bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetic ketoacidosis drives COVID‐19 related hospitalizations in children with type 1 diabetes
Authors: Alonso Guy Todd , Ebekozien Osagie , Gallagher Mary Pat , Rompicherla Saketh , Lyons Sarah K. , Choudhary Abha , Majidi Shideh , Pinnaro Catherina T. , Balachandar Sadana , Gangat Mariam , Curda Roberts Alissa Jeanne , Marks Brynn E. , Creo Ana , Sanchez Janine , Seeherunvong Tossaporn , Jimenez‐Vega Jose , Patel Neha S. , Wood Jamie R. , Gabriel Liana , Sumpter Kathryn M. , Wilkes Meredith , Rapaport Robert , Cymbaluk Anna , Wong Jenise C. , Sanda Srinath , Albanese‐O'neill Anastasia 
Published: April 2021

AbstractBackgroundDiabetes is a risk factor for poor COVID‐19 outcomes, but pediatric patients with type 1 diabetes are poorly represented in current studies.MethodsT1D Exchange coordinated a US type 1 diabetes COVID‐19 registry. Forty‐six diabetes centers submitted pediatric cases for patients with laboratory confirmed COVID‐19. Associations between clinical factors and hospitalization were tested with Fisher's Exact Test. Logistic regression was used to calculate odds ratios for hospitalization.ResultsData from 266 patients with previously established type 1 diabetes aged <19 years with COVID‐19 were reported. Diabetic ketoacidosis (DKA) was the most common adverse outcome (n = 44, 72% of hospitalized patients). There were four hospitalizations for severe hypoglycemia, three hospitalizations requiring respiratory support (one of whom was intubated and mechanically ventilated), one case of multisystem inflammatory syndrome in children, and 10 patients who were hospitalized for reasons unrelated to COVID‐19 or diabetes. Hospitalized patients (n = 61) were more likely than nonhospitalized patients (n = 205) to have minority race/ethnicity (67% vs 39%, P < 0.001), public insurance (64% vs 41%, P < 0.001), higher A1c (11% [97 mmol/mol] vs 8.2% [66 mmol/mol], P < 0.001), and lower insulin pump and lower continuous glucose monitoring use (26% vs 54%, P < 0.001; 39% vs 75%, P < 0.001). Age and gender were not associated with risk of hospitalization. Higher A1c was significantly associated with hospitalization, with an odds ratio of 1.56 (1.34‐1.84) after adjusting for age, gender, insurance, and race/ethnicity.ConclusionsHigher A1c remained the only predictor for hospitalization with COVID‐19. Diabetic ketoacidosis is the primary concern among this group.
The history of pneumatic retinopexy: have we come full circle?
Authors: Fernández‐Vega González Alvaro , Muni Rajeev H. 
Published: April 2021

AbstractThe historical literature on the treatment of rhegmatogenous retinal detachment (RRD) was reviewed from 1911 to the present, focusing on the role of intravitreal air and gas. The history of the pneumatic retinopexy (PnR) technique is described from its original roots to the current day procedure. The treatment of RRD has evolved tremendously over the past century. The introduction of intravitreal gas as a tamponade to reattach the retina was critical in the development of modern day PnR. Although PnR is not a new technique, relatively recent randomized trials have demonstrated the numerous advantages of this procedure compared to pars plana vitrectomy (PPV) and scleral buckle. From a historical perspective, PnR has its origin in 1911 when Ohm performed intravitreal air injection after external subretinal fluid drainage in an attempt to treat RRD. The evolution of the procedure was driven by the introduction and experience with inert expansile intravitreal gas injections, and several great surgeons made critical contributions to the development of the procedure. There is substantial controversy pertaining to the original description of PnR in the literature. Credit has generally been given to Hilton and Grizzard from the United States, although Alfredo Dominguez from Spain published the first description of the procedure and he went to great lengths in an attempt to be rightfully recognized for this. The first randomized trial in retinal detachment repair was led by Dr. Paul Tornambe, comparing PnR to scleral buckle and an additional randomized trial was subsequently carried out demonstrating functional advantages of PnR compared to PPV.
Acquired severe aplastic anaemia: how medical therapy evolved in the 20th and 21st centuries
Authors: Scheinberg Phillip 
Published: April 2021

