bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review and meta-analysis of current rates of first pass effect by thrombectomy technique and associations with clinical outcomes
Authors: Abbasi Mehdi , Liu Yang , Fitzgerald Seán , Mereuta Oana Madalina , Arturo Larco Jorge L , Rizvi Asim , Kadirvel Ramanathan , Savastano Luis , Brinjikji Waleed , Kallmes David F 
Published: January 2021

BackgroundFirst pass effect (FPE) in mechanical thrombectomy is thought to be associated with good clinical outcomes.ObjectiveTo determine FPE rates as a function of thrombectomy technique and to compare clinical outcomes between patients with and without FPE.MethodsIn July 2020, a literature search on FPE (defined as modified Thrombolysis in Cerebral Infarction (TICI) 2c–3 after a single pass) and modified FPE (mFPE, defined as TICI 2b–3 after a single pass) and mechanical thrombectomy for stroke was performed. Using a random-effects meta-analysis, we evaluated the following outcomes for both FPE and mFPE: overall rates, rates by thrombectomy technique, rates of good neurologic outcome (modified Rankin Scale score ≤2 at day 90), mortality, and symptomatic intracerebral hemorrhage (sICH) rate.ResultsSixty-seven studies comprising 16 870 patients were included. Overall rates of FPE and mFPE were 28% and 45%, respectively. Thrombectomy techniques shared similar FPE (p=0.17) and mFPE (p=0.20) rates. Higher odds of good neurologic outcome were found when we compared FPE with non-FPE (56% vs 41%, OR=1.78) and mFPE with non-mFPE (57% vs 44%, OR=1.73). FPE had a lower mortality rate (17% vs 25%, OR=0.62) than non-FPE. FPE and mFPE were not associated with lower sICH rate compared with non-FPE and non-mFPE (4% vs 18%, OR=0.41 for FPE; 5% vs 7%, OR=0.98 for mFPE).ConclusionsOur findings suggest that approximately one-third of patients achieve FPE and around half of patients achieve mFPE, with equivalent results throughout thrombectomy techniques. FPE and mFPE are associated with better clinical outcomes.
IMPLEMENTATION OF ECOLOGICAL EDUCATION TO THE TEACHING PROCESS ON DISCIPLINE “HYGIENE AND ECOLOGY” FOR ENGLISH-SPEAKING SIX YEAR STUDENTS
Authors: Hryhorenko L. V. , Baibakov V. M. 
Published: January 2021

The article adduces the features of training English-speaking students of graduate courses in the departments of hygienic profile at the medical schools. It was established that the following issues remain difficult at the implementation of ecological education for English-speaking students in the departments of hygienic profile: adaptation of current national normative documents to the educational process; application of international regulatory standards and recommendations of US EPA and WHO international organizations, if compared with domestic counterparts; at the teaching of lectures and practical classes, especially on ecological-dependent pathology, should be taking into account deontological, national and religious peculiarities of foreign students. The results of the survey conducted among English-speaking six year students (36 students in total) showed that 40 to 60 % from total number of academic hours in the discipline should be assigned to independent work in a medical university, according to (25 and 19.4 %) respondents. At the same time, the time budget for IWS preparation differs: for theoretical subjects, on average, a foreign student spends 1–2 hours (30.5 %), while less than 1 hour (22.2 %) preparation for clinical disciplines. Majority of English-speaking students (53 %) believe that the amount of time they spend preparing for classes depends on their interest in learning a particular discipline. This is due to the complexity of this or that topic, as 55.5 % of respondents noted. The other 30.8 % of foreigners do not think so, which indicates about low motivation this quota of senior students to study in Medical Higher Education Institutions, and requires more careful attention of teachers in creating interest in the study of hygiene disciplines.
ДОСВІД ПРОВЕДЕННЯ КЛІНІЧНОЇ ПРАКТИКИ ДЛЯ ФІЗИЧНИХ ТЕРАПЕВТІВ НА БАЗІ ГЕРІАТРИЧНОГО ПАНСІОНАТУ
Authors: Mysula I. R. , Bakaliuk T. H. , Stelmakh H. O. 
Published: January 2021

