bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID‐19
Authors: Smith Stephen M. , Boppana Avinash , Traupman Julie A. , Unson Enrique , Maddock Daniel A. , Chao Kathy , Dobesh David P. , Brufsky Adam , Connor Ruth I. 
Published: June 2020

AbstractBackgroundIdentification of risk factors of severe coronavirus disease 2019 (COVID‐19) is critical for improving therapies and understanding severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pathogenesis. We analyzed 184 patients hospitalized for COVID‐19 in Livingston, New Jersey for clinical characteristics associated with severe disease. The majority of patients with COVID‐19 had diabetes mellitus (DM) (62.0%), Pre‐DM (23.9%) with elevated fasting blood glucose (FBG), or a body mass index >30 with normal hemoglobin A1c (HbA1C) (4.3%). SARS‐CoV‐2 infection was associated with new and persistent hyperglycemia in 29 patients, including several with normal HbA1C levels. Forty‐four patients required intubation, which occurred significantly more often in patients with DM as compared with non‐diabetics. Severe COVID‐19 occurs in the presence of impaired glucose metabolism in patients, including those with DM, preDM, and obesity. COVID‐19 is associated with elevated FBG and several patients presented with new onset DM or in DKA. The association of dysregulated glucose metabolism and severe COVID‐19 suggests that SARS‐CoV‐2 pathogenesis involves a novel interplay with glucose metabolism. Exploration of pathways by which SARS‐CoV‐2 interacts glucose metabolism is critical for understanding disease pathogenesis and developing therapies.
The feasibility and effectiveness of a streamlined single‐catheter approach for radiofrequency atrial fibrillation ablation
Authors: Chin Shui Hao , O'Brien Jim , Epicoco Gianluca , Peddinti Prithvi , Gupta Akanksha , Modi Simon , Waktare Johan , Snowdon Richard , Gupta Dhiraj 
Published: June 2020

AbstractBackgroundCatheter ablation for atrial fibrillation (AF) traditionally requires the use of circular mapping catheter (CMC) for pulmonary vein isolation (PVI). This study aimed to assess the feasibility and effectiveness of a CMC‐free approach for AF ablation performed by a contiguous optimized (CLOSE) ablation protocol.MethodsA CLOSE‐guided and CMC‐free PVI protocol with a single transseptal puncture was attempted in 67 patients with AF. Left atrial (LA) CARTO voltage mapping was performed with the ablation catheter pre‐ and postablation to demonstrate entry block into the pulmonary veins, and pacing maneuvers were used to confirm exit block.ResultsThe CMC‐free approach was successful in achieving PVI in 66 (98.5%) cases, with procedure time of 148 ± 32 minutes, ablation time of 27.5 ± 5.7 minutes, and fluoroscopy time of 7.8 ± 1.0 minutes. First‐pass PVI was seen in 58(86.5%) patients, and pacing maneuvers successfully identified the residual gap in eight of the other nine cases. No complication was observed. At 12 months follow‐up, 60 (89.6%) patients remained free from AF. The CMC‐free approach resulted in a cost saving of £47,190.ConclusionA CMC‐free CLOSE‐guided PVI approach is feasible, safe, and cost‐saving, and is associated with excellent clinical outcomes at 1 year.
A prospective multicenter study of direct comparison of feasibility and safety of pulmonary vein isolation using the minimally interrupted apixaban between second‐generation cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: J‐HIT apixaban
Authors: Yagishita Atsuhiko , Goya Masahiko , Iesaka Yoshito , Nitta Junichi , Takahashi Atsushi , Nagata Yasutoshi , Hachiya Hitoshi , Inaba Osamu , Inamura Yukihiro , Tanaka Yasuaki , Watanabe Keita , Tao Susumu , Shirai Yasuhiro , Yamamoto Tasuku , Shiohira Shinya , Akiyoshi Kikou , Sekigawa Masahiro , Maeda Shingo , Sasaki Takeshi , Takahashi Yoshihide , Kawabata Mihoko , Hirao Kenzo ,   for the J‐HIT investigators
Published: June 2020

