bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for development and validation of postpartum cardiovascular disease (CVD) risk prediction model incorporating reproductive and pregnancy-related candidate predictors
Authors: Wambua Steven , Crowe Francesca , Thangaratinam Shakila , O’Reilly Dermot , McCowan Colin , Brophy Sinead , Yau Christopher , Nirantharakumar Krishnarajah , Riley Richard ,   on behalf of the MuM-PreDiCT Group
Published: December 2022

Abstract
Background
Cardiovascular disease (CVD) is a leading cause of death among women. CVD is associated with reduced quality of life, significant treatment and management costs, and lost productivity. Estimating the risk of CVD would help patients at a higher risk of CVD to initiate preventive measures to reduce risk of disease. The Framingham risk score and the QRISK® score are two risk prediction models used to evaluate future CVD risk in the UK. Although the algorithms perform well in the general population, they do not take into account pregnancy complications, which are well known risk factors for CVD in women and have been highlighted in a recent umbrella review.
We plan to develop a robust CVD risk prediction model to assess the additional value of pregnancy risk factors in risk prediction of CVD in women postpartum.

Methods
Using candidate predictors from QRISK®-3, the umbrella review identified from literature and from discussions with clinical experts and patient research partners, we will use time-to-event Cox proportional hazards models to develop and validate a 10-year risk prediction model for CVD postpartum using Clinical Practice Research Datalink (CPRD) primary care database for development and internal validation of the algorithm and the Secure Anonymised Information Linkage (SAIL) databank for external validation. We will then assess the value of additional candidate predictors to the QRISK®-3 in our internal and external validations.

Discussion
The developed risk prediction model will incorporate pregnancy-related factors which have been shown to be associated with future risk of CVD but have not been taken into account in current risk prediction models. Our study will therefore highlight the importance of incorporating pregnancy-related risk factors into risk prediction modeling for CVD postpartum.
Info-pollution: a word of caution for the neurosurgical community
Authors: Narvaez-Rojas Alexis , Arnaout Mohamed M. , Hoz Samer S. , Agrawal Amit , Lee Angel , Moscote-Salazar Luis Rafael , Deora Harsh 
Published: December 2022

AbstractThe medical-patient relationship is facing pollution of information all over the internet, for physician and patients is becoming tougher to keep updated with the highest quality of information. During the last 20 years multiple evaluation tools have been developed trying to find the best tool to assess high-quality information, to date DISCERN tool represents the most widely spread. Information can be found on the surface internet and in the deep web, constituting the biggest chunk of the internet, informing and controlling the quality of information is a formidable task. PubMed and Google Scholar are the most important tools for a physician to find information, although multiple others are available; awareness must be raised over improving current strategies for data mining high-quality information for the patients and the healthcare community.
Sympathetic innervation of human and porcine spleens: implications for between species variation in function
Authors: Kirkland Logan G. , Garbe Chloe G. , Hadaya Joseph , Benson Paul V. , Wagener Brant M. , Tankovic Sanjin , Hoover Donald B. 
Published: December 2022

AbstractBackgroundThe vagus nerve affects innate immune responses by activating spleen-projecting sympathetic neurons, which modulate leukocyte function. Recent basic and clinical research investigating vagus nerve stimulation to engage the cholinergic anti-inflammatory pathway (CAP) has shown promising therapeutic results for a variety of inflammatory diseases. Abundant sympathetic innervation occurs in rodent spleens, and use of these species has dominated mechanistic research investigating the CAP. However, previous neuroanatomical studies of human spleen found a more restricted pattern of innervation compared to rodents. Therefore, our primary goal was to establish the full extent of sympathetic innervation of human spleens using donor tissue with the shortest procurement to fixation time. Parallel studies of porcine spleen, a large animal model, were performed as a positive control and for comparison.MethodsHuman and porcine spleen tissue were fixed immediately after harvest and prepared for immunohistochemistry. Human heart and porcine spleen were stained in conjunction as positive controls. Several immunohistochemical protocols were compared for best results. Tissue was stained for tyrosine hydroxylase (TH), a noradrenergic marker, using VIP purple chromogen. Consecutive tissue slices were stained for neuropeptide Y (NPY), which often co-localizes with TH, or double-labelled for TH and CD3, a T cell marker. High-magnification images and full scans of the tissue were obtained and analyzed for qualitative differences between species.ResultsTH had dominant perivascular localization in human spleen, with negligible innervation of parenchyma, but such nerves were abundant throughout ventricular myocardium. In marked contrast, noradrenergic innervation was abundant in all regions of porcine spleen, with red pulp having more nerves than white pulp. NPY stain results were consistent with this pattern. In human spleen, noradrenergic nerves only ran close to T cells at the boundary of the periarterial lymphatic sheath and arteries. In porcine spleen, noradrenergic nerves were closely associated with T cells in both white and red pulp as well as other leukocytes in red pulp.ConclusionSympathetic innervation of the spleen varies between species in both distribution and abundance, with humans and pigs being at opposite extremes. This has important implications for sympathetic regulation of neuroimmune interactions in the spleen of different species and focused targeting of the CAP in humans.
Predictors of peritoneal metastasis of gastric origin
Authors: ElKordy Mohamed Atef , Soliman Rady Mansour , ElTohamy Mahitab Ibrahim , Mohamed Dalia Negm Eldin , Mustafa Ahmed Morsi 
Published: December 2022

