Favorable Rate Research Articles

Optimal Timing of Microsurgical Treatment for Ruptured Arteriovenous Malformations: A Systematic Review and Meta-Analysis.

The timing of microsurgical treatment (MST) for ruptured brain arteriovenous malformations (bAVM) is a contentious issue in the literature. This study aimed to investigate the impact of MST timing on outcomes in patients with ruptured bAVMs, considering MST with and without preoperative endovascular treatment (EVT). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a comprehensive search was conducted across multiple databases, yielding 15 studies meeting the inclusion criteria. The timing was defined as the duration from the rupture of bAVM to the MST. The patients were divided into 4 different groups based on MST timing: <48 hours, <1 week, <2 weeks, and <1 month. The primary outcome was favorable outcome defined as a modified Rankin Scale score of 0 to 2 or a Glasgow Outcome Scale score of 4 to 5 in the last clinical follow-up. Secondary outcomes included periprocedural mortality and complete excision. MST time >48 hours were associated with a significantly higher favorable outcome rate (odds ratio: 9.71, 95% Cl: 3.09-30.57, P < .01) and a lower mortality rate (OR: 0.15, 95% Cl: 0.02-0.88, P = .04) compared with MST timing ≤48 hours. After exclusion of patients who underwent MST with preoperative EVT, MST time >48 hours had a significantly higher rate of favorable outcome (OR: 9.39, 95% CI: 2.53-34.89, P < .01). This meta-analysis suggests that delayed surgical intervention beyond 48 hours may be associated with improved favorable outcomes in patients who underwent MST with and without preoperative EVT for ruptured bAVMs.

Radically concrete or incrementally abstract? The contingent role of abstract and concrete framing in pitching novel ideas

ABSTRACT Entrepreneurs pitching new ideas are hard-pressed to frame their message in the most compelling way to win the attention and support of relevant audiences. But could a simple shift in framing sanction the success or failure of their communication efforts? Drawing on recent scholarship on the recognition of novel ideas and language, we compare the effectiveness of two framing approaches to idea pitching: abstract vs. concrete framing. We suggest that the best framing strategy to rally audience support depends on the novelty of the idea. Two controlled experiments where we investigate the combined impact of an idea’s degree of novelty and the abstractness level (why vs. how) of the framing strategy used to pitch it on the idea’s evaluation by members of a lay audience (e.g. crowdfunders, students, or other non-professional evaluators) confirm our intuition. The findings indicate that radical ideas are significantly more likely to elicit favourable evaluation from lay audience members when those ideas are framed in concrete ‘How’ terms; whereas incremental ideas fare better when framed in abstract ‘Why’ terms. By focusing on the framing strategies that entrepreneurs can use to communicate their new ideas, our study contributes to the growing research on the role of language in shaping the recognition of novelty. More generally, it provides entrepreneurs with actionable insights that they can leverage to attract attention and support from a general (lay) audience.

ICT mediated gamification in education degrees: A commitment to sustainability

This research explores the perception of university students of Degrees in Education towards gamification mediated by Information and Communication Technologies (ICT) as an innovative teaching strategy, aligned with the principles of educational quality of the UN Agenda 2030. A quantitative, descriptive, cross-sectional and inferential research has been carried out, based on the survey technique. The research was carried out using the population of students in the first year of the Degrees in Early Childhood, Primary and Social Education at the University of Jaén during the 2022-23 academic year (n=521). A questionnaire was used as a research tool. The data collected were analyzed using the SPSS programme, carrying out descriptive statistical analysis, comparison of means and regression analysis. The results reflect a positive receptiveness on the part of the students towards ICT-supported gamification, considering it fun and dynamic. This strategy is widely known by students, which favors its implementation in the university environment. Specifically, quiz games and classroom management games stand out as the best-known ICT-supported gamification strategies. However, students of the Degree in Primary Education show greater knowledge compared to those of Pre-school Education; likewise, those who plan to use gamification in their future professional practice express more favourable evaluations. Gamification is considered an active and innovative methodology being a key element for quality improvement in Higher Education.

