bluuebunny/crossref_metadata_2025_split huggingface dataset:
To determine correlation between VIRADS scoring and pathological staging in bladder cancer: A prospective study and review of literature
Authors: Gupta Prateek , Sarangi Shakti Swarup , Singh Mahendra , Pandey Himanshu , Choudhary Gautam Ram , Madduri Vijay Kumar Sarma , Bhirud Deepak Prakash , Sandhu Arjun Singh , Jena Rahul 
Published: February 2023

The development of standardized reporting systems is of paramount importance in medical-imaging. Based on the “RADS” methodology, PIRADS and BI-RADS have been successfully used. The management of bladder cancer (BC) depends on the stage at the time of identification. Accurate assessment of the muscle-invasive stage can alter therapies that are radically different. MRI can accurately diagnose this in a standardized manner (Vesical Imaging-Reporting and Data System: VIRADS) and spare additional procedures. The aim of the study is to determine diagnostic accuracy of VIRADS scoring in evaluation of muscle invasiveness in patients with BC. This study was conducted in a single center over a period of 2 years from April 2020. A total of 76 patients with bladder SOL/diagnosed BC were included. Final VIRADS scoring was calculated and compared with histopathological report. 76 patients were evaluated which included 64 males and 12 females. Most of the cases came under the VIRADS-II category (23, 30.26%) followed by VIRADS-V (17, 22.36%). VIRADS-I was reported in 14 cases (18.42%). A total of 8 cases (10.52 %) were reported as VIRADS III and 14 cases (18.42%) as VIRADS IV. VIRADS-III was taken as cut off and found to have a sensitivity of 94.44%, a specificity of 87.50%, a positive predictive value of 87.17% and a negative predictive value of 94.59%. Though number of cases are still less to accurately predict test characteristics of VIRADS, our results are consistent with previously done retrospective studies and VIRADS has got good correlation with pathological staging.
A Review of the Data Supporting Use of COVID-19 Vaccinations in the Pediatric Population
Authors: Stultz Jeremy S. , Eiland Lea S. 
Published: February 2023

Objective: The objective of this study was to review the effectiveness and safety of COVID-19 vaccinations in the pediatric population. Data Sources: PubMed/Medline (September 2020 to December 2022), the Centers for Disease Control and Prevention, and Food and Drug Administration (FDA) websites. Study Selection and Data Extraction: Publications regarding the safety and efficacy of COVID-19 vaccinations in children were included. Data Synthesis: Vaccines authorized for use in children include two monovalent mRNA vaccines (≥6 months old) and one monovalent protein subunit adjuvant vaccine (adolescents only). Omicron-specific mRNA bivalent boosters are authorized for children ≥6 months old. Studies after monovalent vaccine authorization illustrated efficacy in children >5 to 6 years of age, specifically decreased severe COVID-19 (including mortality) and multisystem inflammatory response syndrome occurrence (including during Omicron predominance). Available data for children <5 to 6 years suggests efficacy, although data are limited. Monovalent vaccine efficacy against Omicron infections may wane as early as 2 months, but protection against severe disease complications may last longer, and bivalent Omicron boosters are anticipated to increase effectiveness. Myocarditis/pericarditis is a safety concern associated with the COVID-19 vaccinations but occurs less frequently then COVID-19 complications and thus the benefit outweighs the risks. Relevance to Patient Care and Clinical Practice: Caregivers seek information from health care professionals regarding vaccine safety and efficacy. Pharmacists can use the objective information in this review to educate caregivers and effectively administer COVID-19 vaccines to patients. Conclusions: There is sufficient and continually growing safety and efficacy data available to recommend COVID-19 vaccinations for children ≥6 months of age.
Optimal regimen of levetiracetam for prevention of busulfan-induced seizure in patients undergoing hematopoietic stem cell transplantation: A review of available evidence
Authors: Tavajohi Rayeheh , Shahrami Bita , Rostami Tahereh , Kiumarsi Azadeh , Honarmand Hooshyar , Hadjibabaie Molouk 
Published: February 2023

