLT) in treatment of Meibomian Gland Dysfunction (MGD). Methods and Analysis In this prospective study , 70 patients with refractory MGD were enrolled; group 1 received 3 consecutive sessions of IPL + LLLT treatment using Eye-light® on day 1, day 15 and day 45; group 2 received hyaluronate sodium 2 mg/ml drops 3 times a day for 6 months. Patients underwent at baseline, and after 3 and 6 months Ocular Surface Disease Index (OSDI) questionnaire, Symptom Assessment in Dry Eye (SANDE), tear-film breakup time (TBUT), fluorescein ocular surface staining, meibum expressibility and quality evaluations. Keratograph 5M (Oculus, Germany) was used to assess NIBUT, tear meniscus height (TMH), meibography, and bulbar redness score. Results At 6 months a significant improvement of OSDI ( p = 0.03), SANDE ( p = 0.02), NIBUT ( p =  p < 0.0001), TMH ( p = 0.04), TBUT ( p = 0.02), corneal-conjunctival staining score ( p = 0.02), lid margin score ( p < 0.0001), and bulbar redness score ( p = 0.001) were recorded in group 1. Comparing the two groups, statistically significant differences were observed at 6 months in TBUT ( p = 0.03), lid margin score ( p < 0.001), Meibum expressibility ( p = 0.03) and NIBUT ( p < 0.001). No adverse events were recorded throughout the follow-up period. Conclusion This study confirmed the efficacy and safety of combined IPL and LLLT demonstrating its superiority compared to topical treatment.
Electrooxidation of Phenol on Polyelectrolyte Modified Carbon Electrodes for Use in Insulin Pump Infusion Sets
Authors: Zhou Lingyun , Huber David E. , van Antwerp Bill , Pennathur Sumita 
Published: September 2022

Background: Many type 1 diabetes patients using continuous subcutaneous insulin infusion (CSII) suffer from the phenomenon of unexplained hypoglycemia or “site loss.” Site loss is hypothesized to be caused by toxic excipients, for example, phenolic compounds within insulin formulations that are used as preservatives and stabilizers. Here, we develop a bioinspired polyelectrolyte-modified carbon electrode for effective electrooxidative removal of phenol from insulin and eventual incorporations into an infusion set of a CSII device. Methods: We modified a carbon screen printed electrode (SPE) with poly-L-lysine (PLL) to avoid passivation due to polyphenol deposition while still removing phenolic compounds from insulin injections. We characterized these electrodes using scanning electron microscopy (SEM) and electrochemical impedance spectroscopy (EIS) and compared their data with data from bare SPEs. Furthermore, we performed electrochemical measurements to determine the extent of passivation, and high-performance liquid chromatography (HPLC) measurements to confirm both the removal of phenol and the integrity of insulin after phenol removal. Results: Voltammetry measurements show that electrode passivation due to polyphenol deposition is reduced by a factor of 2X. HPLC measurements confirm a 10x greater removal of phenol by our modified electrodes relative to bare electrodes. Conclusion: Using bioinspired polyelectrolytes to modify a carbon electrode surface aids in the electrooxidation of phenolic compounds from insulin and is a step toward integration within an infusion set for mitigating site loss.
Comparison of the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) associated with periodontitis in Korean adults
Authors: Lee Yea-Chan , Lee Ji-Won , Kwon Yu-Jin 
Published: September 2022

