bluuebunny/crossref_metadata_2025_split huggingface dataset:
A practical unification of multi-stage programming and macros
Authors: Stucki Nicolas , Biboudis Aggelos , Odersky Martin 
Published: April 2020

Program generation is indispensable. We propose a novel unification of two existing metaprogramming techniques: multi-stage programming and hygienic generative macros. The former supports runtime code generation and execution in a type-safe manner while the latter offers compile-time code generation.
In this work we draw upon a long line of research on metaprogramming, starting with Lisp, MetaML and MetaOCaml. We provide direct support for quotes, splices and top-level splices, all regulated uniformly by a level-counting Phase Consistency Principle. Our design enables the construction and combination of code values for both expressions and types. Moreover, code generation can happen either at runtime à la MetaML or at compile time, in a macro fashion, à la MacroML.
We provide an implementation of our design in Scala and we present two case studies. The first implements the Hidden Markov Model, Shonan Challenge for HPC. The second implements the staged streaming library Strymonas.
Expanding Primary Care to Pharmaceutical Patient Care in Diabetes Mellitus Type 2 through the European Union’s Community Pharmacies, between 2008 and 2018: A Systematic Review
Authors: Pizarro Ângela Maria Vilaça Pereira de Araújo , Martins Maria Rosário O. , Simões Jorge Almeida 
Published: April 2020

<b><i>Background:</i></b> The analysis of the European Union (EU28) health systems’ intervention for type 2 diabetes mellitus (T2DM) reports an insufficient combination of legal support, prevention, and early diagnosis. This fact compromises the patient’s health outcomes. The inclusion of pharmacy services oriented to T2DM (PS-T2DM) in strategic primary care network’s programs could be a solution. However, the different regulatory frameworks that include good pharmaceutical practices and clinical guidelines for T2DM in each EU28 country may be a limitation. Health systems need to know the evolution of these community services and to analyze their operational and regulatory base, both in time and space. <b><i>Methods:</i></b> A systematic review was carried out on a qualitative and quantitative approach to the expansion and upgrading of PS-T2DM provided in EU28 pharmacies between 2008 and 2018. <b><i>Results:</i></b> The implementation of PS-T2DM in EU28 has increased sharply since 2009 and 2010. Diabetes mellitus (DM) is regulated in 5 countries (Bulgaria, Spain, Italy, Lithuania, and Portugal) and T2DM in 3 (Austria, Latvia, and Romania). Also, in 3 countries (Latvia, Poland, and Spain), pharmacists are involved in implementing guidelines for DM and T2DM, but there is no evidence on the regulation of PS-T2DM. Twenty-two countries showed detailed studies for the PS-T2DM’s provision. The type of PS-T2DM implemented in the highest number of EU28 countries was “promoting the rational use of medicines,” and the specific subtype T2DM-related more commonly reported was the “glucose measurement.” <b><i>Discussion/Conclusion:</i></b> Pharmacy disease-oriented services contributed to improving the accessibility, proximity, and equity of primary care for T2DM provided in community pharmacies across the EU28 in recent decades. This promising strategy for improving health outcome sets may be a call to the action of health systems due to its impact consistent with some objectives of universal health coverage for the eradication of DM and T2DM.
ІСТОРИЧНА РЕТРОСПЕКТИВА І ПЕРСПЕКТИВА РАБІЧНОЇ ІНФЕКЦІЇ В УКРАЇНІ
Authors: Oleksenko O. V. 
Published: April 2020

Метою роботи є виявлення закономірностей і особливостей перебігу епідемічного та епізоотичного процесу рабічної інфекції в Україні, дослідження рушійних сил і факторів, що обумовлюють активізацію захворюваності, для вироблення адекватних заходів боротьби та профілактики.
Проведено епідеміологічний аналіз захворюваності на сказ в Україні. Розглянута епізоотологія рабічної інфекції в історичному контексті. Висвітлена роль диких тварин у поширенні вірусу сказу. Розглянута екологія природного і антропургічного сказу та продемонстровано поширення цієї інфекції на території країни.
ПРІОРИТЕТНІ НАПРЯМКИ РОЗВИТКУ УНІВЕРСИТЕТСЬКИХ КЛІНІК
Authors: Chopchik V. D. 
Published: April 2020