AbstractBackgroundGastric adenocarcinoma is one of the most aggressive forms of cancer. Despite marked advancements in radiological techniques, peritoneal deposits are still only discovered during laparotomies in a significant number of cases. The role of surgery in the management of metastatic gastric cancer is very limited, reducing the value of conducting laparotomies. In addition, conducting laparoscopies for the purposes of properly staging every case of gastric cancer is difficult, especially in healthcare systems with limited resources. It is thus crucial to investigate all possible predictors of peritoneal metastasis of gastric cancer, with the aim of reserving the use of laparoscopies to cases known to have high incidences of peritoneal metastasis despite negative radiological results.Patients and methodsThis is a case control study that included all cases of gastric adenocarcinoma that had presented to the National Cancer Institute–Cairo University between January 2018 and December 2019. The ‘cases’ group encompassed all gastric adenocarcinoma patients who were found to have peritoneal metastasis, whilst the ‘control’ group included those patients who were apparently metastasis-free. Comparisons were made between the two groups in terms of demographics, tumor characteristics, and results of laboratory tumor marker investigations.ResultsPatients with peritoneal metastasis were statistically significantly younger than those who had no apparent metastasis (mean ± SD 51.4 ± 12.5 and 56.2 ± 12.6 respectively;P= 0.020). Significant associations were found between a finding of peritoneal metastasis and (i) a middle tumor site (P= 0.002); (ii) tumor thickening morphology (P< 0.001); (iii) undifferentiated histopathology (P= 0.040); (iv) tumor grade III (P< 0.001); (v) lower lymphocyte counts of < 1.9/ml (P= 0.030); and (vi) high levels of CA 19-9 of > 37 units/ml (P= 0.032).ConclusionTumor pathological criteria, including tumor site, degree of differentiation, shape, and grading, as well as laboratory findings of low lymphocytic counts and high levels of CA 19-9 appear to be reliable predictors of the presence of peritoneal metastasis from a gastric adenocarcinoma.
Novel distance measures of hesitant fuzzy sets and their applications in clustering analysis
Authors: Liao Fuping , Li Wu , Zhou Xiaoqiang , Liu Gang 
Published: December 2022

AbstractDistance and similarity measures are very important in clustering, pattern recognition, decision-making and other scientific fields. For the existing hesitant fuzzy distance, most of them do not consider the hesitance degree. Even if the hesitance degree is considered, only the degree of dispersion or the number of hesitant fuzzy values are considered. Aiming at these shortages, a new hesitance degree is defined, which has better accuracy and applicability. Then, some hesitant fuzzy distance measures based on the proposed hesitance degree are proposed, which can overcome some shortcomings of the existing distance measures. Finally, the new hesitant fuzzy distance is applied to the hierarchical hesitant fuzzy k-means clustering algorithm, and an illustration example is given to illustrate the effectiveness of the proposed method.
Opioid sparing effect of intravenous dexmedetomidine in orthopaedic surgery: a retrospective analysis
Authors: Donatiello Valerio , Alfieri Aniello , Napolitano Andrea , Maffei Vincenzo , Coppolino Francesco , Pota Vincenzo , Passavanti Maria Beatrice , Pace Maria Caterina , Sansone Pasquale 
Published: December 2022

Abstract
Background
Dexmedetomidine is a highly selective alpha-2 receptor agonist without any effect on the GABA receptor. It provides an excellent sedative and analgesic profile with few side effects. We report our experience with dexmedetomidine use during orthopaedic surgery under locoregional anaesthesia to ensure adequate sedation and optimal postoperative pain control.

