bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of dexmedetomidine on neuroprotection in pediatric cardiac surgery patients: study protocol for a prospective randomized controlled trial
Authors: Ji Sang-Hwan , Kang Pyoyoon , Song In-Sun , Jang Young-Eun , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo , Kim Eun-Hee 
Published: April 2022

Abstract
Background
Infants undergoing cardiac surgery under cardiopulmonary bypass are vulnerable to postoperative neurodevelopmental delays. Dexmedetomidine has been shown to have protective effects on the heart, kidneys, and brain in animals and adults undergoing cardiac surgery with cardiopulmonary bypass. We hypothesized that dexmedetomidine would have a neuroprotective effect on infants undergoing cardiopulmonary bypass and planned a prospective randomized controlled trial with postoperative neurodevelopment measurements.

Methods
This is a single-center, prospective, double-blinded, randomized controlled trial with 1:1 allocation. A cohort of 160 infants undergoing cardiac surgery with cardiopulmonary bypass will be enrolled. After induction, dexmedetomidine will be infused with a loading dose of 1 μg/kg and a maintenance dose of 0.5 μg/kg/h or the same amount of normal saline will be administered. Upon initiation of cardiopulmonary bypass, an additional dose of dexmedetomidine (0.01 μg/cardiopulmonary priming volume) will be mixed with the cardiopulmonary bypass circuit. The primary outcome will be the proportion of infants who score lower than 85 in any of the cognitive, language, or motor Bayley scales of infant development-III tests 1 year after the surgery. Other feasible outcome measures will include differences in plasma glial fibrillary acidic protein, troponin I, interleukin-6, urinary neutrophil gelatinase-associated lipocalin, and perioperative major adverse events. The results of the Bayley scales of infant development-III test from the study group and the control group will be compared using a chi-squared test under intention-to-treat analysis. A generalized estimating equation will be used to analyze repeated measurements over time.

Discussion
This study will enable us to assess whether the use of dexmedetomidine can alter the early neurodevelopmental outcome in infants undergoing cardiac surgery with cardiopulmonary bypass and also estimate effects of dexmedetomidine on other organs.

Trial registration
ClinicalTrials.gov NCT04484922. Registered on 24 July 2020
Does closed-loop automated oxygen control reduce the duration of mechanical ventilation? A randomised controlled trial in ventilated preterm infants
Authors: Kaltsogianni Ourania , Dassios Theodore , Greenough Anne 
Published: April 2022

Abstract
Background
Many preterm infants require supplemental oxygen in the newborn period but experience frequent fluctuations of their oxygen saturation levels. Intermittent episodes of hypoxia or hyperoxia increase the risk of complications. Compliance with achievement of oxygen saturation targets is variable, and the need for frequent adjustments of the inspired oxygen concentration increases workload.
Closed-loop automated oxygen control systems (CLAC) improve achievement of oxygen saturation targets and reduce both episodes of hypoxia and hyperoxia and the number of manual adjustments. This study investigates whether CLAC compared with manual oxygen control reduces the duration of mechanical ventilation in preterm infants born at less than 31 weeks of gestation.

Methods
This randomised controlled trial performed at a single tertiary neonatal unit is recruiting 70 infants born at less than 31 weeks of gestational age and within 48 h of initiation of mechanical ventilation. Infants are randomised to CLAC or manual oxygen control from recruitment until successful extubation. The primary outcome is the duration of mechanical ventilation, and secondary outcomes are the percentage of time spent within target oxygen saturation ranges, the time spent in hypoxia or hyperoxia, the number of manual adjustments required, the number of days on oxygen, the incidence of bronchopulmonary dysplasia and the length and cost of neonatal unit stay. The study is performed following informed parental consent and was approved by the Yorkshire and the Humber-Sheffield Research Ethics Committee (protocol version 1.1, 13 July 2021).

Discussion
This trial will investigate the effect of CLAC on the duration of mechanical ventilation, which is an important clinical outcome as prolonged mechanical ventilation is associated with important adverse outcomes, such as bronchopulmonary dysplasia.

