bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three-Year Results of the Nellix Endovascular Aneurysm Sealing System for Treatment of Abdominal Aortic Aneurysms in Frail Patients with Poor Anatomical Features
Authors: Sonetto A. , Laukontaus S. , Vikatmaa L. , Aho P. , Venermo M. 
Published: May 2020

Introduction: Endovascular aneurysm sealing represents an alternative to advanced technology devices for compromised patients with abdominal aortic aneurysms. We report our results of 15 fragile patients with very low-quality infrarenal necks treated with endovascular aneurysm sealing. Material and methods: All patients treated with Nellix device in our hospital between June 2015 and October 2016 were retrospectively reviewed. The primary endpoints are the following: overall survival and freedom from reintervention rates. The secondary endpoints are the following: technical success; 30-day mortality; abdominal aortic aneurysm–related mortality; and freedom from endoleak rate, complications, and surgical conversion rate. Results: Nellix was used in 15 patients, median age 75.5 years, of which 67% were unfit for open surgery. Mean aneurysm diameter was 60 mm. One-third (5/15) of the patients were inside the Nellix instructions for use. Technical success rate was 93.3%. No perioperative complications existed, and 30-day mortality was 0%. Median follow-up was 35 (interquartile range: 11–37) months. Survival rates at 1 and 3 years were 80% and 59.3%. Abdominal aortic aneurysm–related mortality occurred in 3 of 15 cases. Freedom from rupture rates at 1 and 3 years were 92.9% and 66%. Freedom from endoleak rates at 1 and 3 years were 92.9% and 74.5%. Freedom from reintervention rates at 1 and 3 years were 86.7% and 70.6%, with a dramatic drop to 37.1% at 4 years of follow-up. Three open surgery conversions were needed. There were no statistically significant differences in results between patients treated inside and outside instructions for use. Conclusion: The endovascular aneurysm sealing has shown encouraging short-term results, but its safety and effectiveness during time is questionable, because this system still carries high rates of reintervention, conversions for type IA endoleaks, and secondary aneurysm ruptures.
In Search of the Ideal Tool for International School Teachers to Increase their Global Competency: An Action Research Analysis of the Global Competency Learning Continuum
Authors: Carter Adam 
Published: May 2020

It is clear that if international school teachers are to be able to properly prepare students for a 21st century globalized workplace, they must first develop the global competence and intercultural skills needed to implement their students’ development of global knowledge, skills and attitudes. Unfortunately, in many public schools and international schools, teachers do not possess the global competency needed to do so effectively. Since it can be expensive and ambitious to instill global competency in teachers on a school-wide, district-wide or nation-wide level, it may be more feasible for individual teachers to address their global competency deficit and take the necessary steps to improve it. There are several tools that can be used by individual teachers seeking to improve the awareness, skills and dispositions needed to become a truly globally competent teacher. This study focused on an innovative new tool, the Global Competency Learning Continuum (GCLC), which was designed for teachers and offers a resource library to help teachers address their shortcomings in twelve different levels of global competency. The research sought to ascertain whether the Global Competency Learning Continuum is an appropriate tool for international school teachers to use to assess and improve their global competency – or if there is a demand for an entirely new instrument that is more applicable to international school teachers. After reviewing research from surveys of international teachers, the data indicates that the Global Competency Learning Continuum is a promising and effective tool for use by international school teachers. It is the only tool designed specifically for teachers by a highly-respected educational institution, is free of charge and offers a valuable trove of resources for teachers who wish to actively improve their global competency.
Optimal Vessel Sizing and Understanding Dissections in Infrapopliteal Interventions: Data From the iDissection Below the Knee Study
Authors: Shammas Nicolas W. , Shammas W. John , Jones-Miller Susan , Torey James T. , Armstrong Ehrin J. , Radaideh Qais , Shammas Gail A. 
Published: May 2020

