bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Implications of Estimated Glomerular Filtration Rate Dip Following Sodium‐Glucose Cotransporter‐2 Inhibitor Initiation on Cardiovascular and Kidney Outcomes
Authors: Xie Yan , Bowe Benjamin , Gibson Andrew K. , McGill Janet B. , Maddukuri Geetha , Al‐Aly Ziyad 
Published: May 2021

Background
The frequency of the initial short‐term decline in estimated glomerular filtration rate (eGFR), eGFR dip, following initiation of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) and its clinical implications in real‐world practice are not clear.

Methods and Results
We built a cohort of 36 638 new users of SGLT2i and 209 025 new users of other antihyperglycemics. Inverse probability weighting was used to estimate the excess rate of eGFR dip, risk of the composite cardiovascular outcome of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, or all‐cause mortality, and risk of the composite kidney outcome of eGFR decline >50%, end‐stage kidney disease, or all‐cause mortality. In the first 6 months of therapy, compared with other antihyperglycemics, excess rates of eGFR dip >10% and eGFR dip >30% were 9.86 (95% CI: 8.83–11.00) and 1.15 (0.70–1.62) per 100 SGLT2i users, respectively. In mediation analyses that accounted for eGFR dipping, SGLT2i use was associated with reduced risk of cardiovascular and kidney outcomes (hazard ratio, 0.92 [0.84–0.99] and 0.78 [0.71–0.87], respectively); the magnitude of the association reduced by eGFR dipping was small for both outcomes. SGLT2i was associated with reduced risk of both outcomes in those with higher than average probability of eGFR dip >10% or 30%. Compared with discontinuation, continued use of SGLT2i at 6 months was associated with reduced risk of cardiovascular and kidney outcomes in those with no eGFR dip or eGFR dip ≤10%, in those with eGFR dip >10%, and in those with eGFR dip >30%.

Conclusions
The salutary association of SGLT2i with cardiovascular and kidney outcomes was maintained regardless of eGFR dipping; concerns about eGFR dipping should not preclude use, and occurrence of eGFR dip after SGLT2i initiation may not warrant discontinuation.
Longitudinal Measures of Blood Pressure and Subclinical Atrial Arrhythmias: The MESA and the ARIC Study
Authors: Harding Barbara N. , Norby Faye L. , Heckbert Susan R. , McKnight Barbara , Psaty Bruce M. , Soliman Elsayed Z. , Floyd James S. , Chen Lin Yee 
Published: May 2021

Background
High blood pressure (BP) is a well‐known risk factor for atrial fibrillation (AF), but a single BP measurement may provide limited information about AF risk in older adults.

Methods and Results
This study included 1256 MESA (Multi‐Ethnic Study of Atherosclerosis) and 1948 ARIC (Atherosclerosis Risk in Communities) study participants who underwent extended ambulatory electrocardiographic monitoring and who were free of clinically detected cardiovascular disease, including AF. Using BP measurements from 6 examinations (2000–2018 in MESA and 1987–2017 in ARIC study), we calculated individual long‐term mean, trend, and detrended visit‐to‐visit variability in systolic BP and pulse pressure for each participant. Outcomes, assessed at examination 6, included subclinical AF and supraventricular ectopy. Results from each study were combined with inverse variance‐weighted meta‐analysis. At examination 6, the mean age was 73 years in MESA and 79 years in ARIC study, and 4% had subclinical AF. Higher visit‐to‐visit detrended variability in systolic BP was associated with a greater prevalence of subclinical AF (odds ratio [OR], 1.20; 95% CI, 1.02–1.38) and with more premature atrial contractions/hour (geometric mean ratio, 1.08; 95% CI, 1.01–1.15). For pulse pressure as well, higher visit‐to‐visit detrended variability was associated with a greater prevalence of AF (OR, 1.18; 95% CI, 1.00–1.37). In addition, higher long‐term mean pulse pressure was associated with a greater prevalence of subclinical AF (OR, 1.36; 95% CI, 1.08–1.70).