Methods
In this retrospective analysis, we included 128 patients who underwent orthopaedic surgery between January 2019 and December 2021. All patients received the same local anaesthetic dose of 20 ml of ropivacaine 0.375% + mepivacaine 0.5% for axillary and supraclavicular block and 35 ml of ropivacaine 0.375% + mepivacaine 0.5% for triple nerve block (femoral, obturator and sciatic nerve). The cohort was divided into two groups based on sedation drugs used during surgery (dexmedetomidine, or group D, vs midazolam, or group M). All patients received postoperative 24-h analgesia consisting of 60 mg of ketorolac, 200 mg of tramadol and 4 mg of ondansetron. The primary outcome measured how many patients in the two groups required an analgesic rescue dose of pethidine and the time to first pethidine administration. To reduce confounding, we included patients in two groups with non-statistically different demo-anamnestic parameters and who received the same dose of intraoperative local anaesthetic and postoperative analgesia.

Results
The number of patients in group D who did not require a rescue dose of analgesia was significantly greater than in group M (49 vs 11, p < 0.001). Time-to-first postoperative opioid administration did not show a fundamental difference between the two groups under examination (523.75 ± 131.55 min vs 564 ± 117.84 min). Total opioid consumption was higher in the M group than in the D group (3529.8 ± 30.36 μg vs 1864.8 ± 31.59 μg, p 0.075), with a mean opioid consumption significantly higher in the M group than in the D group (26.26 ± 42.8 μg vs 69.21 ± 46.1 μg, p < 0.001): D group received 62.06% less opioid than M group.

Conclusions
The continuous infusion of dexmedetomidine during orthopaedic surgery performed under locoregional anaesthesia has been shown to increase the analgesic effect of local anaesthetics and reduce the consumption of major opioids in the postoperative period. Dexmedetomidine offers a unique ability to supply sedation and analgesia without respiratory depression, having a wide safety margin and an excellent sedative capacity. It does not increase the rate of postoperative complications.
Digitalizing the Clinical Research Informed Consent Process: Assessing the Participant Experience in Comparison With Traditional Paper-Based Methods
Authors: Buckley Michael T. , O'Shea Molly R. , Kundu Sangeeta , Lipitz-Snyderman Allison , Kuperman Gilad , Shah Suken , Iasonos Alexia , Houston Collette , Terzulli Stephanie L. , Lengfellner Joseph M. , Sabbatini Paul 
Published: December 2022

PURPOSE: Consent processes are critical for clinical care and research and may benefit from incorporating digital strategies. We compared an electronic informed consent (eIC) option to paper consent across four outcomes: (1) technology burden, (2) protocol comprehension, (3) participant agency (ability to self-advocate), and (4) completion of required document fields. METHODS: We assessed participant experience with eIC processes compared with traditional paper-based consenting using surveys and compared completeness of required fields, over 3 years (2019-2021). Participants who consented to a clinical trial at a large academic cancer center via paper or eIC were invited to either pre-COVID-19 pandemic survey 1 (technology burden) or intrapandemic survey 2 (comprehension and agency). Consent document completeness was assessed via electronic health records. RESULTS: On survey 1, 83% of participants (n = 777) indicated eIC was easy or very easy to use; discomfort with technology overall was not correlated with discomfort using eIC. For survey 2, eIC (n = 262) and paper consenters (n = 193) had similar comprehension scores. All participants responded favorably to at least five of six agency statements; however, eIC generated a higher proportion of positive free-text comments ( P < .05), with themes such as thoroughness of the discussion and consenter professionalism. eIC use yielded no completeness errors across 235 consents versus 6.4% for paper ( P < .001). CONCLUSION: Our findings suggest that eIC when compared with paper (1) did not increase technology burden, (2) supported comparable comprehension, (3) upheld key elements of participant agency, and (4) increased completion of mandatory consent fields. The results support a broader call for organizations to offer eIC for clinical research discussions to enhance the overall participant experience and increase the completeness of the consent process.
Postcesarean Analgesia With Epidural Morphine After Epidural 2-Chloroprocaine: A Randomized Noninferiority Trial
Authors: Lee Linden O. , Ramirez-Chapman Ana Lisa , White Danielle L. , Zhang Xu , Lu Monica , Suresh Maya S. 
Published: December 2022