Purpose: To investigate if imaging with intravascular ultrasound (IVUS) yields a more accurate estimate of vessel diameter and the presence of dissections than angiography after intervention in the infrapopliteal arteries. Materials and Methods: A prospective, single-center study enrolled 20 consecutive patients (mean age 74.1±12.4 years; 12 women) with infrapopliteal disease who were treated with percutaneous transluminal angioplasty (PTA; n=10) or orbital atherectomy (OA) followed by PTA (n=10). The majority of patients were hypertensive and half were diabetic. The overall lesion length was 7.3±6.3 cm, and the diameter stenosis was 80.3%±22.1%. The baseline characteristics did not differ between the groups. Vessel diameters were measured using IVUS from the internal elastic lamina (IEL) to the IEL. IVUS was performed at baseline, post PTA or OA, and post OA+PTA. Quantitative vascular angiography (QVA) and IVUS were analyzed by a core laboratory. Dissections on cine images were categorized based on the National Heart Lung and Blood Institute (NHLBI) classification, while the arc and depth were used to characterize dissections on IVUS images. Results: Mean vessel diameter by QVA was 2.9±0.6 vs 4.0±1.0 mm by IVUS according to the core laboratory (mean difference 1.1±0.9, p<0.001). On angiography, there were 7 dissections after PTA (6 C, 1 D), 1 dissection after OA (1 B), and 2 dissections after OA+PTA (1 A, 1 B; p=0.028 vs post PTA). IVUS uncovered 3.8 times more dissections than seen on angiography. There were 23 dissections after PTA (18 intima, 3 media, 2 adventitia), 12 dissections after OA (8 intima, 1 media, 3 adventitia), and 11 dissections following OA+PTA (7 intima, 1 media, 3 adventitia; p=0.425 vs PTA). Bailout stenting (all due to angiographic dissections ≥C) was necessary in 6 of the PTA cohort and none of the OA+PTA group. Conclusion: In addition to underestimating the infrapopliteal vessel diameter by ~25%, angiography underappreciated the presence and severity of post-intervention dissections vs IVUS, particularly in the OA+PTA group.
Retrograde Recanalization of the Celiac Artery via the Pancreaticoduodenal Arcade as a Safe and Valid Alternative to Antegrade Access
Authors: Pedersoli Federico , Zimmermann Markus , Schulze-Hagen Maximilian , Sieben Paul , Barzakova Emona , Goerg Fabian , Keil Sebastian , Gombert Alexander , Kuhl Christiane K. , Isfort Peter , Bruners Philipp 
Published: May 2020

Purpose: The antegrade recanalization of an occlusion or high-grade stenosis of the celiac artery via the aorta often represents a technical challenge. A retrograde approach via the superior mesenteric artery and the pancreaticoduodenal arcade may be an alternative approach. Based on our experience, we assess the technical success and the short- and mid-term outcomes of this bailout procedure. Methods: We performed a retrospective analysis of all consecutive patients who underwent recanalization and stent implantation in the celiac artery between January 2010 and December 2018. Data on vascular access, the materials used including stents, as well as the length of the intervention, radiation exposure, and follow-up were assessed. Results: Recanalization in combination with stent implantation into the celiac artery was performed in 43 patients. In 39 (91%) of 43 patients, the recanalization was successful with an antegrade approach via the aorta, whereas in 4 (9%) of 43 patients the passage of the stenosis was possible only through a retrograde approach through the superior mesenteric artery and the pancreaticoduodenal arcade followed be advancement of the microwire through the celiac artery into the aorta. The tip of the microwire was captured in the aorta with a snare and pulled out in the femoral introducer sheath and used as a guide for the antegrade implantation of a balloon-expandable stent. Conclusions: The retrograde recanalization of the celiac artery via the pancreaticoduodenal arcade may be technically challenging yet represents a feasible alternative in case of a failed antegrade approach.
Application of flow diverters in the treatment of aneurysms in the internal carotid artery bifurcation region
Authors: Mahmoud Mostafa , Farag Ahmed , Farid Mostafa , Elserwi Ahmed , Abdelsamad Amr , Guergues Wessam , Hassan Farouk 
Published: May 2020