Мета: здійснити медико-соціальне обґрунтування пріоритетних напрямків розвитку університетських клінік за нових економічних умов.
Матеріали і методи. У дослідженні використано методи системного підходу та аналізу, інформаційно-аналітичний, соціологічний та медико-статистичний методи. Інформаційною базою для формування пріоритетних напрямків розвитку університетських клінік є наукові роботи вітчизняних і зарубіжних спеціалістів із державно-приватного партнерства і менеджменту, а також результати власних соціологічних досліджень, проведених за спеціально розробленою програмою у 2018–2019 рр. на базі Стоматологічного медичного центру Національного медичного університету імені О. О. Богомольця, які охопили 407 пацієнтів та 109 лікарів центру.
Результати. У роботі обґрунтовано пріоритетні напрямки розвитку університетських клінік на основі запрова­дження механізмів державно-приватного партнерства. Використання переваг співпраці держави і приватного бізнесу є важливою умовою організації сучасної моделі університетської клініки. Державно-приватне партнерство становить основу для формування юридично і господарсько самостійних клінічних університетських баз з ефективною технологією лікувального та педагогічного процесу, системою управління і підготовки кадрів.
Державно-приватне партнерство дозволяє наростити інвестиційний потік для медичних університетських клінік, створити умови для використання приватної підприємницької ініціативи, забезпечити більшу ресурсну мобільність, адаптацію до зміни умов функціонування клінік, а також економічну стійкість клінічної університетської бази.
Висновки. Результати дослідження засвідчили неадаптованість діючої моделі університетських клінік до нових економічних умов та необхідність розробки сучасних організаційно-правових засад для створення університетських клінік на принципах державно-приватного партнерства.
Effect of Lesion Complexity and Clinical Risk Factors on the Efficacy and Safety of Dabigatran Dual Therapy Versus Warfarin Triple Therapy in Atrial Fibrillation After Percutaneous Coronary Intervention
Authors: Berry Natalia C. , Mauri Laura , Steg Philippe Gabriel , Bhatt Deepak L. , Hohnloser Stefan H. , Nordaby Matias , Miede Corinna , Kimura Takeshi , Lip Gregory Y.H. , Oldgren Jonas , ten Berg Jurriën M. , Cannon Christopher P. ,   on behalf of the REDUAL PCI Steering Committee and Investigators
Published: April 2020

Background:
The REDUAL PCI trial (Evaluation of Dual Therapy With Dabigatran vs Triple Therapy With Warfarin in Patients With AF That Undergo a PCI With Stenting) demonstrated that, in patients with atrial fibrillation following percutaneous coronary intervention, bleeding risk was lower with dabigatran plus clopidogrel or ticagrelor (dual therapy) than warfarin plus clopidogrel or ticagrelor and aspirin (triple therapy). Dual therapy was noninferior for risk of thromboembolic events. Whether these results apply equally to patients at higher risk of ischemic events due to lesion complexity or clinical risk factors is unclear.

Methods:
The primary end point was time to first major or clinically relevant nonmajor bleeding event. The composite efficacy end point was death, thromboembolic event, or unplanned revascularization. Our prespecified subgroup analysis categorized patients by presence of procedural complexity and/or clinical complexity factors at baseline. A modified dual antiplatelet therapy score categorized patients according to degree of clinical risk.

Results:

Of 2725 patients, 43.1% had clinical complexity factors alone, 9.9% procedural factors alone, 10.0% both, and 37.0% neither. Risk of the primary bleeding end point was lower in both dabigatran dual therapy groups than warfarin triple therapy groups, regardless of procedural and/or clinical lesion complexity (interaction
P
values: 0.90 and 0.37, respectively). Importantly, a similar risk of the efficacy end point was observed between dabigatran dual and warfarin triple therapy, regardless of the presence of clinical or procedural complexity factors (interaction
P
values: 0.67 and 0.54, dabigatran 110 and 150 mg dual therapy, respectively). Similar benefit was seen for each dose of dabigatran dual therapy for bleeding events regardless of dual antiplatelet therapy score (interaction
P
values: 0.53 and 0.54, respectively), with similar risk of thromboembolic events (interaction
P
values: 0.20 and 0.08, respectively).

Conclusions:
In patients with atrial fibrillation undergoing percutaneous coronary intervention, dabigatran 110 and 150 mg dual therapy reduced bleeding risk compared with warfarin triple therapy, with a similar risk of thromboembolic outcomes, irrespective of procedural and/or clinical complexity and modified dual antiplatelet therapy score.

