bluuebunny/crossref_metadata_2025_split huggingface dataset:
The more we know, the more we forget…
Authors: Sokurenko L. M. , Chaikovsky Yu. B. , Majewskyi O. E. , Yaremenko L. M. , Bidenko N. V. , Filonenko V. V. , Melnyk A. O. 
Published: February 2021

Summary. Students of dentistry faculties need a special methodological approach aimed at the acquisition of practical skills, but the study of fundamental disciplines is different from the dental-oriented ones.
The aim of the study – to assess presumed deficits in the histology, cytology, and embryology knowledge of dentistry students at O. Bohomolets National Medical University, to identify the problems associated with it, and to address them.
Materials and Methods. Testing of students of different courses of O. Bohomolets National Medical University using the standard licensed examination tests ‘‘Step 1 Dentistry’’.
Results and Discussion. Students of the dentistry faculty have shown the level of students’ knowledge at 4th and 5th years – 33.5 %. The general result of the ‘‘Step 1 Dentistry’’ license exam in the same students is 66.6 % (2019) and 62.2 % (2018), respectively. The percentage of this result of the test higher when checked professional direct knowledge. We found that it was determined the prevalence of correct answers in the block on the topic "Oral Cavity" at the test on histology, cytology and embryology of O. Bohomolets NMU Dentistry Faculty different courses students.
Conclusions. In accordance with the obtained results and the analysis of the problems, it is recommended to make adjustments to the curricula and control measures with a focus on the competencies that will be applied in professional activities.
Blood Pressure Effects of Sodium Reduction
Authors: Filippini Tommaso , Malavolti Marcella , Whelton Paul K. , Naska Androniki , Orsini Nicola , Vinceti Marco 
Published: February 2021

Background:
The relationship between dietary sodium intake and blood pressure (BP) has been tested in clinical trials and nonexperimental human studies, indicating a direct association. The exact shape of the dose–response relationship has been difficult to assess in clinical trials because of the lack of random-effects dose–response statistical models that can include 2-arm comparisons.

Methods:
After performing a comprehensive literature search for experimental studies that investigated the BP effects of changes in dietary sodium intake, we conducted a dose–response meta-analysis using the new 1-stage cubic spline mixed-effects model. We included trials with at least 4 weeks of follow-up; 24-hour urinary sodium excretion measurements; sodium manipulation through dietary change or supplementation, or both; and measurements of systolic and diastolic BP at the beginning and end of treatment.

Results:
We identified 85 eligible trials with sodium intake ranging from 0.4 to 7.6 g/d and follow-up from 4 weeks to 36 months. The trials were conducted in participants with hypertension (n=65), without hypertension (n=11), or a combination (n=9). Overall, the pooled data were compatible with an approximately linear relationship between achieved sodium intake and mean systolic as well as diastolic BP, with no indication of a flattening of the curve at either the lowest or highest levels of sodium exposure. Results were similar for participants with or without hypertension, but the former group showed a steeper decrease in BP after sodium reduction. Intervention duration (≥12 weeks versus 4 to 11 weeks), type of study design (parallel or crossover), use of antihypertensive medication, and participants’ sex had little influence on the BP effects of sodium reduction. Additional analyses based on the BP effect of difference in sodium exposure between study arms at the end of the trial confirmed the results on the basis of achieved sodium intake.

Conclusions:
In this dose–response analysis of sodium reduction in clinical trials, we identified an approximately linear relationship between sodium intake and reduction in both systolic and diastolic BP across the entire range of dietary sodium exposure. Although this occurred independently of baseline BP, the effect of sodium reduction on level of BP was more pronounced in participants with a higher BP level.
Comparison of the Efficacy and Safety Outcomes of Edoxaban in 8040 Women Versus 13 065 Men With Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial
Authors: Zelniker Thomas A. , Ardissino Maddalena , Andreotti Felicita , O’Donoghue Michelle L. , Yin Ophelia , Park Jeong-Gun , Murphy Sabina A. , Ruff Christian T. , Lanz Hans J. , Antman Elliott M. , Braunwald Eugene , Giugliano Robert P. , Merlini Piera Angelica 
Published: February 2021

Background:
Female sex is an independent risk factor for stroke and systemic embolic events in patients with atrial fibrillation. This study aimed to examine the efficacy and safety profile of edoxaban in women versus men.