У статті здійснено аналіз ролі клінічної практики для бакалаврів та магістрів зі спеціальності «Фізична терапія. Ерготерапія» на базі геріатричного пансіонату у професійному становленні майбутніх фахівців. Показано, що важливу роль у підготовці фізичного терапевта відіграє клінічна практика, мета якої полягає у перевірці й закріпленні знань, отриманих студентами при вивченні основних клінічних та інших дисциплін, подальшому вдосконаленні практичних навичок, набутих упродовж навчального року, ознайомленні з організацією та умовами роботи фізичного терапевта в медичних закладах.
Під час практики студенти навчаються проводити оцінку функціонального стану серцево-судинної і дихальної систем у хворих похилого віку, що є дуже важливим фактором перед початком курсу реабілітації. Це дає можливість проведення раціонального відновного лікування з адекватним дозуванням фізичних навантажень кожному хворому під час перебування в геріатричному пансіонаті, а також моніторингу ефективності проведених процедур та підбору для кожного пацієнта індивідуального комплексу вправ для подальших занять, оскільки люди похилого віку потребують у програмах реабілітації вправ, що відповідають віковим змінам. Практична орієнтованість викладання клінічної практики для бакалаврів та магістрів зі спеціальності «Фізична терапія. Ерготерапія» на базі геріатричного пансіонату розширює світогляд майбутнього фізичного терапевта і дає можливість індивідуально підібрати реабілітаційне втручання та провести його контроль. Якісна організація клінічної практики для фізичних терапевтів дає можливість закріпити практичні навички у реальних професійних умовах. Формування клінічного мислення, відпрацювання практичних навичок, засвоєння культури спілкування з пацієнтами є основними напрямками навчання з клінічної практики для бакалаврів та магістрів зі спеціальності «Фізична терапія. Ерготерапія».
Comparability of Event Adjudication Versus Administrative Billing Claims for Outcome Ascertainment in the DAPT Study
Authors: Faridi Kamil F. , Tamez Hector , Butala Neel M. , Song Yang , Shen Changyu , Secemsky Eric A. , Mauri Laura , Curtis Jeptha P. , Strom Jordan B. , Yeh Robert W. 
Published: January 2021

Background:
Data from administrative claims may provide an efficient alternative for end point ascertainment in clinical trials. However, it is uncertain how well claims data compare to adjudication by a clinical events committee in trials of patients with cardiovascular disease.

Methods:

We matched 1336 patients ≥65 years old who received percutaneous coronary intervention in the DAPT (Dual Antiplatelet Therapy) Study with the National Cardiovascular Data Registry CathPCI Registry linked to Medicare claims as part of the EXTEND (Extending Trial-Based Evaluations of Medical Therapies Using Novel Sources of Data) Study. Adjudicated trial end points were compared with Medicare claims data with
International Classification of Diseases, Ninth Revision
codes from inpatient hospitalizations using time-to-event analyses, sensitivity, specificity, positive predictive value, negative predictive value, and kappa statistics.

Results:

At 21-month follow-up, the cumulative incidence of major adverse cardiovascular and cerebrovascular events (combined mortality, myocardial infarction, and stroke) was similar between trial-adjudicated events and claims data (7.9% versus 7.2%, respectively;
P
=0.50). Bleeding rates were lower using adjudicated events compared with claims (5.0% versus 8.6%, respectively;
P
<0.001). The sensitivity and positive predictive value of comprehensive billing codes for identifying adjudicated events were 65.6% and 85.7% for myocardial infarction, 61.5% and 47.1% for stroke, and 76.8% and 39.3% for bleeding, respectively. Specificity and negative predictive value for all outcomes ranged from 93.7% to 99.5%. All 39 adjudicated deaths were identified using Medicare data. Kappa statistics assessing agreement between events for myocardial infarction, stroke, and bleeding were 0.73, 0.52, and 0.49, respectively.