AbstractBackgroundThe feasibility and safety of pulmonary vein isolation (PVI) using cryoballoon (CB) for paroxysmal atrial fibrillation (PAF) with minimally interrupted apixaban has not fully explored.MethodsIn this multicenter, randomized prospective study, we enrolled patients with PAF undergoing CB or radiofrequency (RF) ablation with interrupted (holding 1 dose) apixaban. The primary composite end point consisted of bleeding events, including pericardial effusion and major bleeding requiring blood transfusion, or thromboembolic events at 4 weeks after ablation; secondary end points included early recurrence of AF and procedural duration.ResultsA total of 250 patients underwent PVI (125 assigned to the RF ablation and 125 assigned to the CB ablation). The primary end point occurred in 1 patient in the CB ablation group (0.8%; 90% confidence interval [CI], 0.04 to 3.70) and 3 patients in the RF group (2.4%, P = .622; risk ratio, 0333; 90% CI, 0.05 to 2.20). All events were pericardial effusion, all of whom recovered after pericardiocentesis. Early recurrence of AF occurred in 4 patients (3.2%) in the RF group and in 6 patients (4.8%) in the CB group (P = .749). The procedural duration was shorter in the CB group than that in the RF group (136.5 ± 39.9 vs 179.5 ± 44.8 min, P < .001).ConclusionCB ablation with minimally interrupted apixaban was feasible and safe in patients with PAF undergoing PVI, which was equivalent to RF ablation.
The platelet‐rich plasma and mesenchymal stem cell milieu: A review of therapeutic effects on bone healing
Authors: Liebig Bethany E. , Kisiday John D. , Bahney Chelsea S. , Ehrhart Nicole P. , Goodrich Laurie R. 
Published: June 2020

AbstractPlatelet‐rich plasma is autologous plasma that contains concentrated platelets compared to whole blood. It is relatively inexpensive to produce, can be easily isolated from whole blood, and can be administered while the patient is in the operating room. Further, because platelet‐rich plasma is an autologous therapy, there is minimal risk for adverse reactions to the patient. Platelet‐rich plasma has been used to promote bone regeneration due to its abundance of concentrated growth factors that are essential to wound healing. In this review, we summarize the methods for producing platelet‐rich plasma and the history of its use in bone regeneration. We also summarize the growth factor profiles derived from platelet‐rich plasma, with emphasis on those factors that play a direct role in promoting bone repair within the local fracture environment. In addition, we discuss the potential advantages of combining platelet‐rich plasma with mesenchymal stem cells, a multipotent cell type often obtained from bone marrow or fat, to improve craniofacial and long bone regeneration. We detail what is currently known about how platelet‐rich plasma influences mesenchymal stem cells in vitro, and then highlight the clinical outcomes of administering platelet‐rich plasma and mesenchymal stem cells as a combination therapy to promote bone regeneration in vivo.
An ex vivo human osteochondral culture model
Authors: Kleuskens Meike W. A. , van Donkelaar Corrinus C. , Kock Linda M. , Janssen Rob P. A. , Ito Keita 
Published: June 2020

AbstractTo reduce animal experimentation and to overcome translational issues in cartilage tissue engineering, there is a need to develop an ex vivo human tissue‐based approach. This study aims to demonstrate that a human osteochondral explant at different stages of osteoarthritis (OA) can be kept in long‐term culture while preserving its viability and composition. Osteochondral explants with either a smooth or fibrillated cartilage surface, representing different OA stages, were harvested from fresh human tibial plateaus. Explants were cultured for 2 or 4 weeks in a double‐chamber culture platform. The biochemical content of the cartilage of cultured explants did not significantly change over a period of 4 weeks and these findings were supported by histology. Chondrocytes mostly preserved their metabolic activity during culture and active bone and marrow were found in the periphery of the explants, while metabolic activity was decreased in the bone core in cultured explants compared to fresh explants. In fibrillated explants, chondrocyte viability decreased in the periphery of the sample in cultured groups compared to fresh explants (fresh, 94 ± 6%; cultured, 64% ± 17%, 2 weeks, and 69% ± 17%, 4 weeks; P < .05). Although biochemical and histological results did not show changes within the cartilage tissue, the viability of the explants should be carefully controlled for each specific use. This system provides an alternative to explore drug treatment and implant performance under more controlled experimental conditions than possible in vivo, in combination with clinically relevant human osteochondral tissue.
Exploring the periodontal disease—ischemic stroke link
Authors: Sen Souvik , Mascari Rachel 
Published: June 2020