Methods:

The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) randomly assigned 21 105 patients (8040 women) with atrial fibrillation and CHADS
2
score ≥2 either to a higher-dose edoxaban regimen, a lower-dose edoxaban regimen, or warfarin. The primary end points of the trial were the composite of stroke or systemic embolic events (efficacy), and International Society on Thrombosis and Haemostasis–defined major bleeding (safety).

Results:

In comparison with men, women were older, had lower body weight, were more likely to have hypertension and renal dysfunction, but less likely to smoke, drink alcohol, or have diabetes or coronary artery disease. Pretreatment endogenous factor Xa activity was significantly higher in women than in men (92.5% versus 86.1%,
P
<0.001). Treatment with edoxaban in women resulted in greater peak edoxaban concentration and inhibition of endogenous factor Xa in comparison with men, resulting in similar endogenous factor Xa activity between the sexes 2 to 4 hours after dose. Treatment with higher-dose edoxaban regimen (versus warfarin) resulted in similar reduction in the risk of stroke/systemic embolic events (women: hazard ratio [HR], 0.87 [0.69–1.11], men: HR, 0.87 [0.71–1.06];
P
-interaction=0.97) and major bleeding (women: HR, 0.74 [0.59–0.92], men: HR, 0.84 [0.72–0.99];
P
-interaction=0.34) in women and men. However, women assigned to higher-dose edoxaban regimen experienced greater reductions in hemorrhagic stroke (HR, 0.30 [95% CI, 0.15–0.59] versus HR, 0.70 [95% CI, 0.46–1.06]), intracranial bleeding (HR, 0.20 [95% CI, 0.10–0.39] versus HR, 0.63 [95% CI, 0.44–0.89]), and life-threatening or fatal bleeding (HR, 0.25 [95% CI, 0.15–0.42] versus HR, 0.72 [95% CI, 0.54–0.96]) than men (each
P
-interaction<0.05).

Conclusions:
Despite many differences in baseline characteristics between women and men and higher baseline endogenous factor Xa levels in women, the intensity of anticoagulation achieved with edoxaban between the sexes was similar. Treatment with higher-dose edoxaban regimen resulted in an even greater reduction in hemorrhagic stroke and several serious bleeding outcomes in women than in men, whereas the efficacy profile was similar between sexes.
Complex Relationship Between Cardiac Fibroblasts and Cardiomyocytes in Health and Disease
Authors: Hall Caitlin , Gehmlich Katja , Denning Chris , Pavlovic Davor 
Published: February 2021

Abstract
Cardiac fibroblasts are the primary cell type responsible for deposition of extracellular matrix in the heart, providing support to the contracting myocardium and contributing to a myriad of physiological signaling processes. Despite the importance of fibrosis in processes of wound healing, excessive fibroblast proliferation and activation can lead to pathological remodeling, driving heart failure and the onset of arrhythmias. Our understanding of the mechanisms driving the cardiac fibroblast activation and proliferation is expanding, and evidence for their direct and indirect effects on cardiac myocyte function is accumulating. In this review, we focus on the importance of the fibroblast‐to‐myofibroblast transition and the cross talk of cardiac fibroblasts with cardiac myocytes. We also consider the current use of models used to explore these questions.
Vienna-Paris-Corfu: Japonisme and Gregorios Manos (1851–1928)
Authors: Kagouridi Kassiani 
Published: February 2021

