bluuebunny/crossref_metadata_2025_split huggingface dataset:
Video laryngoscope-guided urethral catheterization in female minipigs
Authors: Li Dawei , Liu Zhaoxing , Zang Yu , Ma Jinglong , Zhang Wen , Liu Xinzhu , Zhang Bohan , Shen Chuan’an 
Published: May 2022

Objective The objective of this work was to anatomically locate the urethral orifice in female minipigs and describe the use of video laryngoscopes in urethral catheterization. Methods Urethral catheterization guided by a video laryngoscope was attempted in 16 adult female Bama minipigs. The anatomical location of urethral orifices, operating time and complications (mucosal edema and bleeding in the vaginal vestibule, and the numbers of red blood cells (RBCs) and white blood cells (WBCs) in mid-stream urine samples) were recorded. Results The anatomical location of the urethral orifice: the depth of the urethral orifice in female Bama minipigs was 4.2 ± 1.2 cm; all the urethral orifices were covered by mucosal folds of the vaginal vestibule. In the supine position, the orifice of the urethra at 9–12 and 1–3 o’clock accounted for 6.25%, 6.25%, 18.75%, 50%, 12.5%, 6.25% and 6.25%, respectively. All animals were successfully catheterized and the operating time was 9.0 (6.0–12.8) min. Complications: no bleeding in the vaginal vestibule was observed; the incidence of mucosal edema was 12.5%, all of which were mild; of urine samples collected 1 h after catheterization, 12.5% were found to contain RBCs and no RBCs were detected 6 h after catheterization; no WBCs were detected 1 h or 6 h after catheterization. Conclusions The urethral orifice of female minipigs was located deep in the vagina at variable clock directions and was unexceptionally covered by mucosal folds. Applying a video laryngoscope in urethral catheterization allowed quick and accurate exposure of the urethral orifice and minimal operational injury in female minipigs.
Psychometric Properties of the Patient Activation Measure in Community-Dwelling Adults in Singapore
Authors: Ge Lixia , Kaur Palvinder , Yap Chun Wei , Heng Bee Hoon 
Published: May 2022

Introduction Measuring health activation in general population using valid instruments is needed to facilitate the evaluation of health education and behavioral programs in community. The 13-item Patient Activation Measure was well validated in patients with different chronic diseases but rarely validated in general population. The objective of this study was to assess the psychometric properties of the Patient Activation Measure among community-dwelling adults in Singapore. Methods Data of participants having valid responses to the English-version measure (N = 824) were analyzed. The psychometric properties were assessed by demonstrating evidence for uni-dimensionality using Rasch Principal Component Analysis of Residuals, known-group validity, convergent and divergent validity, and internal consistency reliability using Cronbach’s alpha. Results The uni-dimensionality of the Patient Activation Measure was supported by the Rasch Principal Component Analysis of Residuals results. Participants having multimorbidity or polypharmacy and being inactive in physical activity had significantly lower activation scores. The activation score was positively and moderately correlated with health confidence measured by the Health Confidence Measure (r = .38, P < .001), and negatively and weakly correlated with depressive symptoms measured by the Patient Health Questionnaire (r = − .13, P < .001). The internal reliability was good with a Cronbach’s alpha of .82. Conclusion The 13-item Patient Activation Measure has acceptable construct validity and good internal consistency among community-dwelling adults. It is a potential instrument to measure health activation in this population. Further research is required to investigate the expansion of response options, validate the cut-off scores for the activation levels and examine the test-retest reliability and responsiveness.
The Long Struggle for Constitutional Change in Myanmar
Authors: Harding Andrew J , Kyaw Nyi Nyi 
Published: May 2022

AbstractThe rigidity of the 2008 Constitution of the Republic of the Union of Myanmar is rightly notorious, as this rigidity was proven at least three times through failed attempts at reform. Despite these failed attempts, the military disputed the results of the election held in November 2020, and conflict ostensibly over that issue led to a military coup on 1 February 2021. This coup purported to have been undertaken constitutionally as an ‘emergency’ but was the object of popular rejection. In this article, we focus on the struggle over constitutionalism that had its origins in earlier attempts to achieve democracy. In our focus on the current nature and implication of ‘constitutional struggle’ in Myanmar, we make use of analysis based on factual data collected by the second author, located in Mandalay, one of the epicentres of struggle against the military and their actions following the coup. Our argument is that this ‘praetorian constitutionalism’ in Myanmar absent a pre-agreed pact between the military and the civilian defies the basic logic of democratic or liberal constitutionalism and hence is unconstitutional in both spirit and text. This explains how a constitution drafted in order to protect the position and privileges of the military was ultimately in effect rejected by that same military. The article will argue that the praetorian constitutionalism of Myanmar during 2010–21 contains a necessarily built-in struggle between the civilian and the soldier that remains unresolved.
Superior Capsular Reconstruction Versus Lower Trapezius Transfer for Posterosuperior Irreparable Rotator Cuff Tears With High-Grade Fatty Infiltration in the Infraspinatus
Authors: Baek Chang Hee , Lim Chaemoon , Kim Jung Gon 
Published: May 2022

