bluuebunny/crossref_metadata_2025_split huggingface dataset:
Workflow patterns and potential for optimization in endovascular stroke treatment across the world: results from a multinational survey
Authors: Ospel Johanna Maria , Almekhlafi Mohammed A , Menon Bijoy K , Kashani Nima , Chapot René , Fiehler Jens , Hassan Ameer E , Yavagal Dileep , Majoie Charles B L.M , Jayaraman Mahesh V , Hill Michael D , Goyal Mayank 
Published: April 2020

BackgroundThe benefit of endovascular treatment (EVT) is highly time-dependent, and treatment delays reduce patients’ chances to achieve a good outcome. In this survey-based study, we aimed to evaluate current in-hospital EVT workflow characteristics across different countries and hospital settings, and to quantify the time-savings that could be achieved by optimizing particular workflow steps.MethodsIn a multinational survey, neurointerventionalists were asked to provide specific information about EVT workflows in their current working environment. Workflow characteristics were summarized using descriptive statistics and stratified by country and physician characteristics, such as age, career stage, personal and institutional caseload.ResultsAmong 248 respondents from 48 countries, pre-notification of the neurointerventional team was used in 70% of cases. The emergency department (ED) and CT scanner, and the CT scanner and neuroangiography suite, were on different floors in 23% and 38%, respectively. Redundant procedures in the ED were often routinely performed, such as chest x-rays (in 6%). General anesthesia was the most frequently used anesthesia protocol for EVT (42%), and an anesthesiologist was available in 82% for this purpose. 52% of the participants used a pre-prepared EVT kit.ConclusionThe current structure of EVT workflows offers possibilities for improvement. While some bottlenecks, such as the spatial department set-up, cannot easily be resolved, pre-notification tools and pre-prepared EVT kits are more straightforward to implement and could help to reduce treatment delays, and thereby improve patient outcomes.
Exploring veterinarians’ use of practices aimed at understanding and providing emotional support to clients during companion animal euthanasia in Ontario, Canada
Authors: Matte Alisha R , Khosa Deep K , Coe Jason B , Meehan Michael , Niel Lee 
Published: April 2020

BackgroundDuring companion animal euthanasia, support of clients is equally important as the medical care of the companion animal and requires a clear and developed understanding of clients' feelings, needs and expectations. Yet, veterinarians may not be fully exploring such topics.MethodsA 65‐item online questionnaire was developed and distributed to veterinarians (n=368) in Ontario to explore veterinarians’ use of practices aimed at understanding and providing support during companion animal euthanasia. Measures included veterinarians’ use of previously identified communication and support practices, empathy, years in practice and amount of time scheduled for euthanasia appointments. Data were analysed using descriptive statistics and multivariable regression.ResultsVeterinarians reported consistently providing emotional support but inconsistently implementing practices that may assist in enhancing their understanding of clients’ expectations, previous or emotional experiences. Veterinarians’ empathy scores, years in practice and the amount of time scheduled for euthanasia were positively associated with use of these practices.ConclusionProviding adequate time (ideally >30 min) for euthanasia appointments may assist in efforts to understand clients’ experiences, expectations and emotions, and provide support. Combining empathy, hands‐on and self‐care training in veterinary curriculum may also be valuable in improving the comfort level and skill of veterinarians in providing compassionate care.
Physical Activity and Long-term Quality of Life among Colorectal Cancer Survivors—A Population-based Prospective Study
Authors: Eyl Ruth Elisa , Koch-Gallenkamp Lena , Jansen Lina , Walter Viola , Carr Prudence R. , Hoffmeister Michael , Chang-Claude Jenny , Brenner Hermann , Arndt Volker 
Published: April 2020

