bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in hospital procedure volumes for intra-arterial treatment of acute ischemic stroke: results from the paul coverdell national acute stroke program
Authors: Asaithambi Ganesh , Tong Xin , Lakshminarayan Kamakshi , Coleman King Sallyann M , George Mary G 
Published: March 2020

BackgroundRates of intra-arterial revascularization treatments (IAT) for acute ischemic stroke (AIS) are increasing in the USA. Using a multi-state stroke registry, we studied the trend in IAT use among patients with AIS over a period spanning 11 years. We examined the impact of IAT rates on hospital procedure volumes and patient outcome after stroke.MethodsWe used data from the Paul Coverdell National Acute Stroke Program (PCNASP) and explored trends in IAT between 2008 and 2018. Patient outcomes were examined by rates of IAT procedures across hospitals. Specifically, outcomes were compared across low-volume (<15 IAT per year), medium-volume (15–30 IAT per year), and high-volume hospitals (>30 IAT per year). Favorable outcome was defined as discharge to home.ResultsThere were 612 958 patients admitted with AIS to 687 participating hospitals within the PCNASP during this study. Only 2.9% of patients (mean age 68.5 years, 49.3% women) received IAT. The percent of patients with AIS receiving IAT increased from 1% in 2008 to 5.3% in 2018 (p<0.001). The proportion of low-volume hospitals decreased over time (p<0.001), and the proportions of medium-volume (p=0.007) and high-volume hospitals (p<0.001) increased between 2008 and 2018. When compared with medium-volume hospitals, high-volume hospitals had a higher (p<0.0001) and low-volume hospitals had a lower (p<0.0001) percent of patients discharged to home.ConclusionHigh-volume hospitals were associated with a higher rate of favorable outcome. With the increased use of IAT among patients with AIS, the proportion of low-volume hospitals performing IAT significantly decreased.
Development and validation of a contextualised measure of resilience in veterinary practice: the Veterinary Resilience Scale–Personal Resources (VRS–PR)
Authors: Matthew Susan M , Carbonneau Kira J , Mansfield Caroline F , Zaki Sanaa , Cake Martin A , McArthur Michelle L 
Published: March 2020

BackgroundThis article reports on the development and validation of a contextualised measure of personal resources for resilience in veterinary practice.MethodsExploratory factor analysis and structural equation modelling were used to evaluate data from two surveys of veterinary practitioners.ResultsExploratory factor analysis of the first survey (n=300) revealed six items comprising the Veterinary Resilience Scale–Personal Resources (VRS–PR). These items focused on flexibility, adaptability, optimism, building strengths, enjoying challenges, and maintaining motivation and enthusiasm at work. Structural equation modelling using the second survey (n=744) confirmed the factor structure of the VRS–PR and established convergent validity with an established measure of general resilience, the Brief Resilience Scale. Examination of the mean and standard deviation of the combined survey data enabled scores on the VRS–PR to be provisionally classified into ‘low’, ‘moderate’ and ‘high’ (reported by approximately 13%, 72% and 15% of respondents, respectively). Respondents also reported results spanning ‘low’, ‘moderate’ and ‘high’ classifications for the Brief Resilience Scale (approximately 34%, 57% and 9%, respectively).ConclusionThe VRS–PR may be used to evaluate the extent to which respondents draw upon the personal resources captured in the scale and identify areas for improvement.
Trends in Racial/Ethnic Disparity of Health-Related Quality of Life in Older Adults with and without Cancer (1998–2012)
Authors: Rincon Maria A. , Smith Ashley Wilder , Yu Mandi , Kent Erin E. 
Published: March 2020

Abstract

Background:
Non-White cancer survivors often report poorer health compared with Non-Hispanic Whites. Whether those disparities are changing over time is unknown. We examined changes in health-related quality of life (HRQOL) by race/ethnicity from 1998 to 2012 among older adults with and without cancer.

Methods:
Data from Medicare Advantage beneficiaries were obtained from the linkage between the Medicare Health Outcomes Survey and Surveillance, Epidemiology, and End Results cancer registry data (SEER-MHOS). HRQOL was assessed with the SF-36/VR-12 Physical and Mental Component Scores (PCS/MCS) and 8 scales (Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Mental Health, Role-Emotional). Annual average HRQOL scores, adjusting for age at survey, gender, number of comorbidities, education, and SEER registry, were compared over time. Absolute (between-group variance; BGV) and relative (mean log deviation; MLD) indices of disparity were generated using the National Cancer Institute's health disparities calculator (HD*Calc). Joinpoint was used to test for significant changes in the slopes of the linear trend lines.

