bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of early progression of metastatic renal cell carcinoma treated with first-line tyrosine kinase inhibitor
Authors: Teishima Jun , Murata Daiki , Inoue Shogo , Hayashi Tetsutaro , Mita Koji , Hasegawa Yasuhisa , Kato Masao , Kajiwara Mitsuru , Shigeta Masanobu , Maruyama Satoshi , Moriyama Hiroyuki , Fujiwara Seiji , Matsubara Akio 
Published: September 2021

Abstract

Background:
There are various alternative first-line therapeutic options besides tyrosine kinase inhibitors (TKIs) for metastatic renal cell carcinoma (mRCC). To inform therapeutic decision-making for such patients, this study aimed to identify predictive factors for resistance to TKI.

Materials and methods:
A total of 239 cases of mRCC patients who received first-line TKI therapy were retrospectively studied. Patients with a radiologic diagnosis of progressive disease within 3 months after initiating therapy were classified as primary refractory cases; the others were classified as non-primary refractory cases. The association between primary refractory cases and age, gender, pathology findings, serum c-reactive protein (CRP) level, metastatic organ status, and 6 parameters defined by the International Metastatic Renal Cell Carcinoma Database Consortium were analyzed.

Results:
Of 239 cases, 32 (13.3%) received a radiologic diagnosis of progressive disease within 3 months after initiating therapy. The rates of sarcomatoid differentiation, hypercalcemia, a serum CRP level of 0.3 mg/dL or higher, presence of liver metastasis, anemia, and time from diagnosis to treatment interval of less than a year were significantly higher in the primary refractory group. Multivariate analysis showed that sarcomatoid differentiation, hypercalcemia, a serum CRP level of 0.3 mg/dL or higher, and liver metastasis were independently associated with primary refractory disease. A risk-stratified model based upon the number of patients with these factors indicated rates of primary refractory disease of 4.0%, 10.1%, and 45.0% for patients with 0, 1, and 2 or more factors, respectively.

Conclusions:
Sarcomatoid differentiation, hypercalcemia, an elevated serum CRP level, and presence of liver metastasis were associated with primary refractory disease in mRCC patients receiving first-line TKI therapy. These results provide clinicians with useful information when selecting a first-line therapeutic option for mRCC patients.
Physical Activity as Both Predictor and Outcome of Emotional Distress Trajectories in Middle Childhood
Authors: Harbec Marie-Josée , Goldfield Gary , Barnett Tracie A. , Pagani Linda S. 
Published: September 2021

Objective:
This prospective longitudinal study assesses the reciprocal relationship between physical activity, including sport participation, and depressive and anxiety symptoms, conceptualized as emotional distress, over time.

Method:
Boys and girls are from the Quebec Longitudinal Study of Child Development birth cohort (N = 1428). Trajectories of emotional distress symptoms from ages 6 to 10 years, assessed by teachers, were generated using latent class analysis. Multinomial logistic regression analyses examined sport participation at age 5 years, measured by parents, as a predictor of emotional distress trajectory outcomes. Analyses of covariance compared physical activity, measured by children at age 12 years, across different trajectories of emotional distress.

Results:
We identified 3 emotional distress trajectories: “low” (77%), “increasing” (12%), and “declining” (11%). Boys who never participated in sport at age 5 years were more likely to be in the “increasing” (adjusted odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.01–2.63) or “declining” (adjusted OR = 2.19, 95% CI = 1.28–3.75) emotional distress trajectories compared with boys who participated in any sporting activity. Furthermore, boys in the “low” emotional distress trajectory demonstrated better physical activity outcomes at age 12 years (F(2, 1438) = 6.04, p < 0.05). These results, exclusively for boys, are above and beyond pre-existing individual and family factors.

