bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Bleeding and Myocardial Infarction on Mortality in All-Comer Patients Undergoing Percutaneous Coronary Intervention
Authors: Hara Hironori , Takahashi Kuniaki , Kogame Norihiro , Tomaniak Mariusz , Kerkmeijer Laura S.M. , Ono Masafumi , Kawashima Hideyuki , Wang Rutao , Gao Chao , Wykrzykowska Joanna J. , de Winter Robbert J. , Neumann Franz-Josef , Plante Sylvain , Lemos Neto Pedro Alves , Garg Scot , Jüni Peter , Vranckx Pascal , Windecker Stephan , Valgimigli Marco , Hamm Christian , Steg Philippe Gabriel , Onuma Yoshinobu , Serruys Patrick W. 
Published: August 2020

Background:
Bleeding and myocardial infarction (MI) after percutaneous coronary intervention are independent risk factors for mortality. This study aimed to investigate the association of all-cause mortality after percutaneous coronary intervention with site-reported bleeding and MI, when considered as individual, repeated, or combined events.

Methods:
We used the data from the GLOBAL LEADERS trial (GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Anti-Platelet Therapy After Stent Implantation), an all-comers trial of 15 968 patients undergoing percutaneous coronary intervention. Bleeding was defined as Bleeding Academic Research Consortium (BARC) 2, 3, or 5, whereas MI included periprocedural and spontaneous MIs according to the Third Universal Definition.

Results:

At 2-year follow-up, 1061 and 498 patients (6.64% and 3.12%) experienced bleeding and MI, respectively. Patients with a bleeding event had a 10.8% mortality (hazard ratio [HR], 5.97 [95% CI, 4.76–7.49];
P
<0.001), and the mortality of patients with an MI was 10.4% (HR, 5.06 [95% CI, 3.72–6.90];
P
<0.001), whereas the overall mortality was 2.99%. Albeit reduced over time, MI and even minor BARC 2 bleeding significantly influenced mortality beyond 1 year after adverse events (HR of MI, 2.32 [95% CI, 1.18–4.55];
P
=0.014, and HR of BARC 2 bleeding, 1.79 [95% CI, 1.02–3.15];
P
=0.044). The mortality rates in patients with repetitive bleeding, repetitive MI, and both bleeding and MI were 16.1%, 19.2%, and 19.0%, and their HRs for 2-year mortality were 8.58 (95% CI, 5.63–13.09;
P
<0.001), 5.57 (95% CI, 2.53–12.25;
P
<0.001), and 6.60 (95% CI, 3.44–12.65;
P
<0.001), respectively. De-escalation of antiplatelet therapy at the time of BARC 3 bleeding was associated with a lower subsequent bleeding or MI rate, compared with continuation of antiplatelet therapy (HR, 0.32 [95% CI, 0.11–0.92];
P
=0.034).

Conclusions:
The fatal impact of bleeding and MI persisted beyond one year. Additional bleeding or MIs resulted in a poorer prognosis. De-escalation of antiplatelet therapy at the time of BARC 3 bleeding could have a major safety merit. These results emphasize the importance of considering the net clinical benefit including ischemic and bleeding events.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01813435.
Improvements in Supercooled Liquid Water Simulations of Low-Level Mixed-Phase Clouds over the Southern Ocean Using a Single-Column Model
Authors: Seiki Tatsuya , Roh Woosub 
Published: August 2020

AbstractA high-resolution global atmospheric model, the nonhydrostatic icosahedral atmospheric model (NICAM), exhibited underestimation biases in low-level mixed-phase clouds in the midlatitudes and polar regions. The ice-cloud microphysics used in a single-moment bulk cloud microphysics scheme (NSW6) was evaluated and improved using a single-column model by reference to a double-moment bulk cloud microphysics scheme (NDW6). Budget analysis indicated that excessive action of the Bergeron–Findeisen and riming processes crucially reduced supercooled liquid water. In addition, the rapid production of rain directly reduced cloud water and indirectly reduced cloud water through the production of snow and graupel by riming. These biases in growth rates were found to originate from the number concentration diagnosis used in NSW6. The diagnosis based on the midlatitude cloud systems assumption was completely different from the one for low-level mixed-phase clouds. To alleviate underestimation biases, rain production, heterogeneous ice nucleation, vapor deposition by snow and graupel, and riming processes were revised. The sequential revisions of cloud microphysics alleviated the underestimation biases step by step without parameter tuning. The lifetime of cloud layers simulated by NSW6 was reasonably prolonged.
Multispectral Imaging for Automated Tissue Identification of Normal Human Surgical Specimens
Authors: Shenson Jared A. , Liu George S. , Farrell Joyce , Blevins Nikolas H. 
Published: August 2020

