bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Arterial Ischemic Events After Intracerebral Hemorrhage
Authors: Murthy Santosh B. , Diaz Ivan , Wu Xian , Merkler Alexander E. , Iadecola Costantino , Safford Monika M. , Sheth Kevin N. , Navi Babak B. , Kamel Hooman 
Published: November 2019

Background and Purpose—
The risk of arterial ischemic events after intracerebral hemorrhage (ICH) is poorly understood given the lack of a control group in prior studies. This study aimed to evaluate the risk of acute ischemic stroke and myocardial infarction (MI) among patients with and without ICH.

Methods—

We performed a retrospective cohort study using claims data from Medicare beneficiaries from 2008 to 2014. Our exposure was acute ICH, identified using validated
International Classification of Diseases, Ninth Revision, Clinical Modification
diagnosis codes. Our primary outcome was a composite of acute ischemic stroke and MI, whereas secondary outcomes were ischemic stroke alone and MI alone. We used Cox regression analysis to compute hazard ratios during 1-month intervals after ICH. Sensitivity analyses entailed exclusion of patients with atrial fibrillation and valvular heart disease.

Results—
Among 1 760 439 Medicare beneficiaries, 5924 had ICH. The 1-year cumulative incidence of an arterial ischemic event was 5.7% (95% CI, 4.8–6.8) in patients with ICH and 1.8% (95% CI, 1.7–1.9) in patients without ICH. After adjusting for potential confounders, the risk of an arterial ischemic event remained significantly increased for the first 6 months after ICH and was especially high in the first month (hazard ratio, 6.7 [95% CI, 5.0–8.6]). In secondary analysis, the risk of ischemic stroke was increased in the first 6 months after ICH (hazard ratio, 6.1 [95% CI, 3.5–9.3]) but the risk of MI was not (hazard ratio, 1.6 [95% CI, 0.3–2.9]). In sensitivity analyses excluding patients with atrial fibrillation and valvular heart disease, the association between ICH and arterial ischemic events was similar to that of the primary analysis.

Conclusions—
In a large population-based cohort, we found that elderly patients with ICH had a substantially increased risk of ischemic stroke in the first 6 months after diagnosis. Further exploration of this risk is needed to determine optimal secondary prevention strategies for these patients.
Global Survey of Precipitation Properties Observed during Tropical Cyclogenesis and Their Differences Compared to Nondeveloping Disturbances
Authors: Zawislak Jonathan 
Published: November 2019

Abstract
This study evaluates precipitation properties involved in tropical cyclogenesis by analyzing a multiyear, global database of passive microwave overpasses of the pregenesis stage of developing disturbances and nondeveloping disturbances. Precipitation statistics are quantified using brightness temperature proxies from the 85–91-GHz channels of multiple spaceborne sensors, as well as retrieved rain rates. Proxies focus on the overall raining area, areal coverage of deep convection, and the proximity of precipitation to the disturbance center. Of interest are the differences in those proxies for developing versus nondeveloping disturbances, how the properties evolve during the pregenesis stage, and how they differ globally. The results indicate that, of all of the proxies examined, the total raining area and rain volume near the circulation center are the most useful precipitation-related predictors for genesis. The areal coverage of deep convection also differentiates developing from nondeveloping disturbances and, similar to the total raining area, generally also increases during the pregenesis stage, particularly within a day of genesis. As the threshold convective intensity is increased, pregenesis cases are less distinguishable from nondeveloping disturbances. Relative to the western Pacific and Indian Oceans, the Atlantic and eastern North Pacific Oceans have less precipitation and deep convection observed during genesis and the smallest differences between developing and nondeveloping disturbances. This suggests that the total raining area and areal coverage of deep convection associated with tropical disturbances are better predictors of tropical cyclogenesis fate in the Pacific and Indian Oceans than in the Atlantic and eastern North Pacific.
Implications of SAFTA for Indian Economy: Trade, Compatibility and Welfare Effects
Authors: Jain Hansa 
Published: November 2019

