bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anaesthesia for mechanical thrombectomy: a narrative review
Authors: Dinsmore J. E. , Tan A. 
Published: January 2022

SummaryStroke is a leading cause of death and disability, and is associated with a huge societal and economic burden. Interventions for the immediate treatment of ischaemic stroke due to large vessel occlusion are dependent on recanalisation of the occluded vessel. Trials have provided evidence supporting the efficacy of mechanical thrombectomy in ischaemic stroke due to large vessel occlusion. This has resulted in changes in management and organisation of stroke care worldwide. Major determinants of effectiveness of thrombectomy include: time between stroke onset and reperfusion; location of occlusion and local collateral perfusion; adequacy of reperfusion; patient age; and stroke severity. The role of anaesthetic technique on outcome remains controversial with published research showing conflicting results. As a result, choice of conscious sedation or general anaesthesia for mechanical thrombectomy is often dependent on individual operator choice or institutional preference. More recent randomised controlled trials have suggested that protocol‐driven general anaesthesia is no worse than conscious sedation and may even be associated with better outcomes. These and other studies have highlighted the importance of optimal blood pressure management as a major determinant of patient outcome. Anaesthetic management should be tailored to the individual patient and circumstances. Acute ischaemic stroke is a neurological emergency; clinicians should focus on minimising door‐to‐groin puncture time and the provision of high‐quality periprocedural care with a particular emphasis on the maintenance of an adequate blood pressure.
Delirium and COVID‐19: a narrative review of emerging evidence
Authors: White L. , Jackson T. 
Published: January 2022

SummaryDelirium is a common condition affecting hospital inpatients, including those having surgery and on the intensive care unit. Delirium is also common in patients with COVID‐19 in hospital settings, and the occurrence is higher than expected for similar infections. The short‐term outcomes of those with COVID‐19 delirium are similar to that of classical delirium and include increased length of stay and increased mortality. Management of delirium in COVID‐19 in the context of a global pandemic is limited by the severity of the syndrome and compounded by the environmental constraints. Practical management includes effective screening, early identification and appropriate treatment aimed at minimising complications and timely escalation decisions. The pandemic has played out on the national stage and the effect of delirium on patients, relatives and healthcare workers remains unknown but evidence from the previous SARS outbreak suggests there may be long‐lasting psychological damage.
Latest evidence on the management of early‐stage and locally advanced rectal cancer: a narrative review
Authors: Prabhakaran Swetha , Yang Tze Wei Wilson , Johnson Nicholas , Bell Stephen , Chin Martin , Simpson Paul , Carne Peter , Farmer Chip , Skinner Stewart , Warrier Satish K , Kong Joseph CH 
Published: January 2022

AbstractRectal cancer is a challenging disease process to manage, with a rising incidence in young adults. Several clinical advances have been made in the past decade with regards to optimal treatment strategies in early‐stage (T1‐2, node negative tumours) and locally advanced cancers (T3‐4 and/or nodal positivity) utilizing a multimodal approach of surgery, neoadjuvant chemoradiotherapy, and adjuvant chemotherapy, all aiming to optimize oncological outcomes, while minimizing associated morbidity. This narrative review aimed to summarize trial level evidence apropos the management of early and locally advanced rectal cancer. All relevant prospective clinical trials were identified through a computer‐assisted search of PubMed, EMBASE, Medline databases between 1990 and 30 June 2021. With regards to early rectal cancer, there is limited trial‐level evidence in the literature. Total mesorectal excision (TME) is the current standard of care, but local excision could be considered in select patients with pT1 tumours, or patients with near or complete clinical response to neoadjuvant CRT. As for locally advanced rectal cancer, the current standard of care consists of long‐course chemotheradiotherapy or short‐course radiotherapy, followed by TME. However, the role of total neoadjuvant therapy is promising, with respect to both oncological outcomes, as well as in reducing toxicity. Both induction and consolidation chemotherapy treatment approaches have been described in literature, with encouraging early results. The optimal management of rectal cancer is constantly evolving. More research is needed to investigate the long‐term oncological and functional outcomes following new multimodal therapies in the management of early‐stage and locally advanced rectal cancer.
Unwarranted geographic variation in paediatric health care in the United States and Norway
Authors: Moen Atle , Goodman David C. 
Published: January 2022