ObjectiveSafe surgery requires the accurate discrimination of tissue intraoperatively. We assess the feasibility of using multispectral imaging and deep learning to enhance surgical vision by automated identification of normal human head and neck tissues.Study DesignConstruction and feasibility testing of novel multispectral imaging system for surgery.SettingAcademic university hospital.Subjects and MethodsMultispectral images of fresh‐preserved human cadaveric tissues were captured with our adapted digital operating microscope. Eleven tissue types were sampled, each sequentially exposed to 6 lighting conditions. Two convolutional neural network machine learning models were developed to classify tissues based on multispectral and white‐light color images (ARRInet‐M and ARRInet‐W, respectively). Blinded otolaryngology residents were asked to identify tissue specimens from white‐light color images, and their performance was compared with that of the ARRInet models.ResultsA novel multispectral imaging system was developed with minimal adaptation to an existing digital operating microscope. With 81.8% accuracy in tissue identification of full‐size images, the multispectral ARRInet‐M classifier outperformed the white‐light‐only ARRInet‐W model (45.5%) and surgical residents (69.7%). Challenges with discrimination occurred with parotid vs fat and blood vessels vs nerve.ConclusionsA deep learning model using multispectral imaging outperformed a similar model and surgical residents using traditional white‐light imaging at the task of classifying normal human head and neck tissue ex vivo. These results suggest that multispectral imaging can enhance surgical vision and augment surgeons’ ability to identify tissues during a procedure.
Evidence‐Based Medicine in Otolaryngology, Part XI: Modeling and Analysis to Support Decisions
Authors: Caulley Lisa , Hunink Myriam G. , Randolph Gregory W. , Shin Jennifer J. 
Published: August 2020

ObjectiveTo provide a resource to educate clinical decision makers about the analyses and models that can be employed to support data‐driven choices.Data SourcesPublished studies and literature regarding decision analysis, decision trees, and models used to support clinical decisions.Review MethodsDecision models provide insights into the evidence and its implications for those who make choices about clinical care and resource allocation. Decision models are designed to further our understanding and allow exploration of the common problems that we face, with parameters derived from the best available evidence. Analysis of these models demonstrates critical insights and uncertainties surrounding key problems via a readily interpretable yet quantitative format. This 11th installment of the Evidence‐Based Medicine in Otolaryngology series thus provides a step‐by‐step introduction to decision models, their typical framework, and favored approaches to inform data‐driven practice for patient‐level decisions, as well as comparative assessments of proposed health interventions for larger populations.ConclusionsInformation to support decisions may arise from tools such as decision trees, Markov models, microsimulation models, and dynamic transmission models. These data can help guide choices about competing or alternative approaches to health care.Implications for PracticeMethods have been developed to support decisions based on data. Understanding the related techniques may help promote an evidence‐based approach to clinical management and policy.
Efficacy of Adenoidectomy for the Treatment of Mild Sleep Apnea in Children
Authors: Tipold Austin , Vazifedan Turaj , Baldassari Cristina M. 
Published: August 2020

