bluuebunny/crossref_metadata_2025_split huggingface dataset:
ІННОВАЦІЙНІ МЕТОДИ НАВЧАННЯ ПРИ ВИВЧЕННІ БІОЛОГІЧНОЇ ХІМІЇ
Authors: Popova T. M. , Bachinsky R. O. , Polishchuk T. V. 
Published: October 2020

Вступ. Інновації у вищій медичній освіті спрямовані на оптимізацію навчального процесу та забезпечення його відповідності вимогам сьогодення. Гармонійне поєднання прогресивних дидактичних технологій із класичними традиційними методами навчання є результатом творчого пошуку педагогів. У статті розглянуто застосування інноваційних технологій навчання на кафедрі біологічної хімії Харківського національного медичного університету.
Залучення студентів до розв’язання ситуаційних завдань, шляхом розуміння процесів на молекулярному рівні, сприяє успішному вивченню біохімії. Проведення практичних занять у формі змагань та побудова логіко-смислових ланцюгів розвивають самостійність мислення у студентів, здатність до вирішення питань, а також до об’єктивного оцінювання знань своїх колег. На кафедрі біологічної хімії активно працює студентський науково-дослідницький гурток, де реалізовано індивідуальний підхід до талановитих і працьовитих студентів, створено сприятливі умови для вибору студентами спеціалізації в рамках навчальної спеціальності згідно з їх здібностями. Уже на ранньому етапі навчання активна участь у роботі студентського науково-дослідницького гуртка розвиває творчу самостійність у студентів-медиків, дозволяє їм інтегрувати знання, отримані при вивченні різних предметів, та зміцнює їх інтерес до наукових досліджень. Ефективне виконання науково-дослідницьких робіт допомагає студентам інтегрувати наукові й теоретичні знання з клінічною практикою і сприяє розвитку аналітичних навичок та критичного мислення в юних дослідників. Науково-практичні студентські конференції, круглі столи, олімпіади, науково-практичні семінари підкреслюють медичну спрямованість біологічної хімії, сприяють розширенню знань студентів в обраній сфері професійної діяльності. Курс біологічної хімії формує компетенції, що необхідні лікарям для надання ефективних медичних послуг.
Мета дослідження – висвітлити механізми забезпечення якості вищої медичної освіти шляхом упровадження інноваційних технологій організації навчання на кафедрі біологічної хімії Харківського національного медичного університету.
Висновки. На кафедрі біологічної хімії Харківського національного медичного університету відбуваються постійне вдосконалення традиційних методів і розробка нових активних форм навчання. Професійні вміння у студентів можуть успішно формуватися на заняттях, якщо навчання організовано в контрольованих умовах, забезпечено зворотний зв’язок та покроковий аналіз дій.
The Clinical Application of the Deep Learning Technique for Predicting Trigger Origins in Patients With Paroxysmal Atrial Fibrillation With Catheter Ablation
Authors: Liu Chih-Min , Chang Shih-Lin , Chen Hung-Hsun , Chen Wei-Shiang , Lin Yenn-Jiang , Lo Li-Wei , Hu Yu-Feng , Chung Fa-Po , Chao Tze-Fan , Tuan Ta-Chuan , Liao Jo-Nan , Lin Chin-Yu , Chang Ting-Yung , Wu Cheng-I , Kuo Ling , Wu Mei-Han , Chen Chun-Ku , Chang Ying-Yueh , Shiu Yang-Che , Lu Henry Horng-Shing , Chen Shih-Ann 
Published: October 2020

Background:
Non–pulmonary vein (NPV) trigger has been reported as an important predictor of recurrence post–atrial fibrillation ablation. Elimination of NPV triggers can reduce the recurrence of postablation atrial fibrillation. Deep learning was applied to preablation pulmonary vein computed tomography geometric slices to create a prediction model for NPV triggers in patients with paroxysmal atrial fibrillation.

