bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Safety and Efficacy of Direct Oral Anticoagulants Versus Warfarin in Extreme Obesity
Authors: Lorenz Michael A. , Linneman Travis W. 
Published: August 2022

Background: Limited clinical data exists regarding use of direct oral anticoagulants (DOACs) in extreme obesity, specifically those ≥140 kg or having a body mass index (BMI) ≥ 50 kg/m2. Objective: Evaluate the safety and efficacy of DOACs in extreme obesity. Patients/Methods: A retrospective chart review was performed at a single center of patients aged 18-89 years and weight ≥140 kg or BMI ≥50 kg/m2 receiving warfarin or DOAC therapy. Patients were followed for 1 year from prescribing/study inclusion. The primary outcome was the difference in rates of any bleed (composite of major, nonmajor clinically relevant, or minor bleeding events as defined by International Society of Thrombosis and Haemostasis (ISTH) criteria) between groups. Secondary outcomes included individual components of the composite primary outcome and effectiveness in preventing thrombotic events within 12 months. Post-hoc multivariate analysis evaluated potential predictors of bleeding events within overall patient population. Results: Two-hundred eighty-five patients were included, 80 and 205 in the DOAC and warfarin groups, respectively. Rates of any documented bleeding event were comparable in DOAC and warfarin groups (17.5% vs 17.1%, P > .05). No significant difference in rates of minor ( P = .067), nonmajor clinically relevant ( P = .825), and major ( P = 1) bleeding events were observed. Two thrombotic events occurred in the warfarin group compared to none in the DOAC group. Increasing weight was associated with bleeding events in multivariate analysis. Conclusions: This data did not demonstrate a difference in safety or efficacy outcomes between DOACs and warfarin when utilized in patients with extreme obesity.
Constructing a two-level computational model of cross-ply fiberglass-reinforced plastic from micromechanical testing
Authors: Smirnov Alexander , Smirnova Evgeniya , Khudorozhkova Yulia 
Published: August 2022

This paper deals with solving the problem of constructing two-level computational models relating the stress-strain state at the microscale to the stress-strain state of the structural component at the macroscale for layered polymer composite materials with unidirectional fiber stacking in a monolayer. The paper presents a two-level computational mechanical model of a ten-layer cross-ply fiberglass-reinforced polymer composite with (0/90) laying patterns. The model is based on microindentation data. The model is constructed using the finite element method. The constructed model has allowed us to predict the elastic properties of the composite and to calculate stresses at the microscale and macroscale levels of a specimen prior to fracture under tensile conditions. The elastic properties of the polymer composite material predicted by the computational model are compared with the properties obtained from real experiments. Calculated for fiberglass, the elasticity modulus and Poisson’s ratio are 31 GPa and 0.11, respectively. Similar elastic properties obtained from real experiments are 28 GPa and 0.10. The technique used in the paper can be applied to computational experiments with an actual structural component made of a multilayer polymer composite in order to determine the stress-strain state at the micro- and macroscale under external mechanical impact on the structure.
Newborn screening for abnormal haemoglobins in Jamaica: Practical issues in an island programme
Authors: Serjeant Graham R , Serjeant Beryl E , Mason Karlene P , Gibson Felicea , Gardner Ruth-Ann , Warren Lansford , Hambleton Ian R , Thein Swee L , Happich Margit , Kulozik Andreas E 
Published: August 2022

