bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual HRD’s Role in Crisis and the Post Covid-19 Professional Lifeworld: Accelerating Skills for Digital Transformation
Authors: Bennett Elisabeth E. , McWhorter Rochell R. 
Published: January 2021

The Problem. The Covid-19 pandemic brought unprecedented crisis to a world already undergoing digital transformation. Millions of people began working virtually to prevent the spread of disease and to maintain business continuity, suddenly participating in virtual human resource development (VHRD) and alternative work strategies that helped organizations adapt to current challenges and prepare for future disruption. The purpose of this article is to analyze VHRD’s role in the crisis and the transition to a new era marked by further disruption and change. The Recommendation. This article provides a primer for understanding the environmental perspective of VHRD, analyzes reskilling and upskilling trends during the pandemic and for early stages of the fourth industrial revolution, and addresses learning, adaptation, cultural, workplace, and economic implications. We argue that many of the changes to the workplace were already underway, but the pandemic has accelerated transformation. For this reason, organizations must anticipate more digital transformation, strategize VHRD, and leverage learning assets to prepare for the future. The Stakeholders. This article is of interest to those helping their organizations to not only recover from crisis, but to thrive in a new era of work that is being fundamentally transformed by technology. The audience includes organizational leaders, HRD professionals, workers, scholars, as well as school personnel seeking to prepare learners for future career conditions.
New Biparietal Bipolar Catheter Prototype for Hybrid Atrial Fibrillation Ablation
Authors: Matteucci Francesco , Maesen Bart , De Asmundis Carlo , Parise Gianmarco , Micali Linda Renata , Tuijthof Gabrielle , Gerits Peter , Vernooy Kevin , Maessen Jos G. , La Meir Mark , Gelsomino Sandro 
Published: January 2021

Objective To evaluate the size and depth of linear lesions by in vitro testing with a custom-made radio frequency biparietal bipolar ablation catheter in a single-stage setting. Methods A custom-made catheter was created to generate linear lesions around the left atrium and pulmonary veins of an ex vivo pig. Two frames were made, 1 epicardial and 1 endocardial. A continuous copper braid electrode and an alignment system consisting of 2 parallel rows of neodymium magnets were embedded in a flexible plastic support. After 24 hours of formalin conservation, samples of the left atrium of a freshly slaughtered pig were sliced in a cryotome, thus obtaining a sequence of 100-µm thick layers extending from the endocardial to the epicardial side. After being digitized through a scanner, these layers were evaluated using morphometric computer software. For each slice, we evaluated the maximum length of the lesions, the maximum epicardial length, the maximum endocardial length, the total area of the lesion, and the total volume. Results Forty transmural lesions from 40 specimens were obtained. The results were the following (the number in parenthesis is the interquartile range in mm): lesion maximum length ( L MAX) was 7.297 mm (0.006), epicardial maximum length ( L EPI) was 7.291 mm (0.014), and endocardial maximum length was 7.291 mm (0.018). The total area and total volume were 1018.50 ± 36.51 mm2 and 101.85 ± 3.65 mm3, respectively. Conclusions Our prototype showed very promising results. The next step will be to enhance the design for clinical application.
Single Versus Dual Headless Compression Screw Fixation of Scaphoid Nonunions: A Biomechanical Comparison
Authors: Nicholson Luke T. , Sochol Kristen M. , Azad Ali , Alluri Ram Kiran , Hill J. Ryan , Ghiassi Alidad 
Published: January 2021

Background: Management of scaphoid nonunions with bone loss varies substantially. Commonly, internal fixation consists of a single headless compression screw. Recently, some authors have reported on the theoretical benefits of dual-screw fixation. We hypothesized that using 2 headless compression screws would impart improved stiffness over a single-screw construct. Methods: Using a cadaveric model, we compared biomechanical characteristics of a single tapered 3.5- to 3.6-mm headless compression screw with 2 tapered 2.5- to 2.8-mm headless compression screws in a scaphoid waist nonunion model. The primary outcome measurement was construct stiffness. Secondary outcome measurements included load at 1 and 2 mm of displacement, load to failure for each specimen, and qualitative assessment of mode of failure. Results: Stiffness during load to failure was not significantly different between single- and double-screw configurations ( P = .8). Load to failure demonstrated no statistically significant difference between single- and double-screw configurations. Using a qualitative assessment, the double-screw construct maintained rotational stability more than the single-screw construct ( P = .029). Conclusions: Single- and double-screw fixation constructs in a cadaveric scaphoid nonunion model demonstrate similar construct stiffness, load to failure, and load to 1- and 2-mm displacement. Modes of failure may differ between constructs and represent an area for further study. The theoretical benefit of dual-screw fixation should be weighed against the morphologic limitations to placing 2 screws in a scaphoid nonunion.
Direct carotid exposure approach in the treatment of anterior circulation unruptured intracranial aneurysms for elderly patients
Authors: Maruyama Fumiaki , Ishibashi Toshihiro , Kato Naoki , Karagiozov Kostadin , Kan Issei , Kodama Tomonobu , Murayama Yuichi 
Published: January 2021