Methods:
We retrospectively analyzed 521 patients with paroxysmal atrial fibrillation who underwent catheter ablation of paroxysmal atrial fibrillation. Among them, pulmonary vein computed tomography geometric slices from 358 patients with nonrecurrent atrial fibrillation (1–3 mm interspace per slice, 20–200 slices for each patient, ranging from the upper border of the left atrium to the bottom of the heart, for a total of 23 683 images of slices) were used in the deep learning process, the ResNet34 of the neural network, to create the prediction model of the NPV trigger. There were 298 (83.2%) patients with only pulmonary vein triggers and 60 (16.8%) patients with NPV triggers±pulmonary vein triggers. The patients were randomly assigned to either training, validation, or test groups, and their data were allocated according to those sets. The image datasets were split into training (n=17 340), validation (n=3491), and testing (n=2852) groups, which had completely independent sets of patients.

Results:
The accuracy of prediction in each pulmonary vein computed tomography image for NPV trigger was up to 82.4±2.0%. The sensitivity and specificity were 64.3±5.4% and 88.4±1.9%, respectively. For each patient, the accuracy of prediction for a NPV trigger was 88.6±2.3%. The sensitivity and specificity were 75.0±5.8% and 95.7±1.8%, respectively. The area under the curve for each image and patient were 0.82±0.01 and 0.88±0.07, respectively.

Conclusions:
The deep learning model using preablation pulmonary vein computed tomography can be applied to predict the trigger origins in patients with paroxysmal atrial fibrillation receiving catheter ablation. The application of this model may identify patients with a high risk of NPV trigger before ablation.
Chronic Kidney Disease as Risk Factor for Enlarged Perivascular Spaces in Patients With Stroke and Relation to Racial Group
Authors: Penton Ashley A. , Lau Helena , Babikian Viken L. , Shulman Julie , Cervantes-Arslanian Anna , Gangadhara Suhas , Greer David , Aparicio Hugo J. , Romero Jose R. 
Published: October 2020

Background and Purpose:
Enlarged perivascular spaces (EPVS) are considered subclinical markers of small vessel disease, associated with increased risk of stroke and dementia. Increasing evidence links chronic kidney disease (CKD) to small vessel disease. We explored the relationship between CKD and EPVS burden and the influence of racial group in this relation.

Methods:

Consecutive patients with stroke who underwent brain magnetic resonance imaging were included (n=894). Racial group was categorized as White, Black, or other (other racial groups). CKD was defined by glomerular filtration rate <60 mL/minute per 1.73 m
2
for >3 months. EPVS were rated following a standardized method, dichotomized for analyses (mild [<20] versus severe [≥20]), and stratified by brain region (basal ganglia and centrum semiovale).

Results:
In multivariable-adjusted analysis, the association of CKD with severe EPVS varied across racial groups. Comparing patients with and without CKD within racial groups, we found that Whites with CKD had higher odds of severe centrum semiovale EPVS (odds ratio [OR], 2.41 [95% CI, 0.98–5.88]). Among patients with CKD, Black patients had higher odds of severe EPVS in the basal ganglia and centrum semiovale compared with Whites (OR, 1.93 [95% CI, 1.18–3.16] and OR, 1.90 [95% CI, 1.16–3.11], respectively) and other racial groups (OR, 2.03 [95% CI, 1.23–3.36] and OR, 2.02 [95% CI, 1.22–3.34], respectively).

Conclusions:
CKD was more prevalent in our sample of patients with stroke with severe EPVS in the centrum semiovale. The relation differed when stratified by racial group and brain topography. Further studies are needed to confirm that CKD may relate differently to subclinical measures of small vessel disease according to race.
Usefulness of model-based iterative reconstruction in low-dose lumbar spine CT after spine surgery with metal implant: a phantom study
Authors: Fukushima Yasuhiro , Matsuda Akira , Koizumi Koji , Honda Maya , Masamoto Kazutaka , Fujibayashi Shunsuke 
Published: October 2020