Conclusion:
This study supports the relevance of enhancing current public health strategies to understand and promote physical activity and emotional adjustment in early childhood to achieve better a more active lifestyle and overall health across development. We underscore male needs for physical activity for health promotion.
Effect of Gestational Diabetes Mellitus on the Growth, Development, and Stem Cells of Offspring
Authors: Zhang Meihua , Ma Munan , Wang Jinping , Wang Yijun , Yang Xinrui , Fu Songtao 
Published: September 2021

Abstract
The effects of gestational diabetes mellitus (GDM) on offspring include macrosomia, hypoglycemia, respiratory distress syndrome, cardiovascular disease, neural and mental injury, etc. The effects of GDM on the health status of offspring are sustained although pregnancy has ended. It has been proposed that fetal reprogramming causes long-term consequences to metabolic health in offspring. An intrauterine high-glucose environment may lead to changes in the multi-differentiation proficiency of intracorporal stem cells, showing decreased proliferation and osteogenic ability, increased adipogenic ability, accelerated apoptosis, and occurrence of premature failure. This environment also reduces the mobilization of bone marrow stem cells, whereas it increases that of medullary cells. This results in pro-inflammatory conditions and sustained inflammation in the body, thereby increasing the risk of obesity, cardiovascular and neurological disorders, and metabolic abnormalities. Stem cells derived from the amniotic membrane, umbilical cord, or placenta may be a reliable predictor of the long-term effects of GDM on offspring. The levels of blood glucose during pregnancy should be effectively controlled to reduce harm to the neonate.
Sex differences in ambulatory blood pressure levels, control, and phenotypes of hypertension in kidney transplant recipients
Authors: Korogiannou Maria , Sarafidis Pantelis , Theodorakopoulou Marieta P. , Alexandrou Maria Eleni , Xagas Efstathios , Argyris Antonis , Protogerou Athanase , Ferro Charles J. , Boletis Ioannis N. , Marinaki Smaragdi 
Published: September 2021

Objectives:
Ambulatory blood pressure (BP) control is worse in men compared with women with chronic kidney disease (CKD) and this may partially explain the faster CKD progression in men. This is the first study investigating possible sex differences in prevalence, control and phenotypes of hypertension in kidney transplant recipients (KTRs) with office-BP and 24-h ambulatory BP monitoring (ABPM).

Methods:
This cross-sectional study included 136 male and 69 female stable KTRs who underwent office-BP measurements and 24-h ABPM. Hypertension thresholds for office and ambulatory BP were defined according to the 2017 ACC/AHA and 2021 KDIGO guidelines for KTRs.

Results:
Age, time from transplantation, eGFR and history of major comorbidities did not differ between groups. Office SBP/DBP levels were insignificantly higher in men than women (130.3 ± 16.3/77.3 ± 9.4 vs. 126.4 ± 17.8/74.9 ± 11.5 mmHg; P = 0.118/0.104) but daytime SBP/DBP was significantly higher in men (128.5 ± 12.1/83.0 ± 8.2 vs. 124.6 ± 11.9/80.3 ± 9.3 mmHg; P = 0.032/P = 0.044). No significant between-group differences were detected for night-time BP. The prevalence of hypertension was similar by office-BP criteria (93.4 vs. 91.3%; P = 0.589), but higher in men than women with ABPM (100 vs. 95.7%; P = 0.014). The use of ACEIs/ARBs and CCBs was more common in men. Office-BP control was similar (43.3 vs. 44.4%, P = 0.882), but 24-h control was significantly lower in men than women (16.9 vs. 30.3%; P = 0.029). White-coat hypertension was similar (5.1 vs. 7.6%; P = 0.493), whereas masked hypertension was insignificantly more prevalent in men than women (35.3 vs. 24.2%; P = 0.113).

Conclusion:
BP levels, hypertension prevalence and control are similar by office criteria but significantly different by ABPM criteria between male and female KTRs. Worse ambulatory BP control in male compared with female KTRs may interfere with renal and cardiovascular outcomes.
Health Literacy, Cognitive Function, and Mortality in Patients With Heart Failure
Authors: Kuhn Tyler A. , Gathright Emily C. , Dolansky Mary A. , Gunstad John , Josephson Richard , Hughes Joel W. 
Published: September 2021

Background
Health literacy has predicted mortality in heart failure. However, the role of cognitive functioning in this relationship has not been evaluated. We hypothesized that health literacy would predict all-cause mortality but that cognitive functioning would modify the relationship between health literacy and mortality in heart failure.

Objective
The aim of this study was to examine the association between health literacy, cognitive functioning, and mortality in patients with heart failure.