Background: Superior capsular reconstruction (SCR) and lower trapezius transfer (LTT) have recently been utilized to treat irreparable rotator cuff tears (IRCTs). There is still no clear guideline on which treatment method is a better fit for posterosuperior IRCTs with high-grade 4 fatty infiltration in the infraspinatus. Purpose: To compare the clinical and radiological outcomes between arthroscopic-assisted SCR (aSCR) and arthroscopic-assisted LTT (aLTT) in patients with posterosuperior IRCTs with high-grade (Goutallier grade 4) fatty infiltration in the infraspinatus muscle. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included patients who underwent aSCR or aLTT for posterosuperior IRCTs with high-grade 4 fatty infiltration in the infraspinatus and had a minimum follow-up of 2 years between 2017 and 2019. A total of 58 patients were divided into 2 groups according to the surgical procedure: aSCR group (n = 22) and aLTT group (n = 36). Clinical outcomes comprised the visual analog scale score for pain, active shoulder range of motion (ROM), the American Shoulder and Elbow Surgeons (ASES) score, and patient satisfaction. Radiological outcomes comprised the acromiohumeral distance (AHD). The progression of arthritis was evaluated via the Hamada grade. Graft integrity was assessed on postoperative magnetic resonance imaging scans. Results: Significant improvements in clinical outcomes were observed in both groups. However, active shoulder ROM (forward elevation: 165.7°± 22.3° vs 145.5°± 32.3°, respectively [ P = .015]; external rotation: 51.7°± 10.9° vs 41.1°± 7.0°, respectively [ P < .001]), the postoperative ASES score (84.8 ± 7.6 vs 76.8 ± 20.3, respectively; P = .045), and patient satisfaction (8.9 ± 1.2 vs 6.4 ± 2.1, respectively; P = .041) were significantly higher with aLTT than with aSCR. There was no significant difference between the groups in AHD at 2 years postoperatively. However, the rate of progression of arthritis was significantly higher with aSCR (22.7%) than with aLTT (2.8%) ( P = .027). Moreover, the graft retear rate was significantly higher with aSCR (63.6%) than with aLTT (8.3%) at 2 years postoperatively ( P < .001). Conclusion: Although aSCR and aLTT both provided improvements in overall clinical outcomes for posterosuperior IRCTs with high-grade 4 fatty infiltration in the infraspinatus, aLTT was superior in terms of functional improvement, patient satisfaction, progression of arthritis, and graft integrity. Therefore, we prefer aLTT for posterosuperior IRCTs under the condition of high-grade 4 fatty infiltration in the infraspinatus.
Social Rhythm Disruption is Associated with Greater Depressive Symptoms in People with Mood Disorders: Findings from a Multinational Online Survey During COVID-19
Authors: Kahawage Piyumi , Bullock Ben , Meyer Denny , Gottlieb John , Crowe Marie , Swartz Holly A. , Yatham Lakshmi N. , Inder Maree , Porter Richard J. , Nierenberg Andrew A. , Meesters Ybe , Gordijn Marijke , Haarman Bartholomeus C. M. , Murray Greg 
Published: May 2022

