bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Clinical Impact of Cerebral Embolic Protection in Patients Undergoing Transcatheter Aortic Valve Replacement
Authors: Kroon Herbert G. , van der Werf Hindrik W. , Hoeks Sanne E. , van Gils Lennart , van den Berge Fauve R. , El Faquir Nahid , Rahhab Zouhair , Daemen Joost , Poelman Janny , Schurer Remco A.J. , van den Heuvel Ad , de Jaegere Peter , van der Harst Pim , Van Mieghem Nicolas M. 
Published: June 2019

Background:
We aimed to compare the rate of neurological events in patients with or without cerebral embolic protection (CEP) during transcatheter aortic valve replacement (TAVR).

Methods and Results:

Data on clinical end points including neurological events ≤30 days post-TAVR were collected for all patients who underwent transfemoral TAVR in 2 academic tertiary care institutions. Patients were matched through propensity scoring, which resulted in 333 pairs of patients with versus without CEP out of a total of 831 consecutive patients. The median age was 81 (76–85) years, and the median logistic EuroScore was 14% (9%–20%). The CEP group experienced less neurological events at 24 hours (1% versus 4%;
P
=0.035) and at 30 days (3% versus 7%;
P
=0.029). There were significantly more disabling strokes in unprotected patients at 30 days (1% versus 4%;
P
=0.039). CEP was associated with significantly fewer neurological events at 24 hours after TAVR (odds ratio, 0.20; 95% CI, 0.06–0.73;
P
=0.015) by multiple regression analysis, while age and valve type did not contribute significantly. Overall, 67% (2 of 3) in the CEP versus 83% (10 of 12) in the non-CEP cohort experienced neurological events in protected areas (ie, not dependent on the left vertebral artery).

Conclusions:
The use of filter-based CEP during TAVR was associated with less neurological events, especially in CEP-protected brain territories.
Using Worked Examples to Improve Student Understanding of Atmospheric Dynamics
Authors: Davenport Casey E. 
Published: June 2019

AbstractAtmospheric dynamics can represent a significant hurdle for students; the need to successfully apply concepts from calculus and physics, as well as the sometimes counterintuitive nature of fluid flow, combine to produce frustration and suboptimal learning. Additionally, there is often an emphasis on equation derivations and theory, rather than real-world applications. A new approach for teaching atmospheric dynamics, known as worked examples, is discussed herein. This pedagogy resolves identified challenges in a few ways: 1) reducing the cognitive load of students by explicitly demonstrating (via an expert-constructed guide) how mathematics and physics are applied to the atmosphere; 2) utilizing (as much as appropriate) real-world scenarios to demonstrate how equations explain what we observe; and 3) providing opportunities for students to critically examine the scenario, the relevant math and physics, and the underlying theory via a series of self-explanation prompts throughout the example. This study provides detailed information on the creation and implementation of worked examples in the two-semester atmospheric dynamics course sequence at the University of North Carolina at Charlotte. Comparisons in performance between students who took the course as a traditional lecture and derivation-based course and those who were subject to the worked examples pedagogy identify significant improvements with the new approach, especially for first-semester dynamics. Students also express deep satisfaction with the hands-on, application-based pedagogy.
Summer Climate Change in the Midwest and Great Plains due to Agricultural Development during the Twentieth Century
Authors: Nikiel Catherine A. , Eltahir Elfatih A. B. 
Published: June 2019