SummaryThe progress in aplastic anaemia (AA) management is one of success. Once an obscure entity resulting in death in most affected can now be successfully treated with either haematopoietic stem cell transplantation (HSCT) or immunosuppressive therapy (IST). The mechanisms that underly the diminution of haematopoietic stem cells (HSCs) are now better elucidated, and include genetics and immunological alterations. Advances in supportive care with better antimicrobials, safer blood products and iron chelation have greatly impacted AA outcomes. Working somewhat ‘mysteriously’, anti‐thymocyte globulin (ATG) forms the base for both HSCT and IST protocols. Efforts to augment immunosuppression potency have not, unfortunately, led to better outcomes. Stimulating HSCs, an often‐sought approach, has not been effective historically. The thrombopoietin receptor agonists (Tpo‐RA) have been effective in stimulating early HSCs in AA despite the high endogenous Tpo levels. Dosing, timing and best combinations with Tpo‐RAs are being defined to improve HSCs expansion in AA with minimal added toxicity. The more comprehensive access and advances in HSCT and IST protocols are likely to benefit AA patients worldwide. The focus of this review will be on the medical treatment advances in AA.
Insulin secretion is a strong predictor for need of insulin therapy in patients with new‐onset diabetes and HbA1c of more than 10%: A post hoc analysis of the EDICT study
Authors: Abdelgani Siham , Puckett Curtiss , Adams John , Triplitt Curtis , DeFronzo Ralph A. , Abdul‐Ghani Muhammad 
Published: April 2021

AbstractAimTo identify predictors of response to glucose‐lowering therapy in patients with new‐onset diabetes and very high HbA1c (>10%).MethodsThe study included EDICT participants with an initial HbA1c of more than 10% (N = 104). All subjects received a 75‐g oral glucose tolerance test (OGTT) before initiation of therapy, and then were randomized to receive: (a) initial triple therapy with metformin, pioglitazone and exenatide versus (b) stepwise conventional therapy with metformin followed by glipizide and then glargine insulin to reduce HbA1c to less than 6.5%. Insulin secretion and insulin resistance were calculated with OGTT‐derived indices.ResultsSixty‐one per cent of participants in the conventional therapy group achieved HbA1c of less than 6.5% at 6 months without need of insulin therapy compared with 78% in the triple therapy group (P = NS). Insulin secretion at baseline was the strongest predictor of subjects who did not require insulin therapy; a cut point of CPEP120/CPEP0—the ratio between plasma C‐peptide concentration at 120 minutes during the OGTT and fasting plasma C‐peptide concentration—of more than 1.7 predicted subjects who achieved the treatment target without insulin, irrespective of the fasting plasma glucose (FPG) concentration and whether or not they were started on conventional or triple therapy. Subjects with a CPEP120/CPEP0 of less than 1.7 plus FPG of 269 mg/dL or less (≤14.9 mmoL/L) also achieved the treatment goal with triple therapy.ConclusionInsulin secretion in response to a 75‐g OGTT predicts the need for insulin therapy at the time of type 2 diabetes (T2D) diagnosis. A cut point of 1.7 of CPEP120/CPEP0 provides a useful clinical tool to individualize glucose‐lowering therapy in patients with new‐onset T2D and HbA1c of more than 10%.
Management of cluster headache and other trigeminal autonomic cephalalgias in pregnancy and breastfeeding
Authors: Bjørk Marte‐Helene , Kristoffersen Espen Saxhaug , Tronvik Erling , Egeland Nordeng Hedvig Marie 
Published: April 2021

AbstractMany clinicians lack experience in managing trigeminal autonomic cephalalgias (TACs) in pregnancy and lactation. In addition to cluster headache, TACs include hemicrania continua, paroxysmal hemicrania, and short‐lasting unilateral neuralgiform headache with conjunctival injection and tearing/autonomic symptoms (SUNCT/SUNA). Treating these rare, severe headache conditions often requires off‐label drugs that have uncertain teratogenic potential. In the last few years, several new treatment options and safety documentation have emerged, but clinical guidelines are lacking. This narrative review aimed to provide an updated clinical guide and good clinical practice recommendations for the management of these debilitating headache disorders in pregnancy and lactation.
Youth perceptions and experiences of type 2 diabetes: Protocol for a collaborative knowledge translation approach and qualitative study
Authors: Archibald Mandy M. , Dart Allison , Wicklow Brandy , Pundyk Katherine J. , Marks Seth D. , Sellers Elizabeth A. C. 
Published: April 2021

