bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Characteristics and Surgical Outcomes of Obstructive Sleep Apnea Patients With Mixed Apnea Components
Authors: Rha Min‐Seok , Jeong Yeonsu , Kim Chang‐Hoon , Yoon Joo‐Heon , Cho Hyung‐Ju 
Published: June 2022

AbstractObjectiveThis study was aimed to investigate clinical implications of mixed apnea (MA) in patients with obstructive sleep apnea (OSA), particularly whether surgical outcomes differ between OSA patients with and without MA events.Study DesignRetrospective cohort study.SettingSingle tertiary medical center.MethodsEighty‐eight patients with OSA who underwent multilevel upper airway surgery were included. Patients were divided into 2 groups according to the presence of MA events: “pure group” (n = 30) and “mixed group” (n = 58). The clinical characteristics and surgical outcomes were compared between the 2 groups.ResultsThe mixed group included more males (P = .020) and hypertensive patients (P = .009) and had a higher apnea‐hypopnea index (AHI; P < .001) than the pure group. The surgical success rate was lower in the mixed group (29.3%) than in the pure group (73.3%; P < .001). Furthermore, the postoperative improvements in total AHI (P < .001), supine AHI (P < .001), and oxygen desaturation index (P = .006) were lower in the mixed group than in the pure group. Logistic regression analysis confirmed that the presence of MA (P = .002) was an independent predictor of poor surgical outcomes in patients with OSA.ConclusionOSA patients with MA showed different clinical features and poor surgical outcomes compared to those without MA. These results imply that OSA with MA components may have a distinct pathophysiology, and the presence of MA should be considered in the surgical treatment of OSA.
Patient Factors and Preferences in Choosing Sleep Surgery for Obstructive Sleep Apnea: A Qualitative Study
Authors: Ikeda Allison K. , McShay Crystina , Marsh Robin , Saini Shireen , Sardesai Maya G. , Weaver Edward M. , Boss Emily F. 
Published: June 2022

AbstractObjectiveThere are several obstructive sleep apnea (OSA) treatment options available to patients, including surgery and less invasive therapies. Little is known about the factors that influence patient preferences for treatment. We aimed to understand factors influencing patient experience and decision making for undergoing sleep surgery.Study DesignRetrospective qualitative study.SettingTertiary sleep surgery clinic.MethodsWe conducted semistructured interviews with adults who previously underwent any nasal and/or pharyngeal sleep surgery. We asked open‐ended questions about their decision‐making process within a preconceived thematic framework of chief OSA symptoms, expectations for recovery, and sources of information. The interviews were audio recorded and transcribed, and content was analyzed for defined, emergent, and prevalent themes.ResultsTen patients were interviewed from December 11, 2020 through January 29, 2021. Six patients underwent nasal surgery, 1 underwent pharyngeal surgery, and 3 underwent staged nasal and pharyngeal procedures. All patients were beyond the acute recovery phase. Reasons for pursuing surgical consultation varied from sleep apnea burden to external factors, such as recommendations from significant others. Duration of sleep surgery consideration varied from months to years. Major concerns about sleep surgery involved anesthesia and postoperative pain. External factors influencing patients’ decisions to pursue sleep surgery included family and friend support. Postoperative outcomes of surgery included patient satisfaction with decision for surgery, given OSA improvements.ConclusionUnderstanding patient factors that influence decision making for sleep surgery may guide clinicians in patient‐centered counseling that engages patients in decision making, aligning with clinical symptoms and patient preferences.
Loading Mesenchymal Stem Cell–Derived Exosomes Into a Traditionally Designed Rotator Cuff Patch: A Potential Strategy to Enhance the Repair of Chronic Rotator Cuff Tear Associated With Degenerative Changes
Authors: Zhang Xuancheng , Han Zhengzhe , Han Kang , Zhang He , Huang Jinghuan , Huangfu Xiaoqiao , Zhao Jinzhong 
Published: June 2022