The Role of Complainant/Defendant Gender and Form of Sexual Assault on Jurors’ Perceptions of Prototypicality and Verdicts

We sought to test the effects of sexual assault form and complainant/defendant gender on jurors’ perceptions of the prototypicality of a sexual assault case, complainant, and defendant. We examined whether these perceived prototypicality measures predict mock jurors’ complainant/defendant blame and credibility assessments and if these assessments predict verdict decisions in a simulated sexual assault trial. We predicted that the female complainant–male defendant condition, vaginal intercourse condition, and their combination would be perceived as more prototypical than their counterparts, which would predict blame/credibility assessments, ultimately predicting verdict. Mock jurors ( N = 437) recruited via Prolific Academic read a trial transcript involving an alleged sexual assault (oral or vaginal sex forced onto the complainant) with a female complainant–male defendant or a male complainant–female defendant. They provided a verdict and assessed the perceived prototypicality of the case/complainant/defendant, provided blame/credibility assessments for the complainant/defendant, and responded to rape myth questionnaires. Sexual assault form did not significantly affect any of our outcomes. Mock jurors perceived the male complainant–female defendant condition as less prototypical of a sexual assault case/complainant/defendant than the female complainant–male defendant condition, resulting in negative evaluations of the complainant, favorable evaluations of the defendant, and lowered probability of conviction. Simultaneously, for fixed levels of prototypicality, the female complainant received more negative evaluations, and the male defendant received more favorable evaluations, which lowered the probability of conviction; mock jurors’ rape myth acceptance moderated this effect. Rape myths were predictive of decision-making in cases involving a female complainant, and male rape myths were predictive in cases involving a male complainant. Results demonstrate that prototypicality is a mechanism behind mock jurors’ decisions in sexual assault trials and elucidate the distinctive role of prototypes and rape myths on juror decision-making, with practical implications for the field of psychology and the criminal legal system.

Nanomechanical and Structural Characteristics of Nanodiamond Composite Films Dependent on Target-Substrate Distance

AbstractThis study explores the optimization of target-substrate distance (TSD) in coaxial arc plasma deposition technique for depositing nanodiamond composite (NDC) films on unheated WC–Co substrates, with a focus on enhancing properties relevant to cutting tool applications. TSD significantly impacted film growth and adhesion, while hardness and Young’s modulus remained stable within the 10–50 mm TSD range. Increased TSD led to reduced deposition rates and film thickness, but improved quality by eliminating macroparticles and reducing surface roughness. Notably, the NDC film deposited at 10 mm TSD exhibited exceptional adhesion resistance, a thickness of 11.45 μm, low compressive internal stress (2.8 GPa), and a surface roughness (Sa) of 280 nm, coupled with an impressive hardness of 49.12 GPa. This film also achieved a favorable deposition rate of 1.05 nm/s. In comparison, the film deposited at 15 mm TSD displayed a maximum hardness of 51.3 GPa, lower Sa of 179 nm, but a reduced deposition rate of 0.29 nm/s. The estimated C sp3 fraction correlated well with the nanoindentation measurements, while internal stress showed a consistent relationship with film adhesion. These findings suggest that a TSD of 10 mm is optimal for balancing hardness, adhesion, deposition rate, and surface roughness, making NDC films a promising candidate for cutting tool applications.

Rapid Release of Silicon by Ultrafast Joule Heating Generates Mechanically Stable Shell-Shell Si/C Anodes with Dominant Inward Deformation.