Introduction The treatment of aneurysms in the internal carotid bifurcation region (ICABR), including aneurysms of the true internal carotid artery (ICA) terminus, those inclined on the proximal A1 or M1 segments or at the most distal pre-bifurcation (ICA) segment, is often challenging in microsurgical clipping and endovascular surgery. Few reports had discussed flow diversion as a therapeutic option for this group. Methods This was a retrospective study analysing flow diversion in treating ICABR aneurysms. Seven patients harbouring eight aneurysms in the ICABR were treated with flow diversion. Five aneurysms were inclined on the proximal A1 segment, and three were located at the most distal pre-bifurcation segment. Patients’ demographics, presentation, procedure technical description, angiographic and clinical follow-up were recorded. PubMed and Ovid MEDLINE were also reviewed for articles published in English, including case series or case reports, for ICABR aneurysms treated with flow diverters. Results All patients except one underwent angiographic follow-up. The Karman–Byrne occlusion scale was used to determine the occlusion rate. All six patients with documented angiographic follow-up had a class IV occlusion score. No permanent or transient neurological or non-neurological complications were encountered in this study. Conclusion Treating ICABR aneurysms using flow diversion is feasible, with a promising angiographic occlusion rate. Further studies are needed to analyse long-term clinical and angiographic results.
Determinants of Poor Glycemic Control in Patients with Kidney Transplants: A Single-Center Retrospective Cohort Study in Canada
Authors: Chan Chun Kong Daniel , Akbari Ayub , Malcolm Janine , Doyle Mary-Anne , Hoar Stephanie 
Published: May 2020

Background: Kidney transplant immunosuppressive medications are known to impair glucose metabolism, causing worsened glycemic control in patients with pre-transplant diabetes mellitus (PrTDM) and new onset of diabetes after transplant (NODAT). Objectives: To determine the incidence, risk factors, and outcomes of both PrTDM and NODAT patients. Design: This is a single-center retrospective observational cohort study. Setting: The Ottawa Hospital, Ontario, Canada. Participant: A total of 132 adult (>18 years) kidney transplant patients from 2013 to 2015 were retrospectively followed 3 years post-transplant. Measurements: Patient characteristics, transplant information, pre- and post-transplant HbA1C and random glucose, follow-up appointments, complications, and readmissions. Methods: We looked at the prevalence of poor glycemic control (HbA1c >8.5%) in the PrTDM group before and after transplant and compared the prevalence, follow-up appointments, and rate of complications and readmission rates in both the PrTDM and NODAT groups. We determined the risk factors of developing poor glycemic control in PrTDM patients and NODAT. Student t-test was used to compare means, chi-squared test was used to compare percentages, and univariate analysis to determine risk factors was performed by logistical regression. Results: A total of 42 patients (31.8%) had PrTDM and 12 patients (13.3%) developed NODAT. Poor glycemic control (HbA1c >8.5%) was more prevalent in the PrTDM (76.4%) patients compared to those with NODAT (16.7%; P < .01). PrTDM patients were more likely to receive follow-up with an endocrinologist ( P < .01) and diabetes nurse ( P < .01) compared to those with NODAT. There were no differences in the complication and readmission rates for PrTDM and NODAT patients. Receiving a transplant from a deceased donor was associated with having poor glycemic control, odds ratio (OR) = 3.34, confidence interval (CI = 1.08, 10.4), P = .04. Both patient age, OR = 1.07, CI (1.02, 1.3), P < .01, and peritoneal dialysis prior to transplant, OR = 4.57, CI (1.28, 16.3), P = .02, were associated with NODAT. Limitations: Our study was limited by our small sample size. We also could not account for any diabetes screening performed outside of our center or follow-up appointments with family physicians or community endocrinologists. Conclusion: Poor glycemic control is common in the kidney transplant population. Glycemic targets for patients with PrTDM are not being met in our center and our study highlights the gap in the literature focusing on the prevalence and outcomes of poor glycemic control in these patients. Closer follow-up and attention may be needed for those who are at risk for worse glycemic control, which include older patients, those who received a deceased donor kidney, and/or prior peritoneal dialysis.
Bonding integrity and compressive strength of re-bonded, surface conditioned and Er Cr YSGG laser treated lithium disilicate ceramics
Authors: Albaker Abdulaziz M. , Al Deeb Laila , Alhenaki Aasem M , Aldeeb Modhi , Al Ahdal Khold , Abduljabbar Tariq , Vohra Fahim 
Published: May 2020