Objectives Societal restrictions imposed to prevent transmission of COVID-19 may challenge circadian-driven lifestyle behaviours, particularly amongst those vulnerable to mood disorders. The overarching aim of the present study was to investigate the hypothesis that, in the routine-disrupted environment of the COVID-19, amongst a sample of people living with mood disorders, greater social rhythm disruption would be associated with more severe mood symptoms. Methods We conducted a two-wave, multinational survey of 997 participants [Formula: see text] who self-reported a mood disorder diagnosis (i.e., major depressive disorder or bipolar disorder). Respondents completed questionnaires assessing demographics, social rhythmicity (The Brief Social Rhythm Scale), depression symptoms (Patient Health Questionnaire-9), sleep quality and diurnal preference (The Sleep, Circadian Rhythms and Mood questionnaire) and stressful life events during the COVID-19 pandemic (The Social Readjustment Rating Scale). Results The majority of participants indicated COVID-19-related social disruption had affected the regularity of their daily routines to at least some extent ( n = 788, 79.1%). As hypothesised, lower social rhythmicity was associated with greater depressive symptoms when tested cross-sectionally (standardised β = −.25, t = −7.94, P = 0.000) and when tested using a 2-level hierarchical linear model across two time points ( b = −0.14, t = −3.46, df = 264, P ≤ 0.001). Conclusions These results are consistent with the social zeitgeber hypothesis proposing that mood disorders are sensitive to life events that disrupt social rhythms.
The electrical conductivity and interlaminar fracture toughness of composite laminate interleaved with silver-plated nylon mesh
Authors: Guo Miaocai 
Published: May 2022

A composite laminate with high conductivity and high mode I fracture toughness was prepared by using a silver-plated nylon mesh as the interleaf. Through in-depth comparison with the silver-plated non-woven veil interleaved composites, the mechanisms of the conductivity improvement and interlaminar toughening were discussed. The conductivities along the fiber direction, in transverse to fiber direction and through thickness direction reached 739 S/cm, 734 S/cm, and 5.4 S/cm, respectively, which increased by 196%, 344,500%, and 4326%, respectively, and are much higher than these of the other modified systems. At the same time, the mode I interlaminar fracture toughness increased by 112%. Mechanism study shows that the conductivities along the fiber direction and in transverse to fiber direction are greatly affected by the interleaf conductivity, while the conductivity through thickness direction is little affected. The toughening mechanism of the plain or silver-plated nylon mesh is much different from that of the non-woven veils. Both of the composites interleaved with the plain or silver-plated nylon mesh have higher mode I interlaminar fracture toughness, but less improved mode II toughness. The effect of silver-plating on the mode I and mode II fracture toughness was studied.
Comorbidities of systemic lupus erythematosus prior to and following diagnosis in different age-at-onset groups
Authors: Yu Cheng-Ya , Kuo Chang-Fu , Chou I-Jun , Chen Jung-Sheng , Lu Hung-Yi , Wu Chao-Yi , Chen Li-Chen , Huang Jing-Long , Yeh Kuo-Wei 
Published: May 2022

Objectives Systemic lupus erythematosus (SLE) is a female-dominated autoimmune disease that can occur at any age and has a diverse course. The clinical manifestation of this disease can vary depending on the patient’s age at onset. The aim of this study was to characterise the comorbidities at the time of SLE diagnosis and after in different age groups. Methods A total 1042 incident cases of SLE with a Catastrophic Illness Card in 2005 and 10,420 age- and sex-matched controls from the general population registered in the National Health Insurance Research Database in Taiwan were enrolled in the study. The risk of comorbidities before (adjusted odds ratio, [aOR]) and after (adjusted hazard ratio, [aHR]) of SLE was analysed. The burden of these SLE-associated comorbidities was weight by the Charlson comorbidity index (CCI). We used the cumulative incidence to evaluate the impact of comorbidities on different age onset groups. Results In this study, musculoskeletal diseases had the highest positive association (aOR, 5.29; 95% confidence interval [CI]: 4.25–6.57) prior to the diagnosis of SLE and they were also the most common developing incident comorbidity after the diagnosis (HR, 13.7; 95% CI: 11.91–15.77). It only took less than 1 year for 50% of the late-onset SLE patients to develop any increase in CCI score. The developing comorbidities attributed to 16.3% all-cause mortality and they had the greatest impact on late-onset SLE patients, with 33.3% cumulative incidence to all-cause mortality. There is no difference in the incidence of infectious diseases across different age groups. The herpes zoster infection had the greatest cumulative incidence among the category of infection diseases in child-onset SLE patients. Conclusion SLE patients had increased risks of multiple pre-existing comorbidities at diagnosis. The developed comorbidity after diagnosis could contribute to all-cause mortality. The herpes zoster infection is primarily an issue in child-onset SLE patients.
Effects of a Web-Based Pediatric Oncology Legacy Intervention on the Coping of Children With Cancer
Authors: Cho Eunji , Dietrich Mary S. , Friedman Debra L. , Gilmer Mary Jo , Gerhardt Cynthia A. , Given Barbara A. , Hendricks-Ferguson Verna L. , Hinds Pamela S. , Akard Terrah Foster 
Published: May 2022

