bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Histopathology to Assess the Reliability of Intraoperative Magnetic Resonance Imaging in Guiding Additional Brain Tumor Resection: A Multicenter Study
Authors: Shah Amar S , Yahanda Alexander T , Sylvester Peter T , Evans John , Dunn Gavin P , Jensen Randy L , Honeycutt John , Cahill Daniel P , Sutherland Garnette R , Oswood Mark , Shah Mitesh , Abram Steven R , Rich Keith M , Dowling Joshua L , Leuthardt Eric C , Dacey Ralph G , Kim Albert H , Zipfel Gregory J , Limbrick David D , Smyth Matthew D , Leonard Jeffrey , Chicoine Michael R 
Published: July 2020

Abstract

BACKGROUND
Intraoperative magnetic resonance imaging (iMRI) is a powerful tool for guiding brain tumor resections, provided that it accurately discerns residual tumor.

OBJECTIVE
To use histopathology to assess how reliably iMRI may discern additional tumor for a variety of tumor types, independent of the indications for iMRI.

METHODS
A multicenter database was used to calculate the odds of additional resection during the same surgical session for grade I to IV gliomas and pituitary adenomas. The reliability of iMRI for identifying residual tumor was assessed using histopathology of tissue resected after iMRI.

RESULTS
Gliomas (904/1517 cases, 59.6%) were more likely than pituitary adenomas (176/515, 34.2%) to receive additional resection after iMRI (P < .001), but these tumors were equally likely to have additional tissue sent for histopathology (398/904, 44.4% vs 66/176, 37.5%; P = .11). Tissue samples were available for resections after iMRI for 464 cases, with 415 (89.4%) positive for tumor. Additional resections after iMRI for gliomas (361/398, 90.7%) were more likely to yield additional tumor compared to pituitary adenomas (54/66, 81.8%) (P = .03). There were no significant differences in resection after iMRI yielding histopathologically positive tumor between grade I (58/65 cases, 89.2%; referent), grade II (82/92, 89.1%) (P = .98), grade III (72/81, 88.9%) (P = .95), or grade IV gliomas (149/160, 93.1%) (P = .33). Additional resection for previously resected tumors (122/135 cases, 90.4%) was equally likely to yield histopathologically confirmed tumor compared to newly-diagnosed tumors (293/329, 89.0%) (P = .83).

CONCLUSION
Histopathological analysis of tissue resected after use of iMRI for grade I to IV gliomas and pituitary adenomas demonstrates that iMRI is highly reliable for identifying residual tumor.
Participatory Action Research and Photovoice: Applicability, Relevance, and Process in Nursing Education Research
Authors: Oosterbroek Tracy , Yonge Olive , Myrick Florence 
Published: July 2020

Abstract
Participatory action research (PAR) is a philosophy and approach to qualitative research. The purpose of this article is to generate a clearer understanding of PAR and its relevance to the discipline and profession of nursing. The authors provide a description of the principles and process of implementing PAR methodology, using photovoice as an innovative, participant-directed data collection method in rural nursing preceptorship. Participants were undergraduate nursing students and faculty advisors assigned to rural communities during the final clinical preceptorship. Participants described opportunities and challenges experienced during the preceptorship and how these experiences influenced their learning and overall preceptorship experience.
Beyond Discussion: Implementing Multimodal Learning in a Nurse Practitioner Program
Authors: Elertson Kathleen M. , Lehr Michelle 
Published: July 2020

Abstract
End-of-program feedback from students reflected a decreased level of active engagement and retention in learning at a public university in the upper Midwest of the United States. Results prompted educators to explore integration of multimodal instruction within the postlicensure family nurse practitioner program. A graduate program faculty work group was created to review and revise the curriculum. Through the utilization of national organization standards, implementation of evidence-based best practices, and a shared vision, a small group of nurse faculty was able to complete significant improvement in the graduate curriculum within a single academic year.
Using Experiential Learning in Escape Rooms to Deliver Policies and Procedures in Academic and Acute Care Settings
Authors: Diaz Desiree A. , McVerry Kristen , Spears Syretta , Díaz Rubén Z. , Stauffer Loren T. 
Published: July 2020

