bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the blood pressure measurement technology used in the Novacor Diasys 3 Plus (DIP-0001-00) upper-arm device for ambulatory blood pressure measurement, according to AAMI/ANSI/ISO 81060-2:2013, ESH-IP 2010 and MEDDEV 2.7/1
Authors: Atkins Neil , Fania Claudio , Palatini Paolo 
Published: October 2020

Objective
The objective of this study was to determine the accuracy of the auscultatory and oscillometric blood pressure (BP) measurement technologies of the Novacor Diasys 3 Plus (model number DIP-0001-00) BP monitor, intended for ambulatory BP measurement when used with the recommended Standard Plus (ACC-0210-00), Large Plus (ACC-0211-00) and Paediatric Plus (ACC-0212-00) cuffs.

Methods
The auscultatory measurement technology Novacor Diasys 3 Plus (model number DIP-0001-00) was evaluated according to the requirements of the AAMI/ANSI/ISO 81060-2:2013 standard, including an additional cardiac-stress study, a requirement for ambulatory BP measurement devices. It was also validated according to the requirements of the European Society of Hypertension International Protocol revision 2010. The oscillometric measurement technology was compared to that of the Novacor Diasys 3 (model number DIS-0001-00) according to the equivalence requirements of MEDDEV 2.7/1 rev 4. The protocol requirements for all three studies and the equivalence were followed precisely.

Results
The Novacor Diasys 3 Plus (model number DIP-0001-00) fulfilled all of the requirements for a pass in each of the three studies of the auscultatory measurement technology. In the primary AAMI/ANSI/ISO 81060-2:2013 study, the criterion 1 errors were + 3.6 ± 2.7 mmHg for SBP and + 3.0 ± 2.7 mmHg for DBP. It was also proven to be equivalent to the Novacor Diasys 3 (model number DIS-0001-00) with respect to the oscillometric measurement technology

Conclusion
The Novacor Diasys 3 Plus (model number DIP-0001-00), when used with the recommended cuffs, can be recommended for ambulatory BP measurement in the adult population.
The relationship between glycemic variability and blood pressure variability in normoglycemic normotensive individuals
Authors: Sezer Havva , Yazici Dilek , Copur Sidar , Dagel Tuncay , Deyneli Oguzhan , Kanbay Mehmet 
Published: October 2020

Background and aim
Glycemic fluctuations around a mean glucose level, referred as glycemic variability and blood pressure variability (BPV) are considered as independent risk factors for cardiovascular diseases, all-cause mortality, and cardiovascular disease-mortality. With this background in mind, we aimed to investigate the association between glycemic variability and BPV and their association in normoglycemic and normotensive individuals.

Materials and method
Twenty-seven normotensive normoglycemic individuals were recruited. Twenty-four hour Holter devices were utilized to measure ambulatory blood pressure (BP) while continuous glucose monitoring (CGM) devices were applied to measure glycemic variability simultaneously to the subjects. These devices were kept on for 48 h. For BP recordings, daytime, nighttime, and 24-h BP determinations, their mean and SD were calculated. From CGM measurements, mean blood glucose (MBG), SD of blood glucose, the mean amplitude of glycemic excursions (MAGE), the mean of daily differences (MODD), coefficient of variation (correction of variability for the MBG), and daytime and nighttime blood glucose were determined.

Results
The mean age of the subjects was 23.8 ± 2.7 years and 66% were women (18/27). In the correlation analysis between glycemic variability parameters and BPV parameters, SD of 24-h SBP was correlated with the SD of MBG (r = 0.52, P = 0.006), MAGE (r = 0.49, P = 0.009), and MODD (r = 0.46, P = 0.015). SD of daytime SBP was correlated with, MAGE (r = 0.42, P = 0.03) and MODD (r = 0.43, P = 0.02).

Conclusion
We report correlation between glycemic variability and BPV variables in normoglycemic and normotensive healthy individuals.
Tracking COVID-19 via sewage
Authors: Rooney Christopher M. , Moura Ines B. , Wilcox Mark H. 
Published: October 2020

Purpose of review
We discuss the potential role of the faecal chain in COVID-19 and highlight recent studies using waste water-based epidemiology (WBE) to track severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Recent findings
WBE has been suggested as an adjunct to improve disease surveillance and aid early detection of circulating disease. SARS-CoV-2, the aetiological agent of COVID-19, is an enveloped virus, and as such, typically not associated with the waste water environment, given high susceptibility to degradation in aqueous conditions. A review of the current literature supports the ability to detect of SARS-CoV-2 in waste water and suggests methods to predict community prevalence based on viral quantification.