As a promising anode material, silicon-carbon composites encounter great challenges related to internal stress release and contact between the composites during lithiation. These issues lead to material degradation and concomitantly rapid capacity decline. Here, we report a type of shell-shell silicon-carbon (SS-Si/C) composite, which consists of a carbon shell tightly coated with a silicon shell. The mechanical analysis unveils that the dominant inward expansion of the Si shell is achieved through the synergistic effect of the outer carbon shell and the inner hollow structure. Benefiting from the well-tailored shell-shell structure, the SS-Si/C anode exhibits exceptional performance, boasting a high specific capacity (1690.3 mA h g-1 after 550 cycles at 0.5 A g-1), a high areal capacity (2.05 mA h cm-2 after more than 400 cycles at 0.5 mA cm-2), and an extended cycling life (1055.6 mA h g-1 after 1000 cycles at 8 A g-1), far exceeding commercially available Si/C anodes. Using the well-designed SS-Si/C anode, full cells assembled with LiCoO2 (LCO) or LiFePO4 (LFP) cathodes achieve favorable rate capability and cyclic stability. Notably, at a high rate of 6 C (1 C = 170 and 270 mA g-1 for LFP and LCO, respectively), these full cells deliver high specific capacities of 79.5 mA h g-1 and 64.9 mA h g-1 when using LCO and LFP, respectively, demonstrating the potential of SS-Si/C anodes for practical applications. The straightforward and safe synthesis method in this work enables the rational design of hollow structures with distinct properties.

Comparing the effectiveness of letrozole versus methotrexate for treatment of ectopic pregnancy: A randomized controlled trial

ObjectiveTo evaluate the efficacy of two different regimens of Letrozole, an aromatase inhibitor, in the management of ectopic pregnancy compared to methotrexate. Study DesignThis randomized controlled trial was conducted on 88 women diagnosed with ectopic pregnancy with a baseline level of serum beta-human chorionic gonadotropin under 3000 mIU/mL between June 30, 2023, and December 30, 2023, at the Department of Obstetrics and Gynecology of the Vali-e-Asr Hospital affiliated with Tehran University of Medical Sciences. Participants were allocated into either methotrexate (n = 43), 5-day course Letrozole (n = 24), or 10-day course Letrozole (n = 21) treatments. The methotrexate group received a single dose of 50 mg/m2 dosage intramuscular methotrexate. The 5-day Letrozole group received a 2.5 mg Letrozole tablet three times daily for 5 days, whereas the 10-day Letrozole group received a 2.5 mg Letrozole tablet twice daily for 10 days. The primary outcome was the treatment response, defined as the achievement of a negative serum beta-human chorionic level without the need for additional methotrexate treatment or surgery. The secondary outcomes were the need for additional methotrexate dose or laparoscopic surgery intervention. The trial protocol was prospectively registered in ClinicalTrials.gov with code NCT05918718. ResultsThe treatment response rates in methotrexate, 5-day Letrozole, and 10-day Letrozole groups were 76.7 %, 75.0 %, and 90.5 %, respectively, with no significant differences between the groups (P-value = 0.358). A total of 10 (23.3 %) patients from the methotrexate group, 3 (12.5 %) from the 5-day Letrozole group, and 2 (9.5 %) from the 10-day Letrozole group required an additional methotrexate dose, with no significant differences between the groups (P-value = 0.307). Furthermore, only 3 (12.5 %) patients, all from the 5-day Letrozole group, were suspected of tubal rupture and underwent surgery (P-value = 0.016). ConclusionOur findings suggest Letrozole as a safe alternative to methotrexate in treating stable ectopic pregnancies, with a favorable treatment response rate. However, there is still a need for future larger studies to determine the applicability of Letrozole in the EP management. Also, the non-significant higher effectiveness of the 10-day Letrozole regimen than the 5-day Letrozole group underscores the need for future research to determine the optimal Letrozole regimen for the management of ectopic pregnancy.

Accounting Standardization and Separation in the Municipal Debt Market: Evidence from GASB 34

ABSTRACT Governmental Accounting Standards Board Statement No. 34 (GASB 34, 1999) standardized financial reporting and disclosure requirements for U.S. state and local governments. We interpret debt issuing patterns surrounding GASB 34 implementation as evidence of strategic behavior by governments in anticipation of GASB 34 consequences. Specifically, governments that expected more favorable post-GASB 34 evaluations by municipal bond investors delayed new uninsured debt issues until after, whereas governments that expected less favorable evaluations accelerated debt issues to before, GASB 34 information became publicly available. Governments expecting favorable consequences were more likely than governments expecting adverse consequences to substitute away from insured debt and toward uninsured debt, and to choose new debt financing rather than alternative financing sources following GASB 34. These findings are consistent with the notion that expectations about GASB 34 consequences were realized, and that standardization created through GASB 34 facilitated separation in the municipal debt market. Data Availability: Data are from publicly available sources identified in the manuscript. JEL Classifications: G18; H74; M48.

