bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and feasibility of carotid revascularization in patients with cerebral embolic strokes associated with carotid webs and histopathology revisited
Authors: Mathew S , Davidson Darrell D , Tejada J , Martinez M , Kovoor J 
Published: December 2020

Introduction Carotid web is increasingly recognized as the cause of ischemic embolic strokes in younger patients. The best way to treat carotid web is debatable and carotid artery stenting (CAS) has been reported as a treatment for the carotid web in only a few case series. In this study we evaluate the safety and feasibility of CAS in symptomatic carotid webs and examined the histopathology of a carotid web. Materials and methods At our institution between 2017 and 2019, 10 consecutive patients with symptomatic carotid webs were treated. We retrospectively analyzed the data for patient demographics, clinical presentation, imaging, treatment methodology and follow up. Results All the patients had presented with ipsilateral embolic stroke. The mean age at presentation was 50 years (range 37–71) with seven female and three male patients. All patients underwent CAS except one patient who underwent carotid endarterectomy (CEA). In one stented patient, there was significant hypotension in the post-procedural period lasting a week. The patients were followed for a mean of 5.5 months (range one day-12 months). No recurrent stroke or transient ischemic attack (TIA) occurred. Surgical pathological studies confirmed fibromuscular dysplasia in one specimen. Conclusion In our experience CAS for carotid web is feasible and safe in patients presenting with ischemic embolic strokes.
Balloon-assisted maturation of autogenous arteriovenous fistulae: A randomized controlled prospective study
Authors: Elkassaby Mohammed , Elsaadany Nashaat , Mowaphy Khaled , Soliman Mosaad 
Published: December 2020

Background Current guidelines recommend referral of patient with renal failure for access creation 6 months before planned dialysis. There is a growing cohort of patients that require long-term hemodialysis without adequate preparation. Temporary dialysis catheters and rapid access arteriovenous grafts (AVG) are far from being an ideal solution in this scenario. In an effort to expedite maturation of autogenous arteriovenous fistulae (AVF), balloon-assisted maturation (BAM) was advised by some authors. This technique still lacks the support of high-level evidence studies. We investigated the ability of intra-operative BAM to induce early functional maturation of AVFs. Methods This is a prospective randomized controlled study conducted in a tertiary referral center, with a catchment area of more than 15 million population. Cases were divided into two groups; Group (A), where BAM technique was performed, while in the control group (B), the standard technique was used (NO BAM) for creation of AVFs. Results Between June 2017 and May 2019, 300 cases were recruited from a total of 648 primary AVF creation instances. Patients’ age ranged from 19 to 89 (mean 51.17 ±SD 15.5) years. Group A (BAM) included 52.3% ( n = 157) AVFs, while Group B included 47.7% ( n = 143) AVFs. The average maturation time was 3.7 weeks (SD ± 1.3, 95% CI 3.55–3.95) and 5.91 weeks (SD ± 2.2, 95% CI 5.55–6.26) for both groups, respectively ( p = 0.0001). 78.3% of the AVFs that underwent BAM showed early maturation within 2–4 weeks vs 32.2% only in the NO BAM group ( p = 0.002). Successful functional maturation was higher among cases of the BAM group (93%), compared to the NO BAM group (77%) ( p = 0.001). Complication rates were 9.6% and 4.9% in the two groups, respectively ( p = 0.042). Conclusion BAM can play a pivotal role in helping the dialysis society meet the goals of the Fistula First Initiative, keeping in mind that this comes with an increased risk of complications. BAM should be considered only when unplanned early access to long-term dialysis is required.
Therapeutic interventions for COVID-19: a living overview of reviews
Authors: Khalili Malahat , Chegeni Maryam , Javadi Sara , Farokhnia Mehrdad , Sharifi Hamid , Karamouzian Mohammad 
Published: December 2020