Trial registration
ClinicalTrials.Gov NCT05030337. Registered on 17 August 2021
Dynamic nonlinear algebraic models with scale-similarity dynamic procedure for large-eddy simulation of turbulence
Authors: Yuan Zelong , Wang Yunpeng , Xie Chenyue , Wang Jianchun 
Published: April 2022

AbstractA dynamic nonlinear algebraic model with scale-similarity dynamic procedure (DNAM-SSD) is proposed for subgrid-scale (SGS) stress in large-eddy simulation of turbulence. The model coefficients of the DNAM-SSD model are adaptively calculated through the scale-similarity relation, which greatly simplifies the conventional Germano-identity based dynamic procedure (GID). The a priori study shows that the DNAM-SSD model predicts the SGS stress considerably better than the conventional velocity gradient model (VGM), dynamic Smagorinsky model (DSM), dynamic mixed model (DMM) and DNAM-GID model at a variety of filter widths ranging from inertial to viscous ranges. The correlation coefficients of the SGS stress predicted by the DNAM-SSD model can be larger than 95% with the relative errors lower than 30%. In the a posteriori testings of LES, the DNAM-SSD model outperforms the implicit LES (ILES), DSM, DMM and DNAM-GID models without increasing computational costs, which only takes up half the time of the DNAM-GID model. The DNAM-SSD model accurately predicts plenty of turbulent statistics and instantaneous spatial structures in reasonable agreement with the filtered DNS data. These results indicate that the current DNAM-SSD model is attractive for the development of highly accurate SGS models for LES of turbulence.
Genetic Epilepsy Syndromes
Authors: Myers Kenneth A. 
Published: April 2022

ABSTRACT

PURPOSE OF REVIEW
This article reviews the clinical features, typical EEG findings, treatment, prognosis, and underlying molecular etiologies of the more common genetic epilepsy syndromes. Genetic generalized epilepsy, self-limited focal epilepsy of childhood, self-limited neonatal and infantile epilepsy, select developmental and epileptic encephalopathies, progressive myoclonus epilepsies, sleep-related hypermotor epilepsy, photosensitive occipital lobe epilepsy, and focal epilepsy with auditory features are discussed. Also reviewed are two familial epilepsy syndromes: genetic epilepsy with febrile seizures plus and familial focal epilepsy with variable foci.

RECENT FINDINGS
Recent years have seen considerable advances in our understanding of the genetic factors underlying genetic epilepsy syndromes. New therapies are emerging for some of these conditions; in some cases, these precision medicine approaches may dramatically improve the prognosis.

SUMMARY
Many recognizable genetic epilepsy syndromes exist, the identification of which is a crucial skill for neurologists, particularly those who work with children. Proper diagnosis of the electroclinical syndrome allows for appropriate treatment choices and counseling regarding prognosis and possible comorbidities.
Women’s Issues in Epilepsy
Authors: Bui Esther 
Published: April 2022

ABSTRACT

PURPOSE OF REVIEW
Issues pertaining to women with epilepsy have advanced with a better understanding of multidirectional influences among hormones, seizures, and antiseizure medications, as well as pregnancy-related concerns around fertility, seizure destabilization, and antiseizure medication–associated teratogenicity. This article highlights important developments in this field and reviews best practices in the management of women with epilepsy.

RECENT FINDINGS
Important external hormonal influences may impact women with epilepsy particularly in the context of gender-affirming medications, hormonal replacement therapy, and fertility therapies. Fertility for women with epilepsy is influenced by multiple variables; however, in the absence of preexisting fertility issues, epilepsy per se is not associated with significantly impaired fertility. Once women with epilepsy are pregnant, the majority have a stable course. Antiseizure medication use in pregnancy is associated with major congenital malformations 2 to 5 times that of the general population and is highest with high-dose (≥1500 mg or greater total daily) valproate. Carefully considered changes in drug choice and dose may mitigate these risks. Therapeutic drug monitoring plays an important role in pregnancy care, and under expert supervision, women with epilepsy in pregnancy have similar seizure risks as women with epilepsy who are not pregnant. As women with epilepsy age, bone health and menopause may further be impacted by seizures and antiseizure medications.

