bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural History and Clinical Outcomes of Paravertebral Arteriovenous Shunts
Authors: Feng Yueshan , Yu Jiaxing , Xu Jiankun , He Chuan , Bian Lisong , Li Guilin , Ye Ming , Hu Peng , Sun Liyong , Jiang Nan , Ling Feng , Hong Tao , Zhang Hongqi 
Published: August 2021

Background and Purpose:
Paravertebral arteriovenous shunts (PVAVSs) are rare. Whether the intradural venous system is involved in drainage may lead to differences in clinical characteristics through specific pathophysiological mechanisms. This study aims to comprehensively evaluate the natural history and clinical outcomes of PVAVSs with or without intradural drainage.

Methods:
Sixty-four consecutive patients with PVAVSs from 2 institutes were retrospectively reviewed. Lesions were classified as type A (n=28) if the intradural veins were involved in drainage; otherwise, they were classified as type B (n=36). The clinical course from initial presentation to the last follow-up was analyzed.

Results:

The patients with type A shunts were older at presentation (52.5 versus 35.5 years,
P
<0.0001) and more likely to have lower spinal segments affected than patients with type B PVAVSs (67.8% versus 13.9%,
P
=0.00006). After presentation, the deterioration rates related to gait and sphincter dysfunction were significantly higher in patients with type A than type B shunts (gait dysfunction: 71.8%/y versus 17.0%/y,
P
=0.0006; sphincter dysfunction: 63.7%/y versus 11.3%/y,
P
=0.0002). According to the angiogram at the end of the latest treatment, 79% of type A and 75% of type B PVAVSs were completely obliterated. If the lesions were partially obliterated, a significantly higher clinical deterioration rate was observed in patients with type A shunts than those with type B shunts (69.9%/y versus 3.2%/y,
P
=0.0253).

Conclusions:
Type A PVAVSs feature rapid progressive neurological deficits; therefore, early clinical intervention is necessary. For complex lesions that cannot be completely obliterated, surgical disconnection of all refluxed radicular veins is suggested.
Anthropogenic Influences on Tornadic Storms
Authors: Bercos-Hickey Emily , Patricola Christina M. , Gallus William A. 
Published: August 2021

AbstractThe impact of climate change on severe storms and tornadoes remains uncertain, largely owing to inconsistencies in observational data and limitations of climate models. We performed ensembles of convection-permitting climate model simulations to examine how three tornadic storms would change if similar events were to occur in pre-industrial and future climates. The choice of events includes winter, nocturnal, and spring tornadic storms to provide insight into how the timing and seasonality of storms may affect their response to climate change. Updraft helicity (UH), convective available potential energy (CAPE), storm relative helicity (SRH), and convective inhibition (CIN) were used to determine the favorability for the three tornadic storm events in the different climate states. We found that from the pre-industrial to present, the potential for tornadic storms decreased in the winter event and increased in the nocturnal and spring events. With future climate change, the potential for tornadic storms increased in the winter and nocturnal events in association with increased CAPE, and decreased in the spring event despite greater CAPE.
This Is Your Brain on Autopilot: Neural Indices of Driver Workload and Engagement During Partial Vehicle Automation
Authors: McDonnell Amy S. , Simmons Trent G. , Erickson Gus G. , Lohani Monika , Cooper Joel M. , Strayer David L. 
Published: August 2021

Objective This research explores the effect of partial vehicle automation on neural indices of mental workload and visual engagement during on-road driving. Background There is concern that the introduction of automated technology in vehicles may lead to low driver stimulation and subsequent disengagement from the driving environment. Simulator-based studies have examined the effect of automation on a driver’s cognitive state, but it is unknown how the conclusions translate to on-road driving. Electroencephalographic (EEG) measures of frontal theta and parietal alpha can provide insight into a driver’s mental workload and visual engagement while driving under various conditions. Method EEG was recorded from 71 participants while driving on the roadway. We examined two age cohorts, on two different highway configurations, in four different vehicles, with partial vehicle automation both engaged and disengaged. Results Analysis of frontal theta and parietal alpha power revealed that there was no change in mental workload or visual engagement when driving manually compared with driving under partial vehicle automation. Conclusion Drivers new to the technology remained engaged with the driving environment when operating under partial vehicle automation. These findings suggest that the concern surrounding driver disengagement under vehicle automation may need to be tempered, at least for drivers new to the experience. Application These findings expand our understanding of the effects of partial vehicle automation on drivers’ cognitive states.
Construct validity of the enfranchisement scale of the community participation indicators
Authors: Kersey Jessica , Terhorst Lauren , Heinemann Allen W , Hammel Joy , Baum Carolyn , McCue Michael , Skidmore Elizabeth R 
Published: August 2021

Objective: This study examined the construct validity of the Enfranchisement scale of the Community Participation Indicators. Design: We conducted a secondary analysis of data collected in a cross-sectional study of rehabilitation outcomes. Subjects: The parent study included 604 community-dwelling adults with chronic traumatic brain injury, stroke, or spinal cord injury. The sample had a mean age of 64.1 years, was two-thirds male, and included a high proportion of racial minorities ( n = 250, 41.4%). Main measures: The Enfranchisement scale contains two subscales: the Control subscale and the Importance subscale. We examined correlations between each Enfranchisement subscale and measures of participation, environment, and impairments. The current analyses included cases with at least 80% of items completed on each subscale (Control subscale: n = 391; Importance subscale: n = 219). Missing values were imputed using multiple imputation. Results: The sample demonstrated high scores, indicating poor enfranchisement (Control subscale: M = 51.7; Importance subscale: M = 43.0). Both subscales were most strongly associated with measures of participation (Control subscale: r = 0.56; Importance subscale: r = 0.52), and least strongly associated with measures of cognition (Control subscale: r = 0.03; Importance subscale: r = 0.03). The Importance subscale was closely associated with depression ( r = 0.54), and systems, services, and policies ( r = 0.50). Both subscales were associated with social attitudes (Control subscale: r = 0.44; Importance subscale: r = 0.44) and social support (Control subscale: r = 0.49; Importance subscale: r = 0.41). Conclusions: We found evidence of convergent validity between the Enfranchisement scale and measures of participation, and discriminant validity between the Enfranchisement scale and measures of disability-related impairments. The analyses also revealed the importance of the environment to enfranchisement outcomes.
Morphological Changes in the Residual Meniscus After Reshaping Surgery for a Discoid Lateral Meniscus
Authors: Nishino Kazuya , Hashimoto Yusuke , Tsumoto Syuko , Yamasaki Shinya , Nakamura Hiroaki 
Published: August 2021

Background: Arthroscopic reshaping surgery is the first treatment option for a symptomatic discoid lateral meniscus (DLM) to preserve the peripheral rim. However, the degree of postoperative morphological change in the residual meniscus is unclear. Purpose/Hypothesis: The purpose of this study was to measure the meniscus after reshaping surgery for a DLM, to verify when the morphological change occurred, and to examine the related risk factors. The hypothesis was that the residual meniscal width would decrease throughout the postoperative course. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively reviewed the medical records of patients who underwent reshaping surgery for a symptomatic DLM and had undergone follow-up for ≥2 years. Magnetic resonance imaging (MRI) was routinely performed preoperatively and at 3, 6, 12, and 24 months postoperatively, and the width, height, and extrusion of the residual meniscus were measured. According to the width of the midbody on final MRI scans, we compared the preoperative and postoperative data for the preserved group (≥5 mm) and decreased group (<5 mm). The associated risk factors for a decreased meniscal width (<5 mm) of the midbody were analyzed on final MRI scans. Results: We included 61 knees of 54 patients in this study. The mean age at the time of surgery was 11.7 years. The intraobserver and interobserver reliabilities of the midbody width were 0.937 and 0.921, respectively. The width of the anterior horn, midbody, and posterior horn decreased significantly from 3 to 24 months after surgery (from 9.1 to 8.6 mm [ P < .001], from 7.5 to 6.1 mm [ P < .001], and from 9.5 to 8.9 mm [ P = .001], respectively). Meniscal extrusion of the midbody did not change significantly (from 1.2 to 1.5 mm; P = .062). Overall, 46 knees (n = 20/32 in the preserved group and n = 26/29 in the decreased group) had longitudinal tears that required meniscal repair. Clinical outcomes did not differ significantly between the 2 groups. Multivariate logistic analysis showed that intrameniscal degeneration (odds ratio, 4.36; P = .023) significantly increased the risk of a decreased meniscal width. Conclusion: The width of the anterior horn, midbody, and posterior horn decreased significantly from 3 to 24 months after surgery. In particular, the average decrease rate of the midbody was 19%. No clinical difference was seen in patients with a decreased width and height or with peripheral extrusion. Increased intrameniscal signals on preoperative MRI scans were associated with an increased risk of a decreased meniscal width. Surgeons should consider this result to determine the amount of resection.
Does Caregiver Participation in Advance Care Planning Using a Decision Support Tool Together With Patients Reduce Caregiver Strain, Burden and Anxiety Over Time? A Post-Hoc Analysis of a Randomized Controlled Trial
Authors: Kunzler Bronson R. , Foy Andrew J. , Levi Benjamin H. , Van Scoy Lauren J. , Lehman Erik B. , Smith Theresa J. , Green Michael J. 
Published: August 2021

Context: Surrogate decision makers experience significant amounts of anxiety, burden, and strain in their role as caregivers and decision makers for loved ones. Objectives: To investigate longitudinally whether surrogate decision makers engaging in ACP together with their loved one reduces perceived anxiety, burden, and strain felt by surrogate decision makers. Methods: Post-hoc analysis of a randomized controlled trial evaluating caregivers’ perceived self-efficacy to serve as surrogate decision makers. The trial employed a 2×2 study design of patient/caregiver dyads who engaged in advance care planning (ACP) using a standard living will form vs “Making Your Wishes Known” (MYWK), and having the patient engage in ACP alone vs together with the family caregiver. Surrogates completed validated survey instruments surveys longitudinally to compare levels of anxiety, burden, and strain. Results: 246 of 285 dyads completed the measures. No significant reductions in anxiety, burden, or strain were found longitudinally in surrogate decision makers using MYWK together with loved one’s vs other control groups. Increases in strain and anxiety were seen across all study groups and increases in burden across 2/4 study groups. Strain and burden increased most in the MYWK Together arm (▴ = +2.22 and ▴ = +1.91 respectively). Conclusion: Family caregivers who engaged in ACP together with patients using the decision support tool MYWK did not experience less strain, burden, or anxiety longitudinally compared to other study arms. These results may help inform the design of future studies and interventions that promote caregivers’ involvement in ACP interventions.
Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice
Authors: Piscitello Gina M. , Bermea Rene S. , Stokes John W. , Gannon Whitney D. , Kanelidis Anthony J. , Konopka Megan , Shappell Claire , Frye Laura K. , Lyons Patrick G. , Siegler Mark , Parker William F. 
Published: August 2021

Purpose: Extracorporeal membrane oxygenation (ECMO) is an expensive and scarce life sustaining treatment provided to certain critically ill patients. Little is known about the informed consent process for ECMO or clinician viewpoints on ethical complexities related to ECMO in practice. Methods: We sent a cross-sectional survey to all departments providing ECMO within 7 United States hospitals in January 2021. One clinician from each department completed the 42-item survey representing their department. Results: Fourteen departments within 7 hospitals responded (response rate 78%, N = 14/18). The mean time spent consenting patients or surrogate decision-makers for ECMO varied, from 7.5 minutes (95% CI 5-10) for unstable patients to 20 minutes (95% CI 15-30) for stable patients (p = 0.0001). Few clinician respondents (29%) report patients or surrogate decision-makers always possess informed consent for ECMO. Most departments (92%) have absolute exclusion criteria for ECMO such as older age (43%, cutoffs ranging from 60-75 years), active malignancy (36%), and elevated body mass index (29%). A significant minority of departments (29%) do not always offer the option to withdraw ECMO to patients or surrogate decision-makers. For patients who cannot be liberated from ECMO and are ineligible for heart or lung transplant, 36% of departments would recommend the patient be removed from ECMO and 64% would continue ECMO support. Conclusion: Adequate informed consent for ECMO is a major ethical challenge, and the content of these discussions varies. Use of categorical exclusion criteria and withdrawal of ECMO if a patient cannot be liberated from it differ among departments and institutions.
Critical Engagement: Lessons Learned and Implications for HRD About Black Male Faculty Leadership in Higher Education
Authors: Henry Sherman 
Published: August 2021

The Problem Limited discussions of the Black male