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, but safe and effective treatment options remain unavailable. Numerous systematic reviews of varying qualities have tried to summarize the evidence on the available therapeutic interventions for COVID-19. This overview of reviews aims to provide a succinct summary of the findings of systematic reviews on different pharmacological and non-pharmacological therapeutic interventions for COVID-19. Methods: We searched PubMed, Embase, Google Scholar, Cochrane Database of Systematic Reviews, and WHO database of publications on COVID-19 from 1 December 2019 through to 11 June 2020 for peer-reviewed systematic review studies that reported on potential pharmacological or non-pharmacological therapies for COVID-19. Quality assessment was completed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) measure. Results: Out of 816 non-duplicate studies, 45 were included in the overview. Antiviral and antibiotic agents, corticosteroids, and anti-malarial agents were the most common drug classes used to treat COVID-19; however, there was no direct or strong evidence to support their efficacy. Oxygen therapy and ventilatory support was the most common non-pharmacological supportive care. The quality of most of the included reviews was rated as low or critically low. Conclusion: This overview of reviews demonstrates that although some therapeutic interventions may be beneficial to specific subgroups of COVID-19 patients, the available data are insufficient to strongly recommend any particular treatment option to be used at a population level. Future systematic reviews on COVID-19 treatments should adhere to the recommended systematic review methodologies and ensure that promptness and comprehensiveness are balanced. The reviews of this paper are available via the supplemental material section.
Accuracy of the Helicobacter pylori diagnostic tests in patients with peptic ulcer bleeding: a systematic review and network meta-analysis
Authors: Vörhendi Nóra , Soós Alexandra , Anne Engh Marie , Tinusz Benedek , Szakács Zsolt , Pécsi Dániel , Mikó Alexandra , Sarlós Patrícia , Hegyi Péter , Eröss Bálint 
Published: December 2020

Introduction: Some studies suggest that the accuracy of Helicobacter pylori diagnostic tests is decreased in peptic ulcer bleeding (PUB). We aimed to assess the accuracy of diagnostic tests for H. pylori in patients with PUB in a diagnostic test accuracy (DTA) network meta-analysis. Methods: A systematic search was carried out in seven databases until November 2019. We collected or calculated true and false positive and negative values, and constructed 2×2 diagnostic contingency tables with reference standards including histology, rapid urease test, urea breath test, serology, stool antigen test, culture, and polymerase chain reaction. We ranked the index tests by the superiority indices (SI) and calculated pooled sensitivity and specificity of each test. Discussion: Our search yielded 40 eligible studies with 27 different diagnostic strategies for H. pylori. In 32 articles, the reference standard was a combination of multiple tests. In 12 studies, the index tests were compared with a single testing method. We analyzed seven networks with the reference standards against a single or a combination of diagnostic index tests. None of the index tests had better diagnostic accuracy (SI between 9.94 and 2.17) compared with the individual index tests as all the confidence intervals included 1. Combined testing strategies had higher sensitivities (0.92–0.62) and lower specificities (0.85–0.46) while single tests proved to have higher specificities (0.83–0.77) and lower sensitivities (0.73–0.42). Conclusion: Use of combined tests may have a rationale in clinical practice due to their higher sensitivities. The differences between the included DTA studies limited the comparison of the testing strategies.
Immunosuppressive agents for rheumatoid arthritis: a systematic review of clinical trials and their current development stage
Authors: Blaess Julien , Walther Julia , Petitdemange Arthur , Gottenberg Jacques-Eric , Sibilia Jean , Arnaud Laurent , Felten Renaud 
Published: December 2020