Abstract

Evidence suggests that physical activity (PA) is positively associated with (health-related) quality of life (QOL) in colorectal cancer survivors. However, little is known regarding long-term effects of PA on QOL and if prediagnosis PA is associated with QOL in the years after diagnosis. Our study aimed to investigate the association of prediagnosis and postdiagnosis PA with long-term QOL in colorectal cancer survivors.
This study is based on a population-based cohort from Germany of 1,781 newly diagnosed colorectal cancer survivors over a 5-year period. PA was assessed at diagnosis and at 5-year follow-up (5YFU). Quality of life was assessed by the European Organisation for Research and Treatment of Cancer C Quality of Life Questionnaire QLQ-C30 at 5YFU. Multivariable linear regression was used to explore associations between prediagnosis and postdiagnosis PA and QOL at 5YFU.
No evidence of a positive association between higher levels of prediagnosis PA and better long-term QOL was found. Higher levels of prediagnosis work-related PA and vigorous PA were even associated with decreased QOL in domains such as cognitive [Beta(β) = −2.52, 95% confidence interval (CI) = −3.77, −1.27; β = −1.92, CI = −3.17, −0.67) and emotional functioning (β = −2.52, CI = −3.84, −1.19; β = −2.12, CI = −3.44, −0.80). In cross-sectional analyses, higher postdiagnosis PA was strongly associated with higher QOL. Survivors physically active at both prediagnosis and postdiagnosis as well as survivors who increased their PA between prediagnosis and postdiagnosis reported significantly higher long-term QOL compared with survivors who remained inactive at prediagnosis and postdiagnosis. In this study, higher prediagnosis PA does not appear to be associated with higher QOL among long-term colorectal cancer survivors but our results support the importance of ongoing PA throughout survivorship.
Rivaroxaban Plus Aspirin Versus Aspirin Alone in Patients With Prior Percutaneous Coronary Intervention (COMPASS-PCI)
Authors: Bainey Kevin R. , Welsh Robert C. , Connolly Stuart J. , Marsden Tamara , Bosch Jackie , Fox Keith A.A. , Steg P. Gabriel , Vinereanu Dragos , Connolly Derek L. , Berkowitz Scott D. , Foody JoAnne M. , Probstfield Jeffrey L. , Branch Kelley R. , Lewis Basil S. , Diaz Rafael , Muehlhofer Eva , Widimsky Petr , Yusuf Salim , Eikelboom John W. , Bhatt Deepak L. ,   On behalf of the COMPASS Investigators
Published: April 2020

Background:
The COMPASS trial (Cardiovascular Outcomes for People using Anticoagulation Strategies) demonstrated that dual pathway inhibition (DPI) with rivaroxaban 2.5 mg twice daily plus aspirin 100 mg once daily versus aspirin 100 mg once daily reduced the primary major adverse cardiovascular event (MACE) outcome of cardiovascular death, myocardial infarction, or stroke, as well as, mortality, in patients with chronic coronary syndromes or peripheral arterial disease. Whether this remains true in patients with a history of percutaneous coronary intervention (PCI) is unknown.

Methods:
In a prespecified subgroup analysis from COMPASS, we examined the outcomes of patients with a chronic coronary syndrome with or without a previous PCI treated with DPI versus aspirin alone. Among patients with a previous PCI, we studied the effects of treatment according to the timing of the previous PCI.

Results:

Of the 27 395 patients in COMPASS, 16 560 patients with a chronic coronary syndrome were randomly assigned to DPI or aspirin, and, of these, 9862 (59.6%) had previous PCI (mean age 68.2±7.8, female 19.4%, diabetes mellitus 35.7%, previous myocardial infarction 74.8%, multivessel PCI 38.0%). Average time from PCI to randomization was 5.4 years (SD, 4.4) and follow-up was 1.98 (SD, 0.72) years. Regardless of previous PCI, DPI versus aspirin produced consistent reductions in MACE (PCI: 4.0% versus 5.5%; hazard ratio [HR], 0.74 [95% CI, 0.61–0.88]; no PCI: 4.4% versus 5.7%; HR, 0.76 [95% CI, 0.61–0.94],
P
-interaction=0.85) and mortality (PCI: 2.5% versus 3.5%; HR, 0.73 [95% CI, 0.58–0.92]; no PCI: 4.1% versus 5.0%; HR, 0.80 [95% CI, 0.64–1.00],
P
-interaction=0.59), but increased major bleeding (PCI: 3.3% versus 2.0%; HR, 1.72 [95% CI, 1.34–2.21]; no PCI: 2.9% versus 1.8%; HR, 1.58 [95% CI, 1.15–2.17],
P
-interaction=0.68). In those with previous PCI, DPI compared with aspirin produced consistent (robust) reductions in MACE irrespective of time since previous PCI (as early as 1 year and as far as 10 years;
P
-interaction=0.65), irrespective of having a previous myocardial infarction (
P
-interaction=0.64).