SUMMARY
The care of women with epilepsy is a multifaceted discipline that recognizes the life-long impact of sex and gender influences on epilepsy care.
Diagnosis, Management of, and Return to Play Guidance for Venous Thromboembolism in Athletes
Authors: Brennan Fred H. 
Published: April 2022

Abstract
Venous thromboembolism (VTE) is not rare and is becoming more recognized in our athletic population. This diagnosis can be elusive. A provider must have a high clinical suspicion and use pretest probabilities to order the appropriate studies and accurately diagnose a VTE. Treatment using direct oral anticoagulants for 3 months is recommended in most cases. Gradual return to play can be achieved after treatment is complete. Some athletes, however, may require lifelong anticoagulation. Return to collision sports may be possible using a timed dose strategy if long-term anticoagulation is needed. The management of an athlete with a VTE should include an individualized treatment plan and involve shared decision making with the athlete, team physicians, and hematologic specialists.
Addition of strength training modifies the aerobic exercise inflammatory response in heart failure patients – Comments on the underlying pathophysiology
Authors: Delis Dimitrios , Linardatou Vasiliki , Karatzanos Eleftherios , Kourek Chris , Philippou Anastasios , Vagionas Dimitrios , Panagopoulou Niki , Alshamari Manal , Pittaras Theodoros , Nanas Serafim , Vasileiadis Ioannis 
Published: April 2022

Aim: The present study investigates the effect of Strength Training addition in a High Intensity Interval Training (HIIT) program, on the inflammatory profile of chronic heart failure (CHF) patients.
Materials and Methods: Forty-six CHF patients were randomized into the two different exercise rehabilitation groups. A patient group (control) performed HIIT and another group performed Combined (HIIT and strength training) Exercise Training (COM) for a three- month period. Before and after rehabilitation, all patients performed a maximal cardiopulmonary exercise testing (CPET). Microcirculatory parameters were assessed by Near Infrared Spectroscopy; CRP, IL-2, IL-6, IL-10 and VEGF levels were measured in plasma.
Results: Cardiopulmonary parameters and microcirculatory indices improved after rehabilitation. CRP and the IL-6/IL-10 ratio decreased after rehabilitation. By linear regression analysis, a negative correlation was noted between IL-2, IL-6 and IL-10 changes (post-CPET values) and the VE/VCO2 slope change, for the entire patient cohort. The correlation was separately maintained only in the COM group.
Conclusions: Overall, the results of the present study reinforce the view of an anti-inflammatory effect of exercise in CHF patients. The significant correlations demonstrated between the cytokine responses and the ventilatory response to exercise, particularly in the COM group, probably ensue from the special effect of strength training on peripheral muscle function.
Cost reduction strategies in the remediation of petroleum hydrocarbon contaminated soil
Authors: Ahmed Ismail B. , Nwaichi Eucharia O. , Ugwoha Ejikeme , Ugbebor John N. , Arokoyu Samuel B. 
Published: April 2022

Petroleum hydrocarbon spill on land pollutes soil and reduces its ecosystem. Hydrocarbon transport in the soil is aided by several biological, physical, and chemical processes. However, pore characteristics play a major role in the distribution within the soil matrix. Restoring land use after spills necessitates remediation using cost-effective technologies. Several remediation technologies have been demonstrated at different scales, and research is ongoing to improve their performances towards the reduction of treatment costs. The process of removing the contaminants in the soil is through one or a combination of containment, separation, and degradation methods under the influence of biological, physical, chemical, and electrically-dominated processes. Generally, performance improvement is achieved through the introduction of products/materials and/or energy. Nevertheless, the technologies can be categorized based on effectiveness period as short, medium, and long term. The treatment cost of short, medium, and long-term technologies are usually in the range of $39 – 331/t (/tonne), $22 – 131/t, and $8 – 131/t, respectively. However, the total cost depends on other factors such as site location, capital cost, and permitting. This review compiles cost-saving strategies reported for different techniques used in remediating petroleum hydrocarbon polluted soil. We discuss the principles of contaminant removal, performance enhancing methods, and the cost-effectiveness analysis of selected technologies.
Anaemia and associated factors among non-pregnant women of reproductive age in Ethiopia
Authors: Tsehayu Assefa , Tamiru Dessalegn , Mebratu Wondwosen 
Published: April 2022