Objectives(1) To assess outcomes in children undergoing adenoidectomy for the treatment of mild obstructive sleep apnea (OSA). (2) To identify clinical factors that predict which children will have persistent obstruction following adenoidectomy.Study DesignCase series with chart review over a 10‐year period.SettingTertiary children’s hospital.Subjects and MethodsChildren between 2 and 17 years old undergoing adenoidectomy for treatment of mild OSA (obstructive apnea‐hypopnea index [AHI] between 1 and 5 on polysomnogram) were included. The need for additional medical or surgical intervention following adenoidectomy was recorded. When available, postoperative polysomnogram data were reviewed.ResultsIn total, 134 children with a mean age of 5.4 years were included. Fifty‐three percent (n = 71) were female and 57% (n = 76) were black. The mean (SD) baseline AHI was 2.2 (1.09). Caregivers reported a moderate impact of sleep disturbance on quality of life with a mean (SD) preoperative total OSA–18 score of 64.1 (19.28). Postadenoidectomy outcomes were reported for 105 patients (78%) with a mean follow‐up time of 6 months. Sixty‐nine percent (n = 72) of children had resolution of obstructive symptoms. While 31% (n = 33) of children required additional intervention following adenoidectomy, only 6.8% (n = 9) underwent a subsequent tonsillectomy. Demographic factors such as age and baseline AHI did not predict which children required additional treatment following adenoidectomy.ConclusionAdenoidectomy may be an effective treatment for mild OSA. A randomized trial comparing outcomes for adenoidectomy and adenotonsillectomy is needed to determine the ideal surgical treatment for nonsevere OSA in children.
Congenital Absence of Tracheal or Bronchial Rings
Authors: Smith Matthew M. , Kou Yann‐Fuu , Schweiger Claudia , Lehenbauer David G. , de Alarcon Alessandro , Rutter Michael J. 
Published: August 2020

ObjectiveCongenital airway stenosis secondary to absent tracheal or bronchial rings is a rare congenital anomaly that is difficult to manage both clinically and surgically. This typically manifests as severe segmental tracheomalacia, and only isolated cases with short‐term follow‐up have been previously described. We aim to describe a series of children with absent tracheal or bronchial rings who underwent surgical management and had long‐term follow‐up.Study DesignCase series with chart review.SettingTertiary care pediatric hospital.MethodsPatients with absent tracheal or bronchial rings from 2002 to 2016. Electronic and paper medical records were queried to obtain demographics, age at diagnosis and surgery, pre‐ and postoperative symptoms, location of absent rings, procedure performed, length of follow‐up, and adjunctive procedures performed.ResultsNine subjects were identified who underwent slide tracheoplasty for correction of congenital absent tracheal or bronchial rings. Age at diagnosis ranged from 10 days to 5 years of age (median, 4 weeks). Age at surgery ranged from 3 weeks to 5 years of age (median, 5 weeks). Six out of 9 subjects were extubated on postoperative day 1. Only 1 subject required additional intervention, which included balloon dilation, tracheobronchial stenting, and aortopexy to alleviate the obstruction. Mean follow‐up time was 5.89 years.ConclusionsThis is the largest series of children with absent tracheal rings who underwent slide tracheoplasty with long‐term follow‐up presented to date. Slide tracheoplasty is an effective surgical intervention for the treatment of absent tracheal or bronchial rings in infants and young children.
In Vitro Toxicity to Two Cellular Systems of the First Ten Chemicals on the MEIC List
Authors: Ponsoda Xavier , Jover Ramiro , Castell José Vicente , Gómez-Lechón Mariá José 
Published: August 2020

The cytotoxic effects of the first 10 chemicals on the MEIC list were evaluated with two experimental cellular systems, monolayer cultures of rat hepatocytes and cell lines (Hep G2 and 3T3). Three endpoints were measured to evaluate cytotoxicity, intracellular LDH activity, cellular protein content and the MTT test. The results show that: 1. digoxin, amitriptyline and diazepam were the most cytotoxic chemicals (IC50:0.01-0.5mM); 2. alcoholic compounds (sopropanol, ethylene glycol, ethanol and methanol) produced the lowest toxic effects (IC50: 100–1500mM); 3. paracetamol, acetylsalicylic acid and ferrous sulphate showed an intermediate cytotoxic action (C50: 0.05–15mM); 4. regarding the sensitivity of the cellular systems, paracetamol, acetylsalicylic acid, diazepam and ferrous sulphate were more toxic to rat hepatocytes, while digoxin produced a different toxic effect on hepatic and non-hepatic cells; and 5. the other chemicals did not show significant differences in their toxicity in the different cellular systems studied.
Seasonal variation in notified tuberculosis cases from 2014 to 2018 in eastern China
Authors: Li Yishu , Zhu Limei , Lu Wei , Chen Cheng , Yang Haitao 
Published: August 2020