Results:
Racial/ethnic disparities in MCS increased in absolute and relative terms over time for those with [BGV = 15.8 (95% confidence interval [CI], 10.2–21.6); MLD = 16.2 (95% CI, 10.5–22.1)] and without [BGV = 19.3 (95% CI, 14.9–23.8); MLD = 19.6 (95% CI, 15.2–24.0)] cancer. PCS disparities over time did not significantly change. Changes in disparities in 5 of 8 HRQOL scales were significant in those with and without cancer.

Conclusions:
Older adults with cancer show increasing racial/ethnic disparities in HRQOL, particularly in mental health status.

Impact:
Future research should evaluate trends in HRQOL and explore factors that contribute to health disparities.
Influence of Swell on Marine Surface-Layer Structure
Authors: Jiang Qingfang 
Published: March 2020

AbstractThe influence of swell on turbulence and scalar profiles in a marine surface layer and underlying physics is examined in this study through diagnosis of large-eddy simulations (LES) that explicitly resolve the surface layer and underlying swell. In general, under stable conditions, the mean wind and scalar profiles can be significantly modified by swell. The influence of swell on wind shear, turbulence structure, scalar profiles, and evaporation duct (ED) characteristics becomes less pronounced in a more convective boundary layer, where the buoyancy production of turbulence is significant. Dynamically, swell has little direct impact on scalar profiles. Instead it modifies the vertical wind shear by exerting pressure drag on the wave boundary layer. The resulting redistribution of vertical wind shear leads to changes in turbulence production and therefore turbulence mixing of scalars. Over swell, the eddy diffusivities from LES systematically deviate from the Monin–Obukhov similarity theory (MOST) prediction, implying that MOST becomes invalid over a swell-dominated sea. The deviations from MOST are more pronounced in a neutral or stable boundary layer under relatively low winds and less so in a convective boundary layer.
An Estimate of the Relative Contributions of Sea Surface Temperature Variations in Various Regions to Stratospheric Change
Authors: Xie Fei , Zhang Jiankai , Huang Zhe , Lu Jinpeng , Ding Ruiqiang , Sun Cheng 
Published: March 2020

AbstractThis study investigates the effects of global and regional sea surface temperature (SST) warming from the Industrial Revolution to the present on the stratosphere using a climate model, and estimates the relative contributions of SST warming in different regions. The observed global SST warming is found to cause colder and stronger stratospheric zonal circulations in the high latitudes of both hemispheres, and a colder lower stratosphere in the tropics and ozone depletion. This occurs because the warming in the tropical Atlantic and in the north Indian Ocean and North Pacific strongly cool the stratosphere in the southern and northern high latitudes, respectively. The cooling in the lower stratosphere at lower and midlatitudes is mainly caused by SST warming in the tropical Pacific and north Indian Ocean. The changes in stratospheric temperature are related to changes in circulation and ozone. In addition, we investigate the effects on the stratosphere of ideal 1-K uniform warming of SST in different oceans and compare these effects with those caused by the realistic SST warming. The observed global SST warming and 1-K uniform global SST warming have opposite effects on the high-latitude stratosphere in both hemispheres: 1-K uniform global SST warming results in warmer and weaker stratospheric zonal circulations and a corresponding increase in ozone. This is because the 1-K uniform increase in SST in the tropical Pacific causes extremely strong warming and weakening stratospheric zonal circulations. The contribution of a 1-K uniform increase of SST in the tropical Pacific to stratospheric temperature, circulation, and ozone anomalies overwhelms that of a 1-K uniform increase of SST in other regions.
Headache and non-headache symptoms provoked by nitroglycerin in migraineurs: A human pharmacological triggering study
Authors: Karsan Nazia , Bose Pyari R , Thompson Charlotte , Newman Jayde , Goadsby Peter J 
Published: March 2020