BACKGROUND:
Previous studies have suggested that administration of epidural 3% 2-chloroprocaine (CP) before epidural morphine results in decreased analgesic efficacy of epidural morphine. We sought to determine whether these observations were a result of antagonism or a window period between the conclusion of surgical anesthesia for cesarean delivery and the peak onset time of epidural morphine, and whether a method to preserve the analgesic efficacy of epidural morphine exists.

METHODS:
Term parturients scheduled for nonemergent, unscheduled cesarean delivery with preexisting labor epidural catheters were recruited for this exploratory, randomized, single-blinded, noninferiority trial. Subjects were randomized to initial dosing to a T4 dermatome surgical anesthetic level with either 3% CP or 2% lidocaine with 1:200,000 epinephrine and sodium bicarbonate (LEB). Subsequent redosing for both groups was performed with LEB at regular intervals. Epidural morphine 3 mg was administered to both groups after delivery. Assessing the difference between the 2 groups in total opioid use for the first 24 hours after epidural morphine administration was the primary objective. The noninferiority margin of 10 oral milligram morphine equivalents was prespecified based on previous noninferiority studies. Secondary end points included time from epidural morphine administration to first rescue opioid request, numerical pain scores, nausea/vomiting, and pruritus.

RESULTS:
Data were analyzed for 40 parturients, 20 in each group. The median 24-hour opioid consumption for the CP group was 0 (Q1 = 0 and Q3 = 15.6) oral milligram morphine equivalents compared to 15 (6.3–22.5) for the LEB group. The median difference was −7.5, with a 95% confidence interval −15 to 0. Noninferiority was concluded, as the confidence interval was less than the predetermined noninferiority margin of 10 oral milligram morphine equivalents. There was no treatment effect on time to first opioid request and no statistically significant differences in pain scores or nausea, vomiting, or pruritus at all time points (4, 8, 12, and 24 hours after epidural morphine administration).

CONCLUSION:
While designed as an exploratory study, initial epidural dosing with 3% CP and beginning subsequent redosing with LEB within 30 minutes of the initial CP bolus provided noninferior postcesarean analgesia with epidural morphine compared to initial epidural dosing and redosing with LEB. Previous observations of decreased analgesic efficacy of epidural morphine after epidural CP were likely due to a window period that may be mitigated by redosing with lidocaine; however, larger studies are necessary to confirm these findings.
The Chronology of the Reign of Alexios III Komnenos for the years 1198-1202 AD and its Implications
Authors: KALDELLIS Anthony 
Published: December 2022

Η χρονολογία των γεγονότων της βασιλείας του Αλεξίου Γ΄ για τα έτη 1198 -1202 και οι επιπτώσεις της
Η χρονολογία των γεγονότων της βασιλείας του Αλεξίου Γ΄ απασχόλησε την έρευνα για τελευταία φορά προ πεντηκονταετίας, χωρίς όμως να αξιοποιηθούν όλα τα διαθέσιμα στοιχεία. Στην μελέτη επανεξετάζεται το θέμα και ανασκευάζεται η εικόνα του συγκεκριμένου αυτοκράτορα, που παρουσιάζεται από τον Νικήτα Χωνιάτη ως οκνηρός, αδιάφορος και συβαρίτης.
Βιβλιοκρισία:Κ. Ν. Κωνσταντινίδης, Κυπριακά Αγιολογικά και Μοναστηριολογικά Μελετήματα (Πολιτιστική Ακαδημία "¨Αγιος Επιφάνιος".Αυτοτελείς Εκδόσεις, 3). Αγία Νάπα 2021
Authors: TCHKOIDZE Eka 
Published: December 2022