Abstract
Puzzle rooms, recently termed “escape rooms,” have been in existence for several years and are increasing in popularity in the United States. These experiential learning rooms create an inviting learning environment for both the academic and acute care learner. Learners are placed in strategic cooperative learning groups to promote teamwork, collaboration, critical thinking, and communication. Participation in an escape room can be used to reinforce policies and procedures that are standard in nursing practice. Overall acceptance of this novel idea in nursing was positive for registered nurse, student, and community member outcomes; evaluations were affirmative for learning engagement.
Community Partnerships
Authors: Klainberg Marilyn , Mancini Karen , Brickel Kristin 
Published: July 2020

Abstract
Because of the prevalence of chronic health conditions such as diabetes and hypertension, there is an increased need in the United States for nurses with specialized knowledge and training in providing care to dialysis patients. The US Board of Labor Statistics projects growth of 26 percent in dialysis nursing over the next decade. To prepare nursing students for this growing need, a collaborative agreement was made between a college of nursing and public health and hospital executives in an academic and clinical practice partnership to introduce nursing students to dialysis nursing through a clinical experience.
Decreasing Nursing Student Workload and Stress: An Innovative Method to Reform Clinical Assignments Across the Curriculum
Authors: Vignato Julie A. , Gleason Limoges Nicole , Arends Leslie , Nicholson Anita 
Published: July 2020

Abstract
This innovative change to clinical written assignments for prelicensure nursing students is intended to decrease student workload and stress. Student stress and mental health issues are becoming more apparent in nursing programs. Guided by change theories and a modified SWOT (strengths, weaknesses, opportunities, and threats) analysis, a BSN subcommittee evaluated methods of written assignments and publisher products. An electronic platform will be trialed in one course. This innovative process provides nursing programs a template for change implementation aimed to reduce student workload and stress.
Toolkit for a Successful Nurse Educator Sabbatical
Authors: Wilson-Anderson Kaye 
Published: July 2020

Abstract
This article provides evidence to support the need for nursing faculty to attain sabbaticals. In addition, a toolkit is provided that walks faculty through a step-by-step process to ensure a successful sabbatical. Future nurses are counting on strong, engaging, and visionary faculty. Thus, to foster resilience, nursing faculty are encouraged to embrace the sabbatical opportunity.
Circular RNA in gastric cancer
Authors: Li Xue-Wei , Yang Wen-Hui , Xu Jun 
Published: July 2020

Abstract
Gastric cancer (GC) is a common malignancy and is the third leading cause of cancer-related death. At present, there is no simple and effective screening method for early-stage GC, and the treatment results and prognosis are poor. With the continuous improvement of molecular biology techniques, research on circular RNA (circRNA) has gradually expanded over time. Much data supports the role of circRNA in tumorigenesis. Moreover, due to its structural specificity and biological stability, circRNA is anticipated to be a potential biomarker for tumor diagnosis. Studies have confirmed that circRNA can participate in the proliferation, invasion, metastasis, and apoptosis of GC. These findings will lead to novel directions for the diagnosis and treatment of GC. This article reviews the structure and function of circRNA, summarizes the current studies on circRNA, and discusses the potential diagnostic value of circRNA in GC.
Nutrition and physical activity recommendations from the United States and European cardiovascular guidelines: a comparative review
Authors: Ferraro Richard A. , Fischer Nicole Mercado , Xun Helen , Michos Erin D. 
Published: July 2020

Purpose of review
A healthy lifestyle throughout one's lifespan is the core foundation for both primary and secondary prevention of cardiovascular disease (CVD). Risk-based decisions for pharmacological therapy is added on-top of lifestyle management. Thus, understanding lifestyle-based recommendations is central to CVD prevention.