Objective Tuberculosis (TB) incidence shows a seasonal trend. The purpose of this study was to explore seasonal trends in TB cases in Jiangsu Province. Methods TB case data were collected from the TB registration system from 2014 to 2018. The X12-ARIMA model was used to adjust the Jiangsu TB time series. Analysis of variance was used to compare TB seasonal amplitude (SA) between subgroups and identify factors responsible for seasonal variation. Results The TB incidence in Jiangsu showed a seasonal trend. Confirmed active TB peaked in March and reached a minimum in February. The amplitude of the peak-to-bottom difference was 38.15%. The SAs in individuals 7 to 17 years old (80.00%) and students (71.80%) were significantly different than those in other subgroups. Among bacterial culture positive individuals, the SAs among female patients, individuals aged 7 to 17 years and students were significantly different from those in the reference group. Among culture-negative patients, the SA among individuals aged 7 to 17 years was significantly different those in other subgroups. Conclusions The TB incidence in Jiangsu Province displayed a seasonal trend. Factors related to seasonal variation were age and occupation. Our results highlight the importance of controlling Mycobacterium tuberculosis transmission during winter.
The Effect of Music and White Noise on Electroencephalographic (EEG) Functional Connectivity in Neonates in the Neonatal Intensive Care Unit
Authors: Akiyama Akiyoshi , Tsai Jeng-Dau , W. Y. Tam Emily , Kamino Daphne , Hahn Cecil , Go Cristina Y. , Chau Vann , Whyte Hilary , Wilson Diane , McNair Carol , Papaioannou Vicky , Hugh Sarah C. , Papsin Blake C. , Nishijima Sakura , Yamazaki Toshimasa , Miller Steven P. , Ochi Ayako 
Published: August 2020

The purpose of this study is to investigate whether listening to music and white noise affects functional connectivity on scalp electroencephalography (EEG) in neonates in the neonatal intensive care unit. Nine neonates of ≥34 weeks’ gestational age, who were already undergoing clinical continuous EEG monitoring in the neonatal intensive care unit, listened to lullaby-like music and white noise for 1 hour each separated by a 2-hour interval of no intervention. EEG segments during periods of music, white noise, and no intervention were band-pass filtered as delta (0.5-4 Hz), theta (4-8 Hz), lower alpha (8-10 Hz), upper alpha (10-13 Hz), beta (13-30 Hz), and gamma (30-45 Hz). Synchronization likelihood was used as a measure of connectivity between any 2 electrodes. In theta, lower alpha, and upper alpha frequency bands, the synchronization likelihood values yielded statistical significance with sound (music, white noise and no intervention) and with edge (between any 2 electrodes) factors. In theta, lower alpha, and upper alpha frequency bands, statistical significance was obtained between music and white noise ( t = 3.12, 3.32, and 3.68, respectively; P < .017), and between white noise and no intervention ( t = 4.51, 3.09, and 2.95, respectively, P < .017). However, there was no difference between music and no intervention. Although limited by a small sample size and the 1-time only auditory intervention, these preliminary results demonstrate the feasibility of EEG connectivity analyses even at bedside in neonates on continuous EEG monitoring in the neonatal intensive care unit. They also point to the possibility of detecting significant changes in functional connectivity related to the theta and alpha bands using auditory interventions.
E-cigarettes and vaping – a panacea or a bane to smoking in current times?
Authors: Kanniah Guna , Kumar Shailesh , Prasad Soumil 
Published: August 2020

Objective: Use of electronic cigarettes has increased across the world in the last decade with heavy investment from the tobacco industry targeting younger population through well-designed marketing campaigns portraying e-cigarettes as harmless, less addictive and effective in smoking cessation while delivering higher nicotine concentration. The safety profile of e-cigarettes is reviewed in this paper. Conclusions: The safety of e-cigarettes and the chemicals they contain have not been evaluated rigorously. Emerging data suggest e-cigarette use could do severe harm. People with serious mental illness, already the highest nicotine consumers, could be exploited by the tobacco industry.
Bouncing back from Workplace Stress: From HRD’s Individual Employee’s Developmental Focus to Multi-facetted Collective Workforce Resilience Intervention
Authors: Mendy John 
Published: August 2020