Enzymatic Synthesis of Austroeupatol Esters with Enhanced Antiprotozoal Activity.

Austroeupatol, the principal diterpene isolated from the invasive shrub Austroeupatorium inulifolium, holds promise for structural diversification and biological assessment of its derivatives due to its abundant availability and high yield isolation. We propose an efficient enzymatic synthesis of a series of austroeupatol esters derived from aliphatic and heterocyclic carboxylic acids. Systematic optimization of reaction parameters, including enzyme type and quantity, acylating agent amount, solvent, and temperature, was conducted. Thermomyces lanuginosus lipase in cyclohexane at 55 °C, yielded esters with favorable conversion rates. Through enzymatic catalysis, mono- and diacylated derivatives were obtained, with a diacylation-monoacylation ratio influenced by temperature and acylating agent amount. The antiprotozoal activity of austroeupatol and all synthesized derivatives was evaluated, observing that acylation improved it. The 19-valeroyl, 19-indolylpropyl, and 19-octyl derivatives were the most potent compounds against Trypanosoma cruzi and Leishmania infantum, highlighting this approach as a valuable method for synthesizing austroeupatol derivatives as potential antiparasitic agents.

Conventionally instrumented inverse kinematic alignment for total knee arthroplasty: How is it done?

For primary total knee arthroplasty (TKA), there is an increasing trend towards patient-specific alignment strategies such as kinematic alignment (KA) and inverse kinematic alignment (iKA), which by restoring native joint mechanics may yield higher patient satisfaction rates. Second, the most recent Australian joint registry report describes favourable revision rates for conventionally instrumented TKA compared to technology-assisted techniques such as those using navigation, robotics or custom-cutting blocks. The aim of this technique article is to describe in detail a surgical technique for TKA that: (1) utilises the principles of iKA and (2) uses conventionally instrumented guided resections thereby avoiding the use of navigation, robotics or custom blocks. A TKA technique is described, whereby inverse kinematic principles are utilised and patient-specific alignment is achieved. Additionally, the patellofemoral compartment of the knee is restored to the native patellofemoral joint line. The sequenced technical note provided may be utilised for cemented or cementless components; cruciate retaining or sacrificing designs and for fixed or rotating platforms. An uncomplicated, robust and reproducible technique for TKA is described. Knee arthroplasty surgeons may wish to harness the emerging benefits of both a conventionally instrumented technique and a patient-specific alignment strategy. Level V.

Enhancement of La–Ti modification on the conductivity and stability of Co-free Li- and Mn-rich layered cathode

Lithium (Li) - and manganese (Mn)-rich oxides (xLi2MnO3·(1−x) LiTMO2, TM = Ni, Co, Mn, etc.) are one of the most promising cathode materials because of their high theorical capacity, which is contributed by the redox of both transition metal cations and oxygen anion. However, anionic redox leads to transition-metal migration and release of lattice oxygen, which further triggers voltage decay and capacity fade. Here, we report a dual-doping and multiphase co-existence strategy to tackle the structure degradation of Li- and Mn-rich materials and enhance electrochemical kinetics. La–Ti dual cations doping strength the TM-O bonds and improve cycling stability, and the inducement of LaMnO3+δ (LaMO) phase provides higher conductivity. As a result, the unique architecture presents a favourable rate performance, improved capacity retention, and suppressed voltage decay. After 200 cycles at 1C (250 mA g−1), the La–Ti dual cations doped Li-and Mn-rich material shows 24 % higher capacity retention and 52 % lower voltage decay compared to the non-doped material. This study demonstrates the potential of dual transition-metal ion doping combined with doping-induced perovskite phase to enhance the performance of Li- and Mn-rich materials.