Conclusions:
Claims data had moderate agreement with adjudication for myocardial infarction and poor agreement but high specificity for bleeding and stroke in the DAPT Study. Deaths were identified equivalently. Using claims data in clinical trials could be an efficient way to assess mortality among Medicare patients and may help detect other outcomes, although additional monitoring is likely needed to ensure accurate assessment of events.
A Dual-Frequency Radar Retrieval of Two Parameters of the Snowfall Particle Size Distribution Using a Neural Network
Authors: Chase Randy J. , Nesbitt Stephen W. , McFarquhar Greg M. 
Published: January 2021

AbstractWith the launch of the Global Precipitation Measurement Dual-Frequency Precipitation Radar (GPM-DPR) in 2014, renewed interest in retrievals of snowfall in the atmospheric column has occurred. The current operational GPM-DPR retrieval largely underestimates surface snowfall accumulation. Here, a neural network (NN) trained on data that are synthetically derived from state-of-the-art ice particle scattering models and measured in situ particle size distributions (PSDs) is used to retrieve two parameters of the PSD: liquid equivalent mass-weighted mean diameter and the liquid equivalent normalized intercept parameter . Evaluations against a test dataset showed statistically significantly improved ice water content (IWC) retrievals relative to a standard power-law approach and an estimate of the current GPM-DPR algorithm. Furthermore, estimated median percent errors (MPE) on the test dataset were −0.7%, +2.6%, and +1% for , , and IWC, respectively. An evaluation on three case studies with collocated radar observations and in situ microphysical data shows that the NN retrieval has MPE of −13%, +120%, and +10% for , , and IWC, respectively. The NN retrieval applied directly to GPM-DPR data provides improved snowfall retrievals relative to the default algorithm, removing the default algorithm’s ray-to-ray instabilities and recreating the high-resolution radar retrieval results to within 15% MPE. Future work should aim to improve the retrieval by including PSD data collected in more diverse conditions and rimed particles. Furthermore, different desired outputs such as the PSD shape parameter and snowfall rate could be included in future iterations.
Impact of Developing ENSO on Tibetan Plateau Summer Rainfall
Authors: Hu Shuai , Zhou Tianjun , Wu Bo 
Published: January 2021

AbstractThe year-to-year variations of Tibetan Plateau (TP) summer rainfall have tremendous climate impacts on the adjoining and even global climate, attracting extensive research attention in recent decades to understand the underlying mechanism. In this study, we investigate an open question of how El Niño–Southern Oscillation (ENSO) influences the TP precipitation. We show that the developing ENSO has significant impacts on the summer rainfall over the southwestern TP (SWTP), which is the second EOF mode of the interannual variability of summer rainfall over the TP. The moisture budget indicates that both the suppressed vertical motion and the deficit of moisture contribute to the reduction of SWTP rainfall during El Niño’s developing summer, with the former contribution 4 times larger than the latter. Moist static energy analyses indicate that the anomalous advection of climatological moist enthalpy by anomalous zonal wind is responsible for the anomalous descending motions over the SWTP. The El Niño–related southward displacements of the South Asian high and the upper-level cyclonic anomalies over the west of TP stimulated by the suppressed Indian summer monsoon precipitation are two key processes dominating the anomalous zonal moist enthalpy advection over SWTP. Meanwhile, the India–Burma monsoon trough is strengthened during El Niño developing summer, which prevents the advection of water vapor into the SWTP, and thus contributes to the deficit of summer SWTP rainfall. Our results help to understand the complicated ENSO-related air–sea interaction responsible for the variability of TP precipitation and have implications for seasonal prediction of the TP climate.
The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases
Authors: Ugliara Barone Mark Thomaz , Chaluppe Matheus , Ripoli Pedro , Patricio Bruna Talita , Lima Bruna Letícia Souza , Galastri Lucas Leme , Wieselberg Ronaldo Jose Pineda , Xavier de Oliveira Lucas , Ngongo Belinda , Demont Audrey Guibat , de Luca Patrícia Vieira 
Published: January 2021