Objective To report the diagnostic challenges of newborn screening for abnormal haemoglobins. Setting Cord blood samples from 13 hospitals in southwest Jamaica taken in 2008–2019. Methods Blood spots, collected from the umbilical cord, were analysed by high pressure liquid chromatography (HPLC) to reveal phenotypes for HbSS and HbCC, but genotype confirmation may require parental studies or gene sequencing. Such cases that were successfully traced were analysed in this follow-up study. Results HPLC screening of 121,306 samples detected HbAS in 11,846 (9.8%), HbAC in 4508 (3.7%) and other electrophoretic abnormalities in 1090 babies. Among 101 previously unconfirmed cases, 34/90 (38%) with HPLC evidence of a HbSS phenotype had other genotypes, and 7/11 (64%) with a HbCC phenotype had other genotypes. Syndromes from the interaction of β thalassaemia occurred in 112 babies (85 with HbS, 27 with HbC) and of genes for hereditary persistence of fetal haemoglobin (HPFH) in 18 (12 with HbS, 6 with HbC). Variants other than HbS and HbC occurred in 270 babies, 16 in combination with either HbS or HbC, and 254 as traits. Most variants are benign even when inherited with HbS, although HbO Arab, HbD Punjab, or Hb Lepore Washington, which occurred in 6 cases, may cause sickle cell disease. Conclusions Genes for β thalassaemia and HPFH are common in western Jamaica and when associated with HbS may present diagnostic challenges in newborns, as HbF and HbA2 have not reached diagnostic levels. Family and DNA studies may be necessary for genotype confirmation.
Aberrant Expression of Serum MicroRNA-153 and -199a in Generalized Epilepsy and its Correlation with Drug Resistance
Authors: Zahra Mai A. , Kamha Eman S. , Abdelaziz Hanan K. , Nounou Howaida A. , Deeb Hany M. El 
Published: August 2022

Background Epilepsy is one of the common neurological disorders affecting approximately 50 million people worldwide. Despite the recent introduction of new antiepileptic drugs, about one-third of patients with epilepsy have seizures refractory to pharmacotherapy. Early recognition of patients with drug-resistant epilepsy may help direct these patients to appropriate nonpharmacological treatment. Purpose The possible use of serum microRNAs (miRNAs) as noninvasive biomarkers has been explored in various brain diseases, including epilepsy. In this study, we are aiming at analyzing the expression levels of circulating miRNA-153 and miRNA-199a in patients with generalized epilepsy and their correlation with drug resistance. Methods Our study comprised 40 patients with generalized epilepsy and 20 healthy controls. 22 patients were drug-resistant and 18 patients were drug-responsive. The expression levels of miRNA-153 and -199a in serum were analyzed using quantitative real-time polymerase chain reaction. Data analysis was done by IBM SPSS Statistics 20.0. Results The expression of miRNA-153 and -199a in serum was significantly downregulated in patients with generalized epilepsy compared with that of the healthy control ( P < .001). Combined expression level of serum miRNA-153 and -199a had a sensitivity of 85% and a specificity of 90% in the diagnosis of generalized epilepsy. Furthermore, the expression levels of miRNA-153 and -199a were significantly decreased in drug-resistant patients compared to the drug-responsive group, and the combination of both markers gave the best results in differentiating between the two groups. Conclusion We suggest that serum miRNAs-153 and -199a expression levels could be potential noninvasive biomarkers supporting the diagnosis of generalized epilepsy. Moreover, they could be used for the early detection of refractory generalized epilepsy.
A case of recurrent viral retinitis treated with intravitreal antiviral agents in a silicone oil filled eye
Authors: Hussain Aadil , Ching Jared , Saidkasimova Shohista 
Published: August 2022

Purpose To report a case of recurrent acute retinal necrosis (ARN) in an eye filled with silicone oil previously complicated by rhegmatogenous retinal detachment (RRD). Observations A 68-year-old gentlemen with successfully treated herpes simplex virus type 1 (HSV1) ARN complicated by RRD requiring pars plana vitrectomy (PPV) with silicone oil tamponade, presented with a relapse of ARN with silicone oil in situ. Remission of recurrent retinitis was achieved using combined systemic oral and intravitreal antiviral therapy. Conclusions and Importance RRD is a significant complication of ARN which may require surgery with silicone oil tamponade. Recurrence of ARN retinitis can be effectively treated with intravitreal Ganciclovir and Foscarnet injections in a silicone oil filled eye with concurrent oral antiviral therapy. Aqueous humour sampling proved useful in the monitoring of disease activity.
Creating healthy hospital retail food environments: Multiple pathways to successful at scale policy implementation in Australia
Authors: Cranney Leonie , Thomas Margaret , O’Connell Tarli , Moreton Renee , Corbett Lucy , Bauman Adrian , Phongsavan Philayrath 
Published: August 2022

