bluuebunny/crossref_metadata_2025_split huggingface dataset:
Financial implications of using extracorporeal membrane oxygenation following heart transplantation
Authors: Krishnamoorthy Bhuvaneswari , Mehta Vipin , Critchley William , Callan Paul , Shaw Steve , Venkateswaran Rajamiyer 
Published: November 2020

Abstract

OBJECTIVES
Primary graft dysfunction after heart transplant is associated with high morbidity and mortality. Extracorporeal membrane oxygenation (ECMO) can be used to wean patients from cardiopulmonary bypass. This study retrospectively reviews a single-centre experience of post-transplant ECMO in regard to outcomes and associated costs.

METHODS
Between May 2006 and May 2019, a total of 267 adult heart transplants were performed. We compared donor and recipient variables, ECMO duration and the incidence of renal failure, bleeding, infection and cost analysis between ECMO and non-ECMO groups.

RESULTS
ECMO support was required postoperatively to manage primary graft dysfunction in 72 (27%) patients. The mean duration of ECMO support was 6 ± 3.2 days. Mean ischaemic times were similar between the groups. There was a significantly higher proportion of ventricular assist device explant to transplant in the ECMO group versus non-ECMO (38.2% vs 14.1%; P &lt; 0.0001). ECMO patients had a longer duration of stay in the intensive care unit (P &lt; 0.0001) and total hospital stay (P &lt; 0.0001). Greater mortality was observed in the ECMO group (P &lt; 0.0001). The median cost of providing ECMO was £18 000 [interquartile range (IQR): £12 750–£24 000] per patient with an additional median £35 225 (IQR: £21 487.25–£51 780.75) for ITU stay whilst on ECMO. The total median cost per patient inclusive of hospital stay, ECMO and dialysis costs was £65 737.50 (IQR: £52 566.50–£95 221.75) in the non-ECMO group compared to £145 415.71 (IQR: £102 523.21–£200 618.96) per patient in the ECMO group (P &lt; 0.0001).

CONCLUSIONS
Patients with primary graft dysfunction following heart transplantation who require ECMO are frequently bridged to a recovery; however, the medium and longer-term survival for these patients is poorer than for patients who do not require ECMO.
A case of splenic artery pseudoaneurysm rupture presenting as rectal bleeding in a regional hospital
Authors: Holt Jonathon N , Schwalb Heinrich E 
Published: November 2020

Abstract
Splenic artery pseudoaneurysm is a rare phenomenon most associated with chronic pancreatitis or previous trauma. Complications can include erosion and rupture into local structures, a situation that carries a reported mortality of 10–40%. A 58-year-old male with chronic alcoholic pancreatitis and a known splenic artery pseudoaneurysm presented to the emergency department of a regional hospital with rectal bleeding and sepsis. Computed tomography revealed a peri-splenic mass communicating with the splenic flexure. The patient was taken for an emergency splenectomy and left hemicolectomy and was confirmed to have rupture of the splenic artery aneurysm into the large bowel. This case presented with comparable features reported in the literature and demonstrates that access to emergency specialist surgical services in a regional setting offers the capability to manage rare, life threatening surgical emergencies.
Clinical Improvement and Effectiveness of Exercise-Based Pulmonary Rehabilitation in Patients With Idiopathic Pulmonary Fibrosis
Authors: Vainshelboim Baruch 
Published: November 2020

Background:
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease associated with high mortality rates and poor clinical condition. Exercise-based pulmonary rehabilitation (EBPR) has been demonstrated to be effective in improving 6-min walk distance (6MWD), although the clinical improvement and effectiveness are less characterized. The current review examined the existing evidence of EBPR among patients with IPF and aimed to analyze the effect of EBPR on clinical improvement and effectiveness.

Methods:
A systematic databases search (MEDLINE/PubMed, EMBASE, and the Cochrane Library) was conducted for available publications as of January 2020. Randomized controlled trials (RCTs) and meta-analyses of RCTs examining the effect of EBPR in patients with IPF were reviewed. Mean difference for RCTs and weighted mean difference for meta-analyses between the EBPR arm and the usual-care arm in 6MWD were compared with the established minimal clinically important difference (MCID) of 30 m. Clinical improvement following EBPR was determined when mean difference and weighted mean difference were equal or exceeding the MCID. Effectiveness of EBPR was assessed using the number needed to treat (NNT) analysis.