AbstractAgricultural development is among the most significant forms of land-use change globally. In central North America it has consisted of cropland expansion in the early 1900s, yield intensification starting in the 1930s, and the development of large irrigated areas beginning in the 1950s. The area of this study encompasses the Midwest and Great Plains of the United States not only because significant agricultural change has occurred here but also because of the significant cooling (warming hole) there in the midcentury. This study investigates the relative contribution of agricultural development and greenhouse gas (GHG) emissions on the observed patterns of regional changes in summer temperature, precipitation, and evapotranspiration using a long-term twentieth-century reanalysis dataset (CERA-20C) as boundary conditions for simulations with the MIT Regional Climate Model (MRCM). Temperatures in the Great Plains (33°–43°N, 95°–109°W) and the Midwest (38°–48°N, 82°–109°W) would have been significantly higher in the second half of the twentieth century without the influence of agricultural development, largely due to an increase in evaporative cooling. The simulations of precipitation changes reflect a significant influence of global SST teleconnections at decadal time scales. Numerical simulations also demonstrate the competing effects of cropland expansion and yield intensification on shaping the observed pattern of increases in precipitation. Ultimately, a combination of agricultural development and decadal variability of global sea surface temperatures (SST) explains most of the observed variability of summer temperature and precipitation during the twentieth century over central North America.
eHealth Literacy in Otolaryngology Patients
Authors: Bailey Christopher Eric , Kohler William J. , Makary Chadi , Davis Kristin , Sweet Nicholas , Carr Michele 
Published: June 2019

Objectives: The aim of this study was to compare eHealth literacy—one’s perception of one’s ability to use the Internet for health care—among otolaryngology patients in 3 geographic settings of the same department. Setting: An academic otolaryngology department. Method: Patients’ opinions and perceptions of their eHealth literacy were assessed with a validated paper survey administered in the summer of 2017. Results: Of 381 asked, 351 people completed the survey, 149 at a university town teaching hospital clinic (group A), 101 at a nearby rural clinic (group B), and 101 at a remote rural clinic (group C). Mean scores were 30.80, 28.97, and 29.03 for groups A, B, and C, respectively. The overall mean was 29.76 ± 5.97. Three surveys reported the minimum score of 8, and 26 reported the maximum score of 40. Results were statistically significantly different among all sites ( P = .001), between groups A and B ( P = .027), and between groups A and C ( P = .0175). Women reported higher eHealth literacy (30.13 ± 6.27) than men (28.87 ± 5.11) ( P = .045). Participant age and role (patient or parent of a patient) were statistically insignificant. Mean scores were similar to those previously reported in other patient populations. Conclusions: Otolaryngology patients in a university town had better eHealth literacy than patients in more rural settings, suggesting that online medical resources and access points are less likely to be useful in rural populations.
Do published patient decision aids for end-of-life care address patients’ decision-making needs? A systematic review and critical appraisal
Authors: Phillips Georgina , Lifford Kate , Edwards Adrian , Poolman Marlise , Joseph-Williams Natalie 
Published: June 2019

Background: Many decisions are made by patients in their last months of life, creating complex decision-making needs for these individuals. Identifying whether currently existing patient decision aids address the full range of these patient decision-making needs will better inform end-of-life decision support in clinical practice. Aims and design: This systematic review aimed to (a) identify the range of patients’ decision-making needs and (b) assess the extent to which patient decision aids address these needs. Data sources: MEDLINE, PsycINFO and CINAHL electronic literature databases were searched (January 1990–January 2017), supplemented by hand-searching strategies. Eligible literature reported patient decision-making needs throughout end-of-life decision-making or were evaluations of patient decision aids. Identified decision aid content was mapped onto and assessed against all patient decision-making needs that were deemed ‘addressable’. Results: Twenty-two studies described patient needs, and seven end-of-life patient decision aids were identified. Patient needs were categorised, resulting in 48 ‘addressable’ needs. Mapping needs to patient decision aid content showed that 17 patient needs were insufficiently addressed by current patient decision aids. The most substantial gaps included inconsistent acknowledgement, elicitation and documentation of how patient needs varied individually for the level of information provided, the extent patients wanted to participate in decision-making, and the extent they wanted their families and associated healthcare professionals to participate. Conclusion: Patient decision-making needs are broad and varied. Currently developed patient decision aids are insufficiently addressing patient decision-making needs. Improving future end-of-life patient decision aid content through five key suggestions could improve patient-focused decision-making support at the end of life.
Risk of cardiovascular and cerebrovascular events and mortality in patients with migraine receiving prophylactic treatments: An observational cohort study
Authors: Hoffman Veena , Xue Fei , Ezzy Stephen M , Yusuf Akeem , Green Edward , Eisele Osa , Kurth Tobias , Seeger John D 
Published: June 2019