Objective In 2017, the Australian state of New South Wales introduced a revised policy to provide a healthy food and drink environment for staff and visitors in the state’s publicly funded health facilities. We sought to understand how contextual factors, intervention features and the responses of diverse stakeholders affected the policy’s implementation in public hospitals. Methods Ninety-nine interviews were conducted with chief executives, implementers and retailers in the health and food retail systems after the target date for the implementation of 13 initial policy practices. Stakeholder responses were analysed to understand commitment to, engagement with and achievement of these practices and the different contexts and implementation approaches that prompted these responses. Results Key mechanisms that drove systemic change included stakeholders’ broad acceptance of the policy premise; stakeholders’ sense of accountability and desire for the policy to succeed; and the policy’s perceived benefits, feasibility and effectiveness. Important underpinning factors were chief executives’ commitment to implementation and monitoring, a flexible approach to locally tailored implementation and historical precedents. Conclusions This study provides policy and practice insights for the initial phase of state-wide implementation to achieve change in health facility food retail environments.
Me, myself, and nature: living with dementia and connecting with the natural world – more than a breath of fresh air? A literature review
Authors: Bennett Jenny , Wolverson Emma , Price Elizabeth 
Published: August 2022

Objective Despite growing awareness of the importance of engagement with the natural world for people living with dementia, little is known about the impact specifically for people living independently in their own home. This review identifies, analyses and synthesises existing research, incorporating first-person narrative accounts of the benefits and potential challenges experienced in forging meaningful connections with the natural world. Methods Six databases were searched from February 2000 to February 2021. Relevant organisations and authors were contacted, and a hand search of included study reference lists was conducted. The findings of included studies were synthesised using a thematic analysis approach. Findings Sixteen studies were included: 13 qualitative and three mixed methods. Eight themes and three sub-themes were identified, revealing how contact with the natural world held a significance for people living with dementia, associated with a sense of pleasure, comfort, stimulation, freedom and meaning. Support and the use of adaptive strategies afforded opportunities for continued engagement with meaningful outdoor activities and the promotion of identity, independence, social interaction, enhanced wellbeing and quality of life for people living independently with dementia. Conclusion Meaningful connections with the natural world offer far more than a ‘breath of fresh air’. When support mechanisms are in place, engaging with the natural world can be a valuable arena for enablement and continuity, providing a sense of connectedness to self, place and others.
Photo-elicited conversations about meetings with a therapy dog as a tool for communication in dementia care: An observational study
Authors: Nordgren Lena , Arvidsson Alexander , Vincze Mattias , Asp Margareta 
Published: August 2022

Introduction It is well-known that people with dementia living in residential care facilities spend most of their time not engaged in meaningful activities. Being involved in activities can improve their quality of life. Animal-assisted therapy is an activity that can evoke engagement and joy. Another way to create engagement and promote communication between people with dementia and caregivers is to use photos. Methods In this observational study, the researchers combined animal-assisted therapy and photobooks in order to explore whether photos of people with dementia who were engaged in animal-assisted therapy could be used as a tool for communication in dementia care. Ten persons (4 men and 6 women; aged 72–92) with dementia were video recorded during photo-elicited conversations with a dog handler/assistant nurse. The recordings were conducted in two residential care facilities in Sweden during 2017–2018. Each participant was video recorded 2–4 times. The recordings were analysed using The Observed Emotion Rating Scale and The Observational Measurement of Engagement-OME Modified. In addition, the video recordings were interpreted from a hermeneutic perspective. Findings The findings showed that the most frequently observed effects were pleasure and general alertness, and the participants were observed to be attentive most of the time. The most common attitude during the conversations was ‘somewhat positive’. The hermeneutic interpretations were grouped into four themes: Conveys a structure for the conversation with an inherent beginning and ending; An opportunity to recognise oneself and recall a sense of belonging; Awakens emotions and creates fellowship and Entails confirmation and revitalises their identity. Conclusion Photobooks can be used by caregivers as a tool for meaningful and joyful communication with people with dementia, even those with severe dementia.
Triglyceride-glucose index is prospectively associated with chronic kidney disease progression in Type 2 diabetes – mediation by pigment epithelium-derived factor
Authors: Low Serena , Pek Sharon , Moh Angela , Ang Keven , Khoo Jonathon , Shao Yi-Ming , Tang Wern E , Lim Ziliang , Subramaniam Tavintharan , Sum Chee F , Lim Su C 
Published: August 2022