Background: Retraction and degenerative changes of chronic rotator cuff tears limit the healing capacity after routine surgical repair. Purpose: To fabricate a mesenchymal stem cell–derived exosome (MSC–Exos) loaded patch and evaluate the effect of this patch on the activity of rabbit tenocytes in vitro and on the repair of chronic rotator cuff tears associated with degenerative changes in vivo. Study Design: Controlled laboratory study. Methods: The MSC–Exos loaded patch was fabricated using a dynamic wet-spinning system. In the in vitro studies, the proliferation and migration activities of tenocytes were evaluated by culturing tenocytes with saline, a fiber-aligned patch, or an MSC–Exos loaded patch. In the in vivo studies, a rabbit model of chronic rotator cuff tear was established and directly repaired, repaired with fiber-aligned patch augmentation (RFPA group), and repaired with MSC–Exos loaded patch augmentation (REPA group). Histological and biomechanical analyses were performed at 4, 8, and 12 weeks after surgery. Results: An MSC–Exos loaded patch with inner aligned fibers, a loose microstructure, and reliable initial strength was fabricated using a dynamic wet-spinning system. The MSC–Exos loaded patch significantly promoted tenocyte proliferation and migration activities in vitro. In vivo, the REPA group exhibited significantly higher tendon maturing scores at 8 and 12 weeks after surgery compared with both the control and the RFPA groups. Fatty infiltration was significantly reduced in the REPA group at 4, 8, and 12 weeks compared with both the control and the RFPA groups. Biomechanical properties, including load to failure and stress, were also significantly improved at 12 weeks in the REPA group compared with both the control and the RFPA groups. Conclusion: Results in the present study suggested that an MSC–Exos loaded patch was able to enhance the repair of a chronic rotator cuff tear by providing mechanical support and minimizing degeneration. Clinical Relevance: This work supported the idea that loading bioactive MSC–Exos into a traditionally designed rotator cuff patch might exert a better effect on the repair of chronic rotator cuff tears than augmented patch repair alone.
Machine learning and Serious Game for the Early Diagnosis of Alzheimer’s Disease
Authors: Mezrar Samiha , Bendella Fatima 
Published: June 2022

Background and Aim Aging people can suffer from cognitive impairments with a range of symptoms, including memory, perception, and difficulty in solving problems called Alzheimer’s disease (AD). The early detection of Mild Cognitive Impairment (MCI), which can develop AD, plays a major role in the management of patients to slow the decline in cognitive function, as treatments are effective at an early stage of the disease course. For this purpose, advanced computer technologies can provide a tool for the early detection of AD and prediction of disease progression. This article presents a serious game, including 16 mini-games that aimed at detecting AD or MCI in the mild stage. Based on gamification techniques and machine learning (ML), by overcoming the limitations of traditional tests. This gamified cognitive tool, entitled AlzCoGame, evaluates the main cognitive domains considered to be the most pertinent indicators in diagnosing cognitive impairments: working memory, episodic memory, executive functions, Visio-spatial orientation, concentration, and attention. Results and Conclusion Six predictive ML models have been implemented using the AlzCoGame dataset. We used the K-fold cross-validation and classification metrics to validate the model's performance. Based on the results of the pilot study, the best overall performance was obtained by the RF classifier with average Sensitivity = 0.89, Specificity = 0.93, Accuracy = 0.92, F1-Score = 0.91, and ROC = 0.91. We can deduce that including machine learning techniques and serious games could help improve certain aspects of the clinical diagnosis of cognitive impairment. Moreover, clinical trials are required to prove the impact of this gamified program on cognitive skills and evaluate usability measures.
Corneal Endothelial Cell Loss Following Airbag Injury
Authors: Alshehri Omar Abdulaziz , Alsulami Raed Eid , Alqahtani Bader Saad , Alamri Osama Saeed , Alharbi Mosa 
Published: June 2022

Purpose: To report a rare incidence of corneal endothelial cell loss following airbag injury. Observation: A 27-year-old female who sustained a motor vehicle accident with airbag deployment presented with hand motion vision in the left eye. Ocular examination demonstrated corneal abrasion, significant corneal stromal edema with descemet folds, and a central pachymetry of 999 µm. The patient was managed with topical steroids and antibiotic drops. One week later, specular microscopy revealed a central endothelial cell count of 2200/mm2 with pleomorphism, polymegathism, and a decreased central corneal thickness of 569 µm. A repeat of specular microscopy 6 months later showed a decreased central endothelial cell count of 1611/mm2 with recovered visual acuity of 20/30. Conclusion: Corneal endothelial loss is a severe complication of ocular airbag injury. Serial ophthalmic assessment is recommended because endothelial cell loss may continue for some time after the initial impact.
Polysulfone tailor-made implant for the surgical correction of a frontoparietal meningoencephalocoele in a cat
Authors: Farré Mariné Alba , Pumarola Martí , Luján Feliu-Pascual Alejandro 
Published: June 2022