Among the members of South Asian Free Trade Area (SAFTA), India dominates in terms of its geographical location, land area, population size and economic share. However, SAFTA is treated as a weak agreement as India is highly outward oriented for trade. This raises a question about India’s trade compatibility with South Asian countries. Also since SAFTA is now fully implemented, there is a need to determine its welfare effects for India as well as for the region. The study focuses on (a) trends and patterns of India’s intra-regional trade with South Asian countries, (b) trade compatibility and (c) welfare effects of SAFTA for the Indian economy. India’s trade intensity, trade share and trade compatibility with the other regional members is calculated. GTAP simulations are used to determine welfare effects. The study is based upon the secondary data. The study finds that with the implementation of SAFTA, India’s trade intensity and trade share with its regional members has slightly improved. Trade compatibility though low, is gradually improving. The study considers SAFTA as a positive sum game for India. India is likely to have favourable allocative efficiency effect, terms of trade effect and investment-savings effect if trade facilitation measures are adopted. JEL Codes: F150, F10, F140, C150
India–Iran Trade Relations Under the Shadow of USA Sanctions
Authors: Hussain Wani Suadat , Mir Mohd Afzal , Ahmad Shah Imtiyaz 
Published: November 2019

India and Iran have a long history of cooperation on various issues ranging from economic to strategic importance. However, the present phase of cooperation is as old as end of the cold war and reached a peak during the period 2001–2003 with the Tehran and Delhi declarations, which established a substantial set of framework for enhanced cooperation. In the present times given the changing regional and global economic and security conditions, many attempts have been made by both countries to increase their cooperation. Since Islamic revolution, Iran faces continuous confrontation and sanctions from the West and the USA. Iran has continuously tried to improve its relations with its neighbours and other friendly countries to minimize the impact of these sanctions which are badly affecting its economy. India, on the other hand, has been growing at a faster pace from last many years which has increased its energy requirements. Given Iran’s nuclear programme and its confrontation with the West and India’s energy requirements, both countries are working together to sustain their economic and energy cooperation from last many years. In 2015, both countries signed a memorandum of understanding worth USD 195 million for the development of Chabahar Port situated in south-eastern Iran and India agreed to make the investment in infrastructural development of Iran. Through this port, India will get easy access to Central Asian and Afghanistan which will increase its trade relations with these countries. The aim of this research article is to examine the impact of sanctions on Iran due to its nuclear programme on trade relations between India and Iran by using threshold autoregressive model and using trade variables including exports and imports. JEL Codes: 00, 05, 05
An Empirical Analysis on Association Between Selected Macroeconomic Variables and Stock Market in the Context of BSE
Authors: Keswani Sarika , Wadhwa Bharti 
Published: November 2019

The role of macroeconomic variables cannot be ignored because it plays a very important role in shaping the economy of any country, irrespective of whether it is developing, underdeveloped or developed. The macroeconomic variables were disposable income (DI), government policies (GP), inflation rate (INF), interest rate (IR), exchange rate (ER) and stock price. Monthly data of 10 years were used, that is, from April 2006 to March 2016. Analyses of augmented Dickey–Fuller test, preliminary tests, stability tests, cointegration, vector error correction model (VECM) variance decomposition analysis (VDA) and impulse response have been applied to examine the association between the selected macroeconomic variable and stock returns. All the variables are stationary at 1st difference. The results showed that the residues are normally distributed and that there is no problem of multicollinearity, heteroskedasticity and serial correlation. The results of the cointegration showed a strong long-term relationship among DI, GP, the inflation rate, the exchange rate and the IR on the stock price in Bombay Stock Exchange of India. Results of vector error correction model revealed that in the short run, there was a negative and significant relationship between inflation rate and stock returns; therefore, it can be implied that an increase in the inflation rate eroded the prospect of positive performance among the Sensex but was not significant. JEL Classification: E, E01
Treatment of penetrating trauma to the buttock assisted by spinal endoscopy
Authors: Long Zhi-Sheng , Nie Xiao-Yang , Zhang Yuan-Wei 
Published: November 2019