AbstractMultiple risk factors are associated with ischemic stroke. Here, we highlight studies indicating that periodontal disease significantly increases the risk of both primary ischemic stroke and subsequent cardiovascular events. Additionally, studies have shown an association between periodontal disease and multiple causes of ischemic stroke. Finally, we describe an ongoing clinical trial testing the benefit of periodontal disease treatment as a strategy to reduce risk for recurrent cardiovascular events in patients who have had recent ischemic stroke or transient ischemic attack. This article is mostly based on a presentation given in honor of Steven Offenbacher (1950 to 2018).
Machine learning techniques as a tool for predicting overtourism: The case of Spain
Authors: Perles‐Ribes José Francisco , Ramón‐Rodríguez Ana Belén , Moreno‐Izquierdo Luis , Such‐Devesa María Jesús 
Published: June 2020

AbstractOne of the most challenging tasks for tourism scientists is the prediction of potential overtourism situations in the tourist destinations. Until now, some efforts have been proposed for the purpose of establishing early warning systems. However, none of the attempts has tried to make use of a powerful prediction tool that is currently available: machine learning techniques. This article seeks to fill this gap in the existing literature by proposing the use of machine learning techniques in order to predict overtourism issues on a sample of Spanish tourist cities specialized in both, urban and sun and beach tourism products.
Pons Anteroposterior and Cerebellar Vermis Craniocaudal Diameters in Fetuses With Down Syndrome
Authors: Erenel Hakan , Madazli Riza 
Published: June 2020

ObjectivesTo investigate the pons anteroposterior diameter (APD) and cerebellar vermis craniocaudal diameter (CCD) of fetuses with Down syndrome (DS).MethodsThis was a prospective observational study including 200 low‐risk pregnancies and 18 pregnancies with fetuses who had DS. A midsagittal view was obtained to measure the pons APD and cerebellar vermis CCD. Gestational age‐related 5th, mean, and 95th percentiles for the pons APD and cerebellar vermis CCD between 18 and 32 weeks' gestation were created from the low‐risk population. Each measurement of a fetus with DS was plotted on growth charts, and those below the 5th percentile for gestational age were considered small.ResultsThe pons APD and cerebellar vermis CCD measurements were below the 5th percentile for gestational age in 7 of the 18 (38.8%) fetuses with DS. Fetuses who had pons APDs below the 5th percentile for gestational age also had cerebellar vermis CCDs below the 5th percentile. Fetuses who had pons and cerebellar vermis measurements below the 5th percentile for gestational age on the initial examination continued to have small measurements during follow‐up.ConclusionsFetal pons and cerebellar vermis abnormalities could be observed prenatally in fetuses with DS, which could help in the antenatal counseling and postnatal follow‐up of such pregnancies.
Intellectual capital in East and West African social enterprises
Authors: Sgrò Francesca , Ciambotti Giacomo , Bontis Nick , Ayiku Andrews 
Published: June 2020

AbstractPurposeThis study aims to identify the main factors of knowledge assets (i.e., human, relational and structural capital) that affect the value creation process of social enterprises located in East and West Africa.DesignA survey was administered to a sample of social enterprises located in developing countries such as Kenya, Uganda, Sierra Leone and Ghana. The survey was designed to gather background information about social enterprises, social entrepreneurs as well as data pertaining to intellectual capital. Therefore, descriptive statistical analysis, principal component analysis and Pearson correlations were employed to identify the main components of IC for African SEs and the inter‐relationship among intellectual capital components.FindingsResearch findings confirmed that human capital (i.e., a social entrepreneur's knowledge), relational capital (i.e., local and global relationship quality) and structural capital (i.e., long‐term and up‐to‐date firm knowledge) were validated as important resources for African SEs in the value creation process. Moreover, correlation analysis showed that human capital and relational capital were positively correlated; whereas structural capital was positively correlated with the local and global relationship's quality and with the social entrepreneur's skills.LimitationsThe main limitations concern the heterogeneity and the restricted sample size due to challenges in the data gathering process. Moreover, the results could potentially be influenced by the context and the low response rate. However, this study can represent a starting point for future research in this unique but important research setting.OriginalityThis study can be considered original for several reasons. First, empirical evidence on knowledge assets in developing countries in Africa is still scarce, despite the potential of being a new frontier for intellectual capital studies and social and economic growth. Second, the use of a survey method as an IC measurement tool in this context is unique. Finally, this study helps in providing a platform for further investigation in Africa.
Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer
Authors: Borsetto Daniele , Polesel Jerry , Tirelli Giancarlo , Menegaldo Anna , Baggio Vittorio , Gava Alessandro , Nankivell Paul , Pracy Paul , Fussey Jonathan , Boscolo‐Rizzo Paolo 
Published: June 2020