Registration:

URL:
https://clinicaltrials.gov/
; Unique identifier: NCT02164864.
Atrial Fibrillation Risk and Discrimination of Cardioembolic From Noncardioembolic Stroke
Authors: Khurshid Shaan , Trinquart Ludovic , Weng Lu-Chen , Hulme Olivia L. , Guan Wyliena , Ko Darae , Schwab Kristin , Rost Natalia S. , Al-Alusi Mostafa A. , Benjamin Emelia J. , Ellinor Patrick T. , Anderson Christopher D. , Lubitz Steven A. 
Published: April 2020

Background and Purpose—
Classification of stroke as cardioembolic in etiology can be challenging, particularly since the predominant cause, atrial fibrillation (AF), may not be present at the time of stroke. Efficient tools that discriminate cardioembolic from noncardioembolic strokes may improve care as anticoagulation is frequently indicated after cardioembolism. We sought to assess and quantify the discriminative power of AF risk as a classifier for cardioembolism in a real-world population of patients with acute ischemic stroke.

Methods—

We performed a cross-sectional analysis of a multi-institutional sample of patients with acute ischemic stroke. We systematically adjudicated stroke subtype and examined associations between AF risk using CHA
2
DS
2
-VASc, Cohorts for Heart and Aging Research in Genomic Epidemiology-AF score, and the recently developed Electronic Health Record–Based AF score, and cardioembolic stroke using logistic regression. We compared the ability of AF risk to discriminate cardioembolism by calculating C statistics and sensitivity/specificity cutoffs for cardioembolic stroke.

Results—

Of 1431 individuals with ischemic stroke (age, 65±15; 40% women), 323 (22.6%) had cardioembolism. AF risk was significantly associated with cardioembolism (CHA
2
DS
2
-VASc: odds ratio [OR] per SD, 1.69 [95% CI, 1.49–1.93]; Cohorts for Heart and Aging Research in Genomic Epidemiology-AF score: OR, 2.22 [95% CI, 1.90–2.60]; electronic Health Record–Based AF: OR, 2.55 [95% CI, 2.16–3.04]). Discrimination was greater for Cohorts for Heart and Aging Research in Genomic Epidemiology-AF score (C index, 0.695 [95% CI, 0.663–0.726]) and Electronic Health Record–Based AF score (0.713 [95% CI, 0.681–0.744]) versus CHA
2
DS
2
-VASc (C index, 0.651 [95% CI, 0.619–0.683]). Examination of AF scores across a range of thresholds indicated that AF risk may facilitate identification of individuals at low likelihood of cardioembolism (eg, negative likelihood ratios for Electronic Health Record–Based AF score ranged 0.31–0.10 at sensitivity thresholds 0.90–0.99).

Conclusions—
AF risk scores associate with cardioembolic stroke and exhibit moderate discrimination. Utilization of AF risk scores at the time of stroke may be most useful for identifying individuals at low probability of cardioembolism. Future analyses are warranted to assess whether stroke subtype classification can be enhanced to improve outcomes in undifferentiated stroke.
A method for measuring glycerol-blanked triglyceride concentrations by using gas chromatography-isotope dilution mass spectrometry
Authors: Koyama Isao , Imano Hironori , Nakamura Masakazu , Kitamura Akihiko , Kiyama Masahiko , Miyamoto Yoshihiro , Iso Hiroyasu 
Published: April 2020

Background Serum triglyceride concentrations are measured as total glycerides content in many Western countries. In Japan, glycerol-blanked triglycerides (TG-GB) are measured to identify postprandial hypertriglyceridaemia and to minimize the influence of glycerol formulation on serum triglyceride values. However, TG-GB measurements have not been standardized. Therefore, we developed an efficient quantification system for total glycerides and free glycerol that allows the calculation of TG-GB concentrations. Methods We measured total glycerides and free glycerol in human serum by using gas chromatography-isotope dilution mass spectrometry and compared its performance to the reference method of the US Centers for Disease Control and Prevention (CDC). Results Our practical method of total glycerides and free glycerol quantification achieved excellent precision for both within-run and among-run coefficients of variation (<1.5% and <2.7%, respectively), with an average recovery of 99.8% for free glycerol. However, we noted an average %bias of –0.26% for total glycerides and –3.15% for free glycerol between our TG-GB method and the CDC reference method. Conclusions This practical method of total glycerides and free glycerol quantification enables traceability assessment of TG-GB measurements. Differences between the output values of TG-GB and the CDC reference method might result from the differences in free glycerol values.
Association between the rate of fluoroquinolones-resistant gram-negative bacteria and antibiotic consumption from China based on 145 tertiary hospitals data in 2014
Authors: Yang Ping , Chen Yunbo , Jiang Saiping , Shen Ping , Lu Xiaoyang , Xiao Yonghong 
Published: April 2020

Abstract
Background
The purpose of the study is to discuss the correlation between the resistance rate of gram negative bacteria to fluoroquinolones (FQ) and antibiotic consumption intensity of 145 China tertiary hospitals in 2014.