Case summary A 6-week-old entire female domestic shorthair cat was presented for evaluation of a soft bulge and a palpable skull defect on the forehead, present since adoption a few days earlier. The neurological examination revealed an absent menace response bilaterally and apparent blindness, localising the lesion to the occipital cortex. The main differential diagnoses were meningocoele (MC) and meningoencephalocoele (MEC). Surgical repair was proposed once the cat reached adult size. Meanwhile, the cat developed seizures and was treated with anticonvulsant therapy. At 6 months of age, CT confirmed a frontoparietal MEC with associated porencephaly. Based on a three-dimensional printed skull mould, a polysulfone implant was created. The meninges were dissected from the skin, a durectomy was performed and samples of the protruding brain were obtained. Part of the cerebrospinal fluid was drained until the size of the protruding brain decreased enough to be included below the implant that was anchored on top of the skull with cerclages. Histopathology confirmed the diagnosis of MEC. Three years and 7 months later, the cat had partially recovered vision but continued to seize monthly despite antiepileptic drugs. Relevance and novel information MC/MEC is a relatively uncommon disease reported in companion animals, and only four cases of surgical management have been described, and did not use a polysulfone tailor-made implant. In human medicine, surgical intervention is the treatment of choice. This case highlights a new implant option for surgical correction of MEC with good long-term result and no complications after 3 years and 7 months.
Healthcare in the hand: Patients’ use of handheld technology in video consultations with their general practitioner
Authors: Jepsen Carole , Lüchau Elle Christine , Assing Hvidt Elisabeth , Grønning Anette 
Published: June 2022

ObjectiveTo analyse how the patient's use of handheld technology in video consultations with their general practitioner affects communication and the possibilities for the delivery of quality healthcare. Focusing on the visually communicated aspects of the video consultation, we present three episodes from our recordings of eight video consultations between Danish general practitioners and patients.MethodsUsing a multimodal social semiotic framework to conduct a micro-level analysis, we present episodes from our data in which the hardware's affordance of mobility gave rise to salient events in the interactions of patients who used handheld devices to carry out their video consultations.ResultsPatients’ use of technology plays a significant role in the interactions between general practitioner and patient and is thus an important factor to consider in how practice is shaped when using handheld video consultation technology.ConclusionsOur findings demonstrate that the mobility of handheld devices (smartphone, tablet) can be used to augment sensing and embodiment and enhance the delivery of healthcare in video consultations. However, mobility may also disrupt the interaction. As a result, possibilities for the delivery of quality healthcare lie quite literally in the patients’ hands.
Prognostic disclosure in cancer care: a systematic literature review
Authors: Sutar Roshan , Chaudhary Pooja 
Published: June 2022

Background: Collusion in cancer care is the diplomatic concealment of information between a triad of the health care professional (HCP), patient, and caregiver. Free and expressive communication is determined by multiple factors, which establishes a healthy balance between ‘patient-centric’ and ‘family-centric’ decision making. The lack of a universal approach to prognostic disclosure techniques emphasizes the need for a systematic review of contemporary practice. Methods: A systematic review of the literature was conducted till June 2020 using themes based on cancer, communication, prognostic disclosure, and collusion by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Fifty-three studies involving 10,569 subjects were studied for their utility on prognostic disclosure using different communication methods and interfaces. Twenty-three studies used a face-to-face interview with subjects while in-person telephonic interviews were conducted in two studies, 16 studies implicated semi-structured questionnaires, and 6 studies mentioned the development of a new technique/tool for disclosure. The duration of a session for prognosis-disclosure ranged from 22 min to 1 h. The involvement of palliative care specialists and mental health professionals was limited during the disclosure of the prognosis. Conclusion: The findings of the review indicate that patients in cancer care are aware of their diagnosis and to a certain extent of prognosis despite nondisclosure by their family members and treating teams. This review emphasizes the assessment of ‘disclosure wishes’ among patients and caregivers in separate interviews rather than simply relying on one specific method of interviewing. The nonconfrontational approach and training among HCPs are of utmost importance to build therapeutic resilience among the treating team involved in cancer care. Since many factors such as family wishes, cultural dissonance, medical model, and patient perception could become barriers to prognostic disclosure, there is a need to develop a universal approach to prognostic disclosure and handling associated collusion.
Confinement: Spaces and practices of care and control – editorial introduction
Authors: Loughnan Claire , Johns Diana , Spivakovsky Claire 
Published: June 2022