Objective This review aimed to summarize the available data and offer a practical recommendation regarding the optimal regimen of levetiracetam (LEV) for the prevention of busulfan-induced seizure (BIS) in patients undergoing hematopoietic stem cell transplantation (HSCT). Data Sources Published articles by searching databases (PubMed, Google Scholar, Cochrane Library, ScienceDirect) were reviewed. All types of original studies performed in pediatric and adult populations have been investigated and required data was extracted. Data Summary Eleven articles were eligible to be included in this review. A loading dose was not used in any of the studies. LEV had been started from 6 to 48 h before busulfan (Bu) initiation and continued up to 24 to 48 h after its termination. The dose range of LEV was 10 to 20 mg/kg/day divided every 12 h in pediatrics and 500 to 1000 mg twice daily in adults. Both oral and intravenous (IV) routes of administration were used. Except for three studies, no seizure had occurred in patients who had received LEV. Conclusions Considering the available evidence, LEV with the dose range from 500 to 1000 mg twice daily in adults and 10 mg/kg twice daily (20 mg/kg/day in 2 divided doses) in children orally or IV started from 6 to 24 h before Bu initiation up to 24 to 48 h after the last dose of Bu seems to prevent BIS appropriately. More prospective clinical trials with a larger population are needed to validate the optimal dosing of LEV for BIS prophylaxis in patients undergoing HSCT.
Accurately Assessing Teacher ADHD-Specific Attitudes Using the Scale for ADHD-Specific Attitudes
Authors: Mulholland Sarah , Cumming Therese M. , Lee Jihyun 
Published: February 2023

Objective: The aim of this study is therefore twofold, first to accurately examine the ADHD-specific attitudes of New South Wales Government school in-service teachers using the Scale for ADHD-Specific Attitudes (Authors 2016), and second, to determine if any of their socio-demographic features could predict their attitudes Method: Exploratory factor analysis found a 5-factor structure, and multiple regression analysis was performed to establish the existence of groups of variables with respect to teacher attitudes towards ADHD-type behaviours and any demographic predictors of teacher attitudes. Results: The final regression model found significant predictors of each factor with R2 values ranging from .007 to .147. Conclusion: This study illustrated that teachers had generally positive attitudes towards students who display ADHD-type behaviours, however, they found the externalised behaviours of ADHD irritating in the classroom and found teaching students with ADHD-type behaviours difficult, and teachers want more information about ADHD and how to manage it in the classroom.
Construction of Meta-Thinking Educational Program Based on Mental-Brain Simulation (MTMBS) and Evaluating its Effectiveness on Executive Functions, Emotion Regulation, and Impulsivity in Children With ADHD: A Resting-State Functional MRI Study
Authors: Abed Mahdavi , Mansureh Haj-Hosseini , Masoud Gholam-Ali Lavasani , Elaheh Hejazi , Mohammad-Hossein Nili H.K , Yamin Bagheri Davisaraei , Abdol-Hossein Vahabie 
Published: February 2023

Objective: The aim of present research was to make a Meta-Thinking educational program based on mental-brain simulation and to evaluate its effectiveness on executive functions, emotion regulation and impulsivity in children with ADHD. Methods: The research method was Embedded Design: Embedded Experimental Model. The research sample included 32 children with ADHD who were randomly assigned to two experimental and control groups. The intervention was implemented for eight sessions of 1.5 hr for the experimental group, and fMRI images were taken from them, while the control group didn’t receive any treatment. Finally, using semi-structured interviews, coherent information was collected from the parents of the experimental group about the changes made. Data were analyzed with SPSS-24, MAXQDA, fMRIprep, and FSL software. Results: The Meta-Thinking Educational Program had effect on performance of ADHD children and suppressed brain regions related to DMN. Conclusion: The Implementation of this educational program plays a vital role in improving psychological problems of children with ADHD.
Utility of a ML analytics on real time risk stratification and re-intervention risk prediction on AV access outcomes and cost
Authors: Balamuthusamy Saravanan , Dhanabalsamy Nisha , Thankavel Bharath , Bala Manu S , Pfaffle Anthony 
Published: February 2023