Introduction This study quantified risks of cardiovascular, cerebrovascular, and mortality events among patients with migraine receiving prophylaxis. Methods Patients with migraine aged 18–65 years were identified from 2010 through 2015 within a United States administrative claims database. Topiramate initiators during follow-up were propensity score-matched separately to anticonvulsant, cardiovascular treatment, antidepressant, and other prophylactic treatment initiators. Incident outcomes were identified, and hazard ratios were calculated comparing outcome occurrence among topiramate initiators relative to each comparator. A case-control analysis was nested within the full migraine cohort, and odds ratios quantified the association between outcomes and use or non-use of individual prophylactic treatments (anticonvulsants, serotonin norepinephrine reuptake inhibitors, beta blockers, antihypertensives, tricyclic antidepressants, and other prophylactic treatments). Results The cohort included 119,243 patients with migraine. The matched topiramate initiators had a lower mortality risk versus antidepressant (hazard ratio: 0.44, 95% CI: 0.24, 0.83) and anticonvulsant initiators (hazard ratio: 0.45, 95% CI: 0.25, 0.84). In the case-control analysis, increased risks of several outcomes were observed with all prophylactic treatments relative to non-use of that treatment (odds ratios range from 1.54 to 7.90, and 95% CIs exclude 1.0) except for topiramate and calcium channel blockers. Conclusions Although increased risks for several outcomes were observed with certain prophylactic treatments, the treatments other than topiramate likely represent markers for outcome risk factors that developed or progressed after cohort entry, rather than being a direct effect of the treatments. Factors including migraine severity, frequency, and other treatment indications should be considered in future migraine prophylactic treatment safety assessments.
Step It Up! Prioritization of Community Supports for Walking Among US Adults
Authors: Hyde Eric T. , Omura John D. , Watson Kathleen B. , Fulton Janet E. , Carlson Susan A. 
Published: June 2019

Purpose: Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities ( Call to Action) presents goals and supporting strategies to promote walking. We assessed the presence and prioritization of 4 community supports for walking related to the goals of the Call to Action from the perspective of US adults. Design: Cross-sectional web-based survey. Setting: US adults. Participants: A total of 4043 respondents. Measures: SummerStyles 2016 survey assessing the reported presence and prioritization of 4 community supports for walking. Analysis: Estimated prevalence of the presence of supports overall and by demographic characteristics, and prevalence and adjusted prevalence ratios of their prioritization. Results: The most commonly reported community supports for walking were access to walkable locations (46.5%) and safe streets (29.2%), followed by walking groups (12.9%) and promotional campaigns (9.6%). Access to walkable locations (60.0%) and safe streets (50.6%) were most often prioritized by respondents, followed by promotional campaigns (23.6%) and walking groups (18.8%). Many differences in prioritization by demographic characteristics remained significant after adjusting for presence and other demographic characteristics, such as increased prioritization of all supports with older age groups. Conclusions: Presence and prioritization of community supports for walking varied widely by type of support and by demographic characteristics. Opportunities exist to improve access and public sentiment related to these supports to promote walking in the United States.
MRI Radiological Predictors of Requiring Microscopic Lumbar Discectomy After Lumbar Disc Herniation
Authors: Varlotta Christopher G. , Ge David H. , Stekas Nicholas , Frangella Nicholas J. , Manning Jordan H. , Steinmetz Leah , Vasquez-Montes Dennis , Errico Thomas J. , Bendo John A. , Kim Yong H. , Stieber Jonathan R. , Varlotta Gerard , Fischer Charla R. , Protopsaltis Themistocles S. , Passias Peter G. , Buckland Aaron J. 
Published: June 2019