AbstractAimWe present the four US and Norwegian paediatric and neonatal health atlases and discuss the concept and causes of unwarranted geographic variation in paediatric health care.MethodsThe four atlases analyse data from both publicly owned health registers, registers of insurance claims and quality registers. Healthcare utilisation is counted per recipient in predefined hospital service areas, adjusted for relevant confounders and presented as extremal ratios between the highest and lowest rate.ResultsThe atlases describe geographic variation in rates for primary health care, hospital admissions, outpatient visits, treatment procedures and diagnostic testing. A difference in extremal ratios from 2 to 4 between health service areas are common, and for some procedures extremal ratios is even higher.ConclusionVariation in healthcare utilisation of the magnitude described in these four atlases cannot be explained by differences in population morbidity or patient preferences and are therefore characterised as unwarranted variation. Individual provider preferences or supply of resources such as hospital beds may explain the observed variation.
When all COVID breaks loose: Examining determinants of working parents' job performance during a crisis
Authors: Mandeville Ashley , Manegold Jennifer , Matthews Russell , Whitman Marilyn V. 
Published: January 2022

AbstractAs governments mandated organization and school closures due to COVID‐19, working parents involuntarily found themselves trying to balance both work and child educational responsibilities from home while still endeavoring to remain productive at work. As such, we integrate the crisis management literature with boundary theory and the work–home resources model to propose and test a process model to better understand how abrupt shifts to remote work and school closures impact working parents' job performance during a crisis. Using data collected across four time periods beginning at the time when most states had issued “safer at home” orders, we examine a serial mediation model and find, consistent with predictions, that early experiences of boundary violations and job insecurity impact work–family balance self‐efficacy, which in turn drives future job performance by way of its effects on working parents' subjective well‐being. Implications for theory and practice are discussed.
Pharmacokinetics, pharmacodynamics and safety assessment of multiple doses of soticlestat in healthy volunteers
Authors: Wang Shining , Chen Grace , Merlo Pich Emilio , Affinito John , Cwik Michael , Faessel Hélène M. 
Published: January 2022

AimsSoticlestat, a first‐in‐class inhibitor of cholesterol 24‐hydroxylase (also known as cytochrome P450 46A1), is currently in development for the treatment of developmental and epileptic encephalopathies. Here, we report safety, tolerability, pharmacokinetic and pharmacodynamic outcomes from a phase I, randomized, double‐blind, placebo‐controlled, multiple‐rising‐dose study of soticlestat in healthy adults.MethodsFive cohorts of healthy subjects (n = 8 each, randomized 6:2 soticlestat:placebo) received oral soticlestat 100‐600 mg once daily (QD) or 300 mg twice daily (BID) for 10‐14 days. Serial blood and urine samples were obtained on days 1, 7 (blood only) and 14.ResultsSoticlestat in the dose range 100‐400 mg/day for up to 14 days was generally well tolerated. In total, 45 treatment‐emergent adverse events (TEAEs) were reported; most (91%) were transient and mild in intensity. Two subjects experienced TEAEs leading to discontinuation: one receiving soticlestat 600 mg QD reported a severe event of acute psychosis; another receiving 300 mg BID reported a mild event of confusional state. Steady‐state exposure to soticlestat increased in a slightly greater than dose‐proportional manner across the dose range 100‐400 mg QD. Peak plasma concentrations were reached within 0.33‐0.5 hour, and soticlestat elimination half‐life was approximately 4 hours. Renal excretion of soticlestat was negligible. Soticlestat 100‐400 mg QD reduced 24S‐hydroxycholesterol levels by 46.8 (coefficient of variation [CV%] −9.2) to −62.7% (CV% −7.3) at steady state; values of enzymatic inhibition were compatible with antiepileptic effects observed in preclinical models.ConclusionThe pharmacokinetic and pharmacodynamic profiles of soticlestat characterized here provided a data‐driven rationale for clinical trial dose selection.
Multiparameter platelet function analysis of bleeding patients with a prolonged platelet function analyser closure time
Authors: Heubel‐Moenen Floor C. J. I. , Brouns Sanne L. N. , Herfs Linda , Boerenkamp Lara S. , Jooss Natalie J. , Wetzels Rick J. H. , Verhezen Paul W. M. , Machiels Patric , Megy Karyn , Downes Kate , Heemskerk Johan W. M. , Beckers Erik A. M. , Henskens Yvonne M. C. 
Published: January 2022