Background: Periodontitis is one of the most common diseases associated with the oral cavity. Previous studies have suggested that there is an association between periodontitis and metabolic dysfunction. Recently, the triglyceride glucose (TyG) index, high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) index have been identified as useful markers for assessing insulin resistance. Objective: This study aimed to evaluate the relationship between periodontitis and non-insulin-based insulin resistance (IR) indices and compare the predictive values of these indices in the Korean population. Design: This is a cross-sectional study. Methods: A total of 13,584 participants were included in the 2013–2015 Korean National Health and Nutrition Examination Survey data. A community periodontal index score⩾3 was used to define periodontitis. Participants were divided into quartiles according to each index. Odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of periodontitis and the TyG index, TG/HDL-C ratio, and METS-IR index quartiles were calculated using multiple logistic regression analysis. We estimated the areas under the receiver operating characteristic curves (AUCs) of the indices to compare the predictive values of the three indices. Results: Compared with quartile 1, the fourth quartile ORs (95% CIs) for periodontitis were 1.23 (1.01–1.49) for the TyG index, 1.23 (1.02–1.48) for the TG/HDL-C ratio, and 1.53 (1.25–1.88) for the METS-IR index after adjustment for confounders. The AUC (95% CIs) was 0.608 (0.598–0.618) for the TyG index, 0.600 (0.590–0.610) for the TG/HDL-C ratio, and 0.617 (0.608–0.627) for the METS-IR index to identify periodontitis. The predictive power of METS-IR was significantly higher than that of the TyG index and TG/HDL-C. Conclusion: Higher TG/HDL-C ratio, TyG, and METS-IR indices are associated with a higher prevalence of periodontitis. The METS-IR index is a more powerful predictor of periodontitis prevalence than the TyG index and TG/HDL-C ratio.
Need and baseline for harmonising nursing education in respiratory care: preliminary results of a global survey
Authors: Šajnić Andreja , Kelly Carol , Smith Sheree , Heslop-Marshall Karen , Axelsson Malin , Padilha José Miguel , Roberts Nicola , Hernández Carmen , Murray Bridget , Poot Betty , Narsavage Georgia 
Published: September 2022

BackgroundThe COVID-19 pandemic confirmed that respiratory nurses are critical healthcare providers. Limited knowledge is available about appropriate education to prepare nurses to deliver high-quality respiratory care. A survey was developed by the International Coalition for Respiratory Nursing (ICRN) group to identify the need for a respiratory nursing core curriculum.MethodA 39-item survey was distributed to 33 respiratory nursing experts in 27 countries. Questions asked about current roles, perception of need, expectations for a core curriculum project and respiratory content in nursing education in their countries.Results30 responses from 25 countries were analysed; participants predominantly worked in academia (53.3%, 16/30) and clinical practice (40%, 12/30). In total, 97% (29/30) confirmed a need for a core respiratory nursing curriculum. Post-registration nursing programmes at bachelor (83.3%, 25/30) and masters (63.3%, 19/30) levels include internal/medical nursing care; less than half identified separate respiratory nursing content. The core educational programme developed should include knowledge (70%, 21/30), skills (60%, 18/30), and competencies (50%, 15/30), with separate paediatric and adult content.ConclusionSurvey results confirm a wide variation in nursing education and respiratory nursing education across the world, with many countries lacking any formal educational programmes to prepare nurses capable of providing enhanced quality respiratory care. These findings support the need for a core respiratory curriculum. To advance this significant work the ICRN group plans to conduct a Delphi study to identify core curriculum requirements for respiratory nursing education at pre-registration and advanced educational levels to flexibly meet each country's specific educational requirements for recognition of respiratory nursing speciality practice.
Initiatives and challenges in using gamification in transportation: a systematic mapping
Authors: Wang Wenjing , Gan Hongcheng , Wang Xinyu , Lu Huan , Huang Yue 
Published: September 2022

Abstract
Summary
Gamification is a new theme that has been applied in different fields and has contributed to different types of behavioural change. This paper aims to describe how gamification is adopted in the context of transportation.

Methods
We performed a systematic mapping of the scientific literature of Web of Science and retrieved 211 studies. After the inclusion and exclusion criteria were applied, 66 studies were selected. After the full texts were read, 30 studies remained to be analysed.