Background and purpose The direct carotid exposure approach (DCEA) is a technical option for elderly patients with severe vessel tortuosity due to arteriosclerosis. We evaluated complications related to antiplatelet/anticoagulant management and compared the DCEA to standard transfemoral/transbrachial approaches (TFBA) in the treatment of unruptured intracranial aneurysms for elderly patients. Methods From August 2017 to August 2020, 52 patients (53 procedures) aged over 75 years with unruptured aneurysms in the anterior circulation were treated at our institution. All patients received dual antiplatelet drugs before the procedure. Eleven patients (21.2%) (12 procedures) were treated with the DCEA. The rest were treated with TFBA. The main indication of the DCEA was an unfavorable aortic arch or vessel tortuosity. Complications and the duration of the procedure were compared between the two groups. Results There were no significant differences between the two groups in age, aneurysm location, preoperative antiplatelet use, heparin use, or maximum activated clotting time (ACT) values. All endovascular treatments were successfully performed by DCEA. Among all parameters, the DCEA group had only bigger average aneurysm diameter (14 mm) and higher number of pipeline embolic device (PED) placement (58%). Time to the guiding-catheter placement was not significantly different between the groups (DCEA vs TFBA = 31.0 min vs 24.7 min, p = 0.178).　No significant complications of DCEA, such as subcutaneous hematomas, were observed.　 Conclusion Even with the use of antiplatelet and anticoagulation therapy, the DCEA can be performed safely for unruptured aneurysms in elderly patients.
Timing of Acute Stroke in COVID-19—A Health System Registry Study
Authors: Migdady Ibrahim , Shoskes Aaron , Hasan Leen Z. , Hassett Catherine , George Pravin , Newey Christopher , Cho Sung-Min , Rae-Grant Alexander , Uchino Ken 
Published: January 2021

Background and Purpose: The association between SARS-CoV-2 infection and stroke remains unknown. We aimed to compare the characteristics of stroke patients who were hospitalized with Coronavirus Disease 2019 (COVID-19) based on the timing of stroke diagnosis. Methods: We performed a retrospective analysis of adult patients in a health system registry of COVID-19 who were hospitalized and had imaging-confirmed acute stroke during hospitalization. Baseline characteristics and hospital outcomes were collected and analyzed. Results: Out of 882 COVID-19 patients who were hospitalized between March 9 to May 17, 2020, 14 patients (2% of all COVID-19 patients and 21% of those who underwent imaging) presented with stroke or developed stroke during hospitalization. Eleven had acute ischemic stroke (AIS) and 3 had acute hemorrhagic stroke. Six patients (43%) presented to the hospital with acute stroke symptoms and were found to have SARS-CoV-2. Compared to patients who presented with AIS, more patients with AIS during hospitalization were male, of older age, had pneumonia and acute respiratory distress syndrome, were severely ill, and had high inflammatory and thrombotic markers (including C reactive protein, D dimer, ferritin, and fibrinogen). Among all patients, hospital mortality was high (50%) and the majority of patients who were discharged had poor neurological outcome. Conclusions: A distinction should be made between patients who present with acute stroke with concurrent SARS-CoV-2 infection and those who develop stroke as a complication of severe COVID-19. It is likely that a subset of stroke patients will incidentally test positive for the virus given the widespread pandemic.
How Do Capital Ratios Affect Bank Risk-Taking: New Evidence From the United States
Authors: Abbas Faisal , Masood Omar , Ali Shoaib , Rizwan Sohail 
Published: January 2021