Aims: With the arrival of conventional synthetic (csDMARDs), biological (bDMARDS) and then targeted synthetic (tsDMARDs) disease-modifying anti-rheumatic drugs, the therapeutic arsenal against rheumatoid arthritis (RA) has recently expanded. However, there are still some unmet needs for patients who do not achieve remission and continue to worsen despite treatments. Of note, most randomized controlled trials show that, for methotrexate-inadequate responders, only 20% of patients are ACR70 responders. With our better understanding of RA pathogenesis, finding new treatments is a necessary challenge. The objective of our study was to analyse the whole pipeline of immunosuppressive and immunomodulating drugs evaluated in RA and describe their mechanisms of action and stage of clinical development. Methods: We conducted a systematic review of all drugs in clinical development in RA, in 17 online registries of clinical trials. Results: The search yielded 4652 trials, from which we identified 243 molecules. Those molecules belong to csDMARDs ( n = 22), bDMARDs ( n = 118), tsDMARDs ( n = 103). Twenty-four molecules are already marketed in RA in at least one country: eight csDMARDs, 10 bDMARDs and six tsDMARDs. Molecules under current development are mainly bDMARDs ( n = 34) and tsDMARDs ( n = 33). Seven of those have reached phase III. A large number of molecules (150/243, 61.7%) have been withdrawn. Conclusion: Despite the availability of 24 marketed molecules, the development of new targeted molecules is ongoing with a total of 243 molecules in RA. With seven molecules currently reaching phase III, we can expect an increase in the armamentarium in the years to come.
Yield of Head Imaging in Ambulatory and Hospitalized Patients With SARS-CoV-2: A Multi-Center Study of 8675 Patients
Authors: Greenway Melanie R. F. , Erben Young , Huang Josephine F. , Siegel Jason L. , Lamb Christopher J. , Badi Mohammed K. , Sakusic Amra , Gopal Neethu , Meschia James F. , Lin Michelle P. 
Published: December 2020

Background and Purpose: To describe the neurological and cerebrovascular findings in patients who tested positive for SARS-CoV-2 and underwent head imaging in ambulatory and inpatient settings. Methods: Consecutive patients aged ≥18 years with SARS-CoV-2 infection diagnosed or treated at Mayo Clinic sites from 3/11/2020 to 7/23/2020 with head CT or brain MRI within 30 days of SARS-CoV-2 diagnosis were included. Demographics, medical history, indication for SARS-CoV-2 testing, neurologic symptoms, indication for brain imaging, neuroimaging findings, etiology of cerebrovascular events, and hospital course were abstracted from medical records. Results: Of 8,675 patients with SARS-CoV-2, 180 (2.07%) had head imaging. Mean age of the entire cohort was 42 ± 18 years, whereas mean age of those with head imaging was 62 ± 19 years. Common indications for imaging were headache (34.4%), encephalopathy (33.4%), focal neurologic symptom (16.7%), and trauma (13.9%). While 86.1% of patients who underwent head imaging had normal exams, cerebrovascular events occurred in 18 patients (0.21% of the total cohort). Of patients with cerebrovascular events, 8 (44.5%) had acute infarct; 6 (33.3%), acute intracranial hemorrhage; 5 (2.8%), subacute infarct; and 1 (0.6%) posterior reversible encephalopathy syndrome. In the thirteen patients with ischemic stroke, 6 (46.2%) had cryptogenic stroke; 3 (23.1%), other defined causes; 2 (15.4%), small vessel stroke; 1 (7.7%), large vessel stroke; and 1 (7.7%) cardioembolic stroke. Conclusion: In ambulatory and hospitalized patients with SARS-CoV-2 infection, the rate of head imaging is low, with common indications of encephalopathy and headache. Cerebrovascular events occurred rarely, and cryptogenic stroke was the most common stroke mechanism.
Processing employees’ personal data during the Covid-19 pandemic
Authors: Suder Seili 
Published: December 2020