The COVID-19 pandemic and popular confidence in democracy: evidence from China, Japan, and South Korea

ABSTRACT The past decade has witnessed worldwide backsliding on democracy, and the COVID-19 pandemic might have exacerbated this trend. This study examined popular confidence in democracy in China, Japan, and South Korea, which represented authoritarian and democratic contexts. The results show that Chinese citizens had a negative perception of the capacity of democracy to control the outbreak of COVID-19 and achieve economic growth, with an unfavourable evaluation of democracy as a better political system than alternatives. Although Japanese and South Korean citizens had more favourable evaluations of democracy than their Chinese counterparts, such positive evaluations were lukewarm in the former two countries. Confidence in the home political system in South Korea did not correlate with confidence in the capability of democracy to address economic challenges, as observed in Japan. The COVID-19 pandemic prompted ordinary people to seek a strong leader, reinforcing Chinese citizens’ beliefs in the superiority of their authoritarian political system. Simultaneously, it weakened South Korean citizens’ confidence in the effectiveness of their home political system. However, it had no discernible impact on Japanese citizens’ belief in the superiority of their political system.

What drives employers’ favorability ratings on employer review platforms? The role of symbolic, personal, and emotional content

AbstractEmployer review platforms have changed the recruitment landscape by allowing current and former employees to post messages about an employer outside of direct company control. Therefore, they have emerged as an important form of third‐party employer branding. However, we know little about how such open‐ended comments relate to the key variable in employer reviews: employers’ favorability rating. Therefore, we start by situating this variable among other constructs in the employer branding space. Next, we build theory on how content in the open‐ended comments of an employer review relates to the positivity or negativity of the reviews’ favorability rating. We test our hypotheses via a text‐mining analysis of approximately half a million employer reviews. The results reveal an intriguing discrepancy. Although instrumental, impersonal, and cognitive content is more prevalent in employer reviews, symbolic, personal, and emotional content dominates employer reviews’ favorability rating. In terms of practical implications, this result shows that merely inspecting the frequency of attributes mentioned in employer review text comments as a basis for changing company policies of employer branding efforts might be misguided. We discuss implications for theory and future research, and provide our dictionary for further scholarly and practical use.

Bark frequency cepstral coefficient based sadness emotion level recognition system

Based on the adverse physiological and social consequences associated with sadness, recognizing this emotion is crucial to mitigate its negative impacts. To address this issue, an efficient system was proposed for recognizing different level of sadness using embedded technology. The system captured speech input through a microphone and then processed it on Raspberry Pi microcomputer. The key feature extraction technique used was Bark-Frequency Cepstral Coefficient (BFCC) method. After selecting a set of features, a thorough analysis of the computational algorithms was conducted, and dimensionality reduction method was applied to reduce computational costs, including noise. These features served as a pre-processing stage for Machine Learning (ML) model based on K-Nearest Neighbors (KNN) architecture. The results were then shown on a smartphone application through Bluetooth connectivity. Based on experimental results, the system showed an impressive improvement of 11.97 dB in the signal-to-noise ratio (SNR) compared to feature extraction using Mel-frequency Cepstral Coefficient (MFCC) method. The results also showed a favorable accuracy rate, implying the effectiveness of KNN with a k-value of 5 in accurately identifying different level of sadness. The system particularly excelled in correctly recognizing high and low level of sadness. Therefore, the effective categorization of sadness emotion level could be applied to the early diagnosis of mental disorders such as depression and anxiety, contributing to the reduction of the adverse impact of sadness.

Do Past Changes affect Current Stock Prices in the Health Sector?

Investing involves sacrificing present resources for future gains, impacting decisions across various domains, from business to personal finance. This study delves into the rationale behind investing in stocks, exploring factors influencing stock pricing and investor behavior. While the stock market offers potential for financial growth, it also entails inherent risks, prompting investors to seek a favorable risk-adjusted rate of return. Despite the complexities of stock valuation, including considerations beyond projected earnings, such as market trends and investor sentiment, understanding these dynamics is crucial for informed investment decisions.