Objective Penetrating trauma to the buttock is relatively common. Because of the location of the trauma and complicated peripheral anatomical structures, surgery to the area can be difficult. We report the cases of 2 patients who sustained penetrating trauma to the buttock and underwent operative treatment assisted by spinal endoscopy. Methods With the rapid development of minimally invasive spine surgery techniques in recent years, especially the wide application of endoscopy, we treated 2 cases of penetrating trauma with endoscopic probing within the wound channel, followed by hemostasis and postoperative irrigation and drainage. Results Drainage tubes were removed from the 2 patients within 7 days after the surgery. Their wounds were healing well and they were discharged from the hospital within 12 days. Conclusions If there is no injury to the large blood vessels, intestines, or urinary system, satisfactory clinical results can be obtained using spinal endoscopy to probe, irrigate, and identify foreign objects, when combined with hemostasis, postoperative short-term irrigation and debridement, and the use of antibiotics.
Physiotherapy as an Initial Treatment Option for Femoroacetabular Impingement: A Systematic Review of the Literature and Meta-analysis of 5 Randomized Controlled Trials
Authors: Hoit Graeme , Whelan Daniel B. , Dwyer Tim , Ajrawat Prabjit , Chahal Jaskarndip 
Published: November 2019

Background: Femoroacetabular impingement is a common and debilitating source of hip pain in young adults. Although physiotherapy is used as a mainstay of nonoperative care for femoroacetabular impingement, the evidence regarding different physiotherapy practices is poorly understood. Purpose: To collect and synthesize the best available evidence and arrive at a summary estimate of treatment effect for the utility of physiotherapy in the management of femoroacetabular impingement. Study Design: Meta-analysis. Methods: A systematic review was performed on February 2, 2019, of PubMed, EMBASE, and Cochrane Library databases using “femoroacetabular impingement OR hip pain” and “physiotherapy OR nonoperative management” and their synonyms as search terms. Central treatment themes were identified across protocols, and pooled analyses were conducted to assess for differences in patient-reported outcome measures across these themes. Results: A total of 5 randomized controlled trials met our inclusion criteria. The studies included 124 patients with a mean age of 35 years, of whom 24% were male. The average follow-up was 9.4 weeks (range, 6-12 weeks), and the follow-up rate across all participants was 86%. Among these 5 studies, 4 studies used a physiotherapy protocol that focused on core strengthening versus no core strengthening, 4 studies compared active strengthening versus passive modalities, and 3 studies compared supervised versus unsupervised physiotherapy. Pooled analysis across all studies demonstrated improved outcomes in the treatment groups compared with the controls (standardized mean difference [SMD], 0.76; 95% CI, 0.38-1.13; P < .0001). Core strengthening (SMD, 0.82; 95% CI, 0.39-1.26; P = .0002), active physiotherapy (SMD, 0.70; 95% CI, 0.29-1.10; P = .0008), and supervised physiotherapy (SMD, 0.58; 95% CI, 0.14-1.03; P = .01) were found to result in statistically significant improvements in functional outcomes compared with no core strengthening, passive modalities, and unsupervised care, respectively. Conclusion: Supervised physiotherapy programs focusing on active strengthening and core strengthening are more effective than unsupervised, passive, and non–core focused programs. Future studies with longer term follow-up and validated femoroacetabular impingement specific outcome measures are required to determine prognostic factors for success with nonoperative care as well as to determine the ideal patient profile and structured rehabilitation protocol.
Sowing Across a State: Development and Delivery of a Grassroots Pediatric Palliative Care Nursing Curriculum
Authors: Weaver Meaghann S. , Jenkins Rebecca , Wichman Christopher , Robinson Jacob E. , Potthoff Meghan R , Menicucci Traci , Vail Catherine A. 
Published: November 2019