Background Studying a spontaneous migraine attack is challenging, particularly the earliest components. Nitroglycerin is a potent, reliable and reproducible migraine trigger of the entirety of the migraine attack, making its use experimentally attractive. Methods Fifty-three subjects with migraine with a history of spontaneous premonitory symptoms were exposed to a 0.5 mcg/kg/min nitroglycerin infusion. Eighty-three percent (n = 44) developed typical premonitory and headache symptomatology. Fifty-seven percent (n = 25) were invited back to further study visits, during which they were re-exposed to nitroglycerin or placebo infusion in a double-blind randomised design. The phenotype of premonitory symptoms and headache was captured and compared to spontaneous attacks and between triggered attacks using agreement analysis. Results More premonitory symptoms were triggered with nitroglycerin than placebo (mean symptom difference = 4, t20 = 7.06, p < 0.001). The agreement in triggering for the most commonly reported premonitory symptoms (concentration difficulty and tiredness) was >66%. The retriggering agreement for all but one premonitory symptom was >60%. The agreement in timing to onset of premonitory symptoms was reliable across two triggered attacks. The agreement with spontaneous attacks and between attacks for headache and its associated symptoms, including laterality, was less reliable. Conclusions Nitroglycerin can reliably and reproducibly provoke premonitory symptomatology associated with migraine. This forms an ideal model to study the earliest manifestations of migraine attacks.
Blood Flow Restriction Training Applied With High-Intensity Exercise Does Not Improve Quadriceps Muscle Function After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial
Authors: Curran Michael T. , Bedi Asheesh , Mendias Christopher L. , Wojtys Edward M. , Kujawa Megan V. , Palmieri-Smith Riann M. 
Published: March 2020

Background: A major goal of rehabilitation after anterior cruciate ligament reconstruction (ACLR) is restoring quadriceps muscle strength. Unfortunately, current rehabilitation paradigms fall short of this goal, such that substantial quadriceps muscle strength deficits can limit return to play and increase the risk of recurrent injuries. Blood flow restriction training (BFRT) involves the obstruction of venous return to working muscles during exercise and may lead to better recovery of quadriceps muscle strength after ACLR. Purpose: To examine the efficacy of BFRT with high-intensity exercise on the recovery of quadriceps muscle function in patients undergoing ACLR. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 34 patients (19 female, 15 male; mean age, 16.5 ± 2.7 years; mean height, 169.0 ± 19.7 cm; mean weight, 73.2 ± 17.7 kg) scheduled to undergo ACLR were randomly assigned to 1 of 4 groups: concentric (n = 8), eccentric (n = 8), concentric with BFRT (n = 9), and eccentric with BFRT (n = 9). The exercise component of the intervention consisted of patients performing a single-leg isokinetic leg press, at an intensity of 70% of the patients’ 1-repetition maximum during either the concentric or eccentric action, for 4 sets of 10 repetitions 2 times per week for 8 weeks beginning at 10 weeks postoperatively. Patients randomized to the BFRT groups performed the leg-press exercise with a cuff applied to the thigh, set to a limb occlusion pressure of 80%. Isometric and isokinetic (60 deg/s) quadriceps peak torque, quadriceps muscle activation, and rectus femoris muscle volume were assessed before ACLR, after BFRT, and at the time that patients returned to activity and were converted to the change in values from baseline for analysis. Also, 1-way analyses of covariance were used to compare the change in values for each dependent variable between groups after BFRT and at return to activity ( P ≤ .05). Results: No significant differences were found between groups for any outcome measures at either time point ( P > .05). Conclusion: An 8-week BFRT plus high-intensity exercise intervention did not significantly improve quadriceps muscle strength, activation, or volume. On the basis of our findings, the use of BFRT in conjunction with high-intensity resistance exercise in patients undergoing ACLR to improve quadriceps muscle function may not be warranted. Registration: NCT03141801 ( ClinicalTrials.gov identifier)
Determining the Patient Acceptable Symptomatic State for Patients Undergoing Arthroscopic Partial Meniscectomy in the Knee
Authors: Dwyer Tim , Zochowski Thomas , Ogilvie-Harris Darrell , Theodoropoulos John , Whelan Daniel , Chahal Jaskarndip 
Published: March 2020