AbstractAimsThe aim of this study is to generate an in‐depth understanding of youth perceptions and experiences of living with type 2 diabetes to inform knowledge translation, research and intervention development.DesignInterpretive descriptive qualitative study.MethodsTwenty to 25 youth aged 10–18 years with a diagnosis of type 2 diabetes will be purposively recruited through the Diabetes Education Resource for Children and Adolescents in Winnipeg, Manitoba, and through the Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch [iCARE] cohort. Socio‐demographic information will be collected. Semi‐structured interviews will occur iteratively with inductive thematic analysis. Data will be professionally transcribed and managed using NVivo 1.0 software. The University Ethics Committee approved this study (May 2020).DiscussionThere is a critical gap in understanding youth experiences of type 2 diabetes. Research involving youth with type 2 diabetes is predominantly quantitative in nature, largely reflecting risk factors, underlying mechanisms and treatment outcomes associated with diabetes management. In‐depth qualitative research on youth experiences can help identify youth priorities, provide insight into critical misalignments between stakeholder perspectives, and drive forward a more consolidated youth‐centred research agenda.ImpactUnderstanding and applying knowledge of youth experiences is critical as the prevalence of, and challenges associated with, youth onset type 2 diabetes continues to increase worldwide. This research will generate a robust interpretive description of youth lived experiences and perceptions of type 2 diabetes where such research is lacking, to inform basic and applied research within an interdisciplinary investigative and clinical research team with relevance to other jurisdictions. In response to calls for youth‐oriented research in type 2 diabetes, this work will catalyse collaborative knowledge translation using creative and youth‐directed initiatives.
Aquatic micro‐ and nano‐plastics in life cycle assessment: Development of an effect factor for the quantification of their physical impact on biota
Authors: Lavoie Jérôme , Boulay Anne‐Marie , Bulle Cécile 
Published: April 2021

AbstractPlastic litter of all sizes has been acknowledged as a serious threat to biodiversity, especially in the marine environment. The fact that life cycle assessment (LCA) does not properly consider these issues is a serious problem for the aspirations of LCA in the public sphere. This paper focuses on micro‐ and nano‐sized plastics (MNPs), which have the potential to cause a substantial impact on ecosystem quality because of their increased presence in the marine compartment and capacity to affect a greater range of species. The data regarding MNPs’ effect on different aquatic species were extracted from the academic literature. These data were then explored and analyzed to bring to light the possibilities in terms of effect factor (EF) developments and the existing relations between effect on aquatic ecosystems and different parameters such as particle size, polymer type, and shape. No significant difference could be observed between the effect of the different subgroups of MNPs tested when considering a single species. However, when including many species in the analysis, differences could be noted between polystyrene (PS) and other polymer types. The high uncertainty on the developed EFs combined with this lack of statistical difference among subgroups at the single species level suggest that the use of a single generic EF could be appropriate for now. This EF is provided along with Species Sensitivity Distributions developed to allow for a quick visualization of the gathered data used to generate the EFs. This EF can now be used to quantify the physical impact of all MNPs in life cycle impact assessment.
The natural history of insomnia: Does sleep extension differentiate between those that do and do not develop chronic insomnia?
Authors: Perlis Michael L. , Morales Knashawn H. , Vargas Ivan , Posner Donn A. , Grandner Michael A. , Muench Alexandria L. , Seewald Mark W. , Gooneratne Nalaka S. , Kloss Jacqueline D. , Gencarelli Amy M. , Khader Waliuddin S. , Thase Michael E. , Ellis Jason G. 
Published: April 2021