Conclusions:
DPI compared with aspirin produced consistent reductions in MACE and mortality but with increased major bleeding with or without previous PCI. Among those with previous PCI 1 year and beyond, the effects on MACE and mortality were consistent irrespective of time since last PCI.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01776424.
Thrombolysis With Alteplase at 0.6 mg/kg for Stroke With Unknown Time of Onset
Authors: Koga Masatoshi , Yamamoto Haruko , Inoue Manabu , Asakura Koko , Aoki Junya , Hamasaki Toshimitsu , Kanzawa Takao , Kondo Rei , Ohtaki Masafumi , Itabashi Ryo , Kamiyama Kenji , Iwama Toru , Nakase Taizen , Yakushiji Yusuke , Igarashi Shuichi , Nagakane Yoshinari , Takizawa Shunya , Okada Yasushi , Doijiri Ryosuke , Tsujino Akira , Ito Yasuhiro , Ohnishi Hideyuki , Inoue Takeshi , Takagi Yasushi , Hasegawa Yasuhiro , Shiokawa Yoshiaki , Sakai Nobuyuki , Osaki Masato , Uesaka Yoshikazu , Yoshimura Shinichi , Urabe Takao , Ueda Toshihiro , Ihara Masafumi , Kitazono Takanari , Sasaki Makoto , Oita Akira , Yoshimura Sohei , Fukuda-Doi Mayumi , Miwa Kaori , Kimura Kazumi , Minematsu Kazuo , Toyoda Kazunori ,   for the THAWS Trial Investigators
Published: April 2020

Background and Purpose—
We assessed whether lower-dose alteplase at 0.6 mg/kg is efficacious and safe for acute fluid-attenuated inversion recovery-negative stroke with unknown time of onset.

Methods—
This was an investigator-initiated, multicenter, randomized, open-label, blinded-end point trial. Patients met the standard indication criteria for intravenous thrombolysis other than a time last-known-well >4.5 hours (eg, wake-up stroke). Patients were randomly assigned (1:1) to receive alteplase at 0.6 mg/kg or standard medical treatment if magnetic resonance imaging showed acute ischemic lesion on diffusion-weighted imaging and no marked corresponding hyperintensity on fluid-attenuated inversion recovery. The primary outcome was a favorable outcome (90-day modified Rankin Scale score of 0–1).

Results—

Following the early stop and positive results of the WAKE-UP trial (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke), this trial was prematurely terminated with 131 of the anticipated 300 patients (55 women; mean age, 74.4±12.2 years). Favorable outcome was comparable between the alteplase group (32/68, 47.1%) and the control group (28/58, 48.3%; relative risk [RR], 0.97 [95% CI, 0.68–1.41];
P
=0.892). Symptomatic intracranial hemorrhage within 22 to 36 hours occurred in 1/71 and 0/60 (RR, infinity [95% CI, 0.06 to infinity];
P
>0.999), respectively. Death at 90 days occurred in 2/71 and 2/60 (RR, 0.85 [95% CI, 0.06–12.58];
P
>0.999), respectively.

Conclusions—
No difference in favorable outcome was seen between alteplase and control groups among patients with ischemic stroke with unknown time of onset. The safety of alteplase at 0.6 mg/kg was comparable to that of standard treatment. Early study termination precludes any definitive conclusions.

Registration—

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02002325.
Polarimetric Relations for Snow Estimation—Radar Verification
Authors: Bukovčić Petar , Ryzhkov Alexander , Zrnić Dusan 
Published: April 2020

AbstractIn a 2018 paper by Bukovčić et al., polarimetric bivariate power-law relations for estimating snowfall rate S and ice water content (IWC), and , were developed utilizing 2D video disdrometer snow measurements in Oklahoma. Herein, these disdrometer-based relations are generalized for the range of particle aspect ratios from 0.5 to 0.8 and the width of the canting angle distribution from 0° to 40° and are validated via analytical/theoretical derivations and simulations. In addition, a novel S(KDP, Zdr) polarimetric relation utilizing the ratio between specific differential phase KDP and differential reflectivity Zdr, , is derived. Both KDP and are proportionally affected by the ice particles’ aspect ratio and width of the canting angle distribution; therefore, the variables’ ratio tends to be almost invariant to the changes in these parameters. The S(KDP, Z) and S(KDP, Zdr) relations are applied to the polarimetric S-band WSR-88D data obtained from three geographical locations in Virginia, Oklahoma, and Colorado, and their performance is compared with estimations from the standard S(Z) relations and ground snow measurements. The polarimetric estimates of snow accumulations from the three cases exhibit smaller bias in comparison with the S(Z), indicating good potential for more reliable radar snow measurements.
Embracing Uncertainty: Using Probabilistic Weather Forecasts to Make Ensemble Hydraulic Predictions at Remote Low-Water Crossings
Authors: Matus Sean A. , Dominguez Francina , Gambill Daniel R. , Howard Heidi R. 
Published: April 2020