This study aims to examine the impact of different capital ratios on Non-Performing loans, Loan Loss Reserves, and Risk-Weighted Assets by studying large commercial banks of the United States. The study employed a two-step system generalized method of movement (GMM) approach by collecting the data over the period ranging from 2002 to 2018. The study finds that using Non-Performing loans and Loan Loss Reserves as a proxy for risk, results support moral hazard hypothesis theory, whereas the results support regulatory hypothesis theory when Risk-Weighted Assets is used as a proxy for risk. The results confirm that the influence of high-quality capital on Non-Performing loans, Loan Loss Reserves, and Risk-Weighted Assets is substantial. The distinctive signs of Non-Performing loans, Loan Loss Reserves, and Risk-Weighted Assets have indications for policymakers. The results are intimate for formulating new guidelines regarding risk mitigation to recognize Non-Performing loans and Loan Loss Reserves and the Risk-Weighted Assets for better results. JEL Classification: G21, G28, G29
Arthroscopic-assisted percutaneous fixation of intra-articular calcaneal fractures using an intraoperative distraction device
Authors: Gao Di , Wong Tak Man , Fang Christian , Leung Frankie KL , Li Xiang , Jia Bin , Wang Yu , Yu Bin 
Published: January 2021

Purpose: To evaluate the quality of reduction and clinical outcomes by using Percutaneous Distractor and Subtalar Arthroscopy Closed Reduction followed by Internal Fixation (PDSA-CRIF) in the intra-articular calcaneal fracture. Methods: A consecutive case series of 453 patients with 507 displaced intra-articular calcaneal fractures was recruited in this retrospective study. We performed PDSA-CRIF to treat intra-articular calcaneal fractures. The quality of reduction was assessed by early postoperative Computed Tomography (CT) scans and measurement of serial Bohler’s angles during follow-ups. Clinical outcomes were evaluated by Visual Analogue Scale (VAS) and the American Foot & Ankle Society ankle-hind foot scale (AOFAS) scoring system. Results: Fifty-nine patients (68 fractures) who had complete clinical data and follow-up of at least 12-months (mean: 14 months, range: 12–59 months) were finally included. Anatomical and near-anatomical reduction in subtalar articular surface which had less than 2 mm gap or step-off was found in 93% fractures. Unsatisfactory reduction was found in 7%. Conclusion: Arthroscopic-assisted percutaneous fixation using a distraction device is effective in achieving positive short-term results in the displaced intra-articular calcaneal fractures. A multicenter, large sample, randomized control trial is needed to fully evaluate the long-term effects of PDSA-CRIF in comparison to other methods.
Enhancing Patient Experience in Office‐Based Laryngology Procedures With Passive Virtual Reality
Authors: Chang Joseph , Ninan Sen , Liu Katherine , Iloreta Alfred Marc , Kirke Diana , Courey Mark 
Published: January 2021

ObjectivesVirtual reality (VR) has been used as nonpharmacologic anxiolysis benefiting patients undergoing office‐based procedures. There is little research on VR use in laryngology. This study aims to determine the efficacy of VR as anxiolysis for patients undergoing in‐office laryngotracheal procedures.Study DesignRandomized controlled trial.SettingTertiary care center.MethodsAdult patients undergoing office‐based larynx and trachea injections, biopsy, or laser ablation were recruited and randomized to receive standard care with local anesthesia only or local anesthesia with adjunctive VR. Primary end point was procedural anxiety measured by the Subjective Units of Distress Scale (SUDS). Subjective pain, measured using a visual analog scale, satisfaction scores, and procedure time, and baseline anxiety, measured using the Hospital Anxiety and Depression Scale (HADS), were also collected.ResultsEight patients were randomized to the control group and 8 to the VR group. SUDS scores were lower in the VR group than in the control group with mean values of 26.25 and 53.13, respectively (P =. 037). Baseline HADS scores did not differ between groups. There were no statistically significant differences in pain, satisfaction, or procedure time. Average satisfaction scores in VR and control groups were 6.44 and 6.25, respectively (P =. 770). Average pain scores were 3.53 and 2.64, respectively (P =. 434).ConclusionThis pilot study suggests that VR distraction may be used as an adjunctive measure to decrease patient anxiety during office‐based laryngology procedures. Procedures performed using standard local anesthesia resulted in low pain scores and high satisfaction scores even without adjunctive VR analgesia.Level of Evidence1
Serum and pulmonary uric acid in pulmonary arterial hypertension
Authors: Savale Laurent , Akagi Satoshi , Tu Ly , Cumont Amélie , Thuillet Raphaël , Phan Carole , Le Vely Benjamin , Berrebeh Nihel , Huertas Alice , Jaïs Xavier , Cottin Vincent , Chaouat Ari , Tromeur Cécile , Boucly Athénaïs , Jutant Etienne Marie , Mercier Olaf , Fadel Elie , Montani David , Sitbon Olivier , Humbert Marc , Tamura Yuichi , Guignabert Christophe 
Published: January 2021