Recent findings
In 2018 and 2019, the American Heart Association (AHA) and American College of Cardiology (ACC) published new guidelines for lipid management and primary prevention of cardiovascular disease (CVD), respectively. The European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) published new guidelines on lipids and diabetes management in 2019. These guidelines provide recommendations on diet and lifestyle for reducing cardiovascular risk. Both encourage heart-healthy diets consistent with Mediterranean, DASH, or healthy vegetarian patterns. Both provide guidance for recommended physical activity levels but acknowledge any physical activity, even less than recommended, is better than inactivity. Although both ACC/AHA and ESC/EAS guidelines have similar approaches to achieve the same goal of CVD prevention, there were some differences between them.

Summary
In this review, we discussed similarities and differences between the American and European guidelines to familiarize clinicians with both sets of lifestyle recommendations in an effort to provide best practices in individualized patient-care for CVD prevention.
A comparison of surgical, total percutaneous, and hybrid approaches to treatment of combined coronary artery and valvular heart disease
Authors: EL-Andari Ryaan , Bozso Sabin J. , Kang Jimmy , Nagendran Jeevan 
Published: July 2020

Purpose of review
The purpose of this review is to compare outcomes of surgical valve replacement (SVR) and coronary artery bypass grafting (CABG), minimally invasive cardiac surgery (MICS) SVR and percutaneous coronary intervention (PCI), and transcatheter aortic valve replacement and PCI for the treatment of combined coronary artery disease (CAD) and valvular heart disease (VHD).

Recent findings
Several studies have attempted to identify key differences in outcomes with hybrid MICS SVR and PCI approaches to combined CAD and VHD. Recent studies have demonstrated that MICS SVR and PCI, when compared with conventional open SVR and CABG, demonstrate reduced or unchanged morbidity and mortality. However, the rate of bleeding in MICS SVR and PCI is consistently higher likely because of the effects of antiplatelet therapy.

Summary
A shift toward MICS has occurred in the preceding decades, with outcomes improving in recent years. With limited ability to perform CABG through MICS approaches, attempts have been made at hybrid procedures to address multiple presenting concerns while allowing for the benefits of MICS approaches. Hybrid MICS SVR and PCI approaches may provide suitable alternatives to traditional surgical approaches with reduced intra and postoperative morbidity and mortality, with the notable exception of bleeding complications.
Arterial stiffness and pressure wave reflection in the development of isolated diastolic hypertension
Authors: Tomiyama Hirofumi , Shiina Kazuki , Nakano Hiroki , Iwasaki Yoichi , Matsumoto Chisa , Fujii Masatsune , Chikamori Taishiro , Yamashina Akira 
Published: July 2020

Objectives:
This prospective study was conducted to clarify the significance of augmented pressure wave reflection without accompanying increased arterial stiffness in the development of isolated diastolic hypertension (IDHT).

Methods:
A total of 3022 Japanese men without hypertension at the start of this study were included in the analyses. The blood pressure, brachial--ankle pulse wave velocity (brachial-ankle PWV), and radial augmentation index (rAI) were measured annually from year 2007 through year 2015.

Results:
At the end of the study period, 129 participants were diagnosed as having systolic/diastolic hypertension (SDHT), 112 as having isolated systolic hypertension (ISHT), and 74 as having IDHT. Both the brachial--ankle PWV and rAI showed significant individual odds ratios for new onset of SDHT and new onset of ISHT. However, only rAI, but not the brachial--ankle PWV, showed a significant odds ratio (1.44, P < 0.01) for new onset of IDHT. This association was significant in participants without elevated brachial--ankle PWV values at the start of the study, but not in those with elevated brachial--ankle PWV at the start of the study. Generalized estimating equation analyses demonstrated a significant longitudinal association of the rAI, but not brachial--ankle PWV, with the development of IDHT.

Conclusion:
Although increased arterial stiffness and augmented pressure wave reflection present concomitantly may be associated with the development of SDHT and ISHT, augmented pressure wave reflection alone, which may be related to isolated peripheral vascular damage, in the absence of accompanying increase of the arterial stiffness, may be a significant factor in the development of IDHT.
Impact of different dipping patterns on left atrial function in hypertension
Authors: Tadic Marijana , Cuspidi Cesare , Pencic Biljana , Mancia Giuseppe , Grassi Guido , Kocijancic Vesna , Quarti-Trevano Fosca , Celic Vera 
Published: July 2020

Objective:
We aimed to investigate left atrial phasic function in the recently diagnosed hypertensive patients and determine association between circadian blood pressure (BP) patterns and left atrial function.