Abstract
The present study defines the connection between Japonisme and the Greek diplomat and donor-collector Gregorios Manos (1851–1928). Manos collected Japanese pieces during the reign of Japonisme in Europe, was a pioneer of the study of Japanese art in Greece, and the first donor of Chinese and Japanese artifacts to the Greek State in 1919. The donation resulted in the foundation, in 1926, of the Sino-Japanese Museum (renamed in Museum of Asian Art in 1973) in Corfu. The present research is based on primary and secondary sources and seeks to present unpublished data as well as re-examine Manos’ connection to Japonisme. In addition, this micro-perspective research aims to reveal Manos’ studies, diplomatic carrier, collecting practices, and donating vision. At the same time, it hopes to enrich macro-perspective study by outlining the circumstances under which collectors founded museums of Asian art in peripheral places, such as Greece, during the first half of the twentieth century under and beyond the allure of Japonisme.
The Mansana Collection. A Treasury of Japanese Art in Barcelona at the Turn of the Twentieth Century
Authors: Bru Ricard 
Published: February 2021

Abstract
Josep Mansana Dordan, a well-known Catalan late-nineteenth-century businessman, founded what is considered the finest collection of Japanese art established in Catalonia and in Spain at the turn of the century. In the early twentieth century, the Mansana Collection, as it was known, enjoyed popularity and prestige in Barcelona thanks to its constant expansion driven by the founder’s son, Josep Mansana Terrés, also an entrepreneur. The collection was well known at the time, but fell into oblivion after the outbreak of the Spanish Civil War in 1936. It was not until 2013 that, on the occasion of the exhibition Japonisme. La fascinació per l’art japonès, the collection began to be rediscovered and studied. This article aims to present a first complete overview of the history and characteristics of the old Mansana Collection and its impact on Barcelona at and immediately after the turn of the twentieth century.
Different clinical features between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer
Authors: Ji Xianxiu , Xie Huikang , Zhu Ren , Chen Bin , Jiang Sen , Luo Jie 
Published: February 2021

Objective To compare the baseline clinical characteristics between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer (NSCLC), and the correlations of these subtypes with the distribution of metastases. Methods We compared the clinical characteristics and imaging features of patients with ROS1-positive and ALK-positive NSCLC using statistical methods. Results Data for 232 patients were analyzed. Compared with ALK-positive NSCLC, ROS1-positive NSCLC was more likely to occur in women (71% vs 53%), and primary lesions ≤3 cm were more common in patients with ROS1-positive compared with ALK-positive NSCLC (58% vs 37%). There was no significant difference in the distribution of metastases between the two groups. Subgroup analysis within the ROS1-positive group showed that, compared with primary lesions >3 cm, primary lesions ≤3 cm were more likely to present as peripheral tumors (72% vs 43%) and more likely to exhibit non-solid density (44% vs 4%). Conclusions Although ROS1-positive and ALK-positive NSCLCs show similar clinical features, the differences may help clinicians to identify patients requiring further genotyping at initial diagnosis.
Intraoral acupuncture treatment for obstructive sleep apnoea with snoring: a case series
Authors: Ko Jungeun , Baik Jungeui , Lee Suji , Lee Sanghoon 
Published: February 2021

Objectives: To investigate the effects of acupuncture of the intraoral, head and neck regions in patients with obstructive sleep apnoea (OSA). Methods: Four patients diagnosed with OSA were treated with local acupuncture, including intraoral needling, to stimulate the upper airway dilator muscle. Clinical improvements were evaluated with the apnoea-hypopnoea index (AHI), obstructive apnoea-hypopnoea index (oAHI), snoring, and oxygen desaturation index (ODI) using a portable sleep monitoring device. Results: After 10 treatment sessions, all patients showed improvement in the AHI and oAHI, and most of the patients showed decreased ODI and snoring. Conclusions: These results suggest that acupuncture of the intraoral and head regions may be effective at improving the symptoms of OSA. Acupuncture treatment for OSA should be further investigated.
Advance Care Planning Shared Decision-Making Tools for Non-Cancer Chronic Serious Illness: A Mixed Method Systematic Review
Authors: Sloan Danetta H. , Hannum Susan M. , DeGroot Lyndsay , Dy Sydney M. , Waldfogel Julie , Chyr Linda C. , Heughan JaAlah-Ai , Zhang Allen , Wilson Renee F. , Yuan Christina T. , Wu David S. , Robinson Karen A. , Cotter Valerie T. 
Published: February 2021

