bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Peripheral Versus Central Access for Alternative Access Transcatheter Aortic Valve Replacement and Mortality and Stroke: A Report From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry
Authors: Kaneko Tsuyoshi , Hirji Sameer A. , Yazdchi Farhang , Sun Yee-Ping , Nyman Charles , Shook Douglas , Cohen David J. , Stebbins Amanda , Zeitouni Michel , Vemulapalli Sreekanth , Thourani Vinod H. , Shah Pinak B. , O’Gara Patrick 
Published: September 2022

Background:
In some patients, the alternative access route for transcatheter aortic valve replacement (TAVR) is utilized because the conventional transfemoral approach is not felt to be either feasible or optimal. However, accurate prognostication of patient risks is not well established. This study examines the associations between peripheral (transsubclavian/transaxillary, and transcarotid) versus central access (transapical and transaortic) in alternative access TAVR and 30-day and 1-year end points of mortality and stroke for all valve platforms.

Methods:
Using data from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry with linkage to Medicare claims, patients who underwent alternative access TAVR from June 1, 2015 to June 30, 2018 were identified. Adjusted and unadjusted Cox proportional hazards modeling were performed to determine the association between alternate access TAVR site and 30-day and 1-year end points of mortality and stroke.

Results:

Of 7187 alternative access TAVR patients, 3725 (52%) had peripheral access and 3462 (48%) had central access. All-cause mortality was significantly lower in peripheral access versus central access group at in-hospital and 1 year (2.9% versus 6.3% and 20.3% versus 26.6%, respectively), but stroke rates were higher (5.0% versus 2.8% and 7.3% versus 5.5%, respectively; all
P
<0.001). These results persisted after 1-year adjustment (death adjusted hazard ratio, 0.72 [95% CI, 0.62–0.85] and stroke adjusted hazard ratio, 2.92 [95% CI, 2.21–3.85]). When broken down by individual subtypes, compared with transaxillary/subclavian access patients, transapical, and transaortic access patients had higher all-cause mortality but less stroke (
P
<0.05).

Conclusions:
In this real-world, contemporary, nationally representative benchmarking study of alternate access TAVR sites, peripheral access was associated with favorable mortality and morbidity outcomes compared with central access, at the expense of higher stroke. These findings may allow for accurate prognostication of risk for patient counseling and decision-making for the heart team with regard to alternative access TAVR.
Atrial Functional Tricuspid Regurgitation: Novel Definition and Impact on Prognosis
Authors: Schlotter Florian , Dietz Marlieke F. , Stolz Lukas , Kresoja Karl-Patrik , Besler Christian , Sannino Anna , Rommel Karl-Philipp , Unterhuber Matthias , von Roeder Maximilian , Delgado Victoria , Thiele Holger , Hausleiter Jörg , Bax Jeroen J. , Lurz Philipp 
Published: September 2022

Background:
Atrial functional tricuspid regurgitation (atrial TR) has received growing recognition as a TR entity with a distinct cause owing to its independence from valvular tethering as the predominant mechanism underlying TR. However, characterization of atrial TR varies, and a universal definition is lacking.

Methods:
In total, 651 patients with significant functional TR were analyzed, including 438 conservatively treated individuals and 213 patients who received transcatheter tricuspid valve repair (TTVR). Based on a clustering approach, we defined atrial TR as tricuspid valve (TV) tenting height ≤10 mm, midventricular right ventricular diameter ≤38 mm, and left ventricular ejection fraction ≥50%.

Results:

Patients with atrial TR were more often females, had higher right ventricular fractional area change, higher left ventricular ejection fraction, and lower LV end-diastolic diameter, TV tenting area and height, lower right ventricular and tricuspid annular size, enlarged, but lower right atrial area and lower TV effective regurgitant orifice area (all
P
<0.05). Patients with atrial TR had significantly better long-term survival than non-atrial TR in the conservatively treated TR cohort (
P
<0.01, n=438). Atrial TR was independently associated with a lower rate of the combined end point of mortality and heart failure hospitalization at 1-year follow-up in the TTVR cohort (hazard ratio, 0.39;
P
<0.05, n=213). TR degree was significantly reduced after TTVR in non-atrial and atrial TR (
P
<0.01). Functional parameters significantly improved following TTVR independent of TR cause (
P
<0.05).