Background: Acceptance and adjustment to lifelong noncommunicable diseases (NCDs) pose a great challenge for individuals living with these conditions. Diabetes is one of the most prevalent NCDs, with type 1 diabetes usually diagnosed during childhood. Self-leadership is linked to internal and external factors that may motivate individuals with NCDs to play an active role as changemakers in their community or society. The Young Leaders in Diabetes (YLD) training, created to equip young people with skills that would benefit the population to which they belong, uses the Empowerment Ladder as a framework to identify their position relative to three leadership stages (self, community and society). Objective: To describe the stages and the ‘climbing’ process of the Empowerment Ladder and assess its suitability as a framework for use in a leadership training context. Method: From among 29 youth leaders who participated, 15 were selected (5 men and 10 women) and had their community engagement and activity analysed before and after training. Individuals were positioned on the Empowerment Ladder according to their past and current roles and activities. The difference between pre- and post-training test grades (delta scores) was calculated. Results: Post-training scores were significantly higher than pre-training scores (8.9 ± 0.54 vs 7.6 ± 1.08, p = .00084). Most individuals moved to a higher step on the Empowerment Ladder; however, three individuals, with delta scores lower than the median (0.1, 0.15 and 0.85) remained at their pre-YLD training level. Only one individual moved from Stage 1 (self) to Stage 3 (society). Another individual occupied two different steps at Stages 1 and 2 simultaneously because, although they demonstrated community leadership, they had not yet accepted their own health condition. Conclusion: The Empowerment Ladder proved a useful tool for identifying stages from self to broader levels of leadership in individuals living with type 1 diabetes. These initial findings need to be validated with a larger population, which includes other NCD groups.
Survival in Middle Ear Malignancy: A Population‐Based Analysis Based on the SEER Database
Authors: Alam Usman , Shafqat Iram , Ahsan Sara , Alonso Jose , Han Albert Y. , Mukdad Laith , Wang Marilene , Ahsan Syed F. 
Published: January 2021

ObjectiveThe purpose of this study was to investigate the clinical features and survival outcomes of patients with middle ear malignancies at a population level.Study DesignRetrospective cohort study with data from a national database.SettingNational database of middle ear malignancy.MethodsRecords of patients diagnosed with a middle ear malignancy from 1973 to 2016 were extracted from the SEER database (Surveillance, Epidemiology, and End Results). SPSS (version 27; IBM) was used to conduct 5‐year survival analysis.ResultsThe average survival for all 431 patients was 61.4 months. Five‐year disease‐specific survival for squamous cell carcinoma (SCCA), adenocarcinoma, other carcinoma, and noncarcinoma subtypes varied significantly at 54.6%, 82.1%, 71.8%, and 82.6%, respectively (P <. 0001). There was an improved 5‐year survival for patients with adenocarcinoma who received surgery versus those who did not (91.7% vs 65.1%; P =. 023, log‐rank). Five‐year disease‐specific survival was significantly better in patients aged <55 years (mean ± SD, 77.8% ± 0.39%) as compared with those >70 years (55.1% ± 5.1%) and those aged 55 to 69 years (60.2% ± 4.9%; P <. 01 and P <. 001, respectively, log‐rank). Patients with SCCA were significantly older than those with adenocarcinoma (P <. 0001). Noncarcinoma subtypes were more likely to present with local disease, as opposed to regional or distant disease, when compared with SCCA (P =. 0027).ConclusionPrognosis and treatment outcomes for primary middle ear malignancies depend on histologic subtype and age at diagnosis. The noncarcinoma and adenocarcinoma subtypes carry the best prognoses. Patients with adenocarcinoma were most likely to benefit from surgery.
Preoperative Predictors and Costs of 30‐Day Readmission Following Inpatient Pediatric Tonsillectomy in the United States
Authors: Khoury Habib , Azar Shaghauyegh S. , Boutros Hannah , Shapiro Nina L. 
Published: January 2021