Background/Aims Anaemia is a common health problem that has devastating consequences for women of reproductive age. Studies have indicated that anaemia among women of reproductive age contributes to a higher risk of unfavourable pregnancy outcomes, such as low birth weight and mental impairment. The aetiology of anaemia in Ethiopia is not well established and there is a lack of evidence, particularly in the case of non-pregnant women. Therefore, this study aimed to determine the prevalence of anaemia and associated factors among non-pregnant women of reproductive age in Ethiopia. Methods The dataset from the 2016 Ethiopia Demographic and Health Survey was used with the authorisation and permission of the Ethiopia Central Statistics Authority. A total of 13 436 non-pregnant women were included. Data were processed and analysed using STATA-14 format. Multilevel logistic regressions were used to determine anaemia's association with different predictors. Variables with P<0.25 in bivariate analysis were selected as candidate variables for the final model to control for confounding variables. The odds ratio with a 95% confidence interval was used to declare statistical significance at P<0.05. Results The prevalence of anaemia among non-pregnant women of reproductive age in Ethiopia was 26.3%. Locally, the highest (59.2%) and lowest (15.8%) prevalences of anaemia were recorded in Somali and Addis Ababa respectively and a quarter (25.0%) of rural residents were anaemic. Multivariate analysis showed that anaemia was negatively associated with being a from high- or middle-income family (P=0.001), having a job (P=0.001), using hormonal methods of family planning (P=0.001) and having a normal body mass index (P=0.009). However, being married (P=0.001), having had at least one child (P<0.05) and living in a rural residence (P=0.022) were positively associated with anaemia. Conclusions Anaemia is a common public health problem among women of reproductive age in Ethiopia. Economic status, place of residence, birth frequency and household size were significantly associated with anaemia among the participants. Therefore, to reduce anaemia prevalence among women of reproductive age in a sustainable manner in Ethiopia, different strategies and interventions methods such as iron-folic supplementation before pregnancy and nutrition education on iron-rich food and environmental hygiene should be strengthened.
Exploring newly qualified midwives' experiences of acquiring competence and confidence during midwifery training in Zimbabwe
Authors: Goshomi Unice , Bedwell Carol , Mudokwenyu-Rawdon Christina , Campbell Malcolm , Lavender Dame Tina 
Published: April 2022

Background/Aims In Zimbabwe, a 1-year hospital-centred competency-based midwifery training model aims to prepare graduates for clinical practice according to the International Confederation of Midwives Global Standards for Midwifery Education. This model exposes students to various interactive environments from which they gain experiences through a transformational learning process. Their experiences of this programme have never been investigated. This study aimed to explore newly qualified midwives' experiences of acquiring competence and confidence during midwifery training in Zimbabwe. Methods An exploratory qualitative study was conducted at three of the 22 hospital-based midwifery training institutions in Zimbabwe. The study used a classical grounded theory approach and in-depth interviews to achieve data saturation with 35 participants. Purposive sampling was used to select participants followed by theoretical sampling. Sampling stopped when no new analytical insights were being identified. Data were analysed using constant comparison. Results The interviews revealed the reflective experiences of newly qualified midwives during midwifery training. The main theme ‘being transformed’ emerged, and a model related to transformational learning process was developed with the following stages: ‘being engaged’, ‘entering into a relationship’ and ‘being challenged’ during the learning process. Conclusions: The core theme, being transformed, highlights students' educational journeys to becoming professionally qualified midwives. Respectful teaching and creating positive inter-team relationships are essential in implementing competency-based midwifery education programmes. Midwifery education policies should sufficiently support students during training to transform and prepare them for competent midwifery practice.
Newly qualified midwives' knowledge and perceptions of the International Confederation of Midwives and its core competences in Zimbabwe
Authors: Goshomi Unice , Bedwell Carol , Mudokwenyu-Rawdon Christina , Campbell Malcolm , Lavender Dame Tina 
Published: April 2022