Previous studies have suggested an association between uric acid (UA) and the severity of pulmonary arterial hypertension (PAH), but it is unknown whether UA contributes to disease pathogenesis.The aim of this study was to determine the prognostic value of circulating UA in the era of current management of PAH and to investigate the role of UA in pulmonary vascular remodelling.Serum UA levels were determined in idiopathic, heritable or anorexigen PAH at baseline and first re-evaluation in the French Pulmonary Hypertension Network. We studied protein levels of xanthine oxidase (XO) and the voltage-driven urate transporter 1 (URATv1) in lungs of control and PAH patients and of monocrotaline (MCT) and Sugen/hypoxia (SuHx) rats. Functional studies were performed using human pulmonary artery smooth muscle cells (PA-SMCs) and two animal models of pulmonary hypertension (PH).High serum UA levels at first follow-up, but not at baseline, were associated with a poor prognosis. Both the generating enzyme XO and URATv1 were upregulated in the wall of remodelled pulmonary arteries in idiopathic PAH patients and MCT and SuHx rats. High UA concentrations promoted a mild increase in cell growth in idiopathic PAH PA-SMCs, but not in control PA-SMCs. Consistent with these observations, oxonic acid-induced hyperuricaemia did not aggravate MCT-induced PH in rats. Finally, chronic treatment of MCT and SuHx rats with benzbromarone mildly attenuated pulmonary vascular remodelling.UA levels in idiopathic PAH patients were associated with an impaired clinical and haemodynamic profile and might be used as a non-invasive indicator of clinical prognosis during follow-up. Our findings also indicate that UA metabolism is disturbed in remodelled pulmonary vascular walls in both experimental and human PAH.
Exercise training in COPD: muscle O2transport plasticity
Authors: Broxterman Ryan M. , Wagner Peter D. , Richardson Russell S. 
Published: January 2021

Both convective oxygen (O2) transport to, and diffusive transport within, skeletal muscle are markedly diminished in patients with COPD. However, it is unknown how these determinants of peak muscle O2uptake (V′mO2peak) respond to exercise training in patients with COPD. Therefore, the purpose of this study was to assess the plasticity of skeletal muscle O2transport determinants ofV′mO2peakin patients with COPD.Adaptations to 8 weeks of single-leg knee-extensor exercise training were measured in eight patients with severe COPD (mean±semforced expiratory volume in 1 s (FEV1) 0.9±0.1 L) and eight healthy, well-matched controls. Femoral arterial and venous blood samples, and thermodilution-assessed leg blood flow were used to determine muscle O2transport and utilisation at maximal exercise pre- and post-training.Training increasedV′mO2peakin both COPD (by ∼26% from 271±29 to 342±35 mL·min−1) and controls (by ∼32% from 418±37 to 553±41 mL·min−1), restoringV′mO2peakin COPD to only ∼80% of pre-training controlV′mO2peak. Muscle diffusive O2transport increased similarly in both COPD (by ∼38% from 6.6±0.9 to 9.1±0.9 mL·min−1·mmHg−1) and controls (by ∼36% from 10.4±0.7 to 14.1±0.8 mL·min−1·mmHg−1), with the patients reaching ∼90% of pre-training control values. In contrast, muscle convective O2transport increased significantly only in controls (by ∼26% from 688±57 to 865±69 mL·min−1), leaving patients with COPD (438±45versus491±51 mL·min−1) at ∼70% of pre-training control values.While muscle diffusive O2transport in COPD was largely restored by exercise training,V′mO2peakremained constrained by limited plasticity in muscle convective O2transport.
Mechanisms associated with increased physical activity in patients undergoing self-management behaviour modification in the randomised PHYSACTO trial
Authors: Bourbeau Jean , Sedeno Maria , Li Pei Zhi , Troosters Thierry , Hamilton Alan , De Sousa Dorothy , Maltais François , Erzen Damijan , Lavoie Kim L. 
Published: January 2021