Background Triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance. Its role in chronic kidney disease (CKD) progression in Type 2 Diabetes Mellitus (T2DM) is unclear. We investigated the association between TyG index and CKD progression, and possible mediation of the association by pigment epithelium-derived factor (PEDF). Methods This was a prospective study on 1571 patients with T2DM. CKD progression was defined as worsening across KDIGO estimated glomerular filtration rate (eGFR) categories with ≥25% reduction from baseline. PEDF was quantitated using enzyme-linked immunosorbent assay method. Cox proportional hazards regression model was used to assess the relationship between TyG index and CKD progression. Results Over a follow-up period of up to 8.6 years (median 4.6 years, IQR 3.0–3.6), 42.7% of subjects had CKD progression. Every unit increase in TyG was associated with hazards of 1.44 (95%CI 1.29–1.61; p < 0.001) in unadjusted analysis and 1.21 (1.06–1.37; p = 0.004) in fully adjusted model. Compared to tertile 1, tertiles 2 and 3 TyG index were positively associated with CKD progression with corresponding hazard ratios HRs 1.24 (1.01–1.52; p = 0.037) and 1.37 (1.11–1.68; p = 0.003) in fully adjusted models. PEDF accounted for 36.0% of relationship between TyG index and CKD progression. Conclusions Higher TyG index independently predicted CKD progression in T2DM. PEDF mediated the association between TyG index and CKD progression.
Safety and efficacy of the surpass streamline for intracranial aneurysms (SESSIA): A multi-center US experience pooled analysis
Authors: Vivanco-Suarez Juan , Mendez-Ruiz Alan , Farooqui Mudassir , Bekelis Kimon , Singer Justin A , Javed Kainaat , Altschul David J , Fifi Johanna T , Matsoukas Stavros , Cooper Jared , Al-Mufti Fawaz , Gross Bradley , Jankowitz Brian , Kan Peter T , Hafeez Muhammad , Orru Emanuele , Dajles Andres , Galecio-Castillo Milagros , Zevallos Cynthia B , Wakhloo Ajay K , Ortega-Gutierrez Santiago 
Published: August 2022

Background and purpose Flow diversion has established as standard treatment for intracranial aneurysms, the Surpass Streamline is the only FDA-approved braided cobalt/chromium alloy implant with 72-96 wires. We aimed to determine the safety and efficacy of the Surpass in a post-marketing large United States cohort. Materials and methods This is a retrospective multicenter study of consecutive patients treated with the Surpass for intracranial aneurysms between 2018 and 2021. Baseline demographics, comorbidities, and aneurysm characteristics were collected. Efficacy endpoint included aneurysm occlusion on radiographic follow-up. Safety endpoints were major ipsilateral ischemic stroke or treatment-related death. Results A total of 277 patients with 314 aneurysms were included. Median age was 60 years, 202 (73%) patients were females. Hypertension was the most common comorbidity in 156 (56%) patients. The most common location of the aneurysms was the anterior circulation in 89% (279/314). Mean aneurysm dome width was 5.77 ± 4.75 mm, neck width was 4.22 ± 3.83 mm, and dome/neck ratio was 1.63 ± 1.26. Small-sized aneurysms were 185 (59%). Single device was used in 94% of the patients, mean number of devices per patient was 1.06. At final follow-up, complete obliteration rate was 81% (194/239). Major stroke and death were encountered in 7 (3%) and 6 (2%) cases, respectively. Conclusion This is the largest cohort study using a 72–96 wire flow diverter. The Surpass Streamline demonstrated a favorable safety and efficacy profile, making it a valuable option for treating not only large but also wide-necked small and medium-sized intracranial aneurysms.
Hepatic artery and portal vein Doppler ultrasound reference values in children aged 0–17 years old
Authors: Verhagen Martijn V , Kwee Thomas C , de Haas Robbert J 
Published: August 2022