Conclusions
Antecedent visit‐to‐visit variability in systolic BP and pulse pressure, but not current BP, is associated with a higher prevalence of subclinical atrial arrhythmias. Prior longitudinal BP assessment, rather than current BP, may be more helpful in identifying older adults who are at higher risk of atrial arrhythmias.
‘If I Could Just Touch the Hem of His Garment’
Authors: Green Chris E.W. 
Published: May 2021

Abstract
This article proposes an ontology and praxis of mediation for the sake of ecumenical dialog, showing that the Pentecostal theological and spiritual tradition does not necessarily deny mediation or challenge its goodness, even if it does decry clericalism and ‘ecclesio-monism’. Instead, Pentecostals hold to confidence in the freedom of God to work however and whenever is best for us, always so that ‘the means of grace’ prove to be more than mere instruments or channels of divine power.
Wesley, Fletcher, and the Baptism of the Holy Spirit
Authors: Butler Geoffrey 
Published: May 2021

Abstract
Long regarded as a spiritual grandfather of sorts for the Pentecostal movement, John Wesley has been credited by some as paving the way for their doctrinal distinctive of Spirit baptism through his teaching on entire sanctification. Yet, Wesley’s language surrounding Spirit baptism and the meaning of Pentecost differs significantly from that of classical Pentecostalism, calling into question whether a direct line can be drawn from Wesley himself to this Pentecostal distinctive. This article makes the case that their doctrine of Spirit baptism owes much more to the theology of Wesley’s intended successor John Fletcher and the Holiness movement that followed than Wesley’s doctrine of entire sanctification, and that one may find in Fletcher’s theology the seeds that would culminate in this Pentecostal doctrine easier than one could in Wesley’s theology.
Ahd. slecko m. ‚Schnecke‘
Authors: Schuhmann Roland 
Published: May 2021

Abstract
Under the forms listed for the lemma Old High German snecko m. ‚snail‘ also a variant ‹ slecco › is mentioned. The ‑l‑ must then be the result either of a scribal error, a dissimilation or an assimilation. However, there is in Dutch a word for snail that also shows ‑l‑, Middle Dutch slecke (f.). It is argued here that Old High German slecko is a separate lemma that corresponds to Middle Dutch slecke.
Applying Human Factors Engineering to Address the Telemetry Alarm Problem in a Large Medical Center
Authors: Patterson Emily S. , Rayo Michael F. , Edworthy Judy Reed , Moffatt-Bruce Susan D. 
Published: May 2021

Objective Address the alarm problem by redesigning, reorganizing, and reprioritizing to better discriminate alarm sounds and displays in a hospital. Background Alarms in hospitals are frequently misunderstood, disregarded, and overridden. Method Discovery-oriented, intervention, and translational studies were conducted. Study objectives and measures varied, but had the shared goals of increasing positive predictive value (PPV) of critical alarms by reducing low-PPV alarms in the background, prioritizing alarms, redesigning alarm sounds to increase information content, and transparently conveying who initiated alarms. An alarm ontology was iteratively generated and refined until consensus was achieved. Results The ontology distinguishes five levels of urgency that incorporate likely PPV, three categories for who initiates the alarm (hospital staff, patient, or machine), whether it is clinical or technical, and clinical functions. Conclusion This unique collaboration allowed us to make progress on the alarm problem by making unintuitive leaps, avoiding common missteps, and refuting conventional healthcare approaches. Application Hospitals can consistently redesign, reorganize, reprioritize, and better discriminate alarms by priority, PPV, and content to reduce nurse response times.
Time Discount Rate of Forest-Dependent Communities: Evidence from Andhra Pradesh, India
Authors: Balakrishna Sundar , Virmani Vineet 
Published: May 2021

Executive Summary This study presents evidence on time discount rate of forest-dependent communities (FDCs) in the backdrop of the joint forest management program launched by the Government of India in 1990. The study uses data from two regions of the Indian state of Andhra Pradesh—Rayalaseema (a relatively dry forest region with low income) and the coastal region (relatively fertile forest and with higher income). We also identify socio-economic determinants of their patience levels and factors which distinguish the two regions. To elicit individual discount rates of FDCs members and their determinants, we use the choice task design methodology. Members from both regions were found to be highly impatient using the standard choice task design with the revealed time discount rate averaging 800% per annum. Members of FDCs from Rayalaseema were more impatient than their counterparts from the coastal region, although the statistical evidence is weak. We find no association between the income of members of FDCs and their time discount rate for both regions. Membership to caste categories showed a different response in both the regions, with members from the Scheduled Caste category and Other Backward Classes found to have a lower discount rate than those from the Scheduled Tribes category of Rayalaseema region and vice versa for the coastal region. For the coastal region, those with larger family size and heads of households were found to have a lower discount rate.
Trends in extracorporeal membrane oxygenation treatment from 2005 to 2018 in South Korea
Authors: Cho Hyoung-Won , Song In-Ae , Oh Tak Kyu 
Published: May 2021