Conclusions:
An echocardiography-based atrial TR definition is associated with prognostic relevance in patients with functional TR in conservatively treated TR and after TTVR.
Intensive Social Interaction for Treatment of Poststroke Depression in Subacute Aphasia: The CONNECT Trial
Authors: Stahl Benjamin , Millrose Saskia , Denzler Petra , Lucchese Guglielmo , Jacobi Frank , Flöel Agnes 
Published: September 2022

Background:
Limiting the ability to engage in social interaction, aphasia increases the risk of poststroke depression and may prevent classical forms of psychotherapy. Our parallel-group, blinded-assessment, quasi-randomized controlled trial explores the feasibility and potential efficacy of intensive social interaction as a means to alleviate poststroke depression in subacute aphasia.

Methods:
We adopted a linguistically validated treatment program based on massed practice and conversational turn-taking (Intensive Language-Action Therapy). In a routine outpatient setting, 60 individuals with poststroke depression and subacute aphasia (0.5–6 months following left-hemispheric ischemia or hemorrhage) were assigned to Intensive Language-Action Therapy combined with standard care (Group I) or standard care alone (Group II). End points included feasibility (primary outcome) alongside change on self-report and clinician-rated measures of depression severity (co-primary outcomes: Beck’s Depression Inventory; Hamilton Rating Scale for Depression) after a 1-month treatment period (5 weekly 1-hour sessions), controlled for progress in language performance (secondary outcome: Aachen Aphasia Test, AAT).

Results:

100% treatment participation demonstrated feasibility of Intensive Language-Action Therapy in poststroke depression. Analyses (
n
=60) revealed significant between-group differences on the Beck’s Depression Inventory (change in Group I [95% CI]: −12.6 [±4.9]; in Group II: −5.8 [±3.2];
P
=0.040) and Hamilton Rating Scale for Depression (change in Group I: −5.0 [±1.4]; in Group II: −3.3 [±1.2];
P
=0.002), indicating small-to-medium effect sizes in reducing depression severity with Intensive Language-Action Therapy (
η
2
≤0.101). No significant between-group differences emerged on expressive AAT subscales.

Conclusions:
Our results confirm the feasibility and potential efficacy of intensive social interaction for treatment of poststroke depression in subacute aphasia.

Registration:

URL:
www.clinicaltrials.gov
; Unique identifier: NCT04318951.
Perceived Aggressive Tendencies of, and Functional Attitudes Towards, Selected Breeds of Dogs
Authors: Briones Elizabeth M. , Marshall Philip H. , Mangano Serena 
Published: September 2022

Abstract
The aim of this study was to examine the current state of perceptions towards select breeds of dogs with a focus on perceived aggressiveness. While some studies investigating breed perceptions of aggressiveness have presented dogs in various poses, possibly adding to unintentional perception bias towards aggressiveness, this study showed standardized representations of 27 dog breeds. A hierarchical cluster analysis of data collected from a large sample suggests two distinct categories of dogs that were perceived as either higher or lower in aggressiveness. Additionally, this study asked participants about their intended behavior toward those breeds, thus providing data on people’s functional attitudes towards breeds perceived as more or less aggressive. The data show that people are less willing to interact with those breeds of dogs that are perceived to be higher in aggressiveness and intend to engage in more favorable interactions towards those breeds perceived as less aggressive.
A Competing Harvester, Stakeholder, and Environmental Threat: Positioning Reindeer in Metla Forestry Research
Authors: Nyyssönen Jukka 
Published: September 2022

Abstract
What kind of positions have reindeer been given in Finnish forestry science by research institution, Metsäntutkimuslaitos (Metla)? Because of overlapping zones of utilization, reindeer for the most part appeared as a threat to national wealth and a problem to harvesting, as well as spoiling ecosystem productivity. They were perceived as a harmful species that destroyed and “killed” saplings and decreased the forest areal. Closer to the present day, the positions of reindeer have become more versatile, and reindeer receive more positive characterizations, even that of stakeholders, or the ones enjoying the outcomes of better-managed pastures. However, the breakthrough in environmental discourse from the 1980s onwards has led to the marginalization and demonization of the reindeer. The position of reindeer in their ecosystem has become unstable and is defined anew as a risk.
The Lasting Impact of the COVID-19 Pandemic on Surgical Key Indicator Cases for Otolaryngology Residency Education
Authors: Krishnan Pavan S. , Daggumati Srihari , Widmeyer Jonathan , Quinn Kevin J. , Yu Cheryl , Vahidi Nima , Kamdar Rushabh , Kandl Christopher 
Published: September 2022