Results:
Five independent RCTs (including 21-61 patients/study) and five meta-analyses (including two to five studies with 62-169 patients/meta-analysis) were included. The mean difference of 6MWD ranged from 16-81 m in RCTs. Three of five RCTs demonstrated an average improvement that meets or exceeds the MCID. Two RCTs showed favorable improvement in 6MWD but did not reach the MCID. The weighted mean difference of 6MWD ranged from 27-49 m in the meta-analyses. Four of five meta-analyses showed an average improvement that meets or exceeds the MCID. One early meta-analysis of only two RCTs showed significant improvement, although did not reach the MCID. The NNT in three RCTs and four meta-analyses that met clinical improvement in 6MWD was one.

Conclusions:
This review provides novel evidence with respect to clinical improvement and high effectiveness of EBPR among patients with IPF. The results suggest that, on average, the majority of patients would be expected to clinically improve by completing the EBPR program. The findings further support the prescription of EBPR as clinically effective therapy and implementation as standard of care for patients with IPF. Future studies examining clinical improvement and effectiveness utilizing additional outcomes with the MCID are warranted.
Factors Associated With Change in Cardiovascular Fitness for Patients With Peripheral and Coronary Artery Disease in Cardiac Rehabilitation
Authors: Nguyen Cindy H. , Thomas Scott G. , Marzolini Susan 
Published: November 2020

Purpose:
Cardiac rehabilitation (CR) yields improvements in cardiorespiratory fitness (peak oxygen uptake [V˙o
2peak]). Predictors of change in V˙o
2peak have been reported among patients with coronary artery disease (CAD) but have not been compared with peripheral artery disease (PAD). This study determined predictors of improved V˙o
2peak among patients with PAD, CAD, and concomitant PAD and CAD (PAD/CAD) following a 6-mo home-based outpatient CR program (1supervised and 4 home weekly sessions).

Methods:
This study was a retrospective (2006-2017) multiple linear regression analysis of CR patients with PAD (n = 63), CAD (n = 63), and PAD/CAD (n = 164). Peripheral artery disease and CAD were matched for age, sex, smoking status, diabetes, and year in program.

Results:
Mean age of all patients was 68.9±10.1 yr, 72% were male, and mean improvement in V˙o
2peak was 2.1 ± 3.3 mL/kg/min (14.5% improvement) following CR. In CAD, younger age (β = .30, P = .015), male sex (β = −.29, P = .019), and more recent year of entry (β = .26, P = .035) were predictors of improved V˙o
2peak. In PAD, only male sex (β = −.36, P = .004) and in PAD/CAD, not having diabetes (β = −.24, P = .002), not smoking (β = −.25, P = .001), and shorter elapsed time from referring diagnosis to entry (β = −.19, P = .016) were predictors.

Conclusions:
While younger age and male sex were predictors of improved V˙o
2peak in CAD, age did not influence PAD, and neither age nor sex influenced PAD/CAD. Peripheral artery disease–related limitations may override some demographic factors, and strategies for improving V˙o
2peak should be explored. Managing smoking and comorbid diagnoses including diabetes and a timely entry to CR may yield greater improvements in V˙o
2peak among individuals with PAD.
Diffusional kurtosis imaging in evaluation of microstructural changes of spinal cord in cervical spondylotic myelopathy feasibility study
Authors: Yu Jinfen , Sun Yongqiang , Cao Guangliang , Zheng Xiuzhu , Jing Yan , Li Chuanting 
Published: November 2020