Introduction Midwifery educators have a dual responsibility to ensure that students are competently prepared for practice and that they understand the role of the National Midwifery Association, as mandated by the International Confederation of Midwives through its membership. Newly qualified midwives' understanding of the International Confederation of Midwives' mandate in relation to roles and responsibilities is crucial to the development of their knowledge and perceptions towards the International Confederation of Midwives as their professional association. This study describes newly qualified midwives' knowledge and perceptions of the International Confederation of Midwives and its core competences in Zimbabwe. Methods A qualitative study using grounded theory principles was used to recruit and interview 35 newly qualified midwives at three institutions in Zimbabwe. The constant comparative analysis method was used to identify themes from the participants' responses. Results Three categories emerged: midwifery education and practice standards, international midwifery uniformity and defining midwifery competence. Conclusions The emphasis in midwifery education and practice should be both on competence development and motivating newly qualified midwives to appreciate the International Confederation of Midwives as the regulatory body of the midwifery profession. For the midwifery profession to grow and meet its mandate of reducing maternal and child mortality and morbidity, it needs midwives who understand the vision of their profession and are committed to transforming behaviour and skills in alignment with this vision.
Does Tixel® hit the technology treatment sweet spot?
Authors: Arias Laurie 
Published: April 2022

Tixel® is a fractional thermomechanical skin resurfacing device that is suitable for treating most skin indications, including uneven skin tone, elevated scarring and fine lines and wrinkles. It is both non-laser and non-ablative. At lower settings, it produces similar results to laser skin resurfacing without the risks of possible skin or eye damage. It safe and effective on all skin types and can be used around the delicate eye area, causing very little pain or downtime.
Poly (ADP-Ribose) and α–synuclein extracellular vesicles in patients with Parkinson disease: A possible biomarker of disease severity
Authors: Lucien Fabrice , Benarroch Eduardo E. , Mullan Aidan , Ali Farwa , Boeve Bradley F. , Mielke Michelle M. , Petersen Ronald C. , Kim Yohan , Stang Cole , Camerucci Emanuele , Ross Owen A. , Wszolek Zbigniew K. , Knopman David , Bower James , Singer Wolfgang , Savica Rodolfo 
Published: April 2022

Background/Objective
Despite multiple attempts, no surrogate biomarker of Parkinson disease (PD) has been definitively identified. Alternatively, identifying a non-invasive biomarker is crucial to understanding the natural history, severity, and progression of PD and to guide future therapeutic trials. Recent work highlighted alpha synuclein-containing extracellular vesicles and Poly (ADP-ribose) polymerase (PARP-1) activity as drivers of PD pathogenesis and putative PD biomarkers. This exploratory study evaluated the role of alpha-synuclein-positive extracellular vesicles and PARP-1 activity in the plasma of PD patients as non-invasive markers of the disease’s severity and progression.

Methods
We collected plasma of 57 PD patients (discovery cohort 20, replication cohort 37) and compared it with 20 unaffected individuals, 20 individuals with clinically diagnosed Alzheimer’s disease, and 20 individuals with dementia with Lewy bodies. We analyzed alpha-synuclein-positive extracellular vesicles from platelet-free plasma by nanoscale flow cytometry and blood concentrations of poly ADP-ribose using sandwich ELISA kits.

Results
Median concentration of α-synuclein extracellular vesicles was significantly higher in PD patients compared to the other groups (Kruskal-Wallis, p < .0001). In the discovery cohort, patients with higher α-synuclein extracellular vesicles had a higher Unified Parkinson Disease Rating Scale score (UPDRS III median = 22 vs. 5, p = 0.045). Seven out of 20 patients (35%) showed detectable PAR levels, with positive patients showing significantly higher levels of α-synuclein extracellular vesicles. In the replication cohort, we did not observe a significant difference in the PAR-positive cases in relationship with UPDRS III.

Conclusions
Non-invasive determination of α-synuclein-positive extracellular vesicles may provide a potential non-invasive marker of PD disease severity, and longitudinal studies are needed to evaluate the role of α-synuclein-positive extracellular vesicles as a marker of disease progression.