SummaryPatients referred for evaluation of bleeding symptoms occasionally have a prolonged platelet function analyser (PFA) closure time, without evidence for von Willebrand disease or impaired platelet aggregation. The aim of this study was to establish a shear‐dependent platelet function defect in these patients. Patients were included based on high bleeding score and prior PFA prolongation. Common tests of von Willebrand factor (VWF) and platelet function and exome sequencing were performed. Microfluidic analysis of shear‐dependent collagen‐induced whole‐blood thrombus formation was performed. In 14 PFA‐only patients, compared to healthy volunteers, microfluidic tests showed significantly lower platelet adhesion and thrombus formation parameters. This was accompanied by lower integrin activation, phosphatidylserine exposure and P‐selectin expression. Principal components analysis indicated VWF as primary explaining variable of PFA prolongation, whereas conventional platelet aggregation primarily explained the reduced thrombus parameters under shear. In five patients with severe microfluidic abnormalities, conventional platelet aggregation was in the lowest range of normal. No causal variants in Mendelian genes known to cause bleeding or platelet disorders were identified. Multiparameter assessment of whole‐blood thrombus formation under shear indicates single or combined effects of low–normal VWF and low–normal platelet aggregation in these patients, suggesting a shear‐dependent platelet function defect, not detected by static conventional haemostatic tests.
Variable histopathology features of neuronal dyslamination in the cerebral neocortex adjacent to epilepsy‐associated vascular malformations suggest complex pathogenesis of focal cortical dysplasia ILAE type IIIc
Authors: Miyata Hajime , Kuwashige Haruka , Hori Tomokatsu , Kubota Yuichi , Pieper Tom , Coras Roland , Blümcke Ingmar , Yoshida Yasuji 
Published: January 2022

AbstractFocal cortical dysplasia type IIIc (FCD‐IIIc) is histopathologically defined by the International League Against Epilepsy's classification scheme as abnormal cortical organization adjacent to epilepsy‐associated vascular malformations (VM). However, the incidence of FCD‐IIIc, its pathogenesis, or association with the epileptogenic condition remains to be clarified. We reviewed a retrospective series of surgical brain specimens from 14 epilepsy patients with leptomeningeal angiomatosis of Sturge‐Weber syndrome (LMA‐SWS; n = 6), cerebral cavernous malformations (CCM; n = 7), and an arteriovenous malformation (AVM; n = 1) to assess the histopathological spectrum of FCD‐IIIc patterns in VM. FCD‐IIIc was observed in all cases of LMA‐SWS and was designated as cortical pseudolaminar sclerosis (CPLS). CPLS showed a common pattern of horizontally organized layer abnormalities, including neuronal cell loss and astrogliosis, either manifesting predominantly in cortical layer (L) 3 extending variably to deeper areas with or without further extension to L2 and/or L4. Another pattern was more localized, targeting mainly L4 with extension to L3 and/or L5. Abnormal cortical layering characterized by a fusion of L2 and L3 or L4–L6 was also noted in two LMA‐SWS cases and the AVM case. No horizontal or vertical lamination abnormalities were observed in the specimens adjacent to the CCM, despite the presence of vascular congestion and dilated parenchymal veins in all VM. These findings suggest that FCD‐IIIc depends on the type of the VM and developmental timing. We further conclude that FCD‐IIIc represents a secondary lesion acquired during pre‐ and/or perinatal development rather than following a pathomechanism independent of LMA‐SWS. Further studies will be necessary to address the selective vulnerability of the developing cerebral neocortex in LMA‐SWS, including genetic, encephaloclastic, hemodynamic, or metabolic events.
Mothers' experiences of giving medicines to children with severe and profound intellectual disabilities—The impact on time
Authors: Doyle Carmel 
Published: January 2022