Study Design: Retrospective cohort study. Objective: To investigate radiological differences in lumbar disc herniations (herniated nucleus pulposus [HNP]) between patients receiving microscopic lumbar discectomy (MLD) and nonoperative patients. Methods: Patients with primary treatment for an HNP at a single academic institution between November 2012 to March 2017 were divided into MLD and nonoperative treatment groups. Using magnetic resonance imaging (MRI), axial HNP area; axial canal area; HNP canal compromise; HNP cephalad/caudal migration and HNP MRI signal (black, gray, or mixed) were measured. T test and chi-square analyses compared differences in the groups, binary logistic regression analysis determined odds ratios (ORs), and decision tree analysis compared the cutoff values for risk factors. Results: A total of 285 patients (78 MLD, 207 nonoperative) were included. Risk factors for MLD treatment included larger axial HNP area ( P < .01, OR = 1.01), caudal migration, and migration magnitude ( P < .05, OR = 1.90; P < .01, OR = 1.14), and gray HNP MRI signal ( P < .01, OR = 5.42). Cutoff values for risks included axial HNP area (70.52 mm2, OR = 2.66, P < .01), HNP canal compromise (20.0%, OR = 3.29, P < .01), and cephalad/caudal migration (6.8 mm, OR = 2.43, P < .01). MLD risk for those with gray HNP MRI signal (67.6% alone) increased when combined with axial HNP area >70.52 mm2 (75.5%, P = .01) and HNP canal compromise >20.0% (71.1%, P = .05) cutoffs. MLD risk in patients with cephalad/caudal migration >6.8 mm (40.5% alone) increased when combined with axial HNP area and HNP canal compromise (52.4%, 50%; P < .01). Conclusion: Patients who underwent MLD treatment had significantly different axial HNP area, frequency of caudal migration, magnitude of cephalad/caudal migration, and disc herniation MRI signal compared to patients with nonoperative treatment.
Assessment of Ophthalmology Residency Programs in Saudi Arabia: A Trainee-Based Survey
Authors: AlEnezi Saad H , Alfawaz Abdullah M , Al Owaifeer Adi Mohammed , Althiabi Saad M , Tabbara Khalid F 
Published: June 2019

Purpose: To assess the satisfaction and competency of Saudi ophthalmology residents and compare their performance against International Council of Ophthalmology (ICO) standards. Methods: A cross-sectional web-based survey of senior ophthalmology residents (postgraduate years [PGY] 3-4) and recent graduates (from 2010 to 2015) assessed various aspects of training. The questionnaire was sent to the participants and was divided into 3 main domains: demographics, training program evaluation, and preparedness for board exams and clinical practice. Results: Out of the 145 invitees, 120 (82.8%) responded. Fifty percent of respondents reported an overall satisfaction with the program. Adequate clinical exposure was reported in most subspecialties except refraction and low vision rehabilitation with inadequate exposure reported by 55.8% and 95.8%, respectively. Surgical exposure was reported as adequate for phacoemulsification (58.3%) and strabismus surgery (68.3%) only. Eighty-nine percent of respondents reported performing less than 80 cases of phacoemulsification. Of the respondents who had graduated, most (89.7%) passed the final board exam at the first attempt. There were 73.5% of respondents who reported that residency training prepared them well for the board exam. Ongoing clinical and call duties were reported as having a negative impact on exam performance. Conclusions: Saudi ophthalmology residents demonstrate a high level of clinical competency. However, additional efforts should aim at improving surgical training to increase the level of satisfaction among residents and improve the quality of training to meet international standards.
Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission
Authors: Rashidi Armin , Hamadani Mehdi , Zhang Mei-Jie , Wang Hai-Lin , Abdel-Azim Hisham , Aljurf Mahmoud , Assal Amer , Bajel Ashish , Bashey Asad , Battiwalla Minoo , Beitinjaneh Amer M. , Bejanyan Nelli , Bhatt Vijaya Raj , Bolaños-Meade Javier , Byrne Michael , Cahn Jean-Yves , Cairo Mitchell , Ciurea Stefan , Copelan Edward , Cutler Corey , Daly Andrew , Diaz Miguel-Angel , Farhadfar Nosha , Gale Robert P. , Ganguly Siddhartha , Grunwald Michael R. , Hahn Theresa , Hashmi Shahrukh , Hildebrandt Gerhard C. , Holland H. Kent , Hossain Nasheed , Kanakry Christopher G. , Kharfan-Dabaja Mohamed A. , Khera Nandita , Koc Yener , Lazarus Hillard M. , Lee Jong-Wook , Maertens Johan , Martino Rodrigo , McGuirk Joseph , Munker Reinhold , Murthy Hemant S. , Nakamura Ryotaro , Nathan Sunita , Nishihori Taiga , Palmisiano Neil , Patel Sagar , Pidala Joseph , Olin Rebecca , Olsson Richard F. , Oran Betul , Ringden Olov , Rizzieri David , Rowe Jacob , Savoie Mary Lynn , Schultz Kirk R. , Seo Sachiko , Shaffer Brian C. , Singh Anurag , Solh Melhem , Stockerl-Goldstein Keith , Verdonck Leo F. , Wagner John , Waller Edmund K. , De Lima Marcos , Sandmaier Brenda M. , Litzow Mark , Weisdorf Dan , Romee Rizwan , Saber Wael 
Published: June 2019