Objectives: Early on during the COVID-19 pandemic, the US Centers for Medicare & Medicaid Services (CMS) and other government as well as medical institutions recommended that surgeons postpone nonessential surgeries. The aim of our study is to examine the impact of the COVID-19 pandemic on otolaryngology surgical training by evaluating changes in surgical volumes through various time points relative to the height of the pandemic. Methods: We performed a retrospective review of all surgical cases performed by the Otolaryngology-Head and Neck Surgery department at a tertiary care academic center from 3 time periods: July 1st, 2018, to June 30th, 2019; July 1st, 2019, to June 30th, 2020; and July 1st, 2020, to June 30th, 2021. Results: From the 2018-19 period to the 2020-21 period, the total number of overall cases decreased by 9.9%, from 2386 to 2148 cases. During this same time duration, the number of key indicator cases decreased by 13.4%, from 1715 to 1486 cases. Relative to other cases, ethmoidectomy, rhinoplasty, and stapes/OCR cases decreased the most during the 2019-20 period by 41.9%, 41.8%, and 29.5%, respectively. From the 2018-19 period to the 2020-21 period, thyroid/parathyroid cases decreased the most by 35.4%. Only ethmoidectomy and oral cavity cases showed increases during this period at 9.7% and 24.4%, respectively. Conclusions: Although case volumes have stayed relatively constant, key indicator case volumes at the present tertiary care academic center have not yet fully recovered from the COVID-19 pandemic. Efforts must be made to determine how this has impacted residency surgical education.
Predictors of Health Care Utilization Following Major Head and Neck Oncologic Surgery in Older Patients
Authors: Faiq Samya , Solis Roberto N. , Sekhon Harveen K. , Morisada Megan V. , Wilson Machelle , Abouyared Marianne , Bewley Arnaud F. , Birkeland Andrew C. 
Published: September 2022

AbstractObjectiveTo identify patient factors in older patients associated with making posttreatment visits in the first year after major head and neck oncologic surgery.Study DesignRetrospective cohort study.SettingAcademic institution.MethodsPatients aged ≥60 years who underwent a neck dissection with or without a free flap reconstruction were retrospectively analyzed. Data collected included patient demographics, comorbidities, social variables, perioperative course, and clinical visits.ResultsWithin a 1‐year postoperative period, the 181 patients in our cohort had a mean ± SD 6.37 ± 3.6 postoperative clinic visits; 70% attended at least 4 visits. Multivariable regression analysis showed a significant association with distance closer to the hospital (P = .013): for every 10‐mile increase in distance, the number of visits decreased by 0.15 (SE = 0.06). Additionally, receiving adjuvant radiation therapy (P = .0096) demonstrated significant associations: when compared with no adjuvant therapy, radiation therapy had on average 1.5 (SE = 0.56) more visits, and chemoradiation had 0.04 (SE = 0.73) more visits.ConclusionOlder patients who undergo major head and neck oncology surgery are more likely to attend posttreatment visits in the 1 year following surgery if they are discharged home rather than to a skilled nursing facility, live closer to the hospital, and undergo adjuvant radiation therapy.
Impact of Head and Neck Cancer Diagnosis and Treatment on Patient‐Partner Intimacy
Authors: Fiorella Michele , Alnemri Angela , Sussman Sarah , Koka Anusha , Johnson Jennifer , Cognetti David , Curry Joseph , Mady Leila , Worster Brooke , Leader Amy E. , Luginbuhl Adam 
Published: September 2022