Background: Vascular access is the lifeline for patients on hemodialysis. The average survival rates of dialysis dependent patients have been improving over the last 5 years and hence their dialysis access needs longevity for uninterrupted optimal dialysis. With the lack of genomic vascular access failure predictors, there is an unmet need for predicting an event and the appropriate approach to mitigate recurrence of the event that could have cost and outcome implications. Methods: We performed a single center experience that extracted relevant clinical (access flow, laboratory data and CKD details), access intervention (prior interventions, type & location of lesion, type of balloon used, use of stents etc.) and demographic (age, vintage on dialysis, sex, social determinants, other medical conditions) data in real time and feeds it into validated ML algorithms to predict risk of reintervention. (Plexus EMR LLC). Results: About 200 prevalent hemodialysis patients with a AV graft or AV fistula were included for this analysis. Need for re-intervention and use of stent/ flow reduction/new access creation were the outcomes analyzed. Plexus EMR is a licensed Azure based platform. R software was used to develop the ML algorithms. Regression factors were developed to assess and test the validity of individual attributes across all the data attributes. Each patient had a real time risk calculator available to the interventionalist on risk of reintervention/ year. Of the 200 patients, 148 had a AV fistula and the remaining 52 had a AV graft. Mean interventions in the year prior to analysis was 1.8 in patients with AV fistulas and 3.4 in AV grafts which decreased to 1.1 in AV fistulas and to 2.4 in AV grafts ( p < 0.01) post tool deployment. There were 62 AV graft thrombectomies done in the observation year and 62% of those were repeat thrombectomies. Stent utilization increased to 37 (22 in AV grafts and 15 in AV fistulas) and 2 patients had AV access flow reduction surgery. The cumulative cost (predicted) preintervention was $712,609 and decreased to $512,172 post intervention. Stent utilization increased by 68% in the evaluation year and 89% of the stents used were PTFE coated stents. Conclusion: Utilizing AI with ML based algorithms that includes clinical, demographic and patency maintenance variables could become new standards of care to optimally manage AV accesses and lower cost of care.
Primary results of a phase-III, randomized controlled trial of the Behavioral Intervention for increasing Physical Activity in Multiple Sclerosis project
Authors: Motl Robert W , Kidwell-Chandler Ariel , Sandroff Brian M , Pilutti Lara A , Cutter Gary R , Aldunate Roberto , Bollaert Rachel E 
Published: February 2023

Background We undertook a phase-III, randomized controlled trial (RCT) that examined the effectiveness of a behavioral intervention based on social cognitive theory (SCT) and delivered through the Internet using e-learning approaches for immediate and sustained increases in physical activity among persons with multiple sclerosis (MS). Method The study followed a parallel group RCT design. Persons with MS ( N = 318) were randomized into either behavioral intervention ( n = 159) or attention/social contact control ( n = 159) conditions. The conditions were administered over a 6-month period by persons who were uninvolved in screening, recruitment, random assignment, and outcome assessment. There was a 6-month follow-up period without access of conditions. We collected outcome data every 6 months over the 12-month period. The primary outcome was device-measured minutes/day of moderate-to-vigorous physical activity (MVPA). The data analysis involved a modified intent-to-treat approach (i.e. those who received the allocated conditions) using a linear mixed model. Results There was a significant group by time interaction on the primary outcome of device-measured minutes/day of MVPA ( p < 0.005). MVPA was increased immediately after the 6-month period in the behavioral intervention compared with control, and this difference was sustained over the 6-month follow-up. Conclusion This study provides evidence for the effectiveness of a widely scalable approach for increasing MVPA in persons with MS.
Male nurses’ mental health and provision of emotional support during COVID-19: a thematic analysis
Authors: Gadimova Farida , Hall Marc , Jackson Jennifer 
Published: February 2023

Background: COVID-19 has created mental health challenges for nurses. However, it is unknown if there is a gendered influence on nurses’ experiences during the pandemic. Aim: The aim of this study was to explore the experiences of male nurses during COVID-19, including their mental health and experiences of providing emotional support. Methods: We conducted semi-structured interviews using Zoom with nine male nurses and analysed the interviews using thematic analysis. Findings: Male nurses experienced negative mental health outcomes from the pandemic, but participants attributed these outcomes to the context. Male nurses provided emotional support for patients, students, families and other staff and did not describe emotional support as a difficult part of their work. Participants identified their role as a ‘breadwinner’ of being part of their concern during COVID-19. Participants used a variety of approaches to manage the stressors from the pandemic and cautioned against alcohol as a coping strategy. Discussion and Conclusions: Participants provided emotional support routinely as part of their work and went to great lengths to do so. This finding differs from most published literature that suggests male nurses struggle with emotional and interpersonal aspects of nursing. Male nurses require emotional support and employers can note that need for support may present differently by gender.
Heterogeneity in the diagnosis and prognosis of ischemic stroke subtypes: 9-year follow-up of 22,000 cases in Chinese adults
Authors: Chun Matthew , Qin Haiqiang , Turnbull Iain , Sansome Sam , Gilbert Simon , Hacker Alex , Wright Neil , Zhu Tingting , Clifton David , Bennett Derrick , Guo Yu , Pei Pei , Lv Jun , Yu Canqing , Yang Ling , Li Liming , Lu Yan , Chen Zhengming , Cairns Benjamin J , Chen Yiping , Clarke Robert 
Published: February 2023