Introduction: This study aimed to investigate trends in extracorporeal membrane oxygenation (ECMO) treatment during 2005–2018 and examine factors associated with in-hospital mortality. Methods: We conducted a population-based cohort study based on health records obtained from the National Health Insurance Service database in South Korea. All adult patients (⩾18 years old) who received ECMO treatment in the intensive care unit after hospitalization from 2005 to 2018 were enrolled. Results: We analyzed data for 21,129 adult ECMO patients from 128 hospitals. The prevalence of ECMO treatment gradually and continuously increased from 4 per 100,000 individuals (95% confidence interval [CI]: 3–4) in 2005 to 67.4 per 100,000 individuals (95% CI: 65–68) in 2018. There was a significant increase in ECMO treatment for acute respiratory distress syndrome (ARDS) or respiratory failure (from 2.5% during 2005–2008 to 14.5% during 2016–2018). The overall in-hospital and 30-day mortality rates of the patients were 48.4% and 53.5%, respectively. The in-hospital mortality rate was highest among patients with shock (62.1%) and lowest among ECMO patients with liver failure (21.6%). On multivariable logistic regression, a higher hospital case volume was associated with improvement in in-hospital mortality (p < 0.001). Conclusions: In South Korea, the prevalence of ECMO treatment has increased gradually and continuously between 2005 and 2018. There was a significant increase in the prevalence of ECMO treatment for ARDS or respiratory failure. Our results support that ECMO treatment indications have been expanding, and ECMO will become vital for treating critically ill patients in the future.
Magnetic resonance black-blood thrombus imaging can confirm chronic cerebral venous thrombosis: a case report and literature review
Authors: Wu Xiaoqin , Sun Jingkun , Chen Zhiying , Ding Yuchuan , Meng Ran 
Published: May 2021

Background Cerebral venous thrombosis (CVT) is easily missed or misdiagnosed in clinical settings because of its high variability in terms of symptoms and radiological findings. Herein, we aimed to explore a promising modality for confirming presumed CVT in the hope to uncover its superior diagnostic performance to conventional imaging modalities. Case presentation: The patient complained of intolerable pain in her forehead and left eye. Her lumbar puncture opening pressure was 140 mmH2O, and her cerebrospinal fluid composition was normal. No marked abnormalities were observed in routine brain images, including non-contrast computed tomography, magnetic resonance imaging, and contrast-enhanced magnetic resonance venography. However, chronic mural thrombi in the lumen of the left cortical veins, transverse/sigmoid sinus, and superior sagittal sinus were identified in magnetic resonance black-blood thrombus imaging (MRBTI) maps. Conclusions MRBTI can be used to directly and non-invasively visualize thrombi, and may thus be a promising tool over alternative routine techniques for confirming the diagnosis of CVT.
Healing and Functional Results of Dermal Allograft Augmentation of Complex and Revision Rotator Cuff Repairs
Authors: Namdari Surena , Nicholson Thema , Brolin Tyler J. , Lu Jeffrey , Abboud Joseph A. , Lazarus Mark D. 
Published: May 2021