ObjectivesTo understand national trends in 30‐day postoperative readmission following inpatient pediatric tonsillectomy and adenoidectomy.Study DesignRetrospective cohort study.SettingNationwide Readmissions Database.MethodsWe used the Nationwide Readmissions Database to identify and analyze 30‐day readmissions following inpatient tonsillectomy from 2010 to 2015. Using the International Classification of Disease codes, we identified 66,652 patients and analyzed the incidence, causes, risk factors, and costs of 30‐day readmission.ResultsOf 66,652 patients who underwent inpatient tonsillectomy, 2660 (4.0%) experienced a readmission. Readmitted patients were more commonly aged <2 years (23.4 vs 10.6%, P =. 01) and had a greater burden of comorbidities, including preoperative anemia (3.9 vs 1.3%, P <. 001), coagulopathy (3.5 vs 1.4%, P <. 001), and neurologic disorders (19.1 vs 6.6%, P <. 001). Readmitted patients experienced higher rates of postoperative complications (17.4 vs 9.0%, P <. 001) and had a longer length of stay (4.5 vs 2.2 days, P <. 001). Index cost of hospitalization was higher among readmitted patients ($14,129 vs $7307, P <. 001), and each readmission cost an additional $7576. Postoperative hemorrhage (21.3%) and dehydration (17.7%) were the 2 most common causes for readmission. Independent predictors of readmission included age <3 years, multiple comorbidities, and postoperative neurologic complications. The incidences of tonsillectomies and readmissions declined during the study period, most notably between 2010 and 2012.ConclusionReadmission after inpatient tonsillectomy and adenoidectomy places a substantial financial burden on the health care system. Targeted strategies to improve preoperative assessment and optimize postoperative care may prevent readmission, reduce unnecessary health care expenditures, and improve patient outcomes.
Delayed diagnosis adversely affects outcome in systemic lupus erythematosus: Cross sectional analysis of the LuLa cohort
Authors: Kernder Anna , Richter Jutta G , Fischer-Betz Rebecca , Winkler-Rohlfing Borgi , Brinks Ralph , Aringer Martin , Schneider Matthias , Chehab Gamal 
Published: January 2021

Objective Despite increased physician’s awareness and improved diagnostic and serological testing in the recent years, the interval between the initial symptoms and the diagnosis of Systemic lupus erythematosus (SLE) is still very long. Our aim was to study this delay and its association to the outcome of the disease. Methods Information on demographics, onset of first symptoms, first physicians visit and time of diagnosis was assessed by self-reported questionnaires among SLE patients in Germany (LuLa cohort, n = 585) in the year 2012. Disease activity (Systemic Lupus Activity Questionnaire; SLAQ), disease related damage (Brief Index of Lupus Damage; BILD), health related quality of life (Short Form 12) and fatigue (FSS) were chosen as proxies for outcome. Linear regression analysis was used to analyze the association of the delay in diagnosis to the outcome, adjusted for age, disease duration and sex. Results Mean duration between the onset of symptoms and the diagnosis of SLE was 47 months (SD 73). The longer the time to diagnosis, the higher the disease activity (β = 0.199, p < 0.0001), the disease-related damage (β = 0.137, p = 0.002) and fatigue (β 0.145, p = 0.003) and the lower the health-related quality of life (physical β = −0.136, p = 0.004, mental β = −0.143, p = 0.004). Conclusion In systemic lupus erythematosus, longer time to diagnosis was associated with worse outcome. Concepts in care with the intention to shorten the time to diagnosis are needed to improve the long-term outcome of the disease.
Association of coexisting anti-ribosomal P and anti-dsDNA antibodies with histology and renal prognosis in lupus nephritis patients
Authors: Wakamatsu Ayako , Sato Hiroe , Kaneko Yoshikatsu , Cho Takamasa , Ito Yumi , Kurosawa Yoichi , Hasegawa Eriko , Kobayashi Daisuke , Nakatsue Takeshi , Kuroda Takeshi , Suzuki Yoshiki , Uchiumi Toshio , Narita Ichiei 
Published: January 2021

Objectives Anti-ribosomal P protein autoantibodies (anti-P) specifically develop in patients with systemic lupus erythematosus. Associations of anti-P with lupus nephritis (LN) histological subclass and renal outcome remain inconclusive. We sought to determine the association of anti-P and anti-double-stranded DNA antibody (anti-dsDNA) with renal histology and prognosis in LN patients. Methods Thirty-four patients with LN, having undergone kidney biopsy, were included. The 2018 revised ISN/RPS classification system was used for pathophysiological evaluation. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 for > 3 months. Results Six patients (17.6%) were positive for anti-P and 26 (76.5%) for anti-dsDNA. Among the six patients with anti-P, one did not have anti-dsDNA, but did have anti-Sm antibody, and showed a histological subtype of class V. This patient maintained good renal function for over 14 years. The remaining five patients, who had both anti-P and anti-dsDNA, exhibited proliferative nephritis and were associated with prolonged hypocomplementemia, and the incidence of CKD did not differ from patients without anti-P. Conclusion Although this study included a small number of patients, the results indicated that histology class and renal prognosis associated with anti-P depend on the coexistence of anti-dsDNA. Further studies with a large number of patients are required to confirm this conclusion.