Context: Shared decision-making tools can facilitate advance care planning and goals of care conversations in non-cancer serious illness. More information on integrating these tools in ambulatory care could better support clinicians and patients/caregivers in these conversations. Objectives: We evaluated effectiveness and implementation of integrating palliative care shared decision-making tools into ambulatory care for U.S. adults with serious, life-threatening illness and their caregivers. Data sources: We searched PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials (2000 - May 2020) for quantitative controlled, qualitative, and mixed-methods studies. Review methods: Two reviewers screened articles, abstracted data, and independently assessed risk of bias or study quality. For quantitative trials, we graded strength of evidence for key outcomes: patient/caregiver satisfaction, depression or anxiety, concordance between patient preferences for care and care received, and healthcare utilization, including advance directive documentation. Results: We included 6 quantitative effectiveness randomized, controlled trials and 5 qualitative implementation studies across primary care and specialty populations. Shared decision-making tools all addressed goals-of-care communication or advance care planning. Palliative care shared decision-making tools may be effective for improving patient satisfaction with communication and advance directive documentation. We were unable to draw conclusions about concordance between preferences and care received. Patients and caregivers preferred advance care planning discussions grounded in patient and caregiver experiences with individualized timing. Conclusions: For non-cancer serious illness, advance care planning shared decision-making tools may improve several outcomes. Future trials should evaluate concordance with care received and other health care utilization. Key Message: This mixed-methods review concludes that when integrating palliative care into ambulatory care for serious illness and conditions other than cancer, advance care planning shared decision-making tools may improve patient satisfaction and advance directive documentation.
Paracentral acute middle maculopathy in the setting of central retinal artery occlusion following COVID-19 diagnosis
Authors: Turedi Neslihan , Onal Gunay Betul 
Published: February 2021

Background: Since its emergence in Wuhan, China, COVID-19 has disseminated across many other countries worldwide. In this report, we firstly presented a patient with mild COVID-19 disease who developed paracentral acute middle maculopathy (PAMM) due to CRAO. Case presentation: A 54-year-old male patient who reported a contact with a COVID-19 patient applied to the hospital and tested positive for SARS-CoV-2 by polimerase chain reaction testing. He had no significant past medical history. Chest computed tomography was not notable. He had a mild COVID-19 course during hospitalization. Two weeks following COVID-19 diagnosis, he reported profund vision loss (counting fingers) in his right eye where central retinal artery occlusion (CRAO) was detected on fundoscopic examination. Coagulation profile was within normal limits. Hypercoagulable work up was also not notable. Treatment was given for CRAO. Visual acuity was counting fingers at 30 cm. Five days following treatment. Optical coherence tomography analysis showed increased diffuse reflectance and thickening at the level of inner nuclear layer consistent with PAMM. Fluorescein angiography illustrated no perfusion defect. Conclusion: This is the first case that reports PAMM in the setting of CRAO following COVID-19 diagnosis. Viral induced microangiopathy may involve in the development of CRAO in our patient without a hypercoagulable state and additional risk factors. Physicians should be vigilant to seek for retinal evaluation in patients with significant visual loss even after a mild COVID-19 history.
Vascular sound visualization system is useful for monitoring and surveillance of vascular access
Authors: Tsuboi Masato , Suzuki Hiroaki , Kawai Hirokazu , Ejima Toru , Mitsuishi Fukumi 
Published: February 2021