Background: Rural pediatricians and adult-trained hospice teams report feeling ill-prepared to care for children at end of life, resulting in geographies in which children are not able to access home-based services. Objectives: To develop a pediatric palliative care curriculum for inpatient nurses and adult-trained hospice teams caring for children in a rural region. Methods: Curriculum design and delivery was informed by local culture through an interdisciplinary, iterative development approach with confidence, intention, and support measured pre-, post-, and 4 months after delivery. A needs assessment was completed by pediatric nurses caring for children receiving palliative or end-of-life care to inform curricular content (phase 1). A curriculum was designed by an interdisciplinary pediatric palliative care team and piloted with nursing cohorts annually through educational conferences with monthly discussion series for 3 consecutive years (phase 2). Curricular content was then provided for 31 rural hospice team members (phase 3). Results: Self-reported confidence in caring for children increased by 1.1/10 points for adult-trained hospice team members. Mean score for intention to care for children increased by 5.2 points (sustained 5.1 points above baseline at 4 months). Perception of support in caring for children increased by 5 points (mean sustained 5.4 points above baseline at 4 months). Family needs, care goals, and symptom management were prioritized learning topics. Rural hospices previously unwilling to accept children enrolled pediatric patients in the 4 months following the conference. Conclusion: Grassroots curricular initiatives and ongoing educational mentorship can grow pediatric palliative and hospice services in rural regions.
Outcomes and Prognosis Factors in Patients With Vena Cava Filters in a Quaternary Medical Center: A 5-Year Retrospective Analysis
Authors: Elias Michael , Elias Antoine , Oropello John , Doucette John , Jebakumar Jebakaran , Kohli-Seth Roopa 
Published: November 2019

Background: Indications for inferior vena cava filter (IVCF) placement are controversial. This study assesses the proportion of different indications for IVCF placement and the associated 30-day event rates and predictors for all-cause mortality, deep vein thrombosis (DVT), pulmonary embolism, and bleeding after IVCF placement. Method: In this 5-year retrospective cohort observational study in a quaternary care center, consecutive patients with IVCF placement were identified through cross-matching of 3 database sets and classified into 3 indication groups defined as “standard” in patients with venous thromboembolism (VTE) and contraindication to anticoagulants, “extended” in patients with VTE but no contraindication to anticoagulants, and “prophylactic” in patients without VTE. Results: We identified 1248 IVCF placements, that is, 238 (19.1%) IVCF placements for standard indications, 583 (46.7%) IVCF placements for extended indications, and 427 (34.2%) IVCF placements for prophylactic indications. Deep vein thrombosis rates [95% confidence interval] were higher in the extended (8.06% [5.98-10.58]) and prophylactic (7.73% [5.38-10.68]) groups than in the standard group (3.36% [1.46-6.52]). Mortality rates were higher in the standard group (12.18% [8.31-17.03]) than in the extended group (7.55% [5.54-9.99]) and the prophylactic (5.85% [3.82-8.52]) group. Bleeding rates were higher in the standard group (4.62% [2.33-8.12]) than in the prophylactic group (2.11% [0.97-3.96]). Best predictors for VTE were acute medical conditions; best predictors for mortality were age, acute medical conditions, cancer, and Medicare health insurance. Conclusions: Prophylactic and extended indications account for the majority of IVCF placements. The standard indication is associated with the lowest VTE rate that may be explained by the competing risk of mortality higher in this group and related to the underlying medical conditions and bleeding risk. In the prophylactic group (no VTE at baseline), the exceedingly high DVT rate may be related to the IVCF placement.
Low Free T3 Is Associated With Worse Outcomes in Patients in the ICU Requiring Invasive Mechanical Ventilation
Authors: Rothberger Gary D. , Valestra Paul K. , Knight Khalilah , Desai Anish K. , Calixte Rose , Shapiro Lawrence E. 
Published: November 2019