Background: Primary rotator cuff repairs in complex cases (older patient age, larger tear sizes, chronic tears) and revision repairs are at high risk for failure of healing. Purpose: To examine clinical outcomes and healing rates in complex and revision rotator cuff repairs with dermal allograft augmentation. Study Design: Case series; Level of evidence, 4. Methods: A retrospective study was made of cases performed by 3 fellowship-trained surgeons via a uniform technique involving rotator cuff repairs with allograft augmentation. In all cases, a 1.5-mm, human, decellularized dermal graft was tied on top of the tendon at the medial row and compressed to the rotator cuff footprint using a double-row technique. Postoperative magnetic resonance imaging (MRI) was performed at a minimum of 6 months and American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and 12-Item Short Form Health Survey scores were collected at a minimum of 2 years postoperatively. Results: A total of 35 patients (23 revision repairs, 12 primary complex repairs) were included. The mean patient age was 57.9 years (range, 41.0-70.5 years). All shoulders had 2-tendon tears (supraspinatus and infraspinatus), and 8 included the upper 50% of the subscapularis. At a minimum of 2 years after surgery (mean, 3.2 years), mean ASES and SANE scores improved from 42.4 and 35.3 to 77.6 and 73.5, respectively ( P < .001). In the 23 patients (66%) with postoperative MRI evaluation, 11 (48%) had images showing the tendons were retorn. ASES (89.7 vs 66.4; P = .04) and SANE (84.1 vs 50.5; P = .02) scores were higher in healed patients than those with retears. The retear group had a higher degree of preoperative fatty atrophy of the infraspinatus ( P = .024). Conclusion: Double-row arthroscopic repair with dermal allograft augmentation of complex and revision rotator cuff tears led to improved functional outcomes. Approximately half of patients experienced a failure of healing, which was associated with poorer functional results.
Mental Health and Wellness of Service Providers Working with People Experiencing Homelessness in Canada: A National Survey from the Second Wave of the COVID-19 Pandemic
Authors: Kerman Nick , Ecker John , Gaetz Stephen , Tiderington Emmy , A. Kidd Sean 
Published: May 2021

Objective: This study examined the scope of common mental health problems and perceived impacts of the COVID-19 pandemic among direct service providers working with people experiencing homelessness in Canada. Method: This cross-sectional study used an online survey that was disseminated to homeless service, supportive housing, and harm reduction organizations and networks. Data were collected on depression, anxiety, stress, post-traumatic stress, compassion satisfaction and fatigue, and substance use problems as well as pandemic-related changes in mental health and wellness. A total of 701 service providers completed the survey and were included in data analysis. Descriptive statistics were used to examine the primary research questions, with hierarchical multiple regression models also being fit to explore mental health and wellness differences by occupational service setting. Results: Most direct service providers (79.5%) working with people experiencing homelessness reported a decline in their mental health during the pandemic. There were high rates of common mental health problems within the sample that are largely consistent with those found among health-care workers during the pandemic. Occupational service settings were not associated with the severity of mental health problems, indicating pervasive issues across the workforce, though providers who were younger and spent more time in direct service roles were at greater risk. Conclusions: The common mental health problems and negative impacts of the pandemic among service providers working with people experiencing homelessness highlight a highly vulnerable workforce that could benefit from improved access to supports. Given the similarities between our findings and other studies examining essential workforces, it is recommended that initiatives that provide accessible mental health care to the health-care workforce during the pandemic be expanded to include homeless and social service providers.
Evaluating the Impact of Education on Pharmacist Tobramycin Dose Recommendations for Cystic Fibrosis and a Review of Perceptions on Pharmacist-Led Charting
Authors: Le Tran , Lord Louise , Pignataro Silvana , Simioni Diana , Cheah Ron 
Published: May 2021

Background: Pharmacists routinely interpret and optimize tobramycin dosing for people with cystic fibrosis (PwCF). Objectives: To determine the impact of tobramycin therapeutic drug monitoring (TDM) education on pharmacist dose recommendations, and to explore nurses’ and medical doctors’ perceptions toward pharmacist-led TDM charting. Methods: This study involved 3 phases: a 12-month retrospective audit of PwCF prescribed tobramycin to identify the appropriateness of pharmacists’ dose recommendations, a pharmacist tobramycin educational intervention utilizing a voiceover presentation with pre- and post-online tobramycin TDM assessment (involving multiple choice pharmacokinetics and case-based scenario questions), and a cross-sectional survey of respiratory nurses’ and doctors’ perceptions toward pharmacist-led TDM charting. The pharmacists’ dose recommendations, in the audit and case-based questions, were considered appropriate if subsequent levels achieved the targeted area under the curve (AUC). Results: Audit results revealed that 44.4% of the 277 pharmacist dose recommendations identified were appropriate. The pre- and post-interventional assessments were completed by 51 and 52 pharmacists, respectively. Post intervention, correct scores were significantly higher than pre-intervention, evident in both the pharmacokinetics (median score 75% vs 100%; P = 0.048) and case-based scenario (median score 60% vs 90%; P < 0.0001) questions. Of the 54 nurses and medical doctors surveyed, 92.6% supported the implementation of pharmacist-led tobramycin charting. Conclusion: The study demonstrated an increased accuracy and appropriateness of pharmacists’ tobramycin pharmacokinetics knowledge and TDM dose recommendations post-educational intervention and highlighted nurses’ and medical doctors’ support of pharmacist-led tobramycin TDM charting.
Patient experiences and strategies for coping with SLE: A qualitative study
Authors: Case Siobhan , Sinnette Corine , Phillip Courtnie , Grosgogeat Claire , Costenbader Karen H , Leatherwood Cianna , Feldman Candace H , Son Mary Beth 
Published: May 2021

