bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Admission Glucose Is Associated With Poor Outcome After Endovascular Treatment for Ischemic Stroke
Authors: Rinkel Leon A. , Nguyen T. Truc My , Guglielmi Valeria , Groot Adrien E. , Posthuma Laura , Roos Yvo B.W.E.M. , Majoie Charles B.L.M. , Lycklama à Nijeholt Geert J. , Emmer Bart J. , van der Worp H. Bart , Wermer Marieke J.H. , Kruyt Nyika D. , Coutinho Jonathan M. ,   on behalf of the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry Investigators
Published: October 2020

Background and Purpose:
High-serum glucose on admission is a predictor of poor outcome after stroke. We assessed the association between glucose concentrations and clinical outcomes in patients who underwent endovascular treatment.

Methods:
From the MR CLEAN Registry, we selected consecutive adult patients with a large vessel occlusion of the anterior circulation who underwent endovascular treatment and for whom admission glucose levels were available. We assessed the association between admission glucose and the modified Rankin Scale score at 90 days, symptomatic intracranial hemorrhage and successful reperfusion rates. Hyperglycemia was defined as admission glucose ≥7.8 mmol/L. We evaluated the association between glucose and modified Rankin Scale using multivariable ordinal logistic regression and assessed whether successful reperfusion (extended Thrombolysis in Cerebral Infarction 2b-3) modified this association.

Results:

Of 3637 patients in the MR CLEAN Registry, 2908 were included. Median admission glucose concentration was 6.8 mmol/L (interquartile range, 5.9–8.1) and 882 patients (30%) had hyperglycemia. Hyperglycemia on admission was associated with a shift toward worse functional outcome (median modified Rankin Scale score 4 versus 3; adjusted common odds ratio, 1.69 [95% CI, 1.44–1.99]), increased mortality (40% versus 23%; adjusted odds ratio, 1.95 [95% CI, 1.60–2.38]), and an increased risk of symptomatic intracranial hemorrhage (9% versus 5%; adjusted odds ratio, 1.94 [95% CI, 1.41–2.66]) compared with nonhyperglycemic patients. The association between admission glucose levels and poor outcome (modified Rankin Scale score 3–6) was
J
-shaped. Hyperglycemia was not associated with the rate of successful reperfusion nor did successful reperfusion modify the association between glucose and functional outcome.

Conclusions:
Increased admission glucose is associated with poor functional outcome and an increased risk of symptomatic intracranial hemorrhage after endovascular treatment.
Ways of Seeing Nonhuman Animals: Some Likened Zebras to Horses, Others to Asses
Authors: Heywood Peter 
Published: October 2020

Abstract
When Europeans first encountered zebras in South Africa, they variously referred to them as horses, asses, or mules. This type of classification continued into the nineteenth century when mountain zebras were sometimes described as “asinine” and plains zebras as “equine.” Quaggas, a subspecies of the plains zebra with reduced striping and brown coloration that were occasionally used as draft animals, were considered by some observers to be the most equine zebras. This perception seems to have influenced the image of quaggas and led some artists to incorrectly portray them with horse-like tails that they did not possess. This article examines the designations “equine” and “asinine” as applied to plains zebras (including quaggas) and mountain zebras, and connects these terms to their representation by various artists.
Molecular characterization of the ACSS2 gene involved in adaptation to hypoxia in high-altitude cattle breeds
Authors: Zhao Han , Gao Yaping , Jiang Qiang , Wang Jinpeng , Liu Wenhao , Ju Zhihua , Wang Xiuge , Wei Xiaochao , Gao Yundong , Huang Jinming 
Published: October 2020

Abstract
Under extreme environmental conditions such as hypoxia, insufficient nutrition, and glucose deficiency, the acetyl-CoA synthetase 2 (ACSS2)-mediated acetyl-CoA synthesis pathway plays an alternative role to ensure the normal operation of metabolic activities. To investigate the potential effect of the ACSS2 gene on hypoxic adaptation and its regulatory mechanism of gene expression in high-altitude cattle breeds, we analyzed the genetic variations of the ACSS2 gene in five Bos taurus taurus, Bos taurus indicus, hybrid Bos taurus taurus × Bos taurus indicus Chinese cattle breeds, and two Bos grunniens (yak) breeds distributed at different altitudes (95-3850 m). A total of 58 SNPs was detected in seven populations, and abundant genetic variation was found in high-altitude breeds. We identified the bovine ACSS2 core promoter region between g.-682 and g.-264 by using the luciferase assay in FFB and HepG2 cells. We also identified that the high-altitude hypoxia-specific haplotype (CAGTCT) was composed of six highly linked SNPs. The tagSNP g.-473 T>C (rs23) is located in the core promoter of ACSS2 in the Bos taurus taurus and yak breeds. The recombinant plasmid containing rs23 and analyses of luciferase activity of different genotypes showed that the activity of ACSS2 promoter increased significantly when T was mutated to C. We also found a yak-specific SNP rs20 that consists of 12 base insertions (g.-562 ins GAAAGGACCCTA) in the promoter of yak breeds. Luciferase activity analysis showed that the insertion mutant significantly decreased the promoter activity of ACSS2. Hence, ACSS2 may play an important role in the adaptation to high-altitude hypoxia by generating adaptive alleles to influence gene transcription in cattle. These results signify that different genetic variants and haplotypes affect the activity of the core promoter to regulate ACSS2 gene expression and subsequently overcome and adapt to a high-altitude environment within different cattle breeds. Our findings may have important implications for understanding the mechanism of adaptation to high altitude and for application of molecular breeding in Bos species.
Turbulence and Mixing in the Arctic Ocean’s Amundsen Gulf
Authors: Scheifele Benjamin , Waterman Stephanie , Carpenter Jeffrey R. 
Published: October 2020

AbstractThis study uses CTD and microstructure measurements of shear and temperature from 348 glider profiles to characterize turbulence and turbulent mixing in the southeastern Beaufort Sea, where turbulence observations are presently scarce. We find that turbulence is typically weak: the turbulent kinetic energy dissipation rate ε has a median value (with 95% confidence intervals in parentheses) of 2.3 [2.2, 2.4] × 10−11 W kg−1 and is less than 1.0 × 10−10 W kg−1 in 68% of observations. Variability in ε spans five orders of magnitude, with indications that turbulence is bottom enhanced and modulated in time by the semidiurnal tide. Stratification is strong and frequently damps turbulence, inhibiting diapycnal mixing. Buoyancy Reynolds number estimates suggest that turbulent diapycnal mixing is unlikely in 93% of observations; however, a small number of strongly turbulent mixing events are disproportionately important in determining net buoyancy fluxes. The arithmetic mean diapycnal diffusivity of density is 4.5 [2.3, 14] × 10−6 m2 s−1, three orders of magnitude larger than that expected from molecular diffusion. Vertical heat fluxes are modest at O(0.1) W m−2, of the same order of magnitude as those in the Canada Basin double-diffusive staircase, however, staircases are generally not observed. Despite significant heat present in the Pacific Water layer in the form of a warm-core mesoscale eddy and smaller, O(1) km, temperature anomalies, turbulent mixing was found to be too low to release this heat to shallower depths.
Does Disruptive Event Affect Supply Base Size: Evidence from an Emerging Economy
Authors: Pant Pushpesh , Vishal Hari , Sarmah S. P. 
Published: October 2020

This article examines the effect of disruptive event, namely recession, on supply base management (measured by supply base size) by using a large and longitudinal dataset on Indian manufacturing firms. It is found that the buyer firms have increased their supply base size at the annual rate of 8.23 suppliers per year per manufacturer during the pre-recession (2004–2007) period. The strategy of having a larger supply base is viable, specifically, in an emerging economy (e.g., India) as the probability of disruptions is high due to the inadequacy of basic inputs such as physical infrastructure, logistics services, technology, etc. Therefore, manufacturers tend to have a number of suppliers for the same product group to reduce supplier dependence. Further, we find that buying firms preferred to have a larger supply base even after a recession (2010–2013). However, they have increased their supply base size at the annual rate of just 0.2 (compared to 8.3 during the pre-recession period) suppliers per year per manufacturer during the post-recession. This study highlights the importance of a disruptive event (proxied by recession), by examining its association with supply base size in the emerging economy perspective. JEL Codes: C1, C5, C8
The Impact of Nighttime on First Pass Success During the Emergent Endotracheal Intubation of Critically Ill Patients
Authors: Fein Daniel G. , Zhao Dawn , Swartz Kyle , Nauka Peter , Andrea Luke , Aboodi Michael , Shiloh Ariel L. , Eisen Lewis A. 
Published: October 2020

Background: While numerous investigations have described worse outcomes for patients undergoing emergent procedures at night, few studies have investigated the impact of nighttime on the outcomes of emergent endotracheal intubation (EEI). We hypothesized that for patients requiring EEI at night, the outcome of first pass success would be lower as compared to during the day. Methods: We performed a retrospective cohort study of all patients admitted to our institution between January 1st, 2016 and July 17st, 2019 who underwent EEI outside of an emergency department or operating room. Nighttime was defined as between 7:00 pm and 6:59 am. The primary outcome was the rate of first pass success. Logistic regression was utilized with adjustment for demographic, morbidity and procedure related covariables. Results: The final examined cohort included 1,674 EEI during the day and 1,229 EEI at night. The unadjusted rate of first pass success was not different between the day and night (77.5% vs. 74.6%, unadjusted odds ratio (OR): 0.85; 95% confidence interval (CI): 0.72, 1.0; P = 0.073 though following adjustment for prespecified covariables the odds of first pass success was lower at night (adjusted OR: 0.83, 95% CI: 0.69, 0.99; P = 0.042. Obesity was found to be an effect modifier on first pass success rate for day vs. night intubations. In obese patients, nighttime intubations had significantly lower odds of first pass success (adjusted OR: 0.71, 95% CI: 0.52, 0.98; P = 0.037). Discussion: After adjustment for patient and procedure related factors, we have found that the odds of first pass success is lower at night as compared to the day. This finding was, to some degree, driven by obesity which was found to be a significant effect modifier in this relationship.
Impact of aerosol enclosure barrier to videolaryngoscopic oro-tracheal intubation: A pilot manikin study
Authors: Hui Chun Fai , Li Alex , Wong Chi Keung Gordon 
Published: October 2020

Background: Personal protective equipment used for protection of healthcare workers in the combat against Severe Acute Respiratory Syndrome Coronavirus 2 pandemic is in limited supply worldwide at present – 2020. Use of barrier enclosure during endotracheal intubation can potentially act as a cost-effective adjunct to minimize risks of transmitting the infection to healthcare workers. However, there is concern that the enclosure itself will act as a barrier to the intubation procedure in the emergency settings. Objective: To evaluate the negative effect of barrier enclosure (an aerosol box) on the performance of video-assisted intubation in a manikin Methods: A total of 41 Emergency Department doctors from a local hospital were recruited to perform intubation in a manikin simulating normal and more difficult airways (Cormack-Lehane grades I and IIb) with and without the box. The primary outcome was time of successful intubation. The secondary outcomes were first-attempt success rate, number of successful attempts, need of adjuncts, dental injury and ease of intubation as perceived by the participants. Results: The aerosol box had no significant negative effect on the time of successful intubation (p = 0.630 (Grade I airway) and p = 0.436 (Grade IIb airway)), first-attempt success rate, number of successful attempts, need of adjuncts or dental injury. Participants subjectively reported extra yet minor challenges during intubation in the presence of the box. Conclusion: Within limits of the pilot study, the aerosol box had no statistical significant difference but an increasing trend of prolonged endotracheal intubation interval in the Grade IIb airway and negative impact on first-pass success, and could potentially be used to protect healthcare workers during the aerosol-generating intubation procedure.
Nasal Duplication: A Review of Literature and Case Report
Authors: Shen Chen , Shetye Pradip R. , Flores Roberto L. 
Published: October 2020

Introduction: Nasal duplication is a rare congenital deformity with many subtypes including supernumerary nostril. The challenge of surgical correction is to achieve nasal symmetry and restore nasal airflow. However, there is no defined protocol for treatment, especially with regard to presurgical therapy. Methods: We performed a review of literature of studies reporting on patients with supernumerary nostril to complete this review. We then report on a patient with supernumerary nostril who was treated with nostril expansion therapy prior to surgical intervention. Results: We identified 59 cases of nostril duplication. Because of the rarity of the condition, treatment protocols varied greatly. For our patient, preoperative nasal appliance therapy was implemented for 3 months prior to surgical intervention. Patient was followed-up regularly for 1 year. Discussion: Although literature on nasal duplication is scarce, there is a general agreement that early intervention has psychological, anatomic, and functional benefits to the patient. In our case report, nostril expansion therapy was easy to implement and facilitated surgical reconstruction, resulting in aesthetic outcome and expanded airway 1 year postoperatively.
Presurgical Alignment of Bilateral Cleft Segments With 3D Simulation Under Special Consideration of the Vomer: A Technical Note
Authors: Schmidt Gül , Heiland Max , Matuschek Carsten 
Published: October 2020

Background: The main goal of presurgical orthopedics (PSO) for patients with bilateral cleft lip and palate is to correct the protruded and/or twisted premaxilla. However, PSO is associated with the risk of uncontrolled development of the vomer, which has received little attention to date. Solution: We present a removable orthodontic device that can be used to keep or align the vomer and the premaxilla in the midline during preoperative molding of cleft segments independently and 3 dimensionally.
Examining Older Adults’ Attitudes and Perceptions of Cancer Screening and Overscreening: A Qualitative Study
Authors: Roy Siddhartha , Moss Jennifer L. , Rodriguez-Colon Sol M. , Shen Chan , Cooper Joie D. , Lennon Robert P. , Lengerich Eugene J. , Adelman Alan , Curry William , Ruffin Mack T. 
Published: October 2020

Introduction/Objectives: Screening guidelines for breast, cervical, and colorectal cancer (CRC) are less clear for older adults due to the potential harms that may result from screening. Understanding older adults’ attitudes and perceptions, especially racial/ethnic minority and underserved adults, of cancer screening can help health care providers determine how best to communicate with older adults about cancer screening and screening cessation. The objective of this study was to determine how older adults primarily from minority/underserved backgrounds perceive cancer screening and overscreening. Methods: Four focus groups (n = 39) were conducted with adults (>=65 years of age) in 3 community settings in south-central Pennsylvania. Two focus groups were conducted in Spanish and translated to English upon transcription. Focus group data was managed and analyzed using QSR NVivo 12. Inductive thematic analysis was used to analyze the data where themes emerged following the coding process. Results: The focus group participants had an average age of 74 years and were primarily female (74%) and Hispanic (69%), with 69% reporting having less than a high school degree. Four key themes were identified from the focus groups: (1) importance of tailored and targeted education/information; (2) impact of physician/patient communication; (3) impact of barriers and facilitators to screening on cancer screening cessation; and (4) awareness of importance of screening. Participants were more likely to be agreeable to screening cessation if they received specific information regarding their health status and previous medical history from their physician as to why screening should be stopped and told by their physician that the screening decision is up to them. Conclusions: Older adults prefer individualized information from their physician in order to justify screening cessation but are against incorporating life expectancy into the discussion. Future research should focus on developing interventions to test the effectiveness of culturally tailored screening cessation messages for older adults.
Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study
Authors: Korsten Koos , Adriaenssens Niels , Coenen Samuel , Butler Christopher , Ravanfar Behnaz , Rutter Heather , Allen Julie , Falsey Ann , Pirçon Jean-Yves , Gruselle Olivier , Pavot Vincent , Vernhes Charlotte , Balla-Jhagjhoorsingh Sunita , Öner Deniz , Ispas Gabriela , Aerssens Jeroen , Shinde Vivek , Verheij Theo , Bont Louis , Wildenbeest Joanne 
Published: October 2020

BackgroundRespiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.MethodsThis international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov,NCT03621930).ResultsWe recruited 1040 participants (527 in season 2017–2018 and 513 in season 2018–2019) with a median age of 75 years (range 60–100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms.ConclusionThis European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.
Tossing and turning: association of sleep quantity–quality with physical activity in COPD
Authors: Hirata Raquel Pastrello , Dala Pola Daniele Caroline , Schneider Lorena Paltanin , Bertoche Mariana Pereira , Furlanetto Karina Couto , Hernandes Nidia Aparecida , Mesas Arthur Eumann , Pitta Fabio 
Published: October 2020

The association between characteristics of sleep and physical activity in daily life (PADL) has not yet been investigated in depth in subjects with COPD. This study evaluated whether time spent per day in physical activity (PA) and sedentary behaviour are associated with sleep quantity and quality in this population.Sleep and PADL were objectively assessed by an activity monitor for 7 days and analysed on a minute-by-minute basis. Subjects also underwent spirometry and 6-min walking test (6MWT).Fifty-five subjects with moderate-to-severe COPD (28 male, 67±8 years) were studied. Subjects with total time in bed (TIB) per night ≥9 h had higher wake-after-sleep onset than TIB 7–9 h and TIB ≤7 h (195 (147–218)versus117 (75–167) and 106 (84–156) min) and more fragmented sleep than TIB ≤7 h (8.2 (6.7–14.3)versus6.3 (5.6–6.9) sleeping bouts; p<0.05 for all). Subjects with TIB ≥9 h also spent more time per day in sedentary behaviour and less time per day in PA of light and moderate-to-vigorous intensity than those with TIB 7–9 h and ≤7 h. In multiple linear regression, TIB ≥9 h was the only significant predictor of physical inactivity (β=−3.3 (−5.1, −1.6), p≤0.0001), accounting for 20% of its variation. Sleep fragmentation was frequent and more pronounced in physically inactive than active patients (7.5 (6.3–9.6)versus6.4 (5.5–7.3) sleeping bouts; p=0.027).In summary, subjects with COPD with TIB ≥9 h·night−1have more fragmented sleep, are more sedentary and less physically active than those with <9 h·night−1, independently of the awake time. Sleep quality is frequently poor and even worse in patients classified as physically inactive.
Sarcopenia in older people with chronic airway diseases: the Rotterdam study
Authors: Benz Elizabeth , Trajanoska Katerina , Schoufour Josje D. , Lahousse Lies , de Roos Emmely W. , Terzikhan Natalie , Medina-Gomez Carolina , Verhamme Katia , Williams Ross , Stricker Bruno H. , Franco Oscar H. , Ikram M. Arfan , Rivadeneira Fernando , Brusselle Guy 
Published: October 2020

Sarcopenia is a heterogeneous skeletal muscle disorder involving the loss of muscle mass and function. However, the prevalence of sarcopenia based on the most recent definition remains to be determined in older people with chronic airway diseases.The aim was to evaluate sarcopenia prevalence and association with chronic airway diseases and its lung function in an older population, using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria.We performed a cross-sectional analysis in 5082 participants (mean age 69.0±8.8 years, 56% females) from the Rotterdam Study. Participants with interpretable spirometry and an available assessment of sarcopenia were included. The appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS) were assessed using dual-energy X-ray absorptiometry (DXA) and a hydraulic hand dynamometer, respectively. We analysed the association between sarcopenia and chronic airway diseases by using regression models adjusted for age, sex, smoking status, total fat percentage and other relevant confounders.Participants with chronic airway diseases had higher prevalence of probable sarcopenia (12.0%, 95% CI 10.2–13.8) and confirmed sarcopenia (3.0%, 95% CI 2.1–3.9) than without. Chronic airway diseases were associated with “probable sarcopenia” (OR 1.28, 95% CI 1.02–1.60), “confirmed sarcopenia” (OR 2.13, 95% CI 1.33–3.43), reduced HGS (β −0.51 (−0.90–−0.11)) and reduced ASMI (β −0.19 (−0.25–−0.14)). Forced expiratory volume in 1 s <80% was associated with lower HGS (β −1.03 (−1.75–−0.31)) and lower ASMI (β −0.25 (−0.36–−0.15)) than forced expiratory volume in 1 s ≥80%.Sarcopenia was prevalent and associated with chronic airway diseases among older population. These results suggest the need for early diagnosis of sarcopenia in older people with chronic airway diseases by applying EWGSOP2 recommendations.