On 9 August 2019, a workshop convened at the University of Melbourne, Australia, brought together academics, practitioners and advocates to explore patterns of violence and neglect within and across a range of confined settings: youth and adult prisons, immigration detention, aged and disability care and residential ‘child protection’. Some of the participants in that workshop reflect here in eight pieces of writing that comprise this Special Themed Collection on ‘Confinement: The spaces and practice of care and control’. The contributions are anchored and connected by the parallels in how violence manifests within and across these diverse sites of confinement – corporeally and subtly, individually and collectively. Yet as we reflect, separately and together, the differentiation and demarcation of these sites and systems of confinement serves to maintain their material and symbolic separation, and to conceal their connecting threads and commonalities. In our Editorial Introduction, we draw out themes running through the contributions to illustrate how they connect and collide, and how they illuminate intersections, differences and (sometimes unexpected) resonances between spaces, practices, settings and experiences of confinement. We identify three themes running through the seven other pieces that comprise this collection: erasure, identity and voice. Against the backdrop of the global pandemic and its implications for how we think about and experience freedom, autonomy, isolation and connection, we consider these themes: how violence is hidden from view and erased from public and political memory; how identities are shaped and swallowed by institutional practices and patterns of dehumanisation, coercion and control; and how the voices of those with lived experience of confinement – both as ‘keepers’ and the confined – help deepen our understanding of the threads that connect and comprise the carceral webs in which we are all entangled.
Management of pregnancy in cystic fibrosis
Authors: Montemayor Kristina , Tullis Elizabeth , Jain Raksha , Taylor-Cousar Jennifer L. 
Published: June 2022

With recent therapeutic advances in care, people with cystic fibrosis (CF) are living longer and healthier lives. Development of the cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies has led to improved function of the CFTR protein resulting in improved lung function, decreased rates of pulmonary exacerbations and improved nutritional status for the majority of people with CF. Given improved quality and quantity of life, more people with CF are considering becoming pregnant than ever before. Since the first reported pregnancy in a woman with CF in 1960, the management of pregnancy in CF has been of increased interest and is an active field of research.In this review, we aim to discuss the management of pregnancy in CF. We discuss the optimisation of preconception health, management of maintenance CF therapies, and use of CFTR modulators during pregnancy and lactation. We also describe the management of pulmonary exacerbations during pregnancy as well as the unique management of pregnancy in a post-transplant patient with CF.Educational aimsTo describe considerations for optimisation of preconception health.To describe the management of chronic CF therapies including CFTR modulators during pregnancy and lactation.To describe treatment of an acute pulmonary exacerbation during pregnancy.To describe the management of pregnancy in individuals with CF following organ transplantation.
Meta-analysis across Nellore cattle populations identifies common metabolic mechanisms that regulate feed efficiency-related traits
Authors: Mota Lucio F. M. , Santos Samuel W. B. , Júnior Gerardo A. Fernandes , Bresolin Tiago , Mercadante Maria E. Z. , Silva Josineudson A. V. , Cyrillo Joslaine N. S. G. , Monteiro Fábio M. , Carvalheiro Roberto , Albuquerque Lucia G. 
Published: June 2022

Abstract
Background
Feed efficiency (FE) related traits play a key role in the economy and sustainability of beef cattle production systems. The accurate knowledge of the physiologic background for FE-related traits can help the development of more efficient selection strategies for them. Hence, multi-trait weighted GWAS (MTwGWAS) and meta-analyze were used to find genomic regions associated with average daily gain (ADG), dry matter intake (DMI), feed conversion ratio (FCR), feed efficiency (FE), and residual feed intake (RFI). The FE-related traits and genomic information belong to two breeding programs that perform the FE test at different ages: post-weaning (1,024 animals IZ population) and post-yearling (918 animals for the QLT population).