Abstract
To explore the value of diffusion kurtosis imaging in the changes of spinal cord microstructures in patients with early cervical spondylotic myelopathy.
Twenty nine patients with cervical myelopathy were selected in this study. All images were acquired on a 3.0 T MR scanner (Skyra, Siemens Medical Systems, Germany). The imaging parameters for diffusion kurtosis imaging were as follows: repetition time/echo time, 3000/91 ms; averages, 2; slice thickness/gap, 3/0.3 mm; number of slices, 17; field of view, 230 × 230 mm; Voxel size, 0.4 × 0.4 × 3.0 mm; 3 b-values (0, 1000, and 2000 s/mm2) with diffusion encoding in 20 directions for each b-value. Values for fractional anisotropy, mean diffusivity, and mean diffusional kurtosis (MK) were calculated and compared between unaffected and affected spinal cords.
In all patients MK was significantly lower in normal appearing spinal cords adjacent to the affected cervical spinal cords than in normal cervical spinal cords (0.862 ± 0.051 vs 0.976 ± 0.0924, P < .0001), but the difference of fractional anisotropy and apparent diffusion coefficient was no significant (P > .05). The affected cervical spinal cords had lower MK (0.716 ± 0.0753), FA and higher apparent diffusion coefficient than normal cervical spinal cords (P < .001).
MK values in the cervical spinal cord may reflect microstructural changes of spinal cord damage in cervical myelopathy, and it could potentially provide more information that obtained with conventional diffusion metrics.
Retinal Vascular Measures from Diabetes Retinal Screening Photographs and Risk of Incident Dementia in Type 2 Diabetes: A GoDARTS Study
Authors: Doney Alexander SF , Nar Aditya , Huang Yu , Trucco Emanuele , MacGillivray Tom , Connelly Peter , Leese Graham P , McKay Gareth J 
Published: November 2020

AbstractObjectivePatients with diabetes have an increased risk of dementia. Improved prediction of dementia is an important goal in developing future prevention strategies. Diabetic retinopathy screening (DRS) photographs may be a convenient source of imaging biomarkers of brain health. We therefore investigated the association of retinal vascular measures (RVMs) from DRS photographs in patients with type 2 diabetes with dementia risk.Research Design and MethodsRVMs were obtained from 6,111 patients in the GoDARTS bioresource using VAMPIRE software. Their association, independent of Apo E4 genotype and clinical parameters, was determined for incident all cause dementia (ACD) and separately Alzheimer’s dementia (AD) and vascular dementia (VD). We used Cox’s proportional hazards with competing risk of death without dementia. The potential value of RVMs to increase the accuracy of risk prediction was evaluated.ResultsIncreased retinal arteriolar fractal dimension associated with increased risk of ACD (csHR 1.17; 1.08-1.26) and AD (HR 1.33; 1.16-1.52), whereas increased venular fractal dimension (FDV) was associated with reduced risk of AD (csHR 0.85; 0.74-0.96). Conversely, FDV was associated with increased risk of VD (csHR 1.22; 1.07-1.40). Wider arteriolar calibre was associated with a reduced risk of ACD (csHR 0.9; 0.83-0.98) and wider venular calibre was associated with a reduced risk of AD (csHR 0.87; 0.78-0.97). Accounting for competing risk did not substantially alter these findings. RVMs significantly increased the accuracy of prediction.ConclusionsConventional DRS photographs could enhance stratifying patients with diabetes at increased risk of dementia facilitating the development of future prevention strategies.
Potential of machine learning to predict early ischemic events after carotid endarterectomy or stenting: A comparison with surgeon predictions
Authors: Matsuo Kazuya , Fujita Atsushi , Hosoda Kohkichi , Tanaka Jun , Imahori Taichiro , Ishii Taiji , Kohta Masaaki , Tanaka Kazuhiro , Uozumi Yoichi , Kimura Hidehito , Sasayama Takashi , Kohmura Eiji 
Published: November 2020

AbstractBackgroundCarotid endarterectomy (CEA) and carotid artery stenting (CAS) are recommended for high stroke-risk patients with carotid artery stenosis to reduce ischemic events. However, we often face difficulty in determining the best treatment strategy.ObjectiveWe aimed to develop an accurate post-CEA/CAS outcome prediction model using machine learning that will serve as a basis for a new decision support tool for patient-specific treatment planning.MethodsRetrospectively collected data from 165 consecutive patients with carotid stenosis underwent CEA or CAS were divided into training and test samples. The following five machine learning algorithms were tuned, and their predictive performance evaluated by comparison with surgeon predictions: an artificial neural network, logistic regression, support vector machine, random forest, and extreme gradient boosting (XGBoost). Seventeen clinical factors were introduced into the models. Outcome was defined as any ischemic stroke within 30 days after treatment including asymptomatic diffusion-weighted imaging abnormalities.ResultsThe XGBoost model performed the best in the evaluation; its sensitivity, specificity, positive predictive value, and accuracy were 31.9%, 94.6%, 47.2%, and 86.2%, respectively. These statistical measures were comparable to those of surgeons. Internal carotid artery peak systolic velocity, low density lipoprotein cholesterol, and procedure (CEA or CAS) were the most contributing factors according to the XGBoost algorithm.ConclusionWe were able to develop a post-procedural outcome prediction model comparable to surgeons in performance. The accurate outcome prediction model will make it possible to make a more appropriate patient-specific selection of CEA or CAS for the treatment of carotid artery stenosis.
Scientific output on coronavirus and WHO’s Solidarity Project: a science-based choice?
Authors: Galina Andréia Cristina , Sarzi Deise , de Medeiros Larissa Campos , Sampaio André Luiz Franco , Leta Jacqueline 
Published: November 2020