AbstractBackgroundChronic health conditions experienced by children with severe and profound intellectual disabilities are accompanied by numerous challenges because of the prolonged period over which children take medication and the large number of drugs they take. Mothers experience many challenges in giving medicines, from difficulties in physical administration to manipulation of medication, covert administration and alternative formulations. The aim of this study was to explore mothers' lived experience of giving medicines to children with severe and profound intellectual disabilities.MethodsA hermeneutic phenomenological approach was used. Semistructured face‐to‐face interviews and participant diaries were adopted for data collection, resulting in 28 interviews undertaken and 7 diaries completed with mothers of children with severe and profound intellectual disabilities. Van Manen's method for thematic analysis was used for data analysis.ResultsThe concept of time and the impact of giving medicines were apparent, mothers being ‘always on call’ and the constant full‐time pace of their caring role evident. There was little spontaneity in their lives, dampened by the routine of giving medicines and their caregiving role. The necessity to be prepared and organized was highlighted as important in ensuring children got their medications on time and safely.ConclusionsThis study provides insight into the phenomenon of mothers' lived experience of giving medicines to children with severe and profound intellectual disabilities. It has enabled exploration and familiarity with the lifeworld of mothers and offers meaning on the phenomena of giving medicines. It was concluded that this experience is a relentless and challenging one, yet appears invisible as an element of care in professional discourse. Through addressing the gap in understanding and exploring the meaning of this phenomenon, it may be useful in developing care for mothers and children with severe and profound intellectual disabilities.
When pain never goes away: Understanding the lived experiences of children with chronic pain and their parents in Portugal
Authors: Hilário Ana Patrícia 
Published: January 2022

AbstractThis study intends to provide insights into the lives of children who suffer from chronic pain and of their parents. A qualitative, multi‐modal approach was employed, using the draw, write and tell technique with seven children, and semi‐structured interviews with parents. By illustrating that children are active social agents in the management of chronic pain (even when they are understood by parents as vulnerable), the findings support recent sociological work in the field of childhood health. Indeed, the findings show that children with a chronic condition can take autonomous decisions in relation to disease management even when supervised by parents.
Primary cutaneous CD8+ cytotoxic T‐cell lymphoma of the face with intraoral involvement, resulting in facial nerve palsy after chemotherapy
Authors: Travassos Daphine Caxias , Silveira Heitor Albergoni , Silva Evânio Vilela , Panucci Beatriz Zamboni Martins , da Silva Filho Nilson Coelho , Silva Paula Verona Ragusa , Bufalino Andreia , León Jorge Esquiche 
Published: January 2022

AbstractThe primary cutaneous (PC) CD8+ T‐cell lymphoproliferative disorders (LPDs) comprise clinically and histopathologically heterogeneous entities including mycosis fungoides, lymphomatoid papulosis, hydroa‐vacciniforme‐like LPD, subcutaneous panniculitis‐like T‐cell lymphoma (TCL), PC acral CD8+ TCL, PC CD8+ aggressive epidermotropic cytotoxic TCL, and PC peripheral TCL, not otherwise specified (PTCL‐NOS). We describe a 33‐year‐old man who presented with progressive facial swelling and lower lip involvement 1 year ago. Microscopy revealed an atypical small to medium‐sized lymphoid proliferation exhibiting perivascular accentuation, adnexotropism, and apoptotic cell debris, without surface epithelium involvement. The tumor cells were positive for CD3, CD8, granzyme B, perforin, MUM1/IRF4, and TCR‐BF1. The Ki‐67 labeling index was 48%. EBER1/2 was negative. Additional studies confirmed localized disease. The diagnosis favored PC‐PTCL‐NOS. Two months after completing chemotherapy, right‐sided facial nerve palsy was diagnosed. CD8+ T‐cell LPDs should be considered in the differential diagnosis when assessing facial swelling with intraoral involvement.
Type III cutaneous atypical meningioma of the scalp
Authors: Anderson Jarett D. , Anderson Jaclyn B. , Alhatem Albert , Walter Anne , Langston Leila 
Published: January 2022

