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Trends in characteristics of neurologists who provide stroke consultations in the USA,2008-2021

Stroke & Vascular Neurology 2023年第1期8卷 86-88页

作者： Carter H Nakamoto Andrew D Wilcock Lee H Schwamm jennifer j majersik Kori S Zachrison Ateev Mehrotra Department of Health Care Policy Harvard Medical SchoolBostonMassachusettsUSA Department of Family Medicine University of Vermont Larner College of MedicineBurlingtonVermontUSA Department of Neurology Massachusetts General HospitalBostonMassachusettsUSA Department of Neurology University of UtahSalt Lake CityUtahUSA Department of Emergency Medicine Massachusetts General HospitalBostonMassachusettsUSA Division of General Medicine and Primary Care Beth Israel Deaconess Medical CenterBostonMassachusettsUSA

Introduction Patients with acute ischaemic strokes(AIS),on average,fare better with timely neurologist consultation,and a growing proportion of them receive ***,little is known about trends in the characteristics of neurologists who treat *** We identified AIS and transient ischaemic attack(TIA)episodes with neurologist consults in fee-for service Medicare from january 2008 to September *** each episode,we determined whether the neurologist was a vascular neurologist,was a high-volume provider,whether the patient was transferred between hospitals and the distance between the patient’s home and physician’s *** From 2008 to 2021,the share of AIS/TIA episodes(n=5073294)with neurologist consults increased(52.9%to 61.7%).Among episodes with consults,the fraction conducted by a vascular neurologist(5.2%to 13.7%)or by a high-volume neurologist(13.2%to 14.9%)also *** fraction with the patient’s home and neurologist greater than 100 miles apart(4.8%to 9.6%)or in different states(5.1%to 8.1%)increased,as did the fraction with transfers(4.2%to 8.5%).Discussion Over the study period,the proportion of AIS/TIA episodes with consultations from neurologists with either vascular neurology certifications or high volumes increased substantially.

关键词： acute characteristics consultation

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Determinants of the impact of blood pressure variability on neurological outcome after acute ischaemic stroke

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Stroke & Vascular Neurology 2017年第1期2卷 1-6页

作者： Adam de Havenon Alicia Bennett Gregory j Stoddard Gordon Smith Lee Chung Steve O’Donnell j Scott McNally David Tirschwell jennifer j majersik Department of Neurology University of UtahSaltLake CityUtahUSA University of Utah SaltLake CityUtahUSA University of Washington SeattleWashingtonUSA

Introduction: Increased blood pressure variability (BPV) is detrimental after acute ischaemic stroke, but the interaction between BPV and neuroimaging factors that directly influence stroke outcome has not been explored. Methods: We retrospectively reviewed inpatients from 2007 to 2014 with acute anterior circulation ischaemic stroke, CT perfusion and angiography at hospital admission, and a modified Rankin Scale (MRS) 30- 365 days after stroke onset. BPV indices included SD, coefficient of variation and successive variation of the systolic blood pressure between 0 and 120 hours after admission. Ordinal logistic regression models were fitted to MRS with predictor variables of BPV indices. Models were further stratified by CT perfusion volumetric measurements, proximal vessel occlusion and collateral score. Results: 110 patients met the inclusion criteria. The likelihood of a 1-point rise in the MRS increased with every 10 mm Hg increase in BPV (OR for the 3 BPV indices ranged from 2.27 to 5.54), which was more pronounced in patients with larger ischaemic core volumes (OR 8.37 to 18.0) and larger hypoperfused volumes (OR 6.02 to 15.4). This association also held true for patients with larger mismatch volume, proximal vessel occlusion and good collateral vessels. Conclusions: These results indicate that increased BPV is associated with worse neurological outcome after stroke, particularly in patients with a large lesion core volume, concurrent viable ischaemic penumbra, proximal vessel occlusion and good collaterals. This subset of patients, who are often not candidates for or fail acute stroke therapies such as intravenous tissue plasminogen activator or endovascular thrombectomy, may benefit from interventions aimed at reducing BPV.