Background Recurrent or refractory cancer often results in substantial and extensive physical, emotional, psychosocial, and spiritual burdens for children and their families. However, the therapeutic benefits of legacy interventions in children with recurrent or refractory cancer have been examined only recently, with limited attention to specific effects on children’s coping abilities. Objective The purpose of this study was to determine the effects of a digital storytelling-legacy intervention on the adaptive coping of children with recurrent or refractory cancer. Methods This study used a 2-arm randomized, waitlist-controlled trial design. A total of 150 children with recurrent or refractory cancer and their parents were recruited via Facebook advertisements. Results The analysis sample included 92 dyads (35-intervention group, 57-control group). The legacy intervention showed small and statistically nonsignificant effects on primary-control and disengagement coping strategies among children with recurrent or refractory cancer. Conclusions Legacy interventions using readily accessible digital storytelling have the potential to enhance the adaptive coping skills among children with recurrent or refractory cancer. Further research should determine how to enhance interventions tailored to this population to optimize the benefits.
Bupivacaine/meloxicam ER: A New Dual-acting Extended-Release Local Anesthetic for Opioid-Sparing Postoperative Pain Management
Authors: Bourn Taylor , Serpa Sister Michaela 
Published: May 2022

Objective To review data for bupivacaine/meloxicam extended-release (ER) solution for management of postoperative pain and opioid-sparing effects. Data Sources Literature search of PubMed (1946 to August 2021) and ProQuest (1946 to August 2021) was performed using the terms: Zynrelef, HTX-011, and “bupivacaine AND meloxicam.” Additional information sources include ClinicalTrials.gov, prescribing information, Heron Therapeutics’ Clinical and Economic Evidence Dossier, meeting abstracts, and references of identified articles. Study Selection and Data Extraction Clinical trials and articles evaluating bupivacaine/meloxicam ER for postoperative pain management. Data Synthesis Bupivacaine is a short-acting local anesthetic. Its efficacy is negatively impacted by the acidic environment of surgical sites. Meloxicam, a nonsteroidal antiinflammatory, reduces inflammation at the surgical site and increases pH propagating bupivacaine movement into the neurons. In Phase 2 and Phase 3 clinical trials, bupivacaine/meloxicam ER was compared with bupivacaine HCl, bupivacaine ER, and meloxicam ER with and without scheduled nonopioid multimodal analgesia (MMA) in bunionectomies, herniorrhaphies, total knee arthroplasty and abdominoplasty. Postoperative pain was well controlled for 72 hours and consistently superior to placebo, with minimal or no opioid use. Wound healing was not impacted and adverse effects were similar to placebo (most commonly nausea, dizziness, constipation, and headaches). Relevance to Patient Care and Clinical Practice Bupivacaine/meloxicam ER is a viable, safe, nonopioid local anesthetic for sustained 72-hour postoperative pain management mitigating opioid consumption. Conclusion Bupivacaine/meloxicam ER is the only dual-acting, extended-release local anesthetic available. It provides effective analgesia in the postoperative setting and successfully reduces or eliminates postoperative opioid consumption.
Differential Neutralization of Unfractionated Heparin and Enoxaparin by Andexanet Alfa
Authors: Lewis Joseph , Iqbal Omer , Jeske Walter , Hoppensteadt Debra , Siddiqui Fakiha , Fareed Jawed 
Published: May 2022

Introduction Andexanet alfa (andexanet) is an approved antidote used to reverse the bleeding effects of Direct Oral Anticoagulant (Direct-Xa agents) agents because it reverses anti-Xa activity. Unfractionated heparin (UFH) and low molecular weight heparins (LMWHs) exhibit anti-Xa activity. The purpose is to investigate the neutralization of UFH and LMWH by andexanet in activated clotting time (ACT), thrombelastography (TEG), and anti-Xa due to the protamine sulfate shortage. Methods UFH and LMWH were studied with andexanet, PS, or saline as potential reversal agents/controls at varying concentrations in ACT, TEG, and anti-Xa and compared to each other. Results Andexanet partially neutralized both drugs several TEG parameters at high andexanet concentrations, but it was not as effective as protamine sulfate in any of the assays used. Most TEG parameters were correlated with andexanet concentration. In ACT, significant neutralization was demonstrated at many andexanet concentrations for UFH, but not LMWH. UFH was completely neutralized by PS in ACT, while LMWH was partially neutralized by PS in ACT. Andexanet alfa was a less effective neutralization agent than the protamine sulfate as it only partially neutralized UFH in ACT and was ineffective at neutralizing LMWH when tested at the same concentration as PS (10 ug/mL). Conclusion Andexanet partially neutralized UFH and LMWH with variability between assays, necessitating investigation into assay-dependent differences.
Tumours involving the retrobulbar space in cats: 37 cases
Authors: Jones Bryn A , Cotterill Nicole , Drees Randi , Dietrich Ursula M , Purzycka Katarzyna 
Published: May 2022