Background: Arthroscopic partial meniscectomy is one of the most common procedures in orthopaedic surgery. The patient acceptable symptomatic state (PASS), which defines a level of symptoms above which patients consider themselves well, remains to be well-defined in this population. Purpose: Using an anchor-based approach, our goal was to determine the 1-year PASS for the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) Subjective Knee Form, the Western Ontario Meniscal Evaluation Tool (WOMET), and the Marx Activity Scale (MAS) in patients who were treated with partial knee meniscectomy. Study Design: Case series; Level of evidence, 4. Methods: A consecutive series of patients with knee meniscal tears and a Kellgren-Lawrence grade of 0 to 2 treated with arthroscopic partial meniscectomy were eligible. The KOOS (0-100), IKDC (0-100), WOMET (0-100), and MAS (0-16) were administered at baseline and 12 months postoperatively. An external anchor question at 1 year postoperatively was used to determine PASS values. A receiver operating characteristic curve (ROC) analysis was used to determine the PASS value at which patients considered their status to be satisfactory. Results: The study included 110 patients (mean ± SD age, 53.8 ± 12.0 years), 57.3% were male, and the follow-up rate was 82%. In total, 70% of patients had an Outerbridge arthroscopic grade of 2 or lower. Based on ROC analysis, the 1-year postoperative PASS values (sensitivity, specificity) were 64.3 (47.8, 100.0) for KOOS Symptoms, 81.6 (71.6, 100.0) for KOOS Pain, 82.4 (82.1, 86.4) for KOOS Function in Daily Living, 71.0 (62.7, 81.8) for KOOS Function in Sport and Recreation, 51.0 (83.6, 95.5) for KOOS Knee-Related Quality of Life, 56.2 (82.1, 100.0) for IKDC, 58.5 (79.1, 100.0) for WOMET, and 7.0 (44.8, 68.2) for MAS. Baseline scores did not affect the PASS threshold across the different instruments. However, patients with higher baseline scores were more likely to achieve the PASS for the KOOS Symptoms (odds ratio [OR], 2.808; P = .047), IKDC (OR, 4.735; P = .006), and WOMET (OR, 2.985; P = .036). Age, sex, and cartilage status were not significantly related to the odds of achieving the PASS for any of the patient-reported outcome measures. Conclusion: These findings allow researchers and clinicians to determine whether partial meniscectomy is meaningful to patients at the individual level and will be helpful for responder analysis in future trials related to the treatment of meniscal abnormality.
Choroidal lymphoma diagnosed by polymerase chain reaction–based clonality assessment
Authors: Hernández-Pons Antonio , Gómez-Beltrán Elena , Fernández-Zarzoso Miguel , Albert-Fort Mara , Martínez-Costa Lucía 
Published: March 2020

Purpose: To report a case of primary choroidal lymphoma that was confirmed by polymerase chain reaction–based clonality testing. Case report: A 50-year-old woman presented with unilateral progressive vision loss. Fundus examination and B-ultrasonography demonstrated diffuse choroidal thickening without vitritis. Pars plana vitrectomy and subretinal biopsy were performed, and histopathologic analysis revealed choroidal B-cell lymphoid hyperplasia without evidence of neoplasia. Extraocular extension was ruled out, and transitory improvement was observed with oral steroids. After 1-year follow-up, she was referred to our hospital and clonality testing was performed using the samples taken months before. First, we used a forensic DNA extraction kit, and then, a multiplex polymerase chain reaction was carried out using the IgH Rearrangements Molecular Analysis Kit. Clonal rearrangement was identified for the immunoglobulin heavy chain framework regions 1 and 2, and B-cell choroidal lymphoma was confirmed. The patient began treatment with intravitreal rituximab, but no response was observed. Finally, complete regression was achieved using external beam radiotherapy. Conclusion: Polymerase chain reaction–based clonality testing can be a valuable tool to confirm a choroidal lymphoproliferative process.
Mentoring strategies and their impact on social workers’ attitudes
Authors: Ben Amram Miri , Shapira-Lishchinsky Orly 
Published: March 2020