AbstractObjectiveTo determine the effects of head and neck squamous cell carcinoma diagnosis and treatment on patient‐ and partner‐perceived intimacy and to understand if a diagnosis of HPV‐related head and neck squamous cell carcinoma influences patient‐partner intimacy.Study DesignProspective observational.SettingSingle tertiary care center.MethodsAn investigator‐developed questionnaire was used to prospectively survey patients and partners in 2 groups based on human papillomavirus (HPV) status: HPV+ and HPV– at diagnosis (visit 1) and after treatment (visit 2). Surveys were scored on a 60‐point scale, and results were categorized as follows: loss of intimacy (0‐30), stable relationship (31‐41), or improvement in intimacy (42‐60). Responses of couples who participated together were assessed for concordance. Responses were considered discordant if patient and partner scores equated to different levels of perceived intimacy. Median patient and partner scores were compared via Mann‐Whitney U test, and concordance was assessed with a chi‐square test.ResultsThirty‐four patients and 28 partners completed surveys at visit 1 and 28 patients and 15 partners at visit 2. Median scores among patients and partners were similar at the first time point (HPV+, 45 vs 45, P = .64; HPV–, 42.6 vs 40.8, P = .29) and the second (HPV+, 44.5 vs 44, P = .87; HPV–, 40.2 vs 39.6, P = .90). Concordance rates between HPV+ and HPV– couples were 63% vs 44% (P = .43) for the first time point and 89% vs 50% (P = .24) for the second.ConclusionPatients and partners reported stable or improved intimacy at both time points, and most couples tended to agree on their levels of perceived intimacy. A diagnosis of HPV did not appear to significantly affect intimacy scores.
A Needs Assessment for the Future of Otolaryngology Education
Authors: Chen Jenny X. , Yu Sophie E. , Miller Lauren E. , Gray Stacey T. 
Published: September 2022

AbstractThe field of otolaryngology–head and neck surgery is rapidly changing, and surgical education must keep pace. In the face of recent advances in medical knowledge, surgical technique, and novel technology, educators may find it increasingly difficult to identify the evolving educational needs of otolaryngology residents. To better align training activities with modern practice patterns, we propose conducting a longitudinal needs assessment by designing a standardized specialty‐specific survey for practicing otolaryngologists. This recurring survey could be implemented alongside accreditation or other continuing medical education activities. The outcomes would report what contemporary otolaryngologists see and do in everyday practice to guide educational reforms to better prepare trainees for future practice.
Prophylactic renal artery embolization before pregnancy in patients with lymphangioleiomyomatosis and renal angiomyolipoma
Authors: Toei Hiroshi , Zhang Xixi , Seyama Kuniaki , Yashiro Daisuke , Kuwatsuru Yoshiki , Kuwatsuru Ryohei 
Published: September 2022

Objective Pregnant patients with lymphangioleiomyomatosis (LAM) and renal angiomyolipomas (AMLs) require care for both renal AMLs and pulmonary dysfunction because AMLs can grow and rupture during pregnancy, potentially causing hemorrhagic shock and fetal death. This study examined whether prophylactic transcatheter arterial embolization (TAE) could prevent the pregnancy-associated growth and rupture of renal AMLs in patients with LAM. Methods This retrospective study included five women with 14 renal AMLs (initial diameter, ≥2 cm) first encountered between September 2010 and August 2015 who subsequently became pregnant. Seven tumors in five patients were embolized, and seven tumors in two patients were not treated. Changes in the volume of each tumor were evaluated. Results Untreated tumors were much more likely to grow than embolized tumors both during pregnancy (100% vs. 0%) and at the first follow-up visit after delivery (100% vs. 14%). One untreated hypervascular tumor grew rapidly during pregnancy to 409% of the pretreatment volume. No tumor ruptured. Conclusions Prophylactic pre-pregnancy TAE decreased the growth and bleeding of renal AMLs during pregnancy in patients with LAM. TAE can be recommended for hypervascular tumors before pregnancy regardless of the size of the aneurysm.
Effect of microwave heat treatment on physical and mechanical properties of high-Density polyethylene/wood flour/Nano-SiO2 composites
Authors: Amini Amir , Farsi Mohammad , Ebadi Masoud , Sani Fatemeh Maashi , Shahbabaei Majid 
Published: September 2022