Summary
The summary of current practices shows that while the isolation of SARS-CoV-2 is possible from waste water, issues remain regarding the efficacy of virial concentration and subsequent quantification and alignment with epidemiological data.
Diagnosis and management of pediatric epithelial salivary gland malignancy
Authors: You Peng , Dimachkieh Amy L. , Chelius Daniel C. 
Published: October 2020

Purpose of review
Salivary tumors are uncommon among children but are more likely to be malignant compared with adults. A lack of experience makes consensus in treatment elusive. Amidst recent publication of large institutional and national series, this review aims to discuss the epidemiology, diagnosis, investigation, and treatment for pediatric epithelial salivary malignancies.

Recent findings
Pediatric salivary malignancies are often low grade and carry a favorable prognosis. High-grade tumors portend an increased risk of recurrence and a decreased survival. Surgeons should strive for oncologic resection with clear margins and avoid enucleation and excisional biopsies. Overt nodal metastases require concurrent neck dissection, whereas elective neck dissections may be reserved for cases with high risk of occult disease, such as advanced stage and high-grade neoplasms. Adjuvant radiation should be considered in high-grade tumors.

Summary
The paucity of high-level evidence clouds treatment decisions and further encourages pediatric salivary malignancies to be treated in an experienced center with a multidisciplinary approach.
Development of Entrustable Professional Activities and Standards in Training in Pediatric Neurogastroenterology and Motility
Authors: Khlevner Julie , Rosen Rachel , Ambartsumyan Lusine , Lusman Sarah Shrager , Rosen John M. , Yacob Desale , Mousa Hayat , Nurko Samuel , Di Lorenzo Carlo , Boruta Mary , Ratcliffe Elyanne M. , Feinstein Laurence , Snyder Julie , Wood Richard J. , Graham Kahleb , Saps Miguel , Gyawali C. Prakash , Rodriguez Leonel , Belkind‐Gerson Jaime 
Published: October 2020

ABSTRACTNeurogastroenterology and motility (NGM) disorders are common in childhood and are often very debilitating. Although pediatric gastroenterology fellows are expected to obtain training in the diagnosis and management of patients with these disorders, there is an ongoing concern for unmet needs and lack of exposure and standardized curriculum. In the context of tailoring training components, outcome and expressed needs of pediatric gastroenterology fellows and programs, members of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and American Neurogastroenterology and Motility Society (ANMS) developed guidelines for NGM training in North America in line with specific expectations and goals of training as delineated through already established entrustable professional activities (EPAs). Members of the joint task force applied their expertise to identify the components of knowledge, skills, and management, which are expected of NGM consultants. The clinical knowledge, skills and management elements of the NGM curriculum are divided into domains based on anatomic regions including esophagus, stomach, small bowel, colon and anorectum. In addition, dedicated sections on pediatric functional gastrointestinal (GI) disorders, research and collaborative approach, role of behavioral health and surgical approaches to NGM disorders and transition from pediatric to adult neurogastroenterology are included in this document. Members of the NASPGHAN‐ANMS task force anticipate that this document will serve as a resource to break existing barriers to pursuing a career in NGM and provide a framework towards uniform training expectations at 3 hierarchical tiers corresponding to EPA levels.
Care Management and Care Coordination Within a Patient-Centered Medical Home
Authors: Wakefield Bonnie J. , Lampman Michelle A. , Paez Monica B. , Stewart Greg L. 
Published: October 2020

OBJECTIVE
The aim of this study was to analyze perceptions and experiences of clinicians implementing the patient-centered medical home (PCMH).

BACKGROUND
The PCMH model focuses on several important concepts, including team-based care management as well as care coordination and continuity among providers and across settings of care.

METHODS
A qualitative analysis of data collected in 2016 from primary care personnel through a national survey was conducted.

RESULTS
Four themes were found consistent with care management and care coordination: the importance of teamwork and optimized team member roles, need for adequate prioritization of care management and care coordination, need to refine tools and resources supporting care management and care coordination, and challenges with managing and coordinating care with and across complex systems.