Background: Reliable classification of ischemic stroke (IS) etiological subtypes is required in research and clinical practice, but the predictive properties of these subtypes in population studies with incomplete investigations are poorly understood. Aims: To compare the prognosis of etiologically classified IS subtypes and use machine learning (ML) to classify incompletely investigated IS cases. Methods: In a 9-year follow-up of a prospective study of 512,726 Chinese adults, 22,216 incident IS cases, confirmed by clinical adjudication of medical records, were assigned subtypes using a modified Causative Classification System for Ischemic Stroke (CCS) (large artery atherosclerosis (LAA), small artery occlusion (SAO), cardioaortic embolism (CE), or undetermined etiology) and classified by CCS as “evident,” “probable,” or “possible” IS cases. For incompletely investigated IS cases where CCS yielded an undetermined etiology, an ML model was developed to predict IS subtypes from baseline risk factors and screening for cardioaortic sources of embolism. The 5-year risks of subsequent stroke and all-cause mortality (measured using cumulative incidence functions and 1 minus Kaplan–Meier estimates, respectively) for the ML-predicted IS subtypes were compared with etiologically classified IS subtypes. Results: Among 7443 IS subtypes with evident or probable etiology, 66% had SAO, 32% had LAA, and 2% had CE, but proportions of SAO-to-LAA cases varied by regions in China. CE had the highest rates of subsequent stroke and mortality (43.5% and 40.7%), followed by LAA (43.2% and 17.4%) and SAO (38.1% and 11.1%), respectively. ML provided classifications for cases with undetermined etiology and incomplete clinical data (24% of all IS cases; n = 5276), with area under the curves (AUC) of 0.99 (0.99–1.00) for CE, 0.67 (0.64–0.70) for LAA, and 0.70 (0.67–0.73) for SAO for unseen cases. ML-predicted IS subtypes yielded comparable subsequent stroke and all-cause mortality rates to the etiologically classified IS subtypes. Conclusion: This study highlighted substantial heterogeneity in prognosis of IS subtypes and utility of ML approaches for classification of IS cases with incomplete clinical investigations.
Ventilatory ratio and mechanical power in prolonged mechanically ventilated COVID-19 patients versus respiratory failures of other etiologies
Authors: Ghiani Alessandro , Tsitouras Konstantinos , Paderewska Joanna , Kahnert Kathrin , Walcher Swenja , Gernhold Lukas , Neurohr Claus , Kneidinger Nikolaus 
Published: February 2023