While needing to ensure the health and safety of their employees during the Covid-19 pandemic, employers face many burning data protection questions, including under what conditions they can process employees’ personal data (in particular health data) and whether gathering personal data concerning employees’ medical history, trips and contacts with infected persons, is allowed. This article focuses on issues that are problematic, based on the analysis of guidance issued by the European Data Protection Board, as well as national data protection authorities and practitioners from 20 countries in response to these concerns. The first section of the article analyses concepts of personal data and health data in the context of Covid-19. Then the article proceeds with exploring what possible legal bases employers can use to process employees’ personal data in general, and health data in particular, under the General Data Protection Regulation when applying different measures to combat Covid-19. In the latter part of the article two practical questions raised by employers – concerning the checking of employees’ body temperatures and informing them of possible infection – are discussed. The analysis indicates that national data protection authorities seem to look for a reasonable and pragmatic approach regarding compliance with the GDPR in light of the Covid-19 emergency. However, their guidance differs in several areas and the views in between nation states are not always aligned. A more specific, clear and uniform pan-European vision concerning the processing of employees’ data in times of emergency is needed to better protect employees and limit the spread of the virus.
Ethical and Moral Competences of Upper Secondary Students: A Comparative Study
Authors: Peng (彭正梅) Zhengmei , Benner Dietrich , Nikolova Roumiana , Ivanov Stanislav , Peng (彭韬) Tao 
Published: December 2020

Purpose: This article presents the theoretical framework, research design, methodology, and main findings of the comparative measurement of ethical–moral competences of 15-year-old upper secondary students in Shanghai, under the ETiK-International-Shanghai project. Design/Approach/Methods: By dividing the ethical–moral competences into the categories of basic ethical–moral knowledge, ethical–moral judgment competence, and competence in developing ethical–moral action plans, a survey of 2,036 students was conducted, using a reliable and valid testing instrument. Findings: In general, 15-year-olds from homes with more educational resources perform higher in all three scales across all countries taken under consideration in our study. Furthermore, school practices, teaching, as well as quantity and quality of instruction play a very important role in the moral education process and especially in developing students’ proficiency levels of ethical–moral knowledge, reasoning competence, as well as students’ high abilities in developing moral action plans. When relevant educational background factors are held constant, Chinese students show lower average scores on basic ethical–moral knowledge and moral judgment competence. With exception of the tested Vienna students, all other European samples scored better than the Chinese students—also on the test for developing ethical–moral action plans. However, Chinese students are especially able to display outstanding empathy when dealing with suffering, misfortune, and sorrow, as well as in their willingness to help others. Originality/Value: The findings of this article can foster thinking about which topics should be further discussed to improve the ethical–moral knowledge and competences of Chinese students and highlight requirements for the further development of moral education in China at the levels of teaching, curriculum, teacher education, and research.
Resident Involvement in Arthroscopic Knee Surgery Is Not Associated With Increased Short-term Risk to Patients
Authors: Basques Bryce A. , Saltzman Bryan M. , Korber Shane S. , Bolia Ioanna K. , Mayer Erik N. , Bach Bernard R. , Verma Nikhil N. , Cole Brian J. , Weber Alexander E. 
Published: December 2020

Background: Whether resident involvement in surgical procedures affects intra- and/or postoperative outcomes is controversial. Purpose/Hypothesis: The purpose of this study was to compare operative time, adverse events, and readmission rate for arthroscopic knee surgery cases with and without resident involvement. We hypothesized that resident involvement would not negatively affect these variables. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of the prospectively maintained National Surgical Quality Improvement Program was performed. Patients who underwent arthroscopic knee surgery between 2005 and 2012 were identified. Multivariate Poisson regression with robust error variance was used to compare the rates of postoperative adverse events and readmission within 30 days between cases with and without resident involvement. Multivariate linear regression was used to compare operative time between cohorts. Because of multiple statistical comparisons, a Bonferroni correction was used, and statistical significance was set at P < .004. Results: A total of 29,539 patients who underwent arthroscopic knee surgery were included in the study, and 11.3% of these patients had a resident involved with the case. The overall rate of adverse events was 1.62%. On multivariate analysis, resident involvement was not associated with increased rates of adverse events or readmission. Resident cases had a mean 6-minute increase in operative time ( P < .001). Conclusion: Overall, resident involvement in arthroscopic knee surgery was not associated with an increased risk of adverse events or readmission. Resident involvement was associated with only a mean increased operative time of 6 minutes, a difference that is not likely to be clinically significant. These results support the safety of resident involvement with arthroscopic knee surgery.
Effect of Ulnar Collateral Ligament Reconstruction on Pitch Accuracy, Velocity, and Movement in Major League Baseball Pitchers
Authors: McKnight Braden , Heckmann Nathanael D. , Chen Xiao T. , Hindoyan Kevork , Hill J. Ryan , Goldbeck Graham , Omid Reza , Hatch George F. “Rick” , Charlton Timothy P. 
Published: December 2020