ABSTRACTIn March 2020, the World Health Organization (WHO) launched the Solidarity Program probably the largest global initiative to encourage and support research in four promising drugs and therapies (Remdesivir, Hydroxychloroquine, β interferon and the combination Lopinavir / Ritonavir) to reduce the mortality of COVID-19. Considering the potential impact of this project to restrain the current pandemic, the present study aims to investigate whether it was designed upon a scientific basis. For this proposal, we collected all documents on coronavirus indexed in Scopus database by using a search strategy based in MESH terms. Among the studied groups of documents, we looked in more detail the Coronavirus group in order to find documents related to WHO’ s drugs or to other drugs and therapies extracted from another source. The main findings indicate that the number of documents related to WHO’s drugs are higher than in the other groups and this subset of documents involves a larger number of institutions and countries. Hence, the results shown in this study illustrate that decisions by an international body, as WHO, may be science-based and not be merely bureaucratic decisions.
The impact of COVID-19 employment shocks on suicide and safety net use: An early-stage investigation
Authors: Ando Michihito , Furuichi Masato 
Published: November 2020

AbstractThis paper examines whether the COVID-19-induced employment shocks are associated with increases in suicides and safety net use in the second and third quarters of 2020. We exploit plausibly exogenous regional variation in the magnitude of the employment shocks in Japan and adopt a difference-in-differences research design to examine and control for possible confounders. Our preferred point estimates suggest that a one-percentage-point increase in the unemployment rate in the second quarter of 2020 is associated with, approximately, an additional 0.52 suicides, 28 unemployment benefit recipients, 88 recipients of a temporary loan program, and 10 recipients of public assistance per 100,000 population per month. A simple calculation based on these estimates suggests that if a region experienced a one-percentage-point increase in the unemployment rate caused by the COVID-19 crisis in the second quarter of 2020, which is roughly equivalent to the third-highest regional employment shock, this would be associated with 37.4%, 60.5%, and 26.5% increases in the total, female, and male suicide rates respectively in July 2020 compared with July 2019. Our baseline findings are robust to several different model specifications, although we do not assert that our research design perfectly solves the problem of estimation bias.
Age Specific Months of Mortality (MOMa) from Endemic and Pandemic (Covid 19) diseases
Authors: Rembold Christopher M 
Published: November 2020

ABSTRACTPeople do not naturally understand risk. We fear things that happen rarely like kidnapping while ignoring common risks like motor vehicle crashes. We also do not fully comprehend the large effect that age has on risk. In this paper, I introduce a concept that I call age specific months of mortality, abbreviated MOMa, a statistic that will allow people to understand their risk of death within their age group. In a year without excess mortality, i.e. no pandemic, individual causes of death will add up to a total of 12 MOMa. Excess mortality, e.g. a pandemic, adds MOMa beyond 12. For people in their 20s, the MOMa is 5 for accidents, 1.9 for suicide, 1.6 for homicide, and 1.2 for Covid-19. For people in their 60s, the MOMa is 12 for Covid-19, 4 for cancer, 2.6 for coronary heart, and treatment of Covid-19 with dexamethasone reduces MOMa from 12 to 7 months.
A Detailed Map of Coupled Circadian Clock and Cell Cycle with Qualitative Dynamics Validation
Authors: Rougny Adrien , Paulevé Loïc , Teboul Michèle , Delaunay Franck 
Published: November 2020