Results
The meta-analyze MTwGWAS identified 14 genomic regions (-log10(p -value) > 5) regions mapped on BTA 1, 2, 3, 4, 7, 8, 11, 14, 15, 18, 21, and 29. These regions explained a large proportion of the total genetic variance for FE-related traits across-population ranging from 20% (FCR) to 36% (DMI) in the IZ population and from 22% (RFI) to 28% (ADG) in the QLT population. Relevant candidate genes within these regions (LIPE, LPL, IGF1R, IGF1, IGFBP5, IGF2, INS, INSR, LEPR, LEPROT, POMC, NPY, AGRP, TGFB1, GHSR, JAK1, LYN, MOS, PLAG1, CHCD7, LCAT, and PLA2G15) highlighted that the physiological mechanisms related to neuropeptides and the metabolic signals controlling the body's energy balance are responsible for leading to greater feed efficiency. Integrated meta-analysis results and functional pathway enrichment analysis highlighted the major effect of biological functions linked to energy, lipid metabolism, and hormone signaling that mediates the effects of peptide signals in the hypothalamus and whole-body energy homeostasis affecting the genetic control of FE-related traits in Nellore cattle.

Conclusions
Genes and pathways associated with common signals for feed efficiency-related traits provide better knowledge about regions with biological relevance in physiological mechanisms associated with differences in energy metabolism and hypothalamus signaling. These pleiotropic regions would support the selection for feed efficiency-related traits, incorporating and pondering causal variations assigning prior weights in genomic selection approaches.
Dexmedetomidine prolongs the duration of local anesthetics when used as an adjuvant through both perineural and systemic mechanisms: a prospective randomized double-blinded trial
Authors: Bao Nana , Shi Kejian , Wu YiQuan , He Yuting , Chen Zhengjie , Gao Yuan , Xia Yun , Papadimos Thomas J. , Wang Quanguang , Zhou Riyong 
Published: June 2022

Abstract
Background
To study the respective peripheral and systemic mechanisms of action of dexmedetomidine, as adjuvant to regional anesthesia, we compared dexmedetomidine added to ropivacaine for mid-forearm nerve blocks, to either systemic-only dexmedetomidine, and to a control with no dexmedetomidine.

Methods
Sixty patients undergoing hand surgery were randomly divided into three groups (n = 20 per group). Each group underwent a triple-nerve (median, radial and ulnar) mid-forearm blocks with 0.75% ropivacaine. In the DexP group, 60 µg of dexmedetomidine were added to the anesthetic mixture, while in the DexIV group, they were intravenously infused. Normal saline as a placebo was used, either as adjuvant, or intravenously. All patients underwent also a supraclavicular block with 1.5% lidocaine for tourniquet pain. The main outcomes were the duration of analgesia and the duration of sensory blockade separately for each nerve termination of the upper limb, and the duration of motor blockade of the upper limb. Tolerance was assessed by blood pressure and heart rate, and the report of adverse events.

Results
Duration of analgesia was longer in the DexP group, in comparison to the two other groups (P < 0.001), while it was similar in the DexIV and the control group. For cutaneous territories targeted by the three mid-forearm blocks, the between-group differences behaved similarly. For the other cutaneous territories (musculocutaneous and posterior brachial cutaneous nerves), duration of sensory blockade was shorter in the control group than in the two dexmedetomidine groups. For duration of motor blockade, the between-group differences behaved similarly. Both blood pressure and heart rate were reduced in the DexP and the DexIV groups, compared to the control.

Conclusions
Dexmedetomidine used as an adjuvant to regional anesthesia may act mostly though a perineural mechanism, especially for the sensory aspects of anesthesia. A systemic action might however explain other clinical effects.

Trial registration
ChiCTR-IOR-17011149, date of registration: 16/04/2017