Aim: The aim of the study was to investigate the shear bond strength (SBS) and compressive strength (CS) of Er Cr YSGG laser (ECL) treated, re-bonded lithium disilicate (LD) ceramic in comparison to standard conventional conditioning (hydrofluoric acid (HFA) and silane). Methods: One hundred LD ceramic disks were divided equally for SBS and CS testing. Eighty samples were conventionally surface treated and bonded to resin cement followed by de-bonding of the cement build-up. All de-bonded specimens were divided into four groups based on re-bonding surface treatments (HFA, primer, adhesive, and ECL). Resin cement build-ups were performed in 40 specimens for SBS testing (universal testing machine); however, the remaining 40 specimens were tested for CS. Ten specimens each were used as controls (surface treatment was performed once and no primary resin cement bonding) for SBS and CS assessment. Surface topography was assessed using a scanning electron microscope. Results: The maximum and minimum SBS values were shown by groups: control (33.42 ± 3.28 megapascals (MPa)); and ECL (17.50 ± 2.22 MPa) respectively. The maximum and minimum CSs were displayed by specimens in the ECL group (439.45 ± 70.68 MPa) and the control group (237.28 ± 19.96 MPa), respectively. For ECL specimens, SBS was significantly lower and CS was significantly higher as compared to control specimens. Conclusions: Application of the Er Cr YSGG laser significantly improved the CS of de-bonded ceramic specimens. However, it did not show a positive influence on the bond integrity of re-bonded ceramics in comparison to conventional surface treatment regimes.
Judging severity of unethical workplace behavior: Attractiveness and gender as status characteristics
Authors: Klein Galit , Shtudiner Zeev 
Published: May 2020

This research focuses on the role of gender and physical attractiveness in judging severity of unethical workplace behavior. Scenarios with possible ethical dilemmas (commonly referred to as “gray areas” of behavior) were displayed to 4,483 subjects. Our findings show that “gray area” behavior was evaluated as more ethical if performed by male employees compared with women. We also found that attractiveness moderated the connection between gender and tolerance toward unethical work behavior. People judge more severely the same unethical action by plain-looking employees rather than attractive-looking employees, in accordance with the attractiveness-leniency effect—but only for women perpetrators. The physical attributes of men were not found to be relevant. We explore a number of explanations for this discrimination based on Expectation States Theory and Social Role Theory. JEL CLASSIFICATION: C91; J71.
High rates of venous and arterial thrombotic events in patients with POEMS syndrome: results from the UCLH (UK) POEMS Registry
Authors: Sayar Zara , Weatherill Anna , Keddie Stephen , Sive Jonathan , Lunn Michael P. , Thomas Mari , D’Sa Shirley 
Published: May 2020

AbstractArterial and venous thromboses occur in patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein level, and skin changes) syndrome at a previously reported rate of 20%. We reviewed the University College London Hospitals (UCLH) POEMS Registry to determine the rate of venous thromboembolism (VTE), arterial events, and risk factors. This registry, established in 1999 and comprising 103 patients at the time of this study, is the largest single-center cohort in Europe. Of the 83 assessable patients, median age at presentation was 52 years (range, 31-84). Twenty-five patients experienced clinically apparent arterial or venous events, and 2 had concurrent arterial and venous thromboses. Eleven patients had VTEs, including deep vein thrombosis (DVT; 3 of 11), pulmonary embolism (4 of 11), and peripherally inserted central catheter–associated DVT, which occurred during autologous stem cell transplantation (3 of 11). Sixteen patients experienced arterial events: stroke (7 of 16), peripheral arterial occlusion (5 of 16), myocardial infarction (3 of 16), and microvascular disease (1 of 16), with no discernible relationship with thrombocytosis or polycythemia. Thirty percent of POEMS patients have arterial and venous thromboses, higher than previously reported. There were more arterial than venous events, and most occurred during active disease, before the start of chemotherapy, indicating the need for a preemptive approach to thromboprophylaxis.
Binder-Free Electrodes and Their Application for Li-Ion Batteries
Authors: Kang Yuqiong , Deng Changjian , Chen Yuqing , Liu Xinyi , Liang Zheng , Li Tao , Hu Quan , Zhao Yun 
Published: May 2020