Objective: Critical illness causes a decrease in serum free triiodothyronine (T3) levels. This condition, known as nonthyroidal illness syndrome (NTIS), is associated with poor outcomes. The association of NTIS and outcomes in patients in the intensive care unit (ICU) requiring mechanical ventilation has not been well studied. This study aimed to determine the impact of NTIS on the outcomes of these patients. Methods: This prospective study included 162 patients in the ICU who underwent mechanical ventilation. Serum free T3 levels were tested on the day of initiation of mechanical ventilation. The rates of in-hospital mortality and ventilator-free days (VFDs) at day 28 after the initiation of mechanical ventilation were compared between patients with low (<2.3 pg/mL) and normal (≥2.3 pg/mL) free T3 levels. Patients who died while on mechanical ventilation were assigned a VFD of 0. Results: Low T3 was present in 60% of study patients. The in-hospital mortality rate of the entire cohort was 39%, and the mean and median VFDs at day 28 were 13.5 and 21 days, respectively. Compared to patients with normal free T3, patients with low free T3 had higher in-hospital mortality (52% vs 19%, P < .001) and less mean and median VFDs at day 28 (10.7 vs 18 and 0 vs 23, respectively. P < .001 for both mean and median VFDs). Conclusions: The presence of low T3 due to NTIS in patients in the ICU requiring mechanical ventilation is associated with poor outcomes.
Integrating health service delivery for geriatric patients after hospital admission—A register study on the outcomes and costs
Authors: Hiltunen Anna-Maria , Hörhammer Iiris , Silander Katariina , Kaikuluoma Jaakko , Linna Miika 
Published: November 2019

After a care episode in a hospital, elderly patients often face delays in transitions to permanent residence. Poor care coordination burdens both the patients and the healthcare system. Whereas different models for coordinating geriatric patients’ care and discharge planning have been developed, evidence on their cost-effectiveness remains scant. In this study, we evaluated the associations of an integrated care model on health and social care costs and service utilization among geriatric patients admitted to a hospital in a Finnish city with c. 68,000 citizens. Elderly patient cohorts admitted before (N = 709) and after (N = 364) the implementation of the integrated care model were compared restrospectively. The new model consisted of changes in regional care criteria, discharge planning, coordination between inpatient facilities, and the daily work of nursing staff. Patients treated in the new model spent, on average, 7.4 days less in institutionalized care during one year, and the total annual cost of care decreased by 967€ per patient. A regionally coordinated care pathway from hospital admission to permanent residence may improve the cost-effectiveness of elderly care. Coordination and monitoring of outcomes at regional level is essential to avoid fragmentation of care and suboptimization among different care providers serving the elderly.
A double-blind, randomized, placebo-controlled pilot trial to evaluate safety and efficacy of vorapaxar on arteriovenous fistula maturation
Authors: Olivier Christoph B , Sundaram Vandana , Chertow Glenn M , Shashidhar Sumana , McDonnell Lori K , Ding Victoria Y , Desai Manisha , Mahaffey Kenneth W , Mell Matthew 
Published: November 2019

Background: Protease-activated receptor-1 antagonism by vorapaxar could facilitate arteriovenous fistula maturation but may increase bleeding risk. Objective: The primary objective of the Vorapaxar Study for Maturation of arteriovenous fistula for Hemodialysis Access (VorapAccess) was to determine if vorapaxar improves arteriovenous fistula functional maturation in patients with end-stage renal disease. Methods: VorapAccess was a randomized, placebo-controlled, double-blind pilot trial comparing 2.5 mg vorapaxar per day with placebo for twelve weeks starting on day two after arteriovenous fistula creation. The primary outcome was time to functional maturation defined as successful cannulation for six hemodialysis sessions within three weeks. The planned sample size was 50 participants. The study was terminated early after withdrawal of planned financial support. Given the small number of randomized patients, we performed descriptive analyses without inference testing. Results: A total of 13 participants were randomly allocated study drug (six vorapaxar and seven placebo). The median age was 56 years and seven participants (54%) were female. The median (minimum–maximum) days to functional maturation were 169 (77–287) days in the vorapaxar group and 145 (48–198) days in the placebo group. Six of the 13 (46%) participants had arteriovenous fistula functional maturation within 180 days; two of six (33%) in the vorapaxar group and four of seven (57%) in the placebo group. There was one bleeding event in the placebo group. Conclusion: Fewer than half of participants had functional maturation within 180 days after surgery, suggesting a major need for agents or strategies that enhance arteriovenous fistula maturation.