Background: Evidence suggests differences in ventilation efficiency and respiratory mechanics between early COVID-19 pneumonia and classical acute respiratory distress syndrome (ARDS), as measured by established ventilatory indexes, such as the ventilatory ratio (VR; a surrogate of the pulmonary dead-space fraction) or mechanical power (MP; affected, e.g., by changes in lung-thorax compliance). Objectives: The aim of this study was to evaluate VR and MP in the late stages of the disease when patients are ready to be liberated from the ventilator after recovering from COVID-19 pneumonia compared to respiratory failures of other etiologies. Design: A retrospective observational cohort study of 249 prolonged mechanically ventilated, tracheotomized patients with and without COVID-19-related respiratory failure. Methods: We analyzed each group’s VR and MP distributions and trajectories [repeated-measures analysis of variance (ANOVA)] during weaning. Secondary outcomes included weaning failure rates between groups and the ability of VR and MP to predict weaning outcomes (using logistic regression models). Results: The analysis compared 53 COVID-19 cases with a heterogeneous group of 196 non-COVID-19 subjects. VR and MP decreased across both groups during weaning. COVID-19 patients demonstrated higher values for both indexes throughout weaning: median VR 1.54 versus 1.27 ( p < 0.01) and MP 26.0 versus 21.3 Joule/min ( p < 0.01) at the start of weaning, and median VR 1.38 versus 1.24 ( p < 0.01) and MP 24.2 versus 20.1 Joule/min ( p < 0.01) at weaning completion. According to the multivariable analysis, VR was not independently associated with weaning outcomes, and the ability of MP to predict weaning failure or success varied with lung-thorax compliance, with COVID-19 patients demonstrating consistently higher dynamic compliance along with significantly fewer weaning failures (9% versus 30%, p < 0.01). Conclusion: COVID-19 patients differed considerably in ventilation efficiency and respiratory mechanics among prolonged ventilated individuals, demonstrating significantly higher VRs and MP. The differences in MP were linked with higher lung-thorax compliance in COVID-19 patients, possibly contributing to the lower rate of weaning failures observed.
Venous thromboembolism in patients with idiopathic pulmonary fibrosis, based on nationwide claim data
Authors: Lee Jang Ho , Lee Hoon Hee , Park Hyung Jun , Kim Seonok , Kim Ye-Jee , Lee Jae Seung , Kim Ho Cheol 
Published: February 2023

Background: Idiopathic pulmonary fibrosis (IPF) is a known risk factor for venous thromboembolism (VTE). However, it is currently unknown which factors are associated with an increase of VTE in patients with IPF. Objectives: We estimated the incidence of VTE in patients with IPF and identified clinical characteristics related to VTE in patients with IPF. Design and methods: De-identified nationwide health claim data from 2011 to 2019 was collected from the Korean Health Insurance Review and Assessment database. Patients with IPF were selected if they had made at least one claim per year under the J84.1 [ International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10)] and V236 codes of rare intractable diseases. We defined the presence of VTE as at least one claim of pulmonary embolism and deep vein thrombosis ICD-10 codes. Results: The incidence rate per 1000 person-years of VTE was 7.08 (6.44–7.77). Peak incidence rates were noted in the 50–59 years old male and 70–79 years old female groups. Ischemic heart disease, ischemic stroke, and malignancy were associated with VTE in patients with IPF, with an adjusted hazard ratio (aHR) of 1.25 (1.01–1.55), 1.36 (1.04–1.79), and 1.53 (1.17–2.01). The risk for VTE was increased in patients diagnosed with malignancy after IPF diagnosis (aHR = 3.18, 2.47–4.11), especially lung cancer [hazard ratio (HR) = 3.78, 2.90–4.96]. Accompanied VTE was related to more utilization of medical resources. Conclusion: Ischemic heart disease, ischemic stroke, and malignancy, especially lung cancer, were related to higher HR for VTE in IPF.
Nosocomial bacterial infections in Victoria decreased during the COVID-19 pandemic
Authors: Asgill Tess F , Stupart Douglas 
Published: February 2023

Background A number of infection control interventions were implemented during the COVID-19 pandemic in order to reduce the spread of this virus. Objective The purpose of this study was to determine if these interventions were associated with reduced nosocomial bacterial infections in Victoria, Australia. Methods Observational data were obtained from the Victorian Healthcare Associated Infection Surveillance System (VICNISS) based on admitted hospital patients in two 6-month timeframes representing pandemic and pre-pandemic hospital practices. Data were collected for surgical site infections, Staphylococcus aureus bacteraemia, Clostridioides difficile infection, and central line-associated bloodstream infections. Results There was a significant reduction in the rates of S. aureus bacteraemia (0.74 infections/10, 000 bed days pre-pandemic vs. 0.53/10,000 bed days in the pandemic period [rate ratio 0.72, 95% CI 0.57–0.90]; p = .003) and in C. difficile infections (2.2 infections/10,000 bed days pre-pandemic vs. 0.86/10 000 bed days in the pandemic era [rate ratio 0.76, 95% C.I. 0.67–0.86]; p <.001). There was no change in the overall rate of surgical site infections or central line-associated infections however. Discussion The increased emphasis on infection control and prevention strategies during the pandemic period was associated with reduced transmission of S. aureus and C. difficile infections within hospitals.