AbstractThe temporal coordination of biological processes by the circadian clock is an important mechanism, and its disruption has negative health outcomes, including cancer. Experimental and theoretical evidence suggests that the oscillators driving the circadian clock and the cell cycle are coupled through phase locking. We present a detailed and documented SBGN PD map of known mechanisms related to the regulation of the circadian clock, and its coupling with an existing cell cycle SBGN PD map which includes main interactions of the mammalian cell cycle. The coherence of the merged map has been validated with a qualitative dynamics analysis. We verified that the coupled circadian clock and cell cycle maps allow reproducing the observed sequence of phase markers. Moreover, we predicted mutations that contribute to regulating checkpoints of the two oscillators. Strikingly, our approach underlines the potential key role of the core clock protein NR1D1 in regulating cell cycle progression. We predicted that its activity influences negatively the progression of the cell cycle from phase G2 to M. It is consistent with the earlier experimental finding that pharmacological activation of NR1D1 inhibits tumour cell proliferation and shows that our approach can identify biologically relevant species in the context of large and complex networks.
Liquidity risk determinants: Islamic vs conventional banks
Authors: Ghenimi Ameni , Chaibi Hasna , Omri Mohamed Ali Brahim 
Published: November 2020

PurposeThis paper aims to identify and analyze the similarities and differences of the liquidity risk determinants within conventional and Islamic banks.Design/methodology/approachThis study uses a dynamic panel data approach to examine the relationship between liquidity risk and a set of bank-specific and macroeconomic factors during 2005–2015, by selecting 27 Islamic banks and 49 conventional ones operating in the MENA region. More specifically, the dynamic two-step generalized method of moment estimator technique introduced by Arellano and Bond (1991) is applied.FindingsThe results suggest that the set of bank-specific variables influences the liquidity risk of both banking systems, while macroeconomic factors determine the liquidity risk of conventional banks. Islamic banks are not affected by macroeconomic determinants.Practical implicationsThe research facilitates to the academicians, practitioners and bankers to have an alluded picture about liquidity risk determinants and their management. The findings can be used by bankers’ policy decision-makers to improve and enhance their consideration for liquidity risk management in both banking systems. Indeed, the study makes them aware to manage liquidity risk differently between conventional and Islamic banks, as the results reveal different liquidity risk determinants.Originality/valueCompared to the abundant studies on the determinants of credit risk, researchers have not sufficiently addressed the factors influencing liquidity risk. Moreover, none of these few research studies has discussed and compared liquidity risk determinants within both banking systems operating in the Middle East and North Africa (MENA) region. This leads us to identify the similarities and differences between conventional and Islamic banks in the MENA region in respect of systematic and unsystematic determinants of the liquidity risk. The value is attributed to the increasing differentiation between Islamic and conventional banks. Islamic banks are characterized with a different liquidity structure distinguishing them from their conventional counterparts.
Promising practices for de-escalation and use-of-force training in the police setting: a narrative review
Authors: Bennell Craig , Blaskovits Brittany , Jenkins Bryce , Semple Tori , Khanizadeh Ariane-Jade , Brown Andrew Steven , Jones Natalie Jennifer 
Published: November 2020

PurposeA narrative review of existing research literature was conducted to identify practices that are likely to improve the quality of de-escalation and use-of-force training for police officers.Design/methodology/approachPrevious reviews of de-escalation and use-of-force training literature were examined to identify promising training practices, and more targeted literature searches of various databases were undertaken to learn more about the potential impact of each practice on a trainee's ability to learn, retain, and transfer their training. Semi-structured interviews with five subject matter experts were also conducted to assess the degree to which they believed the identified practices were relevant to de-escalation and use-of-force training, and would enhance the quality of such training.FindingsTwenty practices emerged from the literature search. Each was deemed relevant and useful by the subject matter experts. These could be mapped on to four elements of training: (1) commitment to training (e.g. securing organizational support for training), (2) development of training (e.g. aligning training formats with learning objectives), (3) implementation of training (e.g. providing effective corrective feedback) and (4) evaluation and ongoing assessment of training (e.g. using multifaceted evaluation tools to monitor and modify training as necessary).Originality/valueThis review of training practices that may be relevant to de-escalation and use-of-force training is the broadest one conducted to date. The review should prompt more organized attempts to quantify the effectiveness of the training practices (e.g. through meta-analyses), and encourage more focused testing in a police training environment to determine their impact.