AbstractLow-water crossings are structures designed to be overtopped during high river flows. These structures are usually constructed in remote locations, making timely emergency response difficult in case of flooding. In this work, five historical flooding events were hindcasted at a remote low-water crossing in central Texas. An ensemble of model-simulated precipitation forcing cascades uncertainty through hydrologic and hydraulic models. Each precipitation ensemble member corresponds to an independent model run, resulting in an ensemble 24-h streamflow forecast initialized at 0000 UTC. In addition to the hydrologic conditions, the forecast is expanded to predict river hydraulics, through flow velocity and depth. Analysis of the five hindcast events indicates that cascading probabilistic precipitation through hydrologic and hydraulic models adds robustness to river forecasts compared to deterministic methods. The approach provides a means to communicate the uncertainty of predictions through the ensemble spread. Analysis of deterministic hazard thresholds suggest that a hydraulic stability threshold, calculated as the multiplication of flow velocity and depth, is a useful alternative approach to NWS high-water categories for communicating hydrologic/hydraulic risk, as well as associated model uncertainty in the simplest manner possible.
Driving into Danger: Perception and Communication of Flash-Flood Risk
Authors: Coles Ashley R. , Hirschboeck Katherine K. 
Published: April 2020

AbstractFloods, particularly urban flash floods, frequently disrupt traffic, constraining mobility and exposing motorists to danger. Flood risk managers educate the public on the dangers of driving through flooded roadways, yet losses to life and property continue to occur. This study integrates cultural psychology and risk perception theory to explore how cultural and situational factors influence motorists’ behavior during flash floods. Flood risk managers in Tucson, Arizona, collaborated in the development of a questionnaire mailed to local residents in 2007. Self-reported levels of trust, self-efficacy, social incorporation, and situational factors were analyzed with respect to whether respondents stated that they have or have not driven through a flooded roadway. Respondents demonstrate complex reasoning when confronted with flooded roadways, rather than simple or consistent risk-taking or risk-avoidance behaviors. Participants indicate high levels of trust in official warning messages and share information about floods within their social networks, highlighting the success of education campaigns. However, flood conditions are not always clear, so motorists seek additional sources of information and weigh the dangers against other situational factors on a case-by-case basis. Factors that influence respondents’ decisions include the prior successful crossing of other vehicles, presence of signs and barricades, presence of passengers, risk of personal injury or damage to the vehicle, and the availability of flood-related information. The results also show that individuals who know how to avoid floods, including by asking others for advice, are less likely to enter flooded roadways, and thus communicating further instructions will empower more motorists to avoid danger.
Regional Cooperation in Industrial Revolution 4.0 and South Asia: Opportunities, Challenges and Way Forward
Authors: Mukherjee Arpita , Satija Divya 
Published: April 2020

This paper examines the current status of use of Industrial Revolution 4.0 (4th IR) in South Asia and the role and need for regional cooperation to harness the potential and benefits of 4th IR. It examines the development across South Asian countries, their participation in international forums, their level of collaboration and cooperation in technology adaptation and digitalization. Based on secondary data analysis and in-depth meetings with experts, the paper explores the potential of 4th IR in this region and identifies the challenges of South Asian countries. It then presents recommendations on how the South Asian countries can harness the benefits of 4th IR and address their common concerns through collaborations under the South Asian Association for Regional Cooperation (SAARC), so that all member countries can benefit from 4th IR, by leveraging each other’s best practices and comparative advantages. This can help countries in the region to achieve high and inclusive growth and meet their sustainable development goals. JEL: O3, O57, F13
Towards a ‘Responsible AI’: Can India Take the Lead?
Authors: Chakrabarti Rajesh , Sanyal Kaushiki 
Published: April 2020