Summary This study explored different mentoring strategies: simulations and case studies regarding ethical dilemmas involved with employment of intellectual developmental disability workers in supported employment using questionnaires of psychological empowerment, self-efficacy, and attitudes toward employing intellectual developmental disability workers in the free market. Participants were 83 social workers and 60 employers and were divided into simulations, case studies, and control groups. All participants in the simulations and case studies groups attended nine mentoring sessions throughout one year, where they completed questionnaires at the beginning, the end, and six months after mentoring. Findings The level of employers’ psychological empowerment and their positive attitudes toward employment of individuals with intellectual developmental disability in their organizations were higher than among the social workers, but the social workers’ self-efficacy level was higher. In addition, we found that mentoring using simulations had more influence than the case studies. The study findings showed that the more dynamic the mentoring, the greater the changes in psychological empowerment perceptions, self-efficacy, and attitudes toward employing intellectual developmental disability workers, both during the study and subsequently. Applications There is considerable importance in developing in-service training and active mentoring for all those involved in the challenges of supported employment. Simulations with participation of actors among social workers and employers, regarding ethical challenges in supported employment are the recommended mentoring methods, as compared to the case studies tested in the current study. Therefore, the study findings encourage the development of advanced mentoring processes among social workers and employers based on simulations, for coping with ethical challenges in supported employment.
A New Risk Index Combining d-Dimer, Fibrinogen, HE4, and CA199 Differentiates Suspecting Endometrial Cancer From Patients With Abnormal Vaginal Bleeding or Discharge
Authors: Ge Lili , Liu Guangquan , Hu Kai , Huang Ke , zhang Mi , Zhou Juan , Teng Fang , Cao Jian , Dai Chencheng , Jia Xuemei 
Published: March 2020

Purpose: To establish an efficient new risk index for screening patients with endometrial cancer from patients with abnormal vaginal bleeding or discharge. Method: A total of 254 patients with abnormal vaginal bleeding or discharge were included in this study. Several candidate markers, including HE4, CA125, CA199, CA153, AFP, CEA, d-dimer, and fibrinogen, were employed. A new risk index for endometrial cancer screening was established by binary logistic regression. The diagnostic value of the candidate markers and the new risk index were assessed by a receiver operating characteristic curve, sensitivity, and specificity. Results: The most valuable diagnostic indicator for endometrial cancer was HE4, followed by d-dimer and then fibrinogen (area under the receiver operating characteristic curve: HE4 = 0.794, d-dimer = 0.717, fibrinogen = 0.690). The new risk index was superior to a single application of markers and a widely used combination (HE4 and CA125). At the ideal cutoff level, the sensitivity and specificity were 91.34% and 70.08%, respectively. In addition, only patients without organic disease served as controls, which further increase its performance (area under the receiver operating characteristic curve = 0.932, sensitivity = 94.49%, and specificity = 77.42%). Conclusions: The new risk index combining HE4, d-dimer, fibrinogen, and CA199 was the ideal combination for the screening of endometrial cancer. As a simple, rapid, nondestructive detection method, the new risk index is worth promotion in clinical practice, especially in primary medical institutions.
Preoperative computed tomography-guided coil localization for multiple lung nodules
Authors: Teng Fei , Wu An-Le , Yang Shan , Lin Jia , Xian Yu-Tao , Fu Yu-Fei 
Published: March 2020

Background: Preoperative computed tomography (CT)-guided coil localization can increase the technical success of video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection of lung nodules relative to cases treated without localization. When multiple lung nodules (MLNs) are to be resected, preoperative localization for each lung nodule is required. The aim of this study was to explore the feasibility, safety, and clinical efficacy of preoperative CT-guided coil localization of MLNs. Methods: Between November 2015 and July 2019, 31 patients with MLNs were assessed via CT-guided coil localization followed by VATS-guided wedge resection. Rates of technical success for both the localization and wedge resection procedures, as well as data pertaining to patient complication rates and long-term outcomes were recorded and assessed. Results: In total, 68 nodules (average of 2.2 nodules/patient) were localized and resected using this approach. Nodules were unilateral and bilateral in 23 and 8 patients, respectively. The rate of CT-guided coil localization technical success for these nodules was 98.5% (67/68), with a technical success rate of single-stage coil localization on a per-patient basis of 96.8% (30/31). Following localization, asymptomatic pneumothorax occurred in four patients (12.9%). The wedge resection technical success rate was 100%. Mean VATS operative time was 167.3 ± 75.2 min, with a mean blood loss of 92.6 ± 61.5 ml. Patients were followed between 3 and 46 months (median: 24 months), with no evidence of new nodules, distant metastases, or postoperative complications in any patients. Conclusion: Preoperative CT-guided multiple coil localization can be easily and safely used to guide single-stage VATS diagnostic wedge resection in patients with MLNs. The reviews of this paper are available via the supplemental material section.