Objectives The aim of this multicentre retrospective study was to describe the clinical presentation, imaging findings, diagnosis and outcomes of cats with retrobulbar neoplasia. Methods A total of 37 cats that were diagnosed with retrobulbar neoplasia and underwent advanced imaging were recruited from searches of the clinical records of two referral hospitals. All cats had neoplasia confirmed via cytology or histopathology. Data relating to the signalment, presentation, results of investigations, treatment and outcome were recorded. A review of imaging studies was performed where possible. Results In total, 23 cases (62%) were presented with respiratory signs. Exophthalmos was the most common ophthalmological examination finding, present in 18 cases (49%). Thirty-two cases (86%) had secondary extension of neoplasia to the retrobulbar space (most commonly from the nasal cavities), present in 20 cases (54%), of which 12 were lymphoma. In cases where contrast was administered, 28/35 (80%) had contrast-enhancing masses. Orbital extension was detected in 21 cases (57%), exophthalmos in 22 (59%), globe deformation in 12 (32%) and local lymphadenomegaly in 22 (61%). In total, 36 (97%) retrobulbar tumours were malignant. Thoracic imaging, where it was performed, was concerning for metastasis in 8/25 cases (31%), with abdominal imaging suggestive of metastasis in 5/12 (42%). The most common diagnosis was lymphoma with 19 cases (51%), with nasal lymphoma representing 12 of these, followed by carcinoma in 10 (27%). The median survival time, for cases where death was recorded, was 85 days (range 1–263 days). Conclusions and relevance To the authors’ knowledge, this is the largest study of neoplasia affecting the feline retrobulbar space. Retrobulbar tumours in cats are overwhelmingly malignant, and commonly due to secondary extension of tumours originating elsewhere. Lymphoma, particularly arising from the nasal cavities, was the most common cause. Cats presenting with signs suggestive of retrobulbar disease should be assessed for disease affecting any of the structures of the head.
Accelerated corneal crosslinking causes pseudoprogression in keratoconus within the first 6 weeks without affecting posterior corneal curvature
Authors: Xanthopoulou Kassandra , Milioti Georgia , Daas Loay , Munteanu Cristian , Seitz Berthold , Flockerzi Elias 
Published: May 2022

Purpose To evaluate the effectiveness of epithelium-off (epi-off) accelerated corneal crosslinking (A-CXL, 9 mW/cm2, 10 min) in adult keratoconus (KC) patients. Methods The study included 151 KC corneas (124 patients) after A-CXL. The parameters best corrected visual acuity (BCVA) and the tomographic readings (Pentacam HR, Oculus, Germany) were analysed at 24, 12 and 6 months preoperatively, prior to surgery; and 6 weeks, 6 months, 1, 2 and >2 years postoperatively. The demarcation line was assessed by anterior segment optical coherence tomography (Tomey SS-1000, CASIA 2 (Tomey, Nagoya, Japan)). Results Comparing pre- to postoperative findings 6 weeks after A-CXL with paired t-test, the anterior steep (46.8 ± 4.0|47.1 ± 4.1), flat (50.2 ± 4.3|50.6 ± 4.6) and maximal keratometry (57.6 ± 6.8|58.3 ± 6.8) increased (p < 0.05), while the thinnest pachymetry decreased significantly (459 ± 39|444 ± 42, p < 0.05). Lateron, however, there was a decreasing anterior flat (1, 2 and >2 years; p < 0.0001), mean (1 year; p = 0.01 and 2 years; p = 0.03) and maximal keratometry (1, 2 and >2 years; p < 0.0001). The posterior corneal keratometry readings did not change significantly until >2 years after A-CXL (MANOVA; steep, p = 0.008; flat, p = 0.027; mean, p = 0.007). The mean depth of the demarcation line was 242 ± 62 µm (53.6%). The preoperative logMAR BCVA (0.35 ± 0.02) decreased 6 weeks after A-CXL (0.39 ± 0.03) followed by a continuous improvement until the latest follow-up (0.18 ± 0.04). Conclusion A-CXL constitutes a successful method for KC stabilization. Signs of KC progression occur within the first 6 weeks postoperatively (“pseudoprogression”), but this is not indicative of the long-term effect.