Findings
The results show that the most commonly used gamification elements are goals/challenges and points. Gamification provides support for outcomes such as changing travel behaviour, improving driving behaviour and encouraging bicycle commuting. The use of gamification has changed the behavior of travelers, promoted sustainable travel modes, encouraged safe driving, reduced carbon dioxide emissions and reduced energy consumption. Although gamification has achieved many positive results related to transportation, there are still many difficulties and challenges.
Utilization of abortion services from an unsafe provider and associated factors among women with history of induced abortion in Ghana
Authors: Klu Desmond , Yeboah Isaac , Kayi Esinam Afi , Okyere Joshua , Essiaw Mary Naana 
Published: September 2022

Abstract
Background
In sub-Saharan Africa (SSA), numerous studies have examined women’s choice of abortion methods and services using hospital-based data, community-based surveys and nationally representative data. Little research focuses on the factors influencing a woman’s choice of abortion provider. This study sought to identify factors that are associated with why a woman seeks abortion care services from an unsafe provider in Ghana.

Methods
We used nationally representative data of women from the 2017 Ghana Maternal Health Survey (GMHS). Data analysis was restricted to women aged 15–49 with a recent history of induced abortion. Analyses focused on a weighted sample of 1,880. Descriptive analysis and the chi-square test were used to examine the proportion of women utilizing abortion services from unsafe providers. Factors hypothesized to affect the utilization of abortion services from unsafe providers were examined using both bivariable and multivariable logistic regression analyses.

Results
The proportion of survey respondents who reported that they utilize abortion service from unsafe providers were 57.5%. After adjusting for confounders, those who have knowledge of abortion legality [aOR: 0.381 (0.271–0.541)] and those who have attained secondary or higher education [aOR: 0.613 (0.411–0.914)] were less likely to use abortion services from unsafe providers. On the other hand, women belonging to the Ewe ethnic group [aOR: 0.696 (0.508–0.953)], those residing in the middle belt zone [aOR: 1.743 (1.113–2.728)], younger women aged 15–29 years [aOR: 2.037 (1.234–3.362)] were more likely to use abortion services from unsafe abortion providers.

Conclusions
This research suggests that increasing the knowledge of women on the legal status of abortion through public education and encouraging more women to pursue secondary or higher education can contribute to reducing the use of abortion services from unsafe providers. These interventions should be targeted among younger women and those who reside in the middle belt zones of Ghana.
Machine learning-based prediction model for late recurrence after surgery in patients with renal cell carcinoma
Authors: Kim Hyung Min , Byun Seok-Soo , Kim Jung Kwon , Jeong Chang Wook , Kwak Cheol , Hwang Eu Chang , Kang Seok Ho , Chung Jinsoo , Kim Yong-June , Ha Yun-Sok , Hong Sung-Hoo 
Published: September 2022

Abstract
Background
Renal cell carcinoma is characterized by a late recurrence that occurs 5 years after surgery; hence, continuous monitoring and follow-up is necessary. Prognosis of late recurrence of renal cell carcinoma can only be improved if it is detected early and treated appropriately. Therefore, tools for rapid and accurate renal cell carcinoma prediction are essential.

Methods
This study aimed to develop a prediction model for late recurrence after surgery in patients with renal cell carcinoma that can be used as a clinical decision support system for the early detection of late recurrence. We used the KOrean Renal Cell Carcinoma database that contains large-scale cohort data of patients with renal cell carcinoma in Korea. From the collected data, we constructed a dataset of 2956 patients for the analysis. Late recurrence and non-recurrence were classified by applying eight machine learning models, and model performance was evaluated using the area under the receiver operating characteristic curve.

Results
Of the eight models, the AdaBoost model showed the highest performance. The developed algorithm showed a sensitivity of 0.673, specificity of 0.807, accuracy of 0.799, area under the receiver operating characteristic curve of 0.740, and F1-score of 0.609.

Conclusions
To the best of our knowledge, we developed the first algorithm to predict the probability of a late recurrence 5 years after surgery. This algorithm may be used by clinicians to identify patients at high risk of late recurrence that require long-term follow-up and to establish patient-specific treatment strategies.