关键词： impaired perfusion cerebral

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DeepRice: A deep learning and deep feature based classification of Rice leaf disease subtypes

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Artificial Intelligence in Agriculture 2024年第1期11卷 34-49页

作者： P.Isaac Ritharson Kumudha Raimond X.Anitha Mary jennifer Eunice Robert Andrew j Department of CSE Karunya Institute of Technology and Sciences CoimbatoreTamilnaduIndia Department of Robotics Engineering Karunya Institute of Technology and SciencesCoimbatoreIndia Department of Mechatronics Engineering Manipal Institute of TechnologyManipal Academy of Higher EducationManipalKarnataka 576104India Department of Computer Science and Engineering Manipal Institute of TechnologyManipal Academy of Higher EducationManipalKarnataka 576104India

Rice stands as a crucial staple food globally,with its enduring sustainability hinging on the prompt detection of rice leaf ***,efficiently detecting diseases when they have already occurred holds paramount importance for solving the cost of manual visual identification and chemical *** the recent past,the identification of leaf pathologies in crops predominantly relies on manual methods using specialized equipment,which proves to be time-consuming and *** study offers a remedy by harnessing Deep Learning(DL)and transfer learning techniques to accurately identify and classify rice leaf diseases.A comprehensive dataset comprising 5932 self-generated images of rice leaves was assembled along with the benchmark datasets,categorized into 9 classes irrespective of the extent of disease spread across the *** classes encompass diverse states including healthy leaves,mild and severe blight,mild and severe tungro,mild and severe blast,as well as mild and severe brown *** meticulous manual labelling and dataset segmentation,which was validated by horticulture experts,data augmentation strategies were implemented to amplify the number of *** datasets were subjected to evaluation using the proposed tailored Convolutional Neural Networks *** performance are scrutinized in conjunction with alternative transfer learning approaches like VGG16,Xception,ResNet50,DenseNet121,Inception ResnetV2,and Inception *** effectiveness of the proposed custom VGG16 model was gauged by its capacity to generalize to unseen images,yielding an exceptional accuracy of 99.94%,surpassing the benchmarks set by existing state-of-the-art ***,the layer wise feature extraction is also visualized as the interpretable AI.

关键词： Rice leaf disease Deep learning CNN Crop yield Agriculture Food security

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Individual and geospatial factors associated with receipt of colorectal cancer screening:a state-wide mixed-level analysis

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Family Medicine and Community Health 2024年第S2期12卷 18-25页

作者： jennifer E Bayly Mara A Schonberg Marcia C Castro Kenneth j Mukamal Beth Israel Deaconess Medical Center BostonMassachusettsUSA Harvard Medical School BostonMassachusettsUSA Department of Global Health and Population Harvard T H Chan School of Public HealthBostonMassachusettsUSA

Background Colorectal cancer(CRC)is the second leading cause of cancer death in US adults but can be reduced by *** roles of individual and contextual factors,and especially physician supply,in attaining universal CRC screening remains *** We used data from adults 50-75 years old participating in the 2018 New York(NY)Behavioural Risk Factor Surveillance System linked to county-level covariates,including primary care physician(PCP)density and gastroenterologist(GI)*** were analysed in *** analyses included(1)ecological and geospatial analyses of county-level CRC screening prevalence and(2)individual-level Poisson regression models of receipt of screening,adjusted for socioeconomic and county-level contextual *** Mean prevalence of up-to-date CRC screening was 71%(95%CI 70%to 73%)across NY’s 62 ***-level CRC screening demonstrated significant spatial patterning(Global Moran’s I=0.14,p=0.04),consistent with the existence of county-level contextual *** both county-level and individual-level analyses,lack of health insurance was associated with lower likelihood of up-to-date screening(?−1.09(95%CI−2.00 to-0.19);adjusted prevalence ratio 0.68(95%CI 0.60 to 0.77)),even accounting for age,race/ethnicity and *** contrast,county-level densities of both PCPs and GIs were completely unassociated with screening at either the county or individual *** expected,other determinants at the individual level included education status and *** In this state-wide representative analysis,physician density was completely unassociated with CRC screening,although health insurance status remains strongly *** similar screening environments,broadened insurance coverage for CRC screening is likely to improve screening far more effectively than increased physician supply.