CONCLUSIONS
Successful implementation requires adequate support for teamwork and ensuring team members can work according to their clinical competency. Nurses practicing in expanded roles need clear role guidelines and adequate time to function in these roles.
Two Cases of Cerebral Infarcts Caused by Topical Hemostatic Agent Embolism
Authors: Coss Dylan J. , Tlomak Wieslawa , Cochran Elizabeth 
Published: October 2020

Abstract
Resorbable topical hemostatic agents are widely used in surgical procedures to control intraoperative bleeding. There have been multiple reports of complications from use of these agents, including pulmonary vasculature thromboembolism, cerebral venous sinus occlusion, and postoperative inflammatory mass lesions each containing the hemostatic agent. We report 2 cases of inadvertent intra-arterial embolization of hemostatic agent. Both cases followed elective surgical cervical spinal procedures, during which gelatin-based local hemostatic agents were used to control unanticipated bleeding. Postoperatively, both patients exhibited neurologic defects and were found to have infarcts of the brain. At autopsy, vertebrobasilar thromboemboli containing foreign material grossly and microscopically consistent with hemostatic matrix material were found in both cases. These are the first reports of hemostatic agent embolization resulting in cerebral infarcts and leading to death.
The early influence of COVID-19 pandemic-associated restrictions on pain, mood, and everyday life of patients with painful polyneuropathy
Authors: Kersebaum Dilara , Fabig Sophie-Charlotte , Sendel Manon , Sachau Juliane , Lassen Josephine , Rehm Stefanie , Hüllemann Philipp , Baron Ralf , Gierthmühlen Janne 
Published: October 2020

Abstract

Introduction:
The SARS-Cov-2 pandemic requires special attention on its psychological effects and the impact on patients with chronic pain.

Objectives:
This study aimed at examining the influence of the COVID-19 pandemic-associated regulations initiated by the German government on pain intensity and characteristics, emotional well-being, and everyday life of patients with painful polyneuropathy.

Methods:
Forty-three patients (well assessed with questionnaires before the pandemic and without change of their health status between baseline and current assessment) were investigated with validated, self-reported questionnaires and COVID-19-specific items 2 weeks after the regulations came into effect.

Results:
Pain intensity remained stable or even improved like the neuropathic pain symptom inventory total score (t0: 33.54 ± 20.48 vs t1: 27.38 ± 16.16, P = 0.008). Only 11.6% reported a pandemic-associated pain worsening. Rumination scores of the Pain Catastrophizing Scale were lower during t1 compared to before the pandemic regulations (t0: 7.81 ± 4.70, t1: 6.49 ± 4.39; P = 0.030). Interestingly, pain ratings for the last 7 days were higher in patients with a changed social life compared to those without (−1.63 ± 1.60 vs 0.31 ± 1.83; P = 0.01). Quality of life was decreased and helplessness increased in those with higher pain ratings.

Conclusion:
Results suggest a shift of attention from the chronic pain condition towards the imminent threat of a global pandemic. As the impacts of the pandemic are persistent and evolving, the development of the measured parameters in the forthcoming weeks will be of great interest.
Experiences With Three-dimensional Printing in Complex Liver Surgery
Authors: Huber Tobias , Huettl Florentine , Tripke Verena , Baumgart Janine , Lang Hauke 
Published: October 2020

Objective:
We present a series of cases where we used 3D printing in planning of complex liver surgery.

Background:
In liver surgery, three-dimensional reconstruction of the liver anatomy, in particular of vascular structures, has shown to be helpful in operation planning. So far, 3D printing has been used for medical applications only rarely.

Methods and Patients:
From December 2017 to December 2019, in 10 cases where surgery was assumed to be challenging operation planning was performed using full size 3D prints in addition to standard 3 phase CT scans. Models included transparent parenchyma, hepatic veins, vena cava, portal vein, hepatic artery, (biliary tree if requested), and tumors. In 7/10 cases vascular reconstructions were needed during the procedure. Nonstructured feedback of the surgical team revealed that the major benefit was visualization of the critical areas of vascular reconstruction, the expected dimensions of tangential vascular infiltration and the planning of reconstruction. In the multifocal tumors, 3D prints were considered to be helpful for intraoperative orientation to detect metastases and to improve planning of the resection.