Methods
This secondary analysis of a larger study included 298 patients with heart failure with reduced ejection fraction (trial identifier: NCT01461629). Health literacy was evaluated using the Rapid Estimate of Adult Literacy in Medicine (REALM) and Medical Term Recognition Test (METER), and cognitive functioning was evaluated using the Modified Mini-Mental Status Examination (3MS). Cox proportional hazards regression was used with time-until-death as the dependent variable.

Results
After controlling for age, sex, and race, neither METER nor REALM scores predicted mortality in heart failure (Ps ≥ .37). However, 3MS predicted mortality in models using the METER (Δχ2 = 9.20, P < .01; B = −.07; hazard ratio, 0.94 [95% confidence interval, 0.89–0.98]; P < .01) and REALM (Δχ2 = 9.77, P < .01; B = −0.07; hazard ratio, 0.94 [95% confidence interval, 0.90–0.97]; P < .01). Furthermore, adding the 3MS improved model fit.

Conclusions
Cognitive functioning predicted mortality in heart failure better than health literacy. Results suggest the need to further evaluate the contribution of cognitive functioning to increased risk of mortality in those with heart failure.
Improving Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians
Authors: Scofi Jean , Parwani Vivek , Rothenberg Craig , Patel Amitkumar , Ravi Shashank , Sevilla Mark , D'Onofrio Gail , Ulrich Andrew , Venkatesh Arjun K. 
Published: September 2021

ABSTRACT

Introduction:
We sought to determine if audit-and-feedback with peer comparison among emergency physicians is associated with improved emergency department (ED) throughput and decreased variation in physician performance.

Methods:
We implemented an audit-and-feedback with peer comparison tool at a single urban academic ED from March 1, 2013, to July 1, 2018. In the first study period, physicians received no reports. In the second period, they received daily reports. In the third period, they received daily, quarterly, and annual reports. Outcomes included patients per hour, admission rate, time to admission, and time to discharge.

Results:
A total of 272,032 patient visits and 36 ED physicians were included. The mean admission rate decreased 6.8%; the mean time to admission decreased 43.8 minutes; and the mean time to discharge decreased 40.6 minutes. Variation among physicians decreased for admission rate, time to admission, and time to discharge. Low-performing outliers showed disproportionately larger improvements in patients per hour, admission rate, time to admission, and time to discharge.

Conclusions:
Automated peer comparison reports for academic emergency physicians was associated with lower admission rates, shorter times to admission, and shorter times to discharge at the departmental level, as well as decreased practice variation at the individual level.
Facing PHACE Twenty-five Years Later
Authors: Braun Mitchell T. , Mathes Erin F. , Siegel Dawn H. , Hess Christopher P. , Fox Christine K. , Frieden Ilona J. 
Published: September 2021

Objectives:
To review the key features of PHACE syndrome over the past 25 years, highlighting evaluation, management, current gaps in knowledge, and potential next steps in research and patient-centered care.

Methods:
Literature review and synthesis of expert opinion.

Results:
PHACE is a congenital neurocutaneous syndrome in which affected patients have posterior fossa abnormalities, hemangiomas, arterial anomalies, cardiac anomalies, and/or eye anomalies. Since its discovery 25 years ago, the scientific and medical communities have made strides in understanding and developing best practice approaches to diagnosis, outcomes, and surveillance. More research will be needed to fully elucidate the pathogenesis of this condition as well as long-term outcomes. We offer suggestions for healthcare maintenance to coordinate and streamline multidisciplinary patient care.

Conclusions:
Our understanding of PHACE syndrome has grown immensely since its discovery. As we continue to learn about long-term outcomes and the importance of surveillance into adulthood, a multidisciplinary and patient-centered approach is critical to optimize care for individuals with this disease.
Part 1. Payment for Clinical Education Experiences: A Historical Perspective
Authors: Lewis Michele , Gleeson Peggy Blake , Wilkinson Tawna , Manella Kathleen , Konecne Janet 
Published: September 2021

Background and Purpose:
Payment for clinical education (CE) experiences in health care professions has been discussed for many years. Clinical education sites may consider requesting payment to offset expenses, which might include onboarding costs or perceived or real reduction in productivity. The American Council of Academic Physical Therapy–National Consortium of Clinical Educators Task Force on Payment for Clinical Experience explored the history of CE as it relates to payment, costs, productivity, and incentives through this comprehensive literature review.