Introduction: Doppler ultrasound of the portal vein peak systolic velocity and hepatic artery peak systolic velocity and resistive index in children is often performed during abdominal ultrasound for the assessment of liver and other abdominal pathology. However, evidence-based reference values are not available. We aimed to determine these reference values and to investigate whether they are age-dependent. Methods: Children who underwent abdominal ultrasound between 2020 and 2021 were retrospectively identified. Patients without hepatic or cardiac abnormalities at the time of ultrasound or during at least 3 months follow-up were eligible for the study. Ultrasound without hepatic hilum portal vein peak systolic velocity and/or hepatic artery peak systolic velocity and resistive index measurements were excluded. Age-dependent changes were analyzed using linear regression. Normal range reference values were described using percentiles for all ages, and for age subgroups. Results: One-hundred ultrasound examinations performed in 100 healthy children aged 0–17.9 years (median 7.8 years, interquartile range 1.1–14.1 years) were included. Ninety-nine portal vein peak systolic velocity and 80 hepatic artery peak systolic velocity and resistive index measurements were obtained. There was no significant association between portal vein peak systolic velocity and age (β = −0.056, p = 0.68). There were significant associations between age and hepatic artery peak systolic velocity, and between age and hepatic artery resistive index (β = −0.873, p = 0.04 and β = −0.004, p < 0.001, respectively). Detailed reference values were provided for all ages, and for age subgroups. Conclusion: Reference values for the hepatic hilum portal vein peak systolic velocity, hepatic artery peak systolic velocity, and hepatic artery resistive index in children were established. Portal vein peak systolic velocity is not age-dependent, whereas hepatic artery peak systolic velocity and hepatic artery resistive index decrease when children get older.
Readability of Online Foot and Ankle Surgery Patient Education Materials
Authors: Hartnett Davis A. , Philips Alexander P. , Daniels Alan H. , Blankenhorn Brad D. 
Published: August 2022

Background. Online health education resources are frequently accessed by patients seeking information on orthopaedic conditions and procedures. The objectives of this study were to assess the readability of information provided by the American Orthopaedic Foot and Ankle Society (AOFAS) and compare current levels of readability with previous online material. Methods. This study examined 115 articles classified as “Conditions” or “Treatments” on FootCareMD.org . Readability was assessed using the 6 readability assessment tools: Flesch Reading Ease, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Score, Simple Measure of Gobbledygook (SMOG) Index, Coleman-Liau Index, and the Automated Readability Index. Results. The mean readability score across all metrics ranged from 9.1 to 12.1, corresponding to a 9th- to 12th-grade reading level, with a mean FKGL of 9.2 ± SD 1.1 (range: 6.3-15.0). No articles were written below the recommended US sixth-grade reading level, with only 3 articles at or below an eighth-grade level. Treatment articles had higher mean readability grade levels than condition articles (P = .03). Conclusion. Although the volume and quality of the AOFAS resource Web site has increased, readability of information has worsened since 2008 and remains higher than the recommended reading level for optimal comprehension by the general population. Levels of Evidence: Level IV:Retrospective quantitative analysis
Hemichorea-Hemiballism as a Delayed Manifestation of Hyperglycemia: A Case Report
Authors: Shivkumar Vikram , Nemade Dipali 
Published: August 2022

Hemichorea is characterized by involuntary, continuous, non-patterned movements on one side of the body. While it is most commonly caused by strokes, it can also be caused by metabolic derangements such as hyperglycemia. We present two patients who developed hemichorea in the setting of hyperglycemia. Our first patient had a history of uncontrolled diabetes mellitus and developed chorea 2 weeks following a hyperglycemic event. The second patient developed chorea while being on steroids for hip pain and was later diagnosed to have underlying diabetes mellitus. MRI showed hyperintensity in the contralateral lentiform nucleus in both cases. The chorea did not improve despite the correction of the hyperglycemia. Both patients were started on Tetrabenazine with significant improvement. Hyperglycemia-induced hemichorea might be underdiagnosed given the prevalence of diabetes mellitus in the population. Chorea can even be the presenting symptom of diabetes mellitus and in some cases is a delayed manifestation of hyperglycemia.