Loading pattern optimization of a PWR using newly developed Multi-Verse optimization algorithm

In the fuel management of nuclear reactors, which has a direct impact on power generation costs and environmental factors, it is essential to obtain an optimal arrangement of assemblies and core parameters. This complex task relies on both neutronics and thermal hydraulics. This research solves this by employing PARCS and COBRA-EN codes, alongside Multi-Verse Optimization algorithm (MVO) as a novel algorithm. Findings demonstrate the MVO algorithm has reliability and favorable convergence rate. Moreover, integrating the nodal expansion technique with MVO notably decreases the computational time for optimization in the loading pattern optimizations (LPOs). The optimized loading pattern aligns well with the findings in the literature. Also, using multi objective fitness function leads to improving core flatness, cycle length and safety parameters.

Combined application of artificial bone powders and concentrated growth factor membranes on the autotransplantation of mature third molars: A 5‐year retrospective case series

AbstractAimThis study aimed to observe the efficacy and outcomes of the combined application of artificial bone powder and concentrated growth factor (CGF) membranes for tooth transplantation in cases with wide recipient sockets and small donor teeth.Material and MethodsA total of 36 teeth from 36 patients with wide recipient sockets and small donor teeth were enrolled. Autogenous tooth transplantation was performed using bone powders and CGF membranes. After transplantation, the visual analog scale (VAS) score, Landry Wound Healing Index, probing depth (PD), mobility, and gray value of the alveolar bone around the transplanted teeth were measured, and a patient satisfaction questionnaire was administered. All patients underwent clinical and radiographic examinations during follow‐up.ResultsThe VAS score of 16 (44.4%) cases after 1 week was 0, and 26 (72.2%) patients showed excellent gingival healing after 2–4 weeks. The PD of a few cases was deeper than 3 mm during the first month; however, returned to normal after 3 months. Although the majority of the transplanted teeth possessed mobility greater than grade I during the first month, the mobility gradually improved within 3 months. The gray value of the alveolar bone around the transplanted teeth, 1 year postoperatively showed no difference with pre‐operation (p &gt; .05). During the mean follow‐up period of 42.7 months (range 20–72 months), 33 of the 36 transplanted teeth remained in situ without clinical or radiographic complications, with an overall success rate of 91.7%.ConclusionsAlthough the PD and mobility of the transplanted teeth were not ideal during the early stages of healing, most of the transplanted teeth had good clinical outcomes. In cases with large recipient sites accompanied by small donor teeth, autotransplantation of teeth using artificial bone powder combined with CGF membranes is a viable option and can lead to optimistic results with favorable success rates.

Controlling shareholders, their incentives and corporate governance ratings

PurposeThis study aims to facilitate the development of a better understanding of how controlling shareholders respond to the mandatory system of corporate governance rating (CGR) for all firms listed on Taiwanese stock markets and the incentives of controllers to apply corporate governance best practices.Design/methodology/approachUsing CGR data for all Taiwanese listed firms from 2014 to 2020, this study examines whether controlling shareholders determine a firm’s CGR.FindingsSingle-family-controlled firms have the lowest CGRs, and management-controlled firms have the highest ratings. Blockholder-controlled firms are more likely to have top 20% ratings than single-family-controlled firms and bottom 20% ratings than single-family and management-controlled firms. All three categories of firms have unfavorable (favorable) ratings because of substitute governance effects (signaling effects).Originality/valueManagement-controlled firms, in which agency problems refer to principal-agent conflicts, are more likely to have good ratings than single-family controlled firms, in which agency problems refer to principal-principal conflicts. Blockholder-controlled firms have extreme ratings, suggesting that multiple large shareholders develop corporate governance practices consistent with their best interests to increase firm value or expropriate wealth. Low cash flow rights and high control-ownership divergence lead firms to adopt additional governance arrangement(s) to make shareholders trust firms with capital and signal to shareholders that they can trust them with their capital.