Conclusions:
In complex liver surgery with potential need for vascular reconstructions operation planning may be optimized using a 3D printed liver model. Prospective studies are needed to evaluate the clinical impact of 3D printing in liver surgery compared to other 3D visualizations.
Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons
Authors: Gill Thomas M. , Han Ling , Gahbauer Evelyne A. , Leo-Summers Linda , Murphy Terrence E. , Becher Robert D. 
Published: October 2020

Objective:
To evaluate the functional effects of intervening illnesses and injuries, that is, events, in the year after major surgery.

Background:
Intervening events have pronounced deleterious effects on functional status in older persons, but have not been carefully evaluated after major surgery.

Methods:
From a cohort of 754 community-living persons, aged 70+ years, 317 admissions for major surgery were identified from 244 participants who were discharged from the hospital. Functional status (13 activities) and exposure to intervening hospitalizations, emergency department (ED) visits, and restricted activity were assessed each month. Comprehensive assessments (for covariates) were completed every 18 months.

Results:
In the year after major surgery, exposure rates (95% CI) per 100-person months to hospitalizations, ED visits, and restricted activity were 10.0 (8.0–12.5), 3.9 (2.8–5.4), and 12.3 (10.2–14.8) for functional recovery and 7.2 (6.1–8.5), 2.5 (1.9–3.2), 11.2 (9.8–12.9) for functional decline. Each of the 3 intervening events were independently associated with reduced recovery, with adjusted hazard ratios (95% CI) of 0.20 (0.09–0.47), 0.35 (0.15–0.81), and 0.57 (0.36–0.90) for hospitalizations, ED visits, and restricted activity. For functional decline, the corresponding odds ratios (95% CI) were 5.68 (3.87–8.33), 1.90 (1.13–3.20), and 1.30 (0.96–1.75). The effect sizes for hospitalizations and ED visits were larger than those for the covariates.

Conclusions:
Intervening illnesses/injuries are common in the year after major surgery, and those leading to hospitalization and ED visit are strongly associated with adverse functional outcomes, with effect sizes larger than those of traditional risk factors.
Do patients with minimal blunt thoracic aortic injury require thoracic endovascular repair?
Authors: DuBose Joseph J. , Charlton-Ouw Kristofer , Starnes Benjamin , Saqib Naveed , Quiroga Elina , Morrison Jonathan , Gewertz Bruce , Azizzadeh Ali ,   AAST/Aortic Trauma Foundation Study Group
Published: October 2020

INTRODUCTION
The optimal management of minimal blunt thoracic aortic injuries (BTAIs) remains controversial, with experienced centers using therapy ranging from medical management (MM) to thoracic endovascular aortic repair (TEVAR).

METHODS
The Aortic Trauma Foundation registry was used to examine demographics, injury characteristics, management, and outcomes of patients with BTAI.

RESULTS
Two hundred ninety-six patients from 28 international centers were analyzed (mean age, 44.5 years [SD, 18 years]; 76% [225/296] male; mean Injury Severity Score, 34 [SD, 14]). Blunt thoracic aortic injury was classified as Grade I, 22.6% (67/296); Grade II, 17.6% (52/296); Grade III, 47.3% (140/296); and Grade IV, 12.5% (37/296). Overall aortic-related mortality (ARM) was 4.7% (14/296). Among all deaths, 33% (14/42) were ARM. Open repair was required for only 2%, with most undergoing TEVAR (58.4%) or MM (28.0%). Thoracic endovascular repair complications occurred in 3.4% (6/173), most commonly Type 1 endoleak (2.3%; 4/173). Among patients with minimal aortic injury (Grades I and II), 59.7% (71/119) received MM, while 40.3% (48/119) underwent TEVAR. Two patients initially managed with MM required subsequent TEVAR for injury progression during initial hospital stay. No significant difference in ARM between MM and TEVAR was noted for Grades I and II injuries.

CONCLUSION
A third of the trauma victims with BTAI succumb to ARM. Thoracic endovascular repair has replaced open repair but remains equivalent in outcomes to MM for minimal injuries. These data support MM of patients with minimal aortic injury.