SummaryAccording to the “3P model” of insomnia, the variable that mediates the transition from acute insomnia (AI) to chronic insomnia is “sleep extension” (the behavioural tendency to expand sleep opportunity to compensate for sleep loss). In the present analysis, we sought to evaluate how time in bed (TIB) varies relative to the new onset of AI and chronic insomnia. A total of 1,248 subjects were recruited as good sleepers (GS). Subjects were monitored over 1 year with sleep diaries. State transitions were defined, a priori, for AI, recovered from AI (AI‐REC), and for chronic insomnia (AI‐CI). Two additional groupings were added based on profiles that were unanticipated: subjects that exhibited persistent poor sleep following AI (AI‐PPS [those that neither recovered or developed chronic insomnia]) and subjects that recovered from chronic insomnia (CI‐REC). All the groups (GS, AI‐REC, AI–CI, AI‐PPS and CI‐REC) were evaluated for TIB differences with longitudinal mixed effects models. Post hoc analyses for the percentage of the groups that were typed as TIB “restrictors, maintainers, and expanders” were conducted using longitudinal mixed effects models and contingency analyses. Significant differences for pre–post AI TIB were not detected for the insomnia groups. Trends were apparent for the AI‐CI group, which suggested that minor increases in TIB occurred weeks before the declared onset of AI. Additionally, it was found that a significantly larger percentage of AI‐CI subjects engaged in sleep extension (as compared to GS). The present data suggest that transition from AI to chronic insomnia does not appear to be initiated by sleep extension and the transition may occur before the elapse of 3 months of ≥3 nights of sleep continuity disturbance. Given these findings, it may be that the mismatch between sleep ability and sleep opportunity is perpetuated over time given the failure to “naturally” engage in sleep restriction (as opposed to sleep extension).
Evidence for role of capillaries in regulation of skeletal muscle oxygen supply
Authors: Ghonaim Nour W. , Fraser Graham M. , Goldman Daniel , Milkovich Stephanie , Yang Jun , Ellis Christopher G. 
Published: April 2021

AbstractHow oxygen (O2) supply to capillaries is regulated to match the tissue's demand is unknown. Erythrocytes have been proposed as sensors in this regulatory mechanism since they release ATP, a vasodilator, in an oxygen saturation (SO2)‐dependent manner. ATP causes hyperpolarization of endothelial cells resulting in conducted vasodilation to arterioles.ObjectiveWe propose individual capillary units can regulate their own O2 supply by direct communication to upstream arterioles via electrically coupled endothelium.MethodsTo test this hypothesis, we developed a transparent micro‐exchange device for localized O2 exchange with surface capillaries of intact tissue. The device was fabricated with an O2 permeable micro‐outlet 0.2 × 1.0 mm. Experiments were performed on rat extensor digitorum longus (EDL) muscle using dual wavelength video microscopy to measure capillary hemodynamics and erythrocyte SO2. Responses to local O2 perturbations were measured with only capillaries positioned over the micro‐outlet.ResultsStep changes in the gas mixture %O2 caused physiological changes in erythrocyte SO2, and appropriate changes in flow to offset the O2 challenge if at least 3–4 capillaries were stimulated.ConclusionThese results support our hypothesis that individual capillary units play a role in regulating their erythrocyte supply in response to a changing O2 environment.
Quality of alternatives positively associated with interest in opening up a relationship
Authors: MacDonald Geoff , Park Yoobin , Hayes Alathea , Vanasse Grosdidier Isabelle , Park Sun W. 
Published: April 2021

AbstractWe use the Investment Model framework to examine what relationship features are associated with interest in and positive evaluations of consensual non‐monogamy (CNM) among individuals in monogamous relationships. In data sets from the United States (Study 1), Europe (Study 2), and Korea (Study 3; total N = 886), perceptions of higher‐quality alternatives were consistently associated with more interest in CNM. Further, consistent with previous work on commitment‐motivated relationship maintenance processes, we found support for an indirect effect whereby lower commitment was associated with higher perceived attractiveness of alternatives, which in turn was associated with more interest in CNM. The data suggest that the idea of CNM is likely to be most attractive to those who see themselves as having higher‐quality relationship options.
Diagnostic performance of routine electrophoresis and immunofixation for the detection of immunoglobulin paraproteins (M‐Proteins) in dogs with multiple myeloma and related disorders: Part 2—Toward improved diagnostic performance
Authors: Moore A Russell , Harris R. Adam , Jeffries Christina , Ashton Laura , Avery Paul R. 
Published: April 2021