Background: Ulnar collateral ligament (UCL) reconstruction is frequently performed on Major League Baseball (MLB) pitchers. Previous studies have investigated the effects of UCL reconstruction on fastball and curveball velocity, but no study to date has evaluated its effect on fastball accuracy or curveball movement among MLB pitchers. Purpose/Hypothesis: The primary purpose of this study was to determine the effects of UCL reconstruction on fastball accuracy, fastball velocity, and curveball movement in MLB pitchers. Our hypothesis was that MLB pitchers who underwent UCL reconstruction would return to their presurgery fastball velocity, fastball accuracy, and curveball movement. The secondary purpose of this study was to determine which factors, if any, were predictive of poor performance after UCL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: MLB pitchers who underwent UCL reconstruction surgery between 2011 and 2012 were identified. Performance data including fastball velocity, fastball accuracy, and curveball movement were evaluated 1 year preoperatively and up to 3 years of play postoperatively. A repeated-measures analysis of variance with a Tukey-Kramer post hoc test was used to determine statistically significant changes in performance over time. Characteristic factors and presurgery performance statistics were compared between poor performers (>20% decrease in fastball accuracy) and non—poor performers. Results: We identified 56 pitchers with a total of 230,995 individual pitches for this study. After exclusion for lack of return to play (n = 14) and revision surgery (n = 3), 39 pitchers were included in the final analysis. The mean presurgery fastball pitch-to-target distance was 32.9 cm. There was a statistically significant decrease in fastball accuracy after reconstruction, which was present up to 3 years postoperatively ( P = .007). The mean presurgery fastball velocity of 91.82 mph did not significantly change after surgery ( P = .194). The mean presurgery curveball movement of 34.49 cm vertically and 5.89 cm horizontally also did not change significantly ( P = .937 and .161, respectively). Conclusion: Fastball accuracy among MLB pitchers significantly decreased after UCL reconstruction for up to 3 years postoperatively. There were no statistically significant differences in characteristic factors or presurgery performance statistics between poor and non--poor performers.
IJV’s political ties and R&D strategy: Asymmetric contingencies of market versus governmental policy turbulence
Authors: Yang Jie , Ma Jieqiong , Doty D Harold , Lee Jeoung Yul 
Published: December 2020

The purpose of this article is to empirically explore (1) the impact of political ties on international joint ventures’ (IJVs) R&D strategy and (2) the moderating effects of market turbulence and governmental policy turbulence on the relationship between IJV political ties and R&D investment in China. Our sample consists of 1,344 observations taken from 224 IJVs over a period of 6 years (2012–2017), and we applied hierarchical moderated regression analysis (HMRA) with panel data to analyze our three hypotheses. Our findings show that IJVs with political ties tend to invest more in R&D than their counterparts without political ties. Interestingly, this positive relationship grows stronger with high market turbulence, but wanes under high governmental policy turbulence. While the issues regarding the importance of political ties to IJVs competing in China have been discussed, the issues related to why political ties influence IJV’s decisions on R&D investment have been largely overlooked. Hence, this study applies the environmental contingency view to fill this gap and shows how asymmetric contingencies for market turbulence and governmental policy turbulence occur in this context.JEL CLASSIFICATION: M1