The Problem Human resource development (HRD) research has sought to demarcate a human developmental problem by identifying learning interventions through which individuals can contribute towards group and organizational growth. However, there remains the fundamental problem, which is how to go beyond individualized employee development to a more collective resilience model building against workplace stress. Such lesser effectiveness has led to financial, emotional and psycho-social costs to individuals and collectives. Based on the theoretical analysis of human capital theory, HRD research and literature are lacking in how to more effectively operationalize collective resilience against workplace stress. The Solution A multi-faceted collective workforce resilience intervention conceptual model is proposed to enable both management and employees to overcome ineffective implementation of human development and thereby bounce back from workforce stress. Four aspects of the model’s practical operationalization are proposed as steps to help the HRD community of practitioners and scholars to engrain resilience as a workplace culture in resolving stress. Implications on (1) the identification of workplace stress, (2) the effective design and operationalization of development capacities. (3) the resilience intervention initiatives, and (4) the management of collective workforce resilience are highlighted. The Stakeholders The proposed model is designed for the HRD community, including scholars, practitioners, employees and managers in related HRD contexts.
Erectile Dysfunction in Peripheral Vascular Disease: Endovascular Revascularization as a Potential Therapeutic Target
Authors: Benaragama Kapila S. , Singh Aminder A. , Taj Tahani , Hague Julian , Boyle Jonathan R. , Richards Toby 
Published: August 2020

Introduction: Erectile dysfunction (ED) affects more than 150 million men worldwide, with deleterious effects on quality of life. ED is known to be associated with ischemic heart disease but the impact of ED in patients with peripheral arterial disease (PAD) is unknown. We assessed the prevalence and severity of ED in patients with PVD. Methods: Following ethical approval, sequential male patients diagnosed with PAD over a 1-year period following diagnosis of intermittent claudication. The patient demographics and comorbidities were recorded, with the International Index of Erectile Function (IIEF-5) questionnaire used to grade severity of ED. Computed tomographic angiography and severity of stenosis in the proximal vessels and internal pudendal arteries were correlated using a modified Bollinger Matrix scoring system. Results: 60 patients were recruited, most (77.2%) reported erectile dysfunction (52.5% severe, 22.5% moderate). Patients with severe ED were more likely to have 2 or more comorbidities (P = .009). 86.7% with severe ED had bilateral internal pudendal artery stenosis with a mean modified Bollinger score of 17.6. 35.5% of moderate ED patients had bilateral internal pudendal stenosis with a mean Bollinger score of 11.75. There was significant difference in overall scores between moderate and severe erectile dysfunction (p< 0.05), thus indicating a potential link between ED severity and extent of vessel stenosis. Conclusion: There is a substantial burden of clinically significant ED among patients with PAD. This study suggests ED should be discussed with all PAD patients and ED may precede a PAD diagnosis. There is scope for endovascular revascularization as a treatment option for ED secondary to arterial insufficiency.
Successful Initiation of Hybrid Closed-Loop System Using Virtual Pump Training Program in a Teenager With Type 1 Diabetes Previously Treated with Multiple Daily Injections
Authors: Petrovski Goran , Campbell Judith , Almajali Douha , Al Khalaf Fawziya , Hussain Khalid 
Published: August 2020

Due to the coronavirus disease 2019 restrictions in providing diabetes services, we have developed an innovative pump training program, which consisted of technical session, pump training, one in-person practical session, and four consecutive online sessions (Skype Meet Now). A 13-year-old female patient with a 4-year history of type 1 diabetes (T1D) on multiple daily injections (MDI) with glycated hemoglobin 8.9%; 74 mmol/mol) initiated Minimed 670G system using the program. Time in range (70-180 mg/dL) of 39% and sensor glucose (SG) of 214±91 mg/dL (MDI with continuous glucose monitoring) increased to 69% in the first 2 weeks and reached 86% and SG of 140±40 mg/dL in the first month of auto mode initiation, without severe hypoglycemia or hyperglycemia. Virtual pump training program can be an effective tool to initiate a hybrid closed-loop system and to improve glycemic control in people with T1D on MDI.