AbstractMeningiomas occur rarely in extracranial sites, including the skin, where they may pose a diagnostic challenge because of their histopathologic overlap with several other spindle‐cell tumors. Cutaneous meningiomas are divided into type I (congenital), type II (ectopic), and type III (via direct extension) lesions. We present a rare case of atypical meningioma of the skin in a 71‐year‐old woman who presented with a painful and enlarging lesion on the left central frontal scalp. Biopsy showed bone and soft tissue with involvement of a spindle cell neoplasm, consisting of whorled nests with atypical features, including variably increased mitotic index, areas of hypercellularity, and sheeted architecture. The overall findings were consistent with an atypical meningioma (World Health Organization grade 2). Atypical meningiomas constitute only 5% to 15% of all meningiomas. Magnetic resonance imaging of the skull later demonstrated a left frontal tumor consistent with an atypical meningioma that had eroded through the skull. Dermatopathologists should consider cutaneous meningioma as a differential diagnosis of spindle‐cell neoplasms of the skin and subcutaneous tissue in head and neck.
The effects of political design and organizational dynamics on structural disaggregation and integration in Norway 1947–2019
Authors: Danielsen Ole Andreas , Fleischer Julia 
Published: January 2022

AbstractIn countries with long‐standing agency traditions, the creation of new agencies rarely comes as a large‐scale reform but rather as one structural choice of many possible, most notably a ministerial division. In order to make sense of these choices, the article discusses the role ofpolitical design—focusing on the role of political motivations, such as ideological turnover, replacement risks and ideological stands toward administrative efficiency—andorganizational dynamics—focusing on the role of administrative legacies and existing organizational palettes. The article utilizes data on organizational creations in the Norwegian central state between 1947 and 2019, in order to explore how political design and organizational dynamics help us understand the creation of agencies relative to ministry divisions over time. We find that political motives matter a great deal for the structural choices made by consecutive Norwegian governments, but that structural path dependencies may also be at play.
Response to the coronavirus disease 2019 pandemic of dental hygienists in South Korea—Part Ⅰ: Knowledge and practice of infection control
Authors: Yim Hyun‐Kyung , Moon Sook , Min Ji‐Hyun 
Published: January 2022

AbstractObjectivesTo evaluate infection control knowledge and its practice of clinical dental hygienists in response to Coronavirus Disease 2019 (COVID‐19) in South Korea.MethodsNine questions (Q9‐K) on the degree of knowledge acquisition of dental hygienists in response to COVID‐19, and another 9 questions (Q9‐P) on the practices for COVID‐19 infection and spread prevention were prepared. From 500 clinical dental hygienists in South Korea, answers about their general characteristics, Q9‐K, and Q9‐P were collected. 1 point was given to each question based on the ‘yes’ answers from Q9‐K and Q9‐P, and Score‐K and Score‐P were calculated, respectively. To identify factors affecting Score‐P, a multiple linear regression analysis was performed. In all analyses, p‐values lower than 0.05 were considered statistically significant.ResultsAverage scores of Score‐K and Score‐P were 7.36 ± 1.35 and 6.26 ± 2.07, respectively. The regression model of Score‐P was significant (F = 20.788, p < 0.001). Concerning Score‐P, Score‐K (β = 0.385), age (β = 0.275), dental hospital (β = 0.158), monthly income of $2,360~$2,730 (β = 0.104) had a significantly positive correlation, and the total years of career (β = −0.293) are found to have a significantly negative correlation.ConclusionsInfection control knowledge and practice of clinical dental hygienists in South Korea was found to be vulnerable in the group of hygienists who are younger than 27 years old, working in dental clinics, and whose monthly income is less than under $2,000. Also, the factor that influences infection control practice the most was the degree of knowledge. Therefore, continuous infection control education and supplement targeting these vulnerable groups are necessary.
Chemical approach to the glass structure and properties
Authors: Vedishcheva Natalia , López‐Grande Alberto , Muñoz Francisco 
Published: January 2022

AbstractThis paper continues the series of works by the present authors on the modeling of glass structure and properties. Calculations are performed using the concept of the chemical structure based on the rigorous thermodynamic model of associated solutions. The aim of the present contribution is to demonstrate the applicability of the concept to a wider range of systems than that considered before. For this reason, glasses in the systems with different chemical natures determined by the acidity and basicity of the constituent oxides are considered. The glass structure is calculated at the level of the short‐range order in the systems BaO‒SiO2 and M2O(MO)‒P2O5 (M = Li, Na, and Zn) and the intermediate‐range order in the systems Rb2O‒B2O3 and Cs2O‒B2O3. The structure‐property relationship is quantitatively established by the example of the molar volume of BaO‒SiO2 glasses. All calculations are performed without the use of adjustable parameters and the results obtained are compared with the experimental data available in the literature.