Emergency Medical Service Agency Practices and Cardiac Arrest Survival

Survival for out-of-hospital cardiac arrest (OHCA) varies widely across emergency medical service (EMS) agencies in the US. However, little is known about which EMS practices are associated with higher agency-level survival. To identify resuscitation practices associated with favorable neurological survival for OHCA at EMS agencies. This cohort study surveyed EMS agencies participating in the Cardiac Arrest Registry to Enhance Survival (CARES) with 10 or more OHCAs annually during January 2015 to December 2019; data analyses were performed from April to October 2023. Survey of resuscitation practices at EMS agencies. Risk-standardized rates of favorable neurological survival for OHCA at each EMS agency were estimated using hierarchical logistic regression. Multivariable linear regression then examined the association of EMS practices with rates of risk-standardized favorable neurological survival. Of 577 eligible EMS agencies, 470 agencies (81.5%) completed the survey. The mean (SD) rate of risk-standardized favorable neurological survival was 8.1% (1.8%). A total of 7 EMS practices across 3 domains (training, cardiopulmonary resuscitation [CPR], and transport) were associated with higher rates of risk-standardized favorable neurological survival. EMS agencies with higher favorable neurological survival rates were more likely to use simulation to assess CPR competency (β = 0.54; P = .05), perform frequent reassessment (at least once every 6 months) of CPR competency in new staff (β = 0.51; P = .04), use full multiperson scenario simulation for ongoing skills training (β = 0.48; P = .01), perform simulation training at least every 6 months (β = 0.63; P < .001), and conduct training in the use of mechanical CPR devices at least once annually (β = 0.43; P = .04). EMS agencies with higher risk-standardized favorable neurological survival were also more likely to use CPR feedback devices (β = 0.58; P = .007) and to transport patients to a designated cardiac arrest or ST-segment elevation myocardial infarction receiving center (β = 0.57; P = .003). Adoption of more than half (≥4) of the 7 practices was more common at EMS agencies in the highest quartile of favorable neurological survival rates (70 of 118 agencies [59.3%]) vs the lowest quartile (42 of 118 agencies [35.6%]) (P < .001). In a national registry for OHCA, 7 practices associated with higher rates of favorable neurological survival were identified at EMS agencies. Given wide variability in neurological survival across EMS agencies, these findings provide initial insights into EMS practices associated with top-performing EMS agencies in OHCA survival. Future studies are needed to validate these findings and identify best practices for EMS agencies.

Minimally Invasive Direct Coronary Artery Bypass Grafting: Sixteen Years of Single-Center Experience.

Background: Coronary artery disease is a major cause of death globally. Minimally invasive direct coronary artery bypass (MIDCAB), using a small left anterior thoracotomy, aims to provide a less invasive alternative to traditional procedures, potentially improving patient outcomes with reduced recovery times. Methods: This retrospective, non-randomized study analyzed 310 patients who underwent MIDCAB between July 1999 and April 2022. Data were collected on demographics, clinical characteristics, operative and postoperative outcomes, and follow-up mortality and morbidity. Statistical analysis was conducted using IBM SPSS, with survival curves generated via the Kaplan-Meier method. Results: The cohort had a mean age of 63.3 ± 10.9 years, with 30.6% females. The majority of surgeries were elective (76.1%), with an average operating time of 129.7 ± 35.3 min. The median rate of intraoperative blood transfusions was 0.0 (CI 0.0-2.0) Units. The mean in-hospital stay was 8.7 ± 5.5 days, and the median ICU stay was just one day. Early postoperative complications were minimal, with a 0.64% in-hospital mortality rate. The 6-month and 1-year mortalities were 0.97%, with a 10-year survival rate of 94.3%. There were two cases of perioperative myocardial infarction and no instances of stroke or new onset dialysis. Conclusions: The MIDCAB approach demonstrates significant benefits in terms of patient recovery and long-term outcomes, offering a viable and effective alternative for patients suitable for less invasive procedures. Our results suggest that MIDCAB is a safe option with favorable survival rates, justifying its consideration in high-volume centers focused on minimally invasive techniques.