Background The major problems of computed tomography (CT) imaging include radiation exposure and severe artifacts caused by operative implants. Purpose To evaluate the usefulness of the metal artifact reduction algorithm and model-based iterative reconstruction (MBIR) in postoperative low-dose (LD) spine CT. Material and Methods A CT torso phantom was scanned at standard-dose (SD) and LD settings. The CT images were reconstructed by three methods: hybrid iterative reconstruction (HIR); metal artifact reduction; and MBIR. The radiation dose of the phantom imaging was evaluated by volume CT dose index (mGy), dose length product (DLP, mGy × cm), and effective dose (mSv). The image quality of the six images was visually evaluated and analyzed using Scheffe’s paired comparison method. The average preference of each method was calculated based on the comparative scores. The task transfer function (TTF) and noise power spectrum for HIR and MBIR were also measured. Results The respective radiation-dose-related parameters of the SD and LD conditions were: volume CT dose index = 10.2 and 1.2 mGy; DLP = 277.9 and 33.9 mGy × cm; and effective dose = 4.2 and 0.5 mSv. The average preference for diagnostic acceptability of MBIR at LD was not significantly different from the other reconstructions of SD data. MBIR successfully reduced metal artifacts in the LD condition. The 10% TTF was higher for HIR at SD and higher for MBIR at LD. Conclusion MBIR is useful for LD spine CT after spine surgery with metal implant.
Moral distress among nursing professors: The exercise of parrhesia
Authors: Ramos Toescher Aline Marcelino , Barlem Edison Luiz Devos , Tomaschewski Barlem Jamila Geri , Castanheira Janaína Sena , Rocha Laurelize Pereira 
Published: October 2020

Background: Mismatch between the perception of one’s moral duty and one’s real social contribution may trigger moral distress, especially when no specific resistance strategies are used to counteract morally distressing situations. Considering a philosophical-ethical conception, individuals need to first reflect upon themselves to later turn to the world and confront their current situation in order to change it. Objectives: To understand moral distress experienced by nursing professors teaching in higher education institutions and the use of parrhesia as a coping strategy. Method: This qualitative exploratory-descriptive study addressed 33 nursing professors working in Brazilian federal public universities using an open-ended question form. Data were collected between June and December 2018 and analyzed using discursive textual analysis. Ethical considerations: The Institutional Review Board at the Federal University of Rio Grande approved this study. Findings: Three categories emerged: performance of nursing professors and potentially distressing situations, the experience of moral distress, and parrhesia as a strategy to deal with moral distress. Nursing professors face situations that cause moral distress in the context of higher education, however, those who adopt parrhesia as a coping strategy find it easier to express their beliefs from the perspective of moral duty, even in the face of conflicts. Conclusion: When the nursing professors in this study acknowledge elements in the power structure that hinder their actions, they express parrhesia, as an essential virtue in an attempt to modify unsymmetrical power relations that can trigger moral distress.
Association Between Baseline PROMIS Scores, Patient-Provider Communication Factors, and Musculoskeletal Health Literacy on Patient and Surgeon Expectations in Foot and Ankle Surgery
Authors: MacMahon Aoife , Cody Elizabeth A. , Caolo Kristin , Henry Jensen K. , Drakos Mark C. , Demetracopoulos Constantine A. , Savenkov Aleksander , Ellis Scott J. 
Published: October 2020