Methods:
The present study involved 256 untreated hypertensive patients who underwent 24-h ambulatory BP monitoring and comprehensive echocardiographic examination. All patients were divided into four groups according to the percentage of nocturnal BP drop (dippers, extreme dippers, nondippers and reverse dippers).

Results:
There was no significant difference in daytime BPs between the observed groups, whereas night-time BPs significantly and gradually increased from extreme dippers and dippers, across nondippers, to reverse dippers. Total, passive and active left atrial emptying fractions that correspond with left atrial reservoir, conduit and contractile function were lower in nondippers and reverse dippers than in dippers and extreme dippers. Reservoir and contractile left atrial strains were lower in reverse dippers than in dippers and extreme dippers, whereas conduit left atrial strain was lower in reverse dippers in comparison with extreme dippers. Nondipping and reverse dipping BP patterns were, independently of age, sex, nocturnal BPs, left ventricular mass index, E/e′, associated with reduced reservoir function. Nevertheless, only reverse dipping profile was independently of other circadian BP profiles, nocturnal BP, demographic and echocardiographic parameters related with reduced conduit and contractile functions.

Conclusion:
Nondipping and reverse dipping BP patterns were related with impaired left atrial phasic function. However, reverse pattern was the only circadian profile that was independently of other clinical parameters, including night-time BP, associated with decreased reservoir, conduit and contractile function.
Cardiopulmonary coupling-derived sleep quality is associated with improvements in blood pressure in patients with obstructive sleep apnea at high-cardiovascular risk
Authors: Magnusdottir Solveig , Hilmisson Hugi , Thomas Robert J. 
Published: July 2020

Objective:
Investigate if changes in objective sleep quality index (SQI) assessed through cardiopulmonary-coupling analysis impacts blood pressure (BP) in patients with obstructive sleep apnea at high-cardiovascular risk.

Methods:
Secondary analysis of ECG and pulse-oximetry-[oxygen saturation (SpO2)] data from the Heart Biomarker Evaluation in Apnea Treatment study, multicenter, controlled trial in patients with cardiovascular disease and moderate-severe obstructive sleep apnea, randomly assigned to intervention of healthy lifestyle and sleep hygiene education (HLSE; control group), continuous positive airway pressure (CPAP) or nocturnal supplemental oxygen (NSO). Participants with good-quality ECG-signal and SpO2-signal (n = 241) were included.

Results:
CPAP-therapy significantly improved BP, with net average improvement in mean arterial blood pressure during sleep (MAPSleep) when compared with nocturnal supplemental oxygen-therapy or healthy lifestyle and sleep education-therapy, −3.92 (P = 0.012) and −3.83 (P = 0.016), respectively. When stratified on the basis of baseline-SQI, CPAP-therapy improves 24-h MAP24 −3.02 (P = 0.030) and MAPSleep −5.00 (P = 0.001), in patients with compromised baseline-SQI (SQI < 55). Stratifying the cohort based on changes in SQI during the study period (SQIBaseline-SQIFollow-up), controlling for sex, age over 60, apnea–hypopnea index, SpO2 less than 80%, baseline BP and cardiovascular disease, significant differences are observed comparing the groups that Improved-SQI (SQIBaseline < 55, SQIFollow-up ≥ 55) and Declined-SQI (SQIBaseline ≥ 55, SQIFollow-up < 55) in MAP24 −4.87 (P = 0.046) and mean diastolic blood pressure (MDP24) −4.42 (P = 0.026) as well as MAPWake −6.36 (P = 0.015), mean systolic blood pressure wake (MSPWake) −7.80 (P = 0.048) and MDPWake −5.64 (P = 0.009), respectively. Improved SQI reflects the magnitude of positive effect on BP which is reached mostly through initiation of CPAP-therapy.