LEVEL OF EVIDENCE
Therapeutic study, level IV.
Time to weigh in on obesity and associated comorbidities in combat-wounded amputees
Authors: Tavares Kelli B. , Russell Dylan M. , Conrad Robert Joseph , Sizemore Grant C. , Nguyen Scott H. , Moon Andrea Y. , Colgan Bridget A. , Condon Freeman J. , Mayo John S. , Criman Erik T. , Lim Robert B. 
Published: October 2020

BACKGROUND
The Joint Trauma System database estimates that about 1,200 individuals have sustained a combat-related amputation during the Global War on Terror. Previous retrospective studies have demonstrated that combat-related amputees develop obesity and cardiovascular disease, but the incidence of obesity and associated comorbidities in this population is unknown. The objectives of this study are to determine the prevalence of obesity in the military amputee population and to compare this with the general population.

METHODS
This is a retrospective review of 978 patients who sustained a combat-related amputation from 2003 to 2014. Prevalence of obesity and comorbid conditions were determined. A multivariate logistic regression model was performed to identify risk factors for postamputation obesity. Kaplan-Meier curves were constructed using obesity as the event of interest.

RESULTS
A total of 1,233 charts were reviewed with 978 patients included for analysis. The median age of injury was 24 years. Median follow-up time was 8.7 years, ranging from 0.5 years to 16.9 years. The average Injury Severity Score was 23.3. The average body mass index preinjury was 25.6 kg/m2, and the average most recent corrected body mass index was found to be 31.4 kg/m2. Prevalence of comorbidities was higher in the amputee population. Fifty percent of patients who progressed to obesity did so within 1.3 years.

CONCLUSION
There is a notable prevalence of obesity that develops in the amputee population that is much higher than the general population. We determined that the amputee population is at risk, and these patients should be closely monitored for 1 to 2.5 years following injury. This study provides a targeted period for which monitoring and intervention can be implemented.

LEVEL OF EVIDENCE
Retrospective, basic science, outcomes analysis, level III/IV.
Semigroup applications everywhere
Authors: Nagel Rainer , Rhandi Abdelaziz 
Published: October 2020

Most dynamical systems arise from partial differential equations (PDEs) that can be represented as an abstract evolution equation on a suitable state space complemented by an initial or final condition. Thus, the system can be written as a Cauchy problem on an abstract function space with appropriate topological structures. To study the qualitative and quantitative properties of the solutions, the theory of one-parameter operator semigroups is a most powerful tool. This approach has been used by many authors and applied to quite different fields, e.g. ordinary and PDEs, nonlinear dynamical systems, control theory, functional differential and Volterra equations, mathematical physics, mathematical biology, stochastic processes.The present special issue of Philosophical Transactions includes papers on semigroups and their applications.This article is part of the theme issue ‘Semigroup applications everywhere’.
Analysis of respiratory and systemic immune responses in COVID-19 reveals mechanisms of disease pathogenesis
Authors: Szabo Peter A. , Dogra Pranay , Gray Joshua I. , Wells Steven B. , Connors Thomas J. , Weisberg Stuart P. , Krupska Izabela , Matsumoto Rei , Poon Maya M.L. , Idzikowski Emma , Morris Sinead E. , Pasin Chloé , Yates Andrew J. , Ku Amy , Chait Michael , Davis-Porada Julia , Zhou Jing , Steinle Matthew , Mackay Sean , Saqi Anjali , Baldwin Matthew , Sims Peter A. , Farber Donna L. 
Published: October 2020

SUMMARYImmune responses to respiratory viruses like SARS-CoV-2 originate and function in the lung, yet assessments of human immunity are often limited to blood. Here, we conducted longitudinal, high-dimensional profiling of paired airway and blood samples from patients with severe COVID-19, revealing immune processes in the respiratory tract linked to disease pathogenesis. Survival from severe disease was associated with increased CD4+T cells and decreased monocyte/macrophage frequencies in the airway, but not in blood. Airway T cells and macrophages exhibited tissue-resident phenotypes and activation signatures, including high level expression and secretion of monocyte chemoattractants CCL2 and CCL3 by airway macrophages. By contrast, monocytes in blood expressed the CCL2-receptor CCR2 and aberrant CD163+and immature phenotypes. Extensive accumulation of CD163+monocyte/macrophages within alveolar spaces in COVID-19 lung autopsies suggested recruitment from circulation. Our findings provide evidence that COVID-19 pathogenesis is driven by respiratory immunity, and rationale for site-specific treatment and prevention strategies.