Objective This study explored challenges that patients with systemic lupus erythematosus (SLE) and childhood-onset SLE (cSLE) face to identify modifiable influences and coping strategies in patient experiences. Methods Participants were recruited from two academic medical centers through a Lupus Registry of individuals ≥18 years old and ≥4 1997 ACR classification criteria for SLE and a centralized data repository of cSLE patients, and participated in three focus groups. Transcripts were coded thematically and adjudicated by two independent reviewers. Results Thirteen adults, 7 (54%) with cSLE, participated in focus groups. Themes were categorized into two domains: (1) challenges with SLE diagnosis and management; and (2) patient coping strategies and modifiable factors of the SLE experience. Participants identified five primary challenges: diagnostic odyssey, public versus private face of SLE, SLE-related stresses, medication adherence, and transitioning from pediatric to adult care. Coping strategies and modifiable factors included social support, open communication about SLE, and strong patient–provider relationships. Several participants highlighted positive lessons learned through their experiences with SLE, including empathy, resilience, and self-care skills. Conclusions Patients with cSLE and SLE identified common challenges, modifying influences and coping strategies based on personal experiences. A strong patient–provider relationship and trust in the medical team emerged as key modifiable factors. Deriving optimism from experiences with SLE was unique to several patients diagnosed as children or young adults. Leveraging factors that improved the participants’ experiences living with SLE may be used in future studies to address vulnerabilities in care.
Longitudinal assessment of meibomian glands and tear film layer in systemic isotretinoin treatment
Authors: Tanriverdi Cafer , Nurozler Tabakci Burcu , Donmez Sumbule 
Published: May 2021

Purpose: This study aimed to analyze the changes in meibomian glands (MGs) and tear film layer over time in patients taking systemic isotretinoin treatment. Methods: Patients who received systemic isotretinoin treatment between 4 and 8 months were prospectively followed up. In addition to full ophthalmologic examination, MG dysfunction (MGD), noncontact meibography, noninvasive and invasive tear break-up time (TBUT), ocular surface disease index (OSDI), corneal staining, and eyelid margin abnormality scores were recorded before, during, and after treatment. Results: A total of 88 eyes of 88 patients were included in the study. The right eyes of all the patients were included. The mean age of the patients was 21 ± 2.9 years. Of the 88 patients, 70 (79.6%) were females and 18 (20.4%) were males. Before the treatment, MGD, noncontact meibography, first noninvasive TBUT, mean noninvasive TBUT, invasive TBUT, OSDI, corneal staining, and eyelid margin abnormality scores were 0.29 ± 0.45, 4.93 ± 3.50, 13.78 ± 3.89 s, 14.47 ± 3.09 s, 12.96 ± 3.61 s, 0.54 ± 1.00, 0.04 ± 0.20, and 0.09 ± 0.28, respectively. Twelve months after the end of treatment, the scores were 0.97 ± 0.87 ( p < 0.001), 9.62 ± 3.89 ( p < 0.001), 11.24 ± 3.52 s ( p < 0.001), 12.34 ± 3.02 s ( p < 0.001), 11.31 ± 2.90 s ( p < 0.001), 1.90 ± 2.44 ( p < 0.001), 0.20 ± 0.40 ( p < 0.001), and 0.56 ± 0.49 ( p < 0.001), respectively. Conclusion: Systemic isotretinoin treatment causes morphological changes in the MGs. However, this treatment may negatively affect the tear film layer of patients. Some of these changes may persist for a long time even if the treatment is discontinued.