Conclusion:
Cardiopulmonary coupling-derived sleep quality impacted 24-h MAP and MDP, as well as BP during wake, in patients participating in the Heart Biomarker Evaluation in Apnea Treatment-study.
Race modifies the association between animal protein metabolite 1-methylhistidine and blood pressure in middle-aged adults: the Bogalusa Heart Study
Authors: Razavi Alexander C. , Bazzano Lydia A. , He Jiang , Whelton Seamus P. , Rebholz Casey M. , Fernandez Camilo , Krousel-Wood Marie , Li Changwei , Shi Mengyao , Nierenberg Jovia L. , Li Shengxu , Kinchen Jason , Mi Xuenan , Kelly Tanika N. 
Published: July 2020

Objective:
Dietary factors mediate racial disparities in hypertension. However, the physiological mechanisms underlying this relationship are incompletely understood. We sought to assess the association between 1-methylhistidine (1-MH), a metabolite marker of animal protein consumption, and blood pressure (BP) in a community-based cohort of black and white middle-aged adults.

Methods:
This analysis consisted of 655 participants of the Bogalusa Heart Study (25% black, 61% women, aged 34–58 years) who were not taking antihypertensive medication. Fasting serum 1-MH was measured using liquid chromatography-tandem mass spectroscopy. Animal food intakes were quantified by food-frequency questionnaires. Multivariable linear regression assessed the association between 1-MH and BP in combined and race-stratified analyses, adjusting for demographic, dietary, and cardiometabolic factors.

Results:
A significant dose--response relationship was observed for the association of red meat (P-trend <0.01) and poultry (P-trend = 0.03) intake with serum 1-MH among all individuals. Serum 1-MH, per standard deviation increase, had a significant positive association with SBP (β=3.4 ± 1.6 mmHg, P = 0.04) and DBP (β=2.0 ± 1.1 mmHg, P = 0.05) in black participants, whereas no appreciable association was observed in white participants. Among a subgroup of black participants with repeat outcome measures (median follow-up = 3.0 years), one standard deviation increase in 1-MH conferred a 3.1 and 2.2 mmHg higher annual increase in SBP (P = 0.03) and DBP (P = 0.03), respectively.

Conclusion:
Serum 1-MH associates with higher SBP and DBP in blacks, but not whites. These results suggest a utility for further assessing the role of dietary 1-MH among individuals with hypertension to help minimize racial disparities in cardiovascular health.
Adoption of Lean management and hospital performance: Results from a national survey
Authors: Rundall Thomas G. , Shortell Stephen M. , Blodgett Janet C. , Henke Rachel Mosher , Foster David 
Published: July 2020

Background
Despite being adopted by a large number of hospitals, the relationship between Lean management and hospital performance is mixed and not well understood.

Purpose
We examined the relationships between Lean and hospital financial performance, patient outcomes, and patient satisfaction in a large national sample of hospitals, controlling for relevant organizational and market factors.

Methodology/Approach
A mixed effects linear regression analysis was performed to assess the relationships between adoption of Lean and 10 measures of hospital performance using data from 1,152 hospitals that responded to the 2017 National Survey of Lean/Transformational Performance Improvement in Hospitals. Hospital performance, organizational, and market data over the period 2011–2015 come from the 2015 American Hospital Association Annual Hospital Survey and the respective annual Centers for Medicare & Medicaid Services (CMS) Medicare Cost Report, CMS Hospital Compare, CMS MEDPAR, and the CMS Hospital Service Area File.

Results
Lean adoption was significantly associated at alpha < .05, with lower Medicare spending per beneficiary (b = −.005, p = .027). None of the other nine associations were statistically significant, although eight of them were in the predicted direction.

Conclusion
Lean adoption is not associated with most measures of hospital performance. It is likely Lean implementation varies greatly across hospitals. Future research should examine the relationships among the various dimensions of Lean implementation and performance.

Practice Implications
If Lean management is to contribute to hospital performance improvement, leaders must be highly cognizant of what “adoption of Lean” actually means in their hospital. Although limited, single-unit Lean initiatives in an emergency room or other patient care unit may improve performance on some unit-specific measures, improvement on hospital-wide measures of performance requires a broad, sustained commitment to the implementation of Lean practices and tools.