Background: Various factors may affect differences between patient and surgeon expectations. This study aimed to assess associations between patient-reported physical and mental status, patient-surgeon communication, and musculoskeletal health literacy with differences in patient and surgeon expectations of foot and ankle surgery. Methods: Two hundred two patients scheduled to undergo foot or ankle surgery at an academic hospital were enrolled. Preoperatively, patients and surgeons completed the Hospital for Special Surgery Foot & Ankle Surgery Expectations Survey. Patients also completed Patient-Reported Outcomes Measurement Information System (PROMIS) scores in Physical Function, Pain Interference, Pain Intensity, Depression, and Global Health. Patient-surgeon communication and musculoskeletal health literacy were assessed via the modified Patients’ Perceived Involvement in Care Scale (PICS) and Literacy in Musculoskeletal Problems (LiMP) questionnaire, respectively. Results: Greater differences in patient and surgeon overall expectations scores were associated with worse scores in Physical Function ( P = .003), Pain Interference ( P = .001), Pain Intensity ( P = .009), Global Physical Health ( P < .001), and Depression ( P = .009). A greater difference in the number of expectations between patients and surgeons was associated with all of the above ( P ≤ .003) and with worse Global Mental Health ( P = .003). Patient perceptions of higher surgeons’ partnership building were associated with a greater number of patient than surgeon expectations ( P = .017). There were no associations found between musculoskeletal health literacy and differences in expectations. Conclusion: Worse baseline patient physical and mental status and higher patient perceptions of provider partnership building were associated with higher patient than surgeon expectations. It may be beneficial for surgeons to set more realistic expectations with patients who have greater disability and in those whom they have stronger partnerships with. Further studies are warranted to understand how modifications in patient and surgeon interactions and patient health literacy affect agreement in expectations of foot and ankle surgery. Level of Evidence: Level II, prospective comparative series.
Patient-Related Outcome Measures (PROMs) With Nonoperative and Operative Management of Morton’s Neuroma
Authors: Faulkner Alastair , Mayne Alistair , Davies Peter , Ridley David , Harrold Fraser 
Published: October 2020

Background: Morton’s neuroma is associated with chronic pain and disability. There is a paucity of literature regarding patient-related outcome measures (PROMs) in patients managed nonoperatively. We sought to investigate nonoperative and operative management of Morton’s neuroma using PROMs in patients with follow-up to 1 year. Methods: We conducted a prospective observational study and collected data on all patients with a new diagnosis of Morton’s neuroma treated from February 2016 until April 2018. Primary outcome measures were the Manchester-Oxford Foot Questionnaire (MOXFQ) for pain, EuroQoL (EQ) time trade-off (TTO), and EQ visual analog scale (VAS) taken preoperatively and at 52 weeks postoperatively. Forty-four patients were treated nonoperatively and 94 patients were treated operatively. Results: Pretreatment and 52-week scores were 55.7 and 43.10 (nonoperative) and 63.7 and 40.1 (operative) for MOXFQ (pain), 0.72 and 0.82 (nonoperative) and 0.68 and 0.82 (operative) for EQ-TTO, and 71.5 and 76.2 (nonoperative) and 73.1 and 68.7 (operative) for EQ-VAS. There was a statistically significant improvement in MOXFQ (pain) in nonoperative ( P = .02) and operative groups ( P < .001). There was a statistically significant improvement in EQ-TTO in the operative group only ( P = .01). Conclusion: This is the largest study investigating outcomes to 12 months of both nonoperative and operatively managed patients with Morton’s neuroma. Both nonoperative and operative management lead to symptom improvement at 12 months. Level of Evidence: Level III, comparative study.
The Complex Cancer Care Coverage Environment — What is the Role of Legislation?
Authors: Leopold Christine , Haffajee Rebecca L. , Lu Christine Y. , Wagner Anita K. 
Published: October 2020

Over the past decades, anti-cancer treatments have evolved rapidly from cytotoxic chemotherapies to targeted therapies including oral targeted medications and injectable immunooncology and cell therapies. New anti-cancer medications come to markets at increasingly high prices, and health insurance coverage is crucial for patient access to these therapies. State laws are intended to facilitate insurance coverage of anti-cancer therapies.Using Massachusetts as a case study, we identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of the laws and how well they meet the current needs of cancer care given rapid changes in therapies. Interviewees emphasized that cancer therapies, as compared to many other therapeutic areas, are unique because insurance legislation targets their coverage. They identified the oral chemotherapy parity law as contributing to increasing treatment costs in commercial insurance. For commercial insurers, coverage mandates combined with the realities of new cancer medications — including high prices and often limited evidence of efficacy at approval — compound a difficult situation. Respondents recommended policy approaches to address this challenging coverage environment, including the implementation of closed formularies, the use of cost-effectiveness studies to guide coverage decisions, and the application of value-based pricing concepts. Given the evolution of cancer therapeutics, it may be time to evaluate the benefits and challenges of cancer coverage mandates.
Mindfulness as an intervention after multisystem trauma
Authors: Clement Elizabeth , Murphy Patrick , Lee Anna , Ericson Austin , Gratton Carolyn , Clements Thomas , Ryan Joanna , Kim Michael , Ball Chad G , Widder Sandy 
Published: October 2020