Methods:
The literature was exhaustively searched through multiple data bases, compiled, and summarized by the authors.

Results:
Clinical education is an essential component of physical therapy education. The proliferation of academic programs combined with reimbursement challenges and increased productivity requirements has increased the burden of CE on health care facilities. Research in health care professions has investigated direct and indirect costs of providing CE experiences. While some research showed decreases in productivity while supervising a student, most research in physical therapy revealed increased productivity along with improved quality of care and enhanced recruitment of employees. Motivators for educating students in the CE environment included intrinsic factors of enjoyment, professional obligation, and intellectual stimulation; extrinsic factors such as continuing education credits, discounted courses, and academic appointments were also found. Research revealed that students bring value and enthusiasm to the CE environment in a variety of ways. Payment for CE experiences, more common in physician assistant, medicine, and nurse practitioner education, did not always improve quality and may be unsustainable as competition for clinical experiences grows and student debt increases.

Discussion and Conclusion:
Clinical education involves many stakeholders and the topic of payment is multifaceted. This comprehensive literature review highlighted numerous challenges and benefits for providing CE experiences as it relates to payment. This literature review provides background information regarding payment for CE in health care professions and served as foundational work of the Task Force on Payment for Clinical Experience for determining current perspectives related to payment for CE in physical therapist education.
Part 2. Payment for Clinical Education Experiences in Physical Therapy: Perspectives From Stakeholders
Authors: Wilkinson Tawna , Manella Kathleen , Myers Katherine , Alhajeri Sara , Konecne Janet , Lewis Michele , Dunn Jessica , Legar Tara , Fenwick Derek , Bzdweka Todd , Chleboun Gary , Gleeson Peggy Blake 
Published: September 2021

Introduction/Review of the Literature:
Payment for clinical education (CE) experiences is a current topic of discussion within health care professions wherein incidence of payment is described as rare but growing. The American Council of Academic Physical Therapy (ACAPT) Board charged the National Consortium of Clinical Educators (NCCE) to investigate payment for physical therapist (PT) CE experiences. The ACAPT NCCE Task Force (TF) on Payment for Clinical Experience surveyed academic, clinical, and student CE stakeholders to explore perspectives on the current landscape for payment of PT CE experience.

Methods:
Two surveys were constructed using an exploratory research design: an academic and clinical stakeholder survey and a student survey. For the academic and clinical survey, the TF used member content expertise and literature review to draft questions. Final questions were crafted after conducting 2 validation rounds by an expert panel. For the student survey, student focus groups created and validated final survey questions. Snowball sampling was employed for survey dissemination through ACAPT and NCCE networks. Descriptive statistics were examined and significant differences (P < .05) between stakeholder groups were analyzed. Analysis of open-text responses was conducted to categorize and identify common concepts. There were 1,883 academic and clinical stakeholder survey respondents, with 84.3% identifying as a clinical-only role; all NCCE regions and practice settings were represented. First-, second-, and third-year doctor of physical therapy student survey respondents (2,815) represented both private and public academic programs.

Results:
Less than 5% of academic institutions reported paying any portion of full-time CE experiences. A majority of respondents (1,153, 71.9%) were neutral or disagreed that clinical instructors (CIs) should receive direct payment for supervising students and 76.9% indicated that students should not be required to pay for CE experiences. Both intrinsic and extrinsic factors were cited as reasons not to seek payment and as benefits for providing CE experiences. Supervision restrictions and productivity expectations were identified as key barriers to providing CE experiences. Students indicated that prior knowledge of site and CI qualifications would be expected should students be required to pay for CE experiences.

Discussion and Conclusion:
Most academic, clinical, and student CE stakeholders did not support payment for CE experiences. The stakeholder-identified motivators and nonmonetary incentives to provide CE experiences present an opportunity to explore initiatives that will enhance availability of PT CE experiences aligned with an ACAPT strategic plan on a national level.
Tracking of the beat-to-beat blood pressure changes by the Caretaker physiological monitor against invasive central aortic measurement
Authors: Kwon Younghoon , Stafford Patrick L. , Baruch Martin C. , Kim Sung-Hoon , Cho Yeilim , Mazimba Sula , Gimple Lawrence W. 
Published: September 2021

Objective
There is an unmet need for noninvasive continuous blood pressure (BP) monitoring technologies in various clinical settings. Continuous and noninvasive central aortic BP monitoring is technically not feasible currently, but if realized, would provide more accurate and real-time global hemodynamic information than any form of peripheral arterial BP monitoring in an acute care setting. As part of our efforts to develop such, herein we examined the tracking correlation between noninvasively-derived peripheral arterial BP by Caretaker device against invasively measured central aortic BP.