The impact of artificial intelligence (AI) on every aspect of our lives is inevitable and already being felt in numerous ways. Countries are grappling with the opportunities and challenges that AI presents. Among the South Asian countries, India has taken a lead in promoting and regulating AI. However, it lags significantly behind countries such as China or the United States. This article explores India’s AI ecosystem, the threats and challenges it faces, and the ethical issues it needs to consider. Finally, it examines the common concerns among South Asian nations and the possibility of coming together to promote and regulate AI in the region. JEL: Z: Z0: Z000
Differences between intentional and accidental ingestion of foreign body in China
Authors: Zong Ye , Zhao Haiying , Sun Can , Ji Ming , Wu Yongdong , Zhang Shutian , Wang Yongjun 
Published: April 2020

Abstract
Backgrounds
Previous reports of foreign-body ingestion focused primarily on accidental ingestion and very few studies focused on intentional ingestion of foreign body (FB) in China. Our study aimed to compare the prevalence of different age, gender, types, locations and management of FB ingested between intentional ingestion and accidental ingestion of FB in Northern China.

Methods
A retrospective case series studied all patients with suspected FB ingestion in Digestive Endoscopy Center of Beijing Friendship Hospital, between January 2011 and January 2019. The patients were divided into 2 groups. Group A included the patients who intentionally ingested FBs, and Group B included the patients who accidentally ingested FBs. Patients’ database (demographics, past medical history, characteristics of FB, endoscopic findings and treatments) were reviewed. Statistical analyses were conducted using SPSS software.

Results
Group A consisted of 77 prisoners, 2 suspects and 11 psychologically disabled persons. Group B consisted of 1020 patients with no prisoners, suspects or psychologically disabled persons. In Group A, there were no food-related foreign bodies, and the majority of FBs were metallic objects (54.44%). However in Group B, food-related FBs were the most common (91.37%). In Group A, 58 cases (64.44%) were located in the stomach, while in Group B, 893 cases (87.55%) were located in the esophagus (P < 0.05). 1096 patients successfully underwent endoscopic removal and 14 failed, including 9 cases in Group A and 5 cases in Group B. The duration of FBs impaction was longer in Group A than that in Group B (P < 0.05).

Conclusions
In our study, the patients who intentionally ingested FB were mainly prisoners, FBs were mostly sharp metallic objects, the duration of FBs impaction was longer, and the rate of successful endoscopic treatment was lower than that of the general population. Attention should be focused on these patients.
Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty liver disease: the GOASIA study
Authors: Pitisuttithum Panyavee , Chan Wah Kheong , Piyachaturawat Panida , Imajo Kento , Nakajima Atsushi , Seki Yosuke , Kasama Kazunori , Kakizaki Satoru , Fan Jian Gao , Song Myeong Jun , Yoon Seung Kew , Dan Yock Young , Lesmana Laurentius , Ho Khek Yu , Goh Khean Lee , Wong Vincent Wai Sun , Treeprasertsuk Sombat 
Published: April 2020

Abstract
Background
The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. We aimed to 1) compare the characteristics of elderly (i.e. age ≥ 60) vs. non-elderly patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD); 2) identify predictors of advanced fibrosis in elderly patients with NAFLD; and 3) assess the performance of non-invasive fibrosis scores in the prediction of advance fibrosis in the elderly population.

Methods
We abstracted the data of 1008 patients with NAFLD from nine centers across eight countries. Characteristics of elderly and non-elderly patients with NAFLD were compared using 1:3 sex-matched analysis.

Results
Of the 1008 patients, 175 were elderly [age 64 (62–67) years], who were matched with 525 non-elderly patients [46 (36–54) years]. Elderly patients were more likely to have advanced fibrosis (35.4% vs. 13.3%; p < 0.001). By multivariable analysis, factors associated with advanced fibrosis in elderly patients included female sex [odds ratio (OR) 3.21; 95% confidence interval (CI) 1.37–7.54] and hypertension (OR 3.68; 95%CI 1.11–12.23). The area under receiver-operating characteristics curve (95% CI) of aspartate aminotransferase-to-platelet ratio index, NAFLD fibrosis score and Fibrosis-4 index for predicting advanced fibrosis in elderly patients were 0.62 (0.52–0.72), 0.65 (0.55–0.75) and 0.64 (0.54–0.74) respectively.

Conclusions
Elderly patients with NAFLD had a higher prevalence of advanced fibrosis than non-elderly patients. Female and hypertension were predicting factors for advanced fibrosis in the elderly. Non-invasive fibrosis scores had a lower specificity in elderly.