关键词： state screening county

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Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

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Global Health journal 2024年第1期8卷 11-15页

作者： Max j.Goodman jennifer Livschitz ji Won Kim Megan L.Schultz Medical College of Wisconsin MilwaukeeWI 53226USA Department of Pediatrics Division of Emergency MedicineMedical College of WisconsinMilwaukeeWI53226USA

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for *** medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such *** is important that medical students have nuanced global medical perspectives and can contribute to the global medical ***:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health ***:In 2021,a novel medical student PPC was established that began between an American and japanese medical *** a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online *** total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income *** primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their *** February 2022,American PPC members were emailed a qualitative survey to assess the PPC's ***:The survey was completed by 42%of American PPC members,95%of which were 22-26 *** were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural *** a global communication platform for students during medical school education may be an additional way to train aspiring global l

关键词： Pen-pals Medical student Global health Cultural competency

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Neuroprotection by resveratrol-glucuronide and quercetin-glucuronide via binding to polyphenol-and glycosaminoglycan-binding sites in the laminin receptor

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Neural Regeneration Research 2025年第3期20卷 819-820页

作者： Rayudu Gopalakrishna jennifer Aguilar Emily Lee William j.Mack Department of Integrative Anatomical Sciences Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA Department of Neurological Surgery Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA

The dietary polyphenolic compounds resveratrol and quercetin prevent neurodegenerative diseases in experimental models;however, they reach the brain only in nanomolar concentrations in the glucuronidated and sulfated ... 详细信息

关键词： resveratrol molar dated

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Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

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World journal of Cardiology 2024年第6期16卷 318-328页

作者： Ajay Kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna George Anil jha Nitish Sharma jennifer Sargent Mark j Kranis Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Division of CardiologySaint Vincent HospitalWorcesterMA 01608United States Division of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of *** of>10 mm size are associated with increased embolic events and poor *** is a paucity of literature on the association of multiple vegetations with *** To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple *** In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from june 2017 to june 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were *** demographic,clinical,laboratory,and ECHO parameters were *** that were studied included recurrent admission,embolic phenomenon,and *** Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were *** mean age of these patients was ***(35%)had a prior episode of *** features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple *** these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically *** patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically *** This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple *** features of moderate to severe regurgitation,presence of pacemaker lead,impai

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

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Are there sex-based disparities in cataract surgery?

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International journal of Ophthalmology(English edition) 2024年第1期17卷 137-143页

作者： Matthew D.Geiger Anne M.Lynch Alan G.Palestine Nathan C.Grove Karen L.Christopher Richard S.Davidson Michael j.Taravella Naresh Mandava jennifer L.Patnaik Department of Ophthalmology University of Colorado School of MedicineAuroraCO 80045USA

AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract ***:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of *** collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the ***:A total of 11977 eyes from 7253 patients were included in the *** comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for *** had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer *** were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/***:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for ***,observed surgical complicatio

关键词： cataract surgery sex-based disparity phacoemulsification outcomes

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A functional tacrolimus-releasing nerve wrap for enhancing nerve regeneration following surgical nerve repair

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Neural Regeneration Research 2025年第1期20卷 291-304页

作者： Simeon C.Daeschler Katelyn j.W.So Konstantin Feinberg Marina Manoraj jenny Cheung jennifer Zhang Kaveh Mirmoeini jPaul Santerre Tessa Gordon Gregory HBorschel SickKids Research Institute Neuroscience and Mental Health ProgramTorontoONCanada Institute of Biomaterials and Biomedical Engineering University of TorontoTorontoONCanada Indiana University School of Medicine IndianapolisINUSA Division of Plastic and Reconstructive Surgery the Hospital for Sick ChildrenTorontoONCanada Translational Biology and Engineering Program Ted Rogers Centre for Heart ResearchInstitute of Biomedical EngineeringFaculty of DentistryUniversity of TorontoTorontoONCanada