Methods
This retrospective study adopted national monitoring data from 2014. Each participating hospital required to report annual consumption of each antibiotic, and the resistance rate of gram negative bacteria to FQ. Then the correlation between antibiotic usage and fluoroquinolones –resistant (FQR) rate was consequently investigated.

Results
One hundred forty-five hospitals were included in the study, and the median antibiotic consumption intensity was 46.30 (23.93–115.39) defined daily dosages (DDDs) per 100 patient-days. Cephalosporins ranks first in the antibiotics consumption, followed by fluoroquinolones, penicillins, and carbapenems. Fluoroquinolones resistance rate varied from hospital to hospital. The correlation analysis showed significant relationship between the percentage of FQR Escherichia coli and the consumption of FQs (r = 0.308, p<0.01) and levofloxacin (r = 0.252, p<0.01). For FQR Klebsiella pneumoniae, not only FQs (r = 0.291, p<0.01) and levofloxacin (r = 0.260, p<0.01) use but also carbapenems (r = 0.242, p<0.01) and overall antibiotics (r = 0.247, p<0.01) use showed significant correlation. The resistant proportion of FQR Pseudomonas aeruginosa was observed to be correlated with the consumption of all antibiotics (r = 0.260, p<0.01), FQs (r = 0.319, p<0.01) and levofloxacin (r = 0.377, p<0.01). The percentage of levofloxacin-resistant Acinetobacter baumannii was significantly correlated with the consumption of all antibiotics (r = 0.282, p<0.01), third-generation cephalosporins excluding combinations with beta-lactamase inhibitors (r = 0.246, p<0.01), FQs (r = 0.254, p<0.01) and levofloxacin (r = 0.336, p<0.01). However, the correlation of the ciprofloxacin-resistant A. baumannii and the antibiotics consumption was not found.

Conclusions
A strong correlation was demonstrated between the antibiotic consumption and the rates of FQR gram-negative bacteria. As unreasonable antibiotics usage remains crucial in the proceeding of resistant bacteria selection, our study could greatly promote the avoidance of unnecessary antibiotic usage.
High contribution and impact of resistant gram negative pathogens causing surgical site infections at a multi-hospital healthcare system in Saudi Arabia, 2007–2016
Authors: El-Saed Aiman , Balkhy Hanan H. , Alshamrani Majid M. , Aljohani Sameera , Alsaedi Asim , Al Nasser Wafa , El Gammal Ayman , Almohrij Saad A. , Alyousef Ziyad , Almunif Sara , Alzahrani Mohammad 
Published: April 2020

Abstract
Background
Despite being largely preventable, surgical site infections (SSIs) are still one of the most frequent healthcare-associated infections. The presence of resistant pathogens can further augment their clinical and economic impacts. The objective was to estimate the distribution and resistance in SSI pathogens in Saudi Arabia and to compare them to the US National Healthcare Safety Network (NHSN) hospitals.

Methods
Targeted SSI surveillance was prospectively conducted on several surgical procedures done between 2007 and 2016 in four hospitals of Ministry of National Guard Health Affairs. Definitions and methodology of SSI and bacterial resistance were based on NHSN.

Results
A total 492 pathogens causing 403 SSI events were included. The most frequent pathogens were Staphylococcus aureus (22.8%), Pseudomonas aeruginosa (20.1%), Klebsiella spp. (12.2%), and Escherichia coli (12.2%), with marked variability between surgeries. Approximately 30.3% of Staphylococcus aureus was methicillin-resistant (MRSA), 13.0% of Enterococcus spp. was vancomycin-resistant (VRE), and 5.5% of Enterobacteriaceae were carbapenem resistant (CRE). The highest multidrug-resistant (MDR) GNPs were Acinetobacter spp. (58.3%), Klebsiella spp. (20.4%) and Escherichia coli (16.3%). MRSA was significantly less frequent while cephalosporin-resistant Klebsiella spp., MDR Klebsiella spp., and MDR Escherichia coli were significantly more frequent in our hospitals compared with NHSN hospitals.