Methods
Beat-to-beat BP by Caretaker was recorded simultaneously with central aortic BP measured in patients undergoing cardiac catheterization. Pearson’s correlation was also derived for SBP and DBP. A trend comparison analysis of the beat-to-beat BP change was performed using a four-quadrant plot analysis with the exclusion zones of 0.5 mmHg/s to determine concordance, (i.e. the direction of beat-to-beat changes in SBP and DBP).

Results
A total of 47 patients were included in the study. A total of 31 369 beats representing an average of 17.3 min of recording were used for analysis. The trend analysis yielded concordances of 84.4 and 83.5% for SBP and DBP, respectively. Respective correlations (Pearson’s r) for SBP and DBP trends were 0.87 and 0.86 (P < 0.01). Tracking of beat-to-beat BP by Caretaker showed excellent concordance and correlation in the direction and the degree of BP change with central aortic BP, respectively.

Conclusion
This study supports the satisfactory performance of the Caretaker device in continuous tracking of central aortic BP beat-to-beat BP and provides a basis to develop an algorithm for absolute central aortic BP estimation in the future.
Blood purification in sepsis and systemic inflammation
Authors: Feng Ying , Peng Jin-Yu , Peng Zhiyong 
Published: September 2021

Purpose of review
Sepsis and septic shock are life-threatening diseases with high mortality. Although efforts have made to improve the survivals, the outcomes are still frustrating. Blood purification was thought to be a promising adjunctive therapy to regulate the excessive cytokine storm or to reduce the endotoxin activity caused by sepsis. Critically ill COVID-19 characterized with the similar disease to sepsis may also benefit from blood purification.

Recent findings
The recent studies mainly focused on hemadsorption materials. The results of the clinical trials showed a tendency in decrease of cytokine levels and endotoxin activity and improvement in haemodynamics. However, the results were controversial. More evidence about blood purification in sepsis and COVID-19 are needed from currently ongoing trials and future well designed trials.

Summary
The blood purification therapy demonstrated the tendency in decrease of cytokines and endotoxin activity in different degree according to the current studies. However, the effect on mortality and haemodynamics is still in controversy. Further well designed, large sample sized studies should focus on the timing of initiating blood purification, the appropriate indications and the optimal type of blood purification membrane or cartridge to provide more evidence for clinical practice.
Acceptability of Texting 4 Relapse Prevention, Text Messaging-Based Relapse Prevention Program for People With Schizophrenia and Schizoaffective Disorder
Authors: Ybarra Michele L. , Rodriguez Katrina M. , Fehmie Desirée A. , Mojtabai Ramin , Cullen Bernadette 
Published: September 2021

Abstract
We report process outcomes of the pilot randomized controlled trial of Texting 4 Relapse Prevention (T4RP), a text messaging-based relapse prevention program for people with schizophrenia or schizoaffective disorder (SAD). Forty people were randomized to either the intervention or treatment as usual control group at a 2:1 ratio. Process indicators were collected at 6 months post enrollment.
Over 90% of patients agreed or strongly agreed that the text messages were easy to understand, easy to answer, positive, and helped them feel supported. Patient acceptability was positively associated with recovery (β = 0.29, p = <0.001) and patient-provider communication scores (β = 1.04, p < 0.001), and negatively associated with symptoms of the disorder (β = −0.27, p = 0.07). Acceptability was similar by diagnosis (β, SAD diagnosis = 0.40, p = 0.90) and age (β = 0.05, p = 0.67). Findings suggest that a text messaging intervention aimed at preventing relapse is feasible and perceived as beneficial in individuals with schizophrenia and SAD. Future research might include a targeted study of T4RP within the context of hospital discharge when people with schizophrenia/SAD are at highest risk of relapse.