ObjectiveMean corpuscular volume (MCV) has been shown in to be a reliable prognostic marker in other cancers; however, no evidence exists on its use in head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the association between MCV, hemoglobin, platelet count and albumin concentration, and survival in stage III/IVA‐B HNSCC treated with concurrent chemoradiotherapy.Study DesignRetrospective cohort study.MethodsIn this multicenter retrospective study, we analyzed MCV, platelet count, hemoglobin concentration, and albumin concentration in peripheral blood samples from 260 patients with HNSCC undergoing organ preservation treatment with curative intent at the time of diagnosis. We then analyzed survival outcomes after accounting for confounders using multivariate analysis.ResultsAfter adjustment for potential confounders, patients with low hemoglobin had a 3.3‐fold higher risk of death (95% confidence interval [CI]: 2.26‐4.81) than those with normal hemoglobin. Patients with an elevated MCV had a 1.54‐fold higher risk of death (95% CI: 1.06‐2.24), independent of site, stage, and human papillomavirus status. Interestingly, the effect of MCV on overall and progression‐free survival was limited to those with a normal pretreatment hemoglobin. We identified no associations between pretreatment platelet count or albumin concentration and survival.ConclusionThese findings suggest that pretreatment anemia and macrocytosis are independent predictors of lower overall and progression‐free survival in HNSCC patients undergoing organ preservation treatment.Level of EvidenceIII Laryngoscope, 131:E836–E843, 2021
Do high‐frequency air‐bone gaps persist after ossiculoplasty?
Authors: Polanik Marc D. , Trakimas Danielle R. , Castillo‐Bustamante Melissa , Cheng Jeffrey T. , Kozin Elliott D. , Remenschneider Aaron K. 
Published: June 2020

AbstractObjectivesConventional reporting of postoperative hearing outcomes utilizes a pure‐tone averaged air‐bone gap (ABG) that is biased toward low frequencies. Consequently, a high‐frequency ABG after otologic surgery may go unnoticed. In this study, we evaluate changes in low‐ and high‐frequency ABG following ossiculoplasty.Study designRetrospective review.Subjects and settingConsecutive series of patients who underwent ossiculoplasty at a single tertiary care center. Patients with pre‐ and postoperative audiograms were included.MethodsLow‐frequency ABG was calculated as the mean ABG at 250, 500, and 1000 Hz. High‐frequency ABG was calculated at 4 kHz. Pre‐ and postoperative ABGs were compared.ResultsThirty‐seven consecutive patients were included. Mean age at surgery was 38 years (range, 7‐77 years). Reconstruction materials included: cartilage (N = 4), hydroxyapatite cement (N = 5), and partial or total ossicular replacement prostheses (N = 20 and N = 8, respectively). Postoperatively, the mean low‐frequency ABG improved by 11.9 ± 15.1 dB (P < .0001) and the mean high‐frequency ABG improved by 5.9 ± 16.0 dB (P = .030). Low‐frequency ABG closure was significantly larger than high‐frequency ABG closure (P = .007). Mean postoperative persistent high‐frequency ABG was 22.0 ± 13.8 dB.ConclusionIn this series, ossiculoplasty improved ABG across all frequencies, but greater improvements were observed at low frequencies when compared to high frequency. Current reporting standards may not identify persistent high‐frequency ABG. Additional study of the mechanisms of high‐frequency sound conduction in reconstructed middle ears is needed to improve high‐frequency hearing outcomes in ossiculoplasty.Level of evidenceLevel 4.
A maturity grid assessment tool for learning networks
Authors: Lannon Carole , Schuler Christine L. , Seid Michael , Provost Lloyd P. , Fuller Sandra , Purcell David , Forrest Christopher B. , Margolis Peter A. 
Published: June 2020