Axonal regeneration following surgical nerve repair is slow and often incomplete,resulting in poor functional recovery which sometimes contributes to lifelong ***,there are no FDA-approved therapies available to promote nerve *** accelerates axonal regeneration,but systemic side effects presently outweigh its potential benefits for peripheral nerve *** authors describe herein a biodegradable polyurethane-based drug delivery system for the sustained local release of tacrolimus at the nerve repair site,with suitable properties for scalable production and clinical application,aiming to promote nerve regeneration and functional recovery with minimal systemic drug *** is encapsulated into co-axially electrospun polycarbonate-urethane nanofibers to generate an implantable nerve wrap that releases therapeutic doses of bioactive tacrolimus over 31 *** and drug loading are adjustable for applications in small and large caliber nerves,and the wrap degrades within 120 days into biocompatible *** released from the nerve wrap promotes axon elongation in vitro and accelerates nerve regeneration and functional recovery in preclinical nerve repair models while off-target systemic drug exposure is reduced by 80%compared with systemic *** its surgical suitability and preclinical efficacy and safety,this system may provide a readily translatable approach to support axonal regeneration and recovery in patients undergoing nerve surgery.

关键词： biodegradable local drug delivery nerve injury nerve regeneration nerve wrap tacrolimus

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Dissection of a rapidly evolving wheat resistance gene cluster by long-read genome sequencing accelerated the cloning of Pm69

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Plant Communications 2024年第1期5卷 69-83页

作者： Yinghui Li Zhen-Zhen Wei Hanan Sela Liubov Govta Valentyna Klymiuk Rajib Roychowdhury Harmeet Singh Chawla jennifer Ens Krystalee Wiebe Valeria Bocharova Roi Ben-David Prerna B.Pawar Yuqi Zhang Samidha jaiwar Istvan Molnar jaroslav Dolezel Gitta Coaker Curtis j.Pozniak Tzion Fahima Institute of Evolution University of HaifaMt.CarmelHaifa 3498838Israel The Department of Evolutionary and Environmental Biology University of HaifaMt.CarmelHaifa 3498838Israel The Institute of Plant Protection Sichuan Academy of Agricultural SciencesChengdu 610066China Crop Development Centre and Department of Plant Sciences University of Saskatchewan51 Campus DriveSaskatoonSK S7N 5A8Canada Department of Vegetables and Field Crops Institute of Plant SciencesAgricultural Research Organization(ARO)–Volcani CenterRishon Lezion 7505101Israel Department of Crop Genomics and Bioinformatics China Agricultural UniversityBeijing 100094China Institute of Experimental Botany of the Czech Academy of Sciences Centre of the Region Hana´for Biotechnological and Agricultural ResearchSlechtitelu 3177900 OlomoucCzech Republic Plant Pathology Department University of CaliforniaDavisDavisCA 95616USA Present address:Department of Plant Science University of ManitobaWinnipegMB R3T 2N2Canada Present address:Agricultural Institute Centre for Agricultural ResearchELKHMartonvasar 2462Hungary

Gene cloning in repeat-rich polyploid genomes remains ***,we describe a strategy for overcoming major bottlenecks in cloning of the powdery mildew resistance gene(R-gene)Pm69 derived from tetraploid wild emmer wheat.A conventional positional cloning approach was not effective owing to suppressed *** sorting was compromised by insufficient purity.A Pm69 physical map,constructed by assembling Oxford Nanopore Technology(ONT)long-read genome sequences,revealed a rapidly evolving nucleotide-binding leucine-rich repeat(NLR)R-gene cluster with structural variations.A single candidate NLR was identified by anchoring RNA sequencing reads from susceptible mutants to ONT contigs and was validated by virus-induced gene ***69 is likely a newly evolved NLR and was discovered in only one location across the wild emmer wheat distribution range in ***69 was successfully introgressed into cultivated wheat,and a diagnostic molecular marker was used to accelerate its deployment and pyramiding with other R-genes.

关键词： cluster resistance Israel

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