Abstract
HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy–based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor–based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65% vs 30%) and bone marrow grafts (62% vs 7%), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P = .15), leukemia-free survival (P = .50), nonrelapse mortality (P = .16), relapse (P = .90), or grade II-IV acute GVHD (P = .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95% confidence interval, 0.30-0.48; P &lt; .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease–donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy–based Haplo-HCT vs MSD using calcineurin inhibitor–based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients.
Ameloblastomas: current aspects of the new WHO classification in an analysis of 136 cases
Authors: Cadavid Ana Maria Hoyos , Araujo Juliane Piragine , Coutinho-Camillo Cláudia Malheiros , Bologna Sheyla , Junior Celso Augusto Lemos , Lourenço Silvia Vanessa 
Published: June 2019

Abstract
Introduction
Ameloblastomas are neoplasms that have inspired great controversy and clinical interest; their incidence, radiographic features, treatment and behavior are still discussed quite often in the literature. In 2017, the classification of these lesions underwent modifications in terminology with the introduction of prospective views based on updates in current genetic studies.

Objective
To describe the most important features of the new classification, as well as to evaluate the prevalence and the clinical and radiographic characteristics of 136 ameloblastomas.

Methodology
The clinical-pathological characteristics of 136 patients diagnosed with ameloblastoma in two large hospitals in São Paulo were analyzed. All the hematoxylin-eosin (HE) stained slides were reviewed using an optical microscope (Olympus Cover) and tumors were classified according to the new WHO criteria (2017). Two independent evaluators analyzed the slides; in cases where there was disagreement a third evaluator was used and the result was established in consensus.

Results
71% of the lesions were of the conventional type, the predominant histopathological pattern being plexiform (40%), 72% of the tumors showed cortical expansion, and 84% had a radiographic pattern of the multilocular type. The treatment of choice in most cases was segmental resection (45%) and recurrence was present in 13% of the cases.

Conclusion
Studies with clinical-pathological correlations will be necessary in the near future, in order to provide new therapies that are more effective and conservative, improving the quality of life of patients effected.
Trends in State-Level Opinions toward the Affordable Care Act
Authors: Pacheco Julianna , Maltby Elizabeth 
Published: June 2019

Abstract
Context: This article argues that the devolution of the Affordable Care Act (ACA) to the states contributed to the slow progression of national public support for health care reform.
Methods: Using small-area estimation techniques, the authors measured quarterly state ACA attitudes on five topics from 2009 to the start of the 2016 presidential election.
Findings: Public support for the ACA increased after gubernatorial announcement of state-based exchanges. However, the adoption of federal or partnership marketplaces had virtually no effect on public opinion of the ACA and, in some cases, even decreased positive perceptions.
Conclusions: The authors' analyses point to the complexities in mass preferences toward the ACA and policy feedback more generally. The slow movement of national ACA support was due partly to state-level variations in policy making. The findings suggest that, as time progresses, attitudes in Republican-leaning states with state-based marketplaces will become more positive toward the ACA, presumably as residents begin to experience the positive effects of the law. More broadly, this work highlights the importance of looking at state-level variations in opinions and policies.