AbstractBackgroundThe diagnostic performance of routine electrophoresis (agarose gel electrophoresis [AGE] and capillary zone electrophoresis [CZE]) and species‐specific immunofixation (IF) for the detection of immunoglobulin paraproteins (M‐proteins) and diagnosis of secretory myeloma‐related disorders (sMRD) can be improved. Available canine IF targets were IgG‐FC, IgA, IgM, light chain (LC), IgG4, and free LC (fLC) antibodies.ObjectiveWe aimed to review specific features associated with the presence of M‐proteins in canine serum samples and the common features causing inaccurate reporting of M‐proteins to improve the diagnostic performance of routine electrophoresis and IF for the detection of M‐proteins.MethodsFeatures found in AGE, CZE, routine IF, IgG4 IF, and fLC IF of 100 canine serum samples from Part 1 of this study were evaluated by simple and multivariate logistic regression to identify factors associated with the presence of M‐proteins. Cases falsely called negative or positive for M‐proteins were reviewed to identify the common features that could be used to increase the diagnostic performance of SPE and IF for M‐protein detection.ResultsThe presence of hypogammaglobulinemia or any peak taller than albumin was associated with an M‐protein. Total protein concentrations, globulin concentrations, or peaks wider than albumin were not associated with an M‐protein. Free LC sMRD cases were not diagnosed by SPE and routine IF. Cases with infectious and inflammatory etiologies had a restricted polyclonal gammopathy with multiple γ‐globulin restrictions resulting in some false‐positive results. SPE combined with all available IF results and the specific features identified in this study had an estimated sensitivity of 95.1% and specificity of 81.4%.ConclusionsThe identified criteria of this study increase the diagnostic performance of the electrophoretic evaluation for M‐proteins.
Comparison of 18F‐sodium fluoride positron emission tomography and CT: An exploratory study in 12 dogs with elbow pain
Authors: McLarty Ehren , Spriet Mathieu , Beylin David , Chou Po‐Yen , Filliquist Barbro , Marcellin‐Little Denis J. , Kapatkin Amy S. 
Published: April 2021

Abstract18F‐Sodium Fluoride (18F‐NaF) positron emission tomography (PET) provides high resolution functional information about bone activity and can be fused with CT images to improve three‐dimensional localization and characterization of lesions. This prospective, observational study assessed 18F‐NaF PET‐CT for imaging of canine elbows, compared PET with CT findings, and assessed correlation with lameness. Twelve patients with elbow pain were included. Cases included primarily young, large breed dogs. A three‐level clinical lameness score was assigned to each forelimb. All dogs had bilateral elbow joints imaged with CT and PET under general anesthesia, approximately 1.5 h after intravenous injection of 3 MBq/kg of 18F‐NaF. Imaging findings were independently reviewed by two radiologists using a three‐level scoring scheme over nine anatomical regions in the elbow. PET imaging identified areas of bone activity where minimal change was identified on CT. PET imaging also demonstrated absence of uptake in areas where modeling was present on CT. A stronger correlation was observed between clinical grades and PET scores (r2 = 0.38, P = .001) than between clinical grades and CT scores (r2 = 0.17, P = .048). The total PET scores were significantly different for each clinical grade (P = .013) but total CT scores did not differ (P = .139). This exploratory study suggests that PET improves the ability to detect lesions and to determine the clinical significance of CT findings in dogs with elbow pain.
Mentorship and workplace support needs of new graduate physiotherapists in rural and remote settings: A qualitative study
Authors: Martin Romany Anne , Mandrusiak Allison , Lu Andric , Forbes Roma 
Published: April 2021

Introduction: New graduate physiotherapists working in rural and remote Australia must develop unique skills to work in this setting, while at the same time managing the difficulties typically faced by novice practitioners entering the workforce. Workplace mentorship is commonly used to facilitate this transition, yet little is known about new graduate physiotherapists’ needs in rural and remote settings. This study aimed to explore workplace mentorship in rural and remote Australia from the perspective of new graduate physiotherapists and investigate what new graduates feel they need from mentorship that is specific to rural and remote settings.Methods: A qualitative study with a thematic analytical approach was used. Semi-structured interviews of 12 new graduate physiotherapists working in rural and remote settings were undertaken within the graduates’ first 8 to 10 months of clinical practice. Interviews were audio-recorded between August and November 2019.Results: Three key themes were constructed during the analysis: 1) Mentorship is best when it is frequent and consistent, 2) Initiating mentorship can be challenging and 3) Mentorship needs to be accessible and individualised.Conclusion: There are challenges to mentorship of new graduate physiotherapists in rural and remote areas, including infrequency of mentorship, limited access to mentors and reluctance to request support. Whilst new graduate physiotherapists desire mentorship that is accessible, individualised and, ultimately, similar to what they perceive they would receive in the metropolitan setting, they acknowledge that to suit rural and remote localities, the delivery must be flexible. Mentorship is considered critical to support new graduates entering rural and remote settings.