AbstractBackgroundThe vision of learning healthcare systems (LHSs) is attractive as a more effective model for health care services, but achieving the vision is complex. There is limited literature describing the processes needed to construct such multicomponent systems or to assess development.MethodsWe used the concept of a capability maturity matrix to describe the maturation of necessary infrastructure and processes to create learning networks (LNs), multisite collaborative LHSs that use an actor‐oriented network organizational architecture. We developed a network maturity grid (NMG) assessment tool by incorporating information from literature review, content theory from existing networks, and expert opinion to establish domains and components. We refined the maturity grid in response to feedback from network leadership teams. We followed NMG scores over time for nine LNs and plotted scores for each domain component with respect to SD for one participating network. We sought subjective feedback on the experience of applying the NMG to individual networks.ResultsLN leaders evaluated the scope, depth, and applicability of the NMG to their networks. Qualitative feedback from network leaders indicated that changes in NMG scores over time aligned with leaders' reports about growth in specific domains; changes in scores were consistent with network efforts to improve in various areas. Scores over time showed differences in maturation in the individual domains of each network. Scoring patterns, and SD for domain component scores, indicated consistency among LN leaders in some but not all aspects of network maturity. A case example from a participating network highlighted the value of the NMG in prompting strategic discussions about network development and demonstrated that the process of using the tool was itself valuable.ConclusionsThe capability maturity grid proposed here provides a framework to help those interested in creating Learning Health Networks plan and develop them over time.
HOW TO RECAPTURE LEADERSHIP'S LOST MOMENT
Authors: Powell Lili , Hunter Jeremy 
Published: June 2020

AbstractDefining leadership moments happen in a flash. And yet the real experiential skills that moments like these require are rarely ever systematically taught to leaders. Instead, leaders are left to learn them through trial and error, or not at all. People often use a catch‐all colloquial term, chalking up this kind of inefficient and sometimes ineffective learning to “Experience.” To recapture leadership's lost moment, leaders can learn to refocus on their immediate experience so they can lead more mindfully. Our approach emphasizes using intention, attention, and awareness to act and perform skillfully and dynamically in real time. Using diverse practices ranging from meditation, yoga, athletics, and the performing arts, leaders can learn to experience a moment in a high‐definition way that increases the potential for better choices and leadership results. Leading mindfully begins simply and profoundly. Doing the inner work of noticing reactions, you can shift into more productive stances for action. Fueled by more productive intentions, you can increase the odds of moving skillfully into more productive actions. Skillful action then becomes a basis for skillful interaction and coordinated action toward a common goal, which of course is what leadership is really all about.
Deep Brain Stimulation Impact on Social and Occupational Functioning in Parkinson's Disease with Early Motor Complications
Authors: Stoker Valerie , Krack Paul , Tonder Lisa , Barnett Gillian , Durand‐Zaleski Isabelle , Schnitzler Alfons , Houeto Jean‐Luc , Timmermann Lars , Rau Joern , Schade‐Brittinger Carmen , Vidailhet Marie , Deuschl Günther ,   EARLYSTIM Study Group
Published: June 2020

ABSTRACTBackgroundDeep brain stimulation (DBS) improves motor symptoms and quality of life in patients with Parkinson's disease (PD) and early motor complications, suggesting that DBS could be prescribed to the working‐age PD population.ObjectivesTo investigate the effect of DBS compared with best medical therapy (BMT) on social, psychosocial, and occupational functioning in patients with PD ≤60 years of age with early motor complications, its correlates, and possible underlying rationale.MethodsMethods included analyses of the Social and Occupational Functioning Assessment Scale, Scales for Outcomes for Parkinson's–Psychosocial, Professional Fitness, Starkstein Apathy Scale, and Schwab and England Activities of Daily Living Scale from the EARLYSTIM study.ResultsCompared with BMT, DBS resulted in significantly greater improvements from baseline through 24 months in social,occupational, and psychosocial functioning. Yet, work status in the 2 groups did not differ at baseline and 24 months. Physicians reported a significantly higher percentage of patients in the BMT group unable to work at 24 months relative to baseline compared with the DBS group. Apathy was significantly worse in patients for whom physicians overrated ability to work when compared with patients’ own ratings than in the group of patients who physicians' ability to work ratings were comparable to, or worse than, patients' self‐ratings of ability to work.ConclusionsFor patients aged ≤60 years with PD and early motor complications, DBS provided significant improvements in social, occupational, and psychosocial function, but not in the actual work engagement compared with BMT at 2 years. Apathy may impact ability to work.