Conclusion
GNPs in a tertiary care setting in Saudi Arabia are responsible for more than 60% of SSI with more resistant patterns than Western countries. This information may be critical to secure resources and ensure support for caregivers and healthcare leaders in implementing antimicrobial stewardship programs and evidence-based SSI preventive practices.
A case of successful maintained pregnancy after neoadjuvant chemotherapy plus radical surgery for stage IB3 cervical cancer diagnosed at 13 weeks
Authors: Guo Ying , Zhang Dandan , Li Yuhong , Wang Yudong 
Published: April 2020

Abstract
Background
Cervical cancer during pregnancy is rare. The management for stage IB3 during pregnancy remains unclear and challenging. We report a successful preserved pregnancy in a stage IB3 patient who was treated with neoadjuvant chemotherapy (NACT) plus radical surgery.

Case presentation
A 36-year-old pregnant woman was diagnosed with a 5-cm-diameter stage IB3 squamous cell carcinoma of the uterine cervix at 13 gestational weeks. The patient received 5 courses of systemic chemotherapy with carboplatin and paclitaxel every 3 weeks, followed by caesarean section and radical hysterectomy. Both the mother and infant are in good general condition.

Conclusion
This case suggests that NACT plus radical surgery could be one method to maintain pregnancy in stage IB3 cervical cancer diagnosed as early as 13 gestational weeks.
Intranasal perillyl alcohol therapy improves survival of patients with recurrent glioblastoma harboring mutant variant for MTHFR rs1801133 polymorphism
Authors: Faria Giselle M. , Soares Igor D. P. , D’Alincourt Salazar Marcela , Amorim Marcia R. , Pessoa Bruno L. , da Fonseca Clovis O. , Quirico-Santos Thereza 
Published: April 2020

AbstractBackgroundPolymorphisms inMTHFRgene influence risk and overall survival of patients with brain tumor. Global genomic DNA (gDNA) methylation profile from tumor tissues is replicated in peripheral leukocytes. This study aimed to draw a correlation betweenrs1801133 MTHFRvariants, gDNA methylation and overall survival of patients with recurrent glioblastoma (rGBM) under perillyl alcohol (POH) treatment.MethodsgDNA from whole blood was extracted using a commercially available kit (Axygen) and quantified by spectrophotometry. Global gDNA methylation was determined by ELISA andrs1801133polymorphism by PCR-RFLP. Statistical analysis of gDNA methylation profile andrs1801133variants included Mann-Whitney, Kruskal-Wallis, Spearman point-biserial correlation tests (SPSS and Graphpad Prism packages; significant results for effect size higher than 0.4). Prognostic value of gDNA methylation andrs1801133variants considered survival profiles at 25 weeks of POH treatment, having the date of protocol adhesion as starting count and death as the final event.ResultsMost rGBM patients showed global gDNA hypomethylation (median = 31.7%) and a significant, moderate and negative correlation between TT genotype and gDNA hypomethylation (median = 13.35%; rho = − 0.520;p = 0.003) compared to CC variant (median = 32.10%), which was not observed for CT variant (median = 33.34%; rho = − 0.289;p = 0.06). gDNA hypermethylated phenotype (median = 131.90%) exhibited significant, moderate and negative correlations between TT genotype (median = 112.02%) and gDNA hypermethylation levels when compared to CC (median = 132.45%; rho = − 0,450;p = 0.04) or CT (median = 137.80%; rho = − 0.518;p = 0.023) variants. TT variant ofrs1801133significantly decreased gDNA methylation levels for both patient groups, when compared to CC (d values: hypomethylated = 1.189; hypermethylated = 0.979) or CT (d values: hypomethylated = 0.597; hypermethylated = 1.167) variants. Positive prognostic for rGBM patients may be assigned to gDNA hypermethylation for survivors above 25 weeks of treatment (median = 88 weeks); and TT variant ofrs1801133regardless POH treatment length.ConclusionrGBM patients under POH-based therapy harboring hypermethylated phenotype and TT variant forrs1801133had longer survival. Intranasal POH therapy mitigates detrimental effects of gDNA hypomethylation and improved survival of patients with rGBM harboring TT mutant variant forMTHFR rs1801133polymorphism.Trial registrationCONEP -9681- 25,000.009267 / 2004. Registered 12th July, 2004.