The study aimed at investigating the impact of Microwave Heat Treatment (MHT) on the physical and mechanical properties of wood flour (WF)/Nano-SiO2/High-Density polyethylene composites by varying Nano-SiO2 loading from 0, 1, 2, and 3% wt with a constant WF loading at 50% wt. By milling the materials in which were firstly mixed in a twin-screw extruder (Brabender® Plasti-Corder®), wood-plastic composites ASTM Standard samples were produced by an injection molding machine. Microwave irradiation with a power of 900 W and a temperature of 85°C for 7 min was applied for post-treatment of WPCs. After applying the microwave treatment, samples were subjected to physical and mechanical tests. The results indicated that increased Nano-SiO2 loading up to 3 wt% led to increasing the flexural strength and modulus while decreasing the impact resistance, water absorption, and thickness swelling of samples. As such, morphological analyses revealed that MHT increased the flexural modulus and strength, as well as, decreased the impact strength, water adsorption, and thickness swelling of the samples.
Swelling assessment after total knee arthroplasty
Authors: Yau LI Ka , Henry FU , Man Hong CHEUNG , Amy CHEUNG , Wai Kwan Vincent CHAN , Ping Keung CHAN , Kwong Yuen CHIU 
Published: September 2022

Background Total knee arthroplasty is a commonly performed elective orthopaedic surgery. Patients may endure substantial knee swelling following surgery, which are attributable to both effusion and edema. Studies have been aiming to identify an accurate and reliable method to quantify post-operative knee swelling to aid monitoring progress and treatment. The aim of this article was to review the means of clinically applicable measurements for knee swelling post TKA. Methods The medical literature was searched using PubMed to search for articles published using the terms knee edema, effusion, swelling, knee arthroplasty, knee replacement, total knee arthroplasty, total knee replacement, TKA, TKR. Year of publication was not restricted. Only English language publications were included. Only full-text published articles from peer-reviewed journals were eligible for inclusion. The knee swelling measurement methods used in post TKA were reviewed. Results Advancement in bioimpedance spectroscopy and handheld 3D scanning technology allows quick and precise quantification of knee swelling volume that the traditional clinical circumferential measurement and volumetric measurement lack. Handheld 3D scanning is also a potential tool to estimate the change of knee effusion volume and muscular volume after the surgery. Magnetic resonance imaging is accurate in effusion measurement but also the most time and resource demanding method. Conclusion Bioimpedance spectroscopy and 3D scanning technology can be the future tools for clinically measurement of knee swelling after total knee arthroplasty.
Comparison of permeabilities of eight different types of cytotoxic drugs to five gloves with different materials by LC-MS/MS methods to reduce occupational exposure of medical personnel
Authors: Zhou Hailong , Li Yunyun , Xu Fan 
Published: September 2022

Purpose Occupational exposure is a long-standing public health concern, which has drawn more and more attention in recent years to the problem of how to carry out occupational protection effectively. Gloves are regarded as the most critical protective equipment for cytotoxic medications. However, there is still little research conducted on the protective performance of gloves made of different materials and the optimal glove combination for cytotoxic agents. Methods In this research, a specific instrument intended for glove permeation experiment was designed, with various methods of liquid chromatography-tandem mass spectrometry (LC-MS/MS) developed and validated. By using the specific instrument and LC-MS/MS methods, a study was conducted on the permeation ability of eight selected cytotoxic drugs (fluorouracil, epirubicin (EPI), docetaxel (DCT), methotrexate (MTX), cyclophosphamide (CTX), etoposide (ETP), vincristine sulfate (VCR), and cisplatin derivatives Pt-(DDTC)3) into five kinds of gloves (rubber (RB), nitrile (NT), chlorinated polyethylene (CPE), low-density polyethylene, and polyvinylchloride (PVC) resin) given different contact times. Then, the experimental data were analyzed through a generalized estimation equation and Pearson correlation analysis. Results The results show that within a short period of time (less than five minutes), ETP, CTX, fluorouracil, DCT, and cisplatin passed through five types of gloves but the level of MTX, VCR, and EPI permeation was minimal, despite the duration of contact between the three drugs and the gloves reaching as long as three hours. Furthermore, the permeation of DCT and ETP was found to be positively correlated with time. Conclusions Chlorinated polyethylene and PVC resin perform well in protecting against most cytotoxic drugs and are recommendable for clinical practice. Due to the poor protective ability, RB gloves are not recommended for this purpose. Based on the performance of various gloves in offering protection, the protection grade of two gloves can be deduced. Chlorinated polyethylene  +  PVC resin, CPE  +  NT glove combination shows good protective performance against most target drugs and can be recommended for clinical practice.