Background There is a known significant risk of negative mental health consequences following traumatic injury, yet no standard approach to prevent psychiatric illness in trauma patients currently exists. Mindfulness-based psychotherapies have been shown to reduce symptoms of post-traumatic stress disorder, depression and anxiety and improve resiliency, however it is unknown whether a mindfulness intervention immediately following traumatic injury would lead to diminished mental health consequences. Methods Multi-system trauma patients at the University of Alberta Hospital (N = 63) and the Foothills Hospital (N = 60) were assigned to the experimental and control groups respectively. Patients in the experimental group were asked to use the guided mindfulness application “Stop, Breathe & Think” for 28 consecutive days. All patients completed the Depression Anxiety Stress Scale (DASS-21) and Connor-Davidson Resilience Scale (CD-RISC) 48 hours and 28 days following admission. An exit interview was conducted for patients in the experimental group. Results There was no significant difference in mean enrollment DASS-21 scores, mean enrollment CD-RISC scores, mean follow-up DASS-21 scores and mean follow-up CD-RISC scores between experimental and control groups. Paired t-tests of mean admission and mean follow-up DASS-21 and CD-RISC scores were not significantly different in the experimental group. Paired t-tests of mean admission and follow-up CD-RISC scores were not significantly different in the control group whereas mean followup DASS-21 scores were decreased in the control group relative to enrolment DASS-21 scores (p = 0.014). Patients reported improved mood after use of mindfulness, and most planned to continue using the therapy and would recommend it to others. Conclusion Our study did not demonstrate an objective benefit of mindfulness intervention immediately following traumatic injury. Exit interview data suggests that a web-based mindfulness intervention may be beneficial for certain trauma patients however further research is required to identify those most likely to realize substantial gains.
Surgery in Nasal Polyp Patients: Outcome After a Minimum Observation of 10 Years
Authors: Vlaminck Stephan , Acke Frederic , Prokopakis Emmanuel , Speleman Kato , Kawauchi Hideyuki , van Cutsem Jean-Christophe , Hellings Peter W. , Jorissen Mark , Seys Sven , Bachert Claus , Zele Thibaut Van , Lambrecht Bart N. , Gevaert Philippe 
Published: October 2020

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) often requires surgery, but recurrence even after surgery is common. Recurrence rates largely vary in literature and asthma seems to be a comorbid factor. Objective In this study, we aim to estimate disease recurrence during a long-term follow-up, together with the investigation of possible predicting and/or influencing parameters. Methods Out of 196 patients operated for CRSwNP between 01/2000 and 01/2006, 133 patients had a follow-up of at least 10 years and could be included. The inflammatory profile at surgery was determined on nasal tissue and sinonasal secretions, and included analysis of eosinophils, eosinophilic-rich mucus (ERM) typically containing Charcot-Leyden crystals (CLC), and fungal hyphae (FH). During follow-up, recurrence, received treatments and comorbidities were collected. Results Out of the 133 included patients, local eosinophilia was present in 81% and ERM in 60%. Recurrence during follow-up was observed in 62%, and was associated with local eosinophilia and ERM (both p < 0.001). Asthma was present in 28% at inclusion, and 17% developed asthma after surgery during follow-up. The presence of asthma, at inclusion as well as developed during follow-up, was significantly associated with recurrence of CRSwNP (p = 0.001 for group comparison). Conclusion Recurrence after CRSwNP surgery is common when a long-term follow-up is taken into account. ERM detected in sinonasal secretions at surgery seems to be a predictive factor for recurrence and need for revision surgery. Asthma is a frequently found comorbid factor in CRSwNP, develops even at higher age despite surgical treatment for CRSwNP, and is also associated with a higher recurrence rate. Sustained medical care after surgery is mandatory.