AbstractLithium-ion batteries (LIB) as energy supply and storage systems have been widely used in electronics, electric vehicles, and utility grids. However, there is an increasing demand to enhance the energy density of LIB. Therefore, the development of new electrode materials with high energy density becomes significant. Although many novel materials have been discovered, issues remain as (1) the weak interaction and interface problem between the binder and the active material (metal oxide, Si, Li, S, etc.), (2) large volume change, (3) low ion/electron conductivity, and (4) self-aggregation of active materials during charge and discharge processes. Currently, the binder-free electrode serves as a promising candidate to address the issues above. Firstly, the interface problem of the binder and active materials can be solved by fixing the active material directly to the conductive substrate. Secondly, the large volume expansion of active materials can be accommodated by the porosity of the binder-free electrode. Thirdly, the ion and electron conductivity can be enhanced by the close contact between the conductive substrate and the active material. Therefore, the binder-free electrode generally exhibits excellent electrochemical performances. The traditional manufacture process contains electrochemically inactive binders and conductive materials, which reduces the specific capacity and energy density of the active materials. When the binder and the conductive material are eliminated, the energy density of the battery can be largely improved. This review presents the preparation, application, and outlook of binder-free electrodes. First, different conductive substrates are introduced, which serve as carriers for the active materials. It is followed by the binder-free electrode fabrication method from the perspectives of chemistry, physics, and electricity. Subsequently, the application of the binder-free electrode in the field of the flexible battery is presented. Finally, the outlook in terms of these processing methods and the applications are provided.
Metabolic diversity and co-occurrence of multiple Ferrovum species at an acid mine drainage site
Authors: Grettenberger Christen L. , Havig Jeff R. , Hamilton Trinity L. 
Published: May 2020

Abstract
Background
Ferrovum spp. are abundant in acid mine drainage sites globally where they play an important role in biogeochemical cycling. All known taxa in this genus are Fe(II) oxidizers. Thus, co-occurring members of the genus could be competitors within the same environment. However, we found multiple, co-occurring Ferrovum spp. in Cabin Branch, an acid mine drainage site in the Daniel Boone National Forest, KY.

Results
Here we describe the distribution of Ferrovum spp. within the Cabin Branch communities and metagenome assembled genomes (MAGs) of two new Ferrovum spp. In contrast to previous studies, we recovered multiple 16S rRNA gene sequence variants suggesting the commonly used 97% cutoff may not be appropriate to differentiate Ferrovum spp. We also retrieved two nearly-complete Ferrovum spp. genomes from metagenomic data. The genomes of these taxa differ in several key ways relating to nutrient cycling, motility, and chemotaxis.

Conclusions
Previously reported Ferrovum genomes are also diverse with respect to these categories suggesting that the genus Ferrovum contains substantial metabolic diversity. This diversity likely explains how the members of this genus successfully co-occur in Cabin Branch and why Ferrovum spp. are abundant across geochemical gradients.
Cannabis use is associated with a small increase in the risk of postoperative nausea and vomiting: a retrospective machine-learning causal analysis
Authors: Suhre Wendy , O’Reilly-Shah Vikas , Van Cleve Wil 
Published: May 2020

Abstract
Background
Cannabis legalization may contribute to an increased frequency of chronic use among patients presenting for surgery. At present, it is unknown whether chronic cannabis use modifies the risk of postoperative nausea and vomiting (PONV).

Methods
This study was a retrospective cohort study conducted at 2 academic medical centers. Twenty-seven thousand three hundred eighty-eight adult ASA 1–3 patients having general anesthesia for non-obstetric, non-cardiac procedures and receiving postoperative care in the Post Anesthesia Care Unit (PACU) were analyzed in the main dataset, and 16,245 patients in the external validation dataset. The main predictor was patient reported use of cannabis in any form collected during pre-anesthesia evaluation and recorded in the chart. The primary outcome was documented PONV of any severity prior to PACU discharge, including administration of rescue medications in PACU. Relevant clinical covariates (risk factors for PONV, surgical characteristics, administered prophylactic antiemetic drugs) were also recorded.

Results
10.0% of patients in the analytic dataset endorsed chronic cannabis use. Using Bayesian Additive Regression Trees (BART), we estimated that the relative risk for PONV associated with daily cannabis use was 1.19 (95 CI% 1.00–1.45). The absolute marginal increase in risk of PONV associated with daily cannabis use was 3.3% (95% CI 0.4–6.4%). We observed a lesser association between current, non-daily use of cannabis (RR 1.07, 95% CI 0.94–1.21). An internal validation analysis conducted using propensity score adjustment and Bayesian logistic modeling indicated a similar size and magnitude of the association between cannabis use and PONV (OR 1.15, 90% CI 0.98–1.33). As an external validation, we used data from another hospital in our care system to create an independent model that demonstrated essentially identical associations between cannabis use and PONV.

Conclusions
Cannabis use is associated with an increased relative risk and a small increase in the marginal probability of PONV.