Βιβλιοκρισία: Κ. Ν.Κωνσταντινίδης,Κυπριακά Αγιολογικά και Μοναστηριολογικά Μελετήματα.(Πολιτιστική Ακαδημία "Άγιος Επιφάνιος". Αυτοτελείς Εκδόσεις, 3), Αγία Νάπα 2021
Βιβλιοκρισία: Le monde byzantin du xiiie au xve siècle. Anciennes ou nouvelles formes d’impérialité, édité par Marie-Hélène Blanchet & Raúl Estangüi Gómez, Travaux et Mémoires 25/1. Association des Amis du Centre d’Histoire et Civilisation de Byzance, Paris 2021
Authors: ΧΡΥΣΟΣ Ευάγγελος 
Published: December 2022

Βιβλιοκρισία: Le monde byzantin du xiiie au xve siècle. Anciennes ou nouvelles formes d’impérialité, édité par Marie-Hélène Blanchet & Raúl Estangüi Gómez, Travaux et Mémoires 25/1. Association des Amis du Centre d’Histoire et Civilisation de Byzance, Paris 2021
Vortex Circular Dichroism: An experimental technique to assess the scalar/vectorial regime of diffraction
Authors: Zambrana-Puyalto Xavier , De Angelis Francesco , D'Ambrosio Vincenzo 
Published: December 2022

Background: In classical electrodynamics, light-matter interactions are modelled using Maxwell equations. The solution of Maxwell equations, which is typically given by means of the electric and magnetic field, is vectorial in nature. Yet it is well known that light-matter interactions can be approximately described in a scalar (polarization independent) way for many optical applications. While the accuracy of the scalar approximation can be theoretically computed, to the best of our knowledge, it has never been determined experimentally. Here, we show that the vectoriality of diffraction can be probed with a new technique: Vortex Circular Dichroism(VCD). Methods: We measure the differential transmission of left and right circularly polarized vortex beams through a set of single circular nano-apertures with diameters ranging from 150 to 1950 nm. We observe that VCD > 0 for smaller diameters, VCD ≲ 0 for intermediate values and VCD ≈ 0 for larger values of the diameter. We also carry out Mie Theory simulations for spheres with the same diameters as the nanoholes and observe that the theoretical and experimental VCD values follow the same trend line. Results: We relate VCD ≠ 0 to a vectorial diffraction, and VCD ≈ 0 to a scalar one. This is corroborated by the simulations, which show that a diffraction process characterized by a VCD ≈ 0 (VCD ≠ 0) is polarization-independent (polarization-dependent). Conclusions: Overall, our results give a wealth of evidence that VCD allows for the experimental assessment of the scalar/vectorial regime of diffraction.
Current state of knowledge concerning experimental applications for deep brain stimulation in specific neurologic and psychiatric disorders
Authors: Senger Michał , Doruch Patrycja , Kędziora-Kornatowska Kornelia 
Published: December 2022

Introduction and objectives. Deep brain stimulation (DBS) is an invasive treatment method of certain neurologic and psychiatric disorders. It relies on sending external electrical stimulus to specific targets within the brain, causing change in their functioning. DBS is an approved management procedure, for instance in Parkinson’s Disease or Obsessive-compulsive disorder. Currently, studies are being conducted on the possible utilization of DBS in other disorders, especially exhibiting resistance for standard treatment. The objective of this study, is to present the state of knowledge concerning experimental usage of DBS in specific disorders. The following study is based on the review of scientific literature for the years 2000 – 2022.
State of knowledge. Regarding experimental applications, DBS is being used among others in Tourette’s Syndrome, Huntington’s Disease, Depression and Alzheimer’s Disease. The review of the literature allows to gather data concerning initial patients selection, mechanism of action, potential benefits and thus far noted adverse effects. Evaluation of therapy efficacy is mostly limited, due to short observation periods and lack of unified patient qualification criteria for the operation.
Conclusion. Deep brain stimulation is a management method, in many cases acknowledged as safe and efficient. It is observed to have a beneficial impact on the disorders described in the following article. However, the approval of DBS as a conventional treatment requires improvement of many factors decisive of therapeutic success. Conduction of more randomised clinical trials in the future, may be helpful in achieving this objective.