Backgrounds: Vascular access (VA) is a lifeline for maintenance hemodialysis patients. Monitoring and surveillance of VA, therefore, play an important role for maintaining VA patency. Surveillance needs special apparatus to estimate the VA function, while, monitoring including physical examination does not usually need such devices but highly skill-dependent and qualitative. Purpose: We report the clinical utility in monitoring and surveillance of VA using a newly developed electronic stethoscope and vascular sound visualization application. Methods: One hundred eight patients participated in the study. The vascular sounds were collected using the electronic stethoscope, converted into digital data, sent wirelessly to a personal computer, and then calculated. The units for the calculated intensity of the vascular sound were decibel [dB]. The intensity, however, was normalized as INDEX values ranging from 0 to 99 for practical use. Correlation between INDEX and the mean flow volume (mFV) and resistance index (RI) of brachial artery measured by Doppler ultrasound sonography were examined for VA surveillance. INDEX was continually measured at each dialysis session in ten patients who underwent the angioplasty for VA monitoring. Results: INDEX significantly correlated with the mFV (coefficient of correlation value = 0.68, p < 0.001) and RI (coefficient of correlation value = −0.51, p < 0.001) of brachial artery. Using the calculated cut-off values, the accuracy of INDEX for the diagnosis of AVF dysfunction ranged from 66% to 82%. INDEX attained the peak just after the angioplasty of culprit lesions and gradually decreased from one patient to another. Conclusion: These results suggest that vascular sound visualization system can be useful in VA monitoring and surveillance for detecting and predicting the access stenosis.
Hospital Architecture in Spain and Italy: Gaps Between Education and Practice
Authors: Cambra-Rufino Laura , Brambilla Andrea , Paniagua-Caparrós José León , Capolongo Stefano 
Published: February 2021

Aim: The research sheds light on the challenges and limitations of Spanish and Italian hospital design by looking at the gaps between education and practice. Background: Hospital design plays an important role in providing high-quality and cost-effective facilities for any healthcare system. Spain and Italy face contemporary challenges (i.e., elderly population, staff retention, and obsolete healthcare facilities) and have similar issues of life expectancy, health expenditure, hospital beds provision, and decentralized tax-financed healthcare systems. Method: A cross-sectional, mixed-method study was used. This involved two different data collection strategies and analysis for each area of investigation: (i) education and (ii) practice. For the former, educational programs were reviewed via a web search; for the latter, an online survey of 53 architectural/engineering offices involved in hospital design was conducted. Results: Hospital design education is limited to 0/58 in Spanish and 2/60 courses in Italian universities, although each country offers three postgraduate courses. The practitioners’ survey shows that even though their offices have a long history of healthcare design, only 48% in Spain and 60% in Italy have received specific university training. Office staff lack employees with medical backgrounds, which hinders any partnership between health and design fields either for design practice or the education fields. Laws, national regulations, technical guidelines, and previous experience are the most useful information sources, while international scientific publications appear underused by practitioners. Conclusions: Italian and Spanish healthcare architecture could be improved by promoting multidisciplinary teams (in practice and education) and improving the education offer by tailoring it to national needs.
Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
Authors: Patel Saavan , Nunna Ravi S. , Nie James , Ansari Darius , Chaudhry Nauman S. , Mehta Ankit I. 
Published: February 2021

Study Design: Retrospective cohort study. Objective: Spinal chordomas are rare primary malignant neoplasms of the primitive notochord. They are slow growing but locally aggressive lesions that have high rates of recurrence and metastasis after treatment. Gold standard treatment remains en-bloc surgical resection with questionable efficacy of adjuvant therapies such as radiation and chemotherapy. Here we provide a comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with spinal chordoma. Methods: Patients with diagnosis codes specific for chordoma of spine, sacrum, and coccyx were queried from the National Cancer Database (NCDB) during the years 2004-2016. Outcomes were investigated using Cox univariate and multivariate regression analyses, and survival curves were generated for comparative visualization. Results: 1,548 individuals were identified with a diagnosis of chordoma, 60.9% of which were at the sacrum or coccyx and 39.1% at the spine. The mean overall survival of patients in our cohort was 8.2 years. Increased age, larger tumor size, and presence of metastases were associated with worsened overall survival. 71.2% of patients received surgical intervention and both partial and radical resection were associated with significantly improved overall survival ( P < 0.001). Neither radiotherapy nor chemotherapy administration improved overall survival; however, amongst patients who received radiation, those who received proton-based radiation had significantly improved overall survival compared to traditional radiation. Conclusion: Surgical resection significantly improves overall survival in patients with spinal chordoma. In those patients receiving radiation, those who receive proton-based modalities have improved overall survival. Further studies into proton radiotherapy doses are required.