IntroductionIn this analysis of the PHYSACTO® study, we assessed the efficacy of a self-management behaviour modification (SMBM) programme to improve physical activity (PA) levels, and the extent to which effects were mediated by readiness to change, motivation and confidence.MethodsPHYSACTO® was a randomised, partially double-blind, parallel-group, 12-week trial to evaluate the effects of treatment on exercise capacity and PA. COPD patients received placebo, tiotropium 5 µg or tiotropium/olodaterol 5/5 µg, with or without exercise training, all with an SMBM intervention (the Living Well with COPD programme). Changes were assessed in readiness to change (stage of change visual analogue scale [VAS]), motivation (Treatment Self-Regulation Questionnaire [TSRQ]) and confidence (Perceived Competence Scale [PCS]) to engage in PA.ResultsPA was increased in all patients with complete PA data at Week 12 (n=262; +6038 steps·week−1, p<0.001). Significant increases were observed in patients' readiness to change (VAS 0.7 [0.6–0.8]), autonomous regulation (TRSQ 0.2 [0.1–0.3]) and confidence (PCS 0.5 [0.3–0.6]) (all p<0.01). Of note, 23% of the total effect of SMBM on steps·week−1was found to be mediated by increases in readiness to change, 5% by TSRQ autonomous regulation and 12% by PCS.ConclusionOur study demonstrated that an SMBM programme delivered to COPD patients increased PA, mediated by an improvement of three key hypothesised mechanisms of change: readiness to change, autonomous motivation and confidence. For the first time, this study shows that an SMBM programme can be successful in altering the mechanisms of change targeted by the intervention.
Lumacaftor/ivacaftor changes the lung microbiome and metabolome in cystic fibrosis patients
Authors: Neerincx Anne H. , Whiteson Katrine , Phan Joann L. , Brinkman Paul , Abdel-Aziz Mahmoud I. , Weersink Els J.M. , Altenburg Josje , Majoor Christof J. , Maitland-van der Zee Anke H. , Bos Lieuwe D.J. 
Published: January 2021

RationaleTargeted cystic fibrosis (CF) therapy with lumacaftor/ivacaftor partly restores chloride channel function and improves epithelial fluid transport in the airways. Consequently, changes may occur in the microbiome, which is adapted to CF lungs.ObjectivesTo investigate the effects of lumacaftor/ivacaftor on respiratory microbial composition and microbial metabolic activity by repeatedly sampling the lower respiratory tract.MethodsThis was a single-centre longitudinal observational cohort study in adult CF patients with a homozygous Phe508del mutation. Lung function measurements and microbial cultures of sputum were performed as part of routine care. An oral and nasal wash, and a breath sample, were collected before and every 3 months after starting therapy, for up to 12 months.ResultsTwenty patients were included in this study. Amplicon 16S RNA and metagenomics sequencing revealed thatPseudomonas aeruginosawas most abundant in sputum and seemed to decrease after 6 months of treatment, although this did not reach statistical significance after correction for multiple testing. Two types of untargeted metabolomics analyses in sputum showed a change in metabolic composition between 3 and 9 months that almost returned to baseline levels after 12 months of treatment. The volatile metabolic composition of breath was significantly different after 3 months and remained different from baseline until 12 months follow-up.ConclusionsAfter starting CF transmembrane conductance regulator (CFTR) modulating treatment in CF patients with a homozygous Phe508del mutation, a temporary and moderate change in the lung microbiome is observed, which is mainly characterised by a reduction in the relative abundance ofPseudomonas aeruginosa.
The International Federation for Emergency Medicine report on emergency department crowding and access block: a brief summary
Authors:   on behalf of the IFEM Task Force on Emergency Department Crowding and Access Block, Javidan A. P. , Hansen K. , Higginson I. , Jones P. , Lang E. 
Published: January 2021

Abstract
Objective
To develop comprehensive guidance that captures international impacts, causes, and solutions related to emergency department crowding and access block

Methods
Emergency physicians representing 15 countries from all IFEM regions composed the Task Force. Monthly meetings were held via video-conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020.

Results
A total of 14 topic dossiers, each relating to an aspect of ED crowding, were researched and completed collaboratively by members of the Task Force.

Conclusions
The IFEM report is a comprehensive document intended to be used in whole or by section to inform and address aspects of ED crowding and access block. Overall, ED crowding is a multifactorial issue requiring systems-wide solutions applied at local, regional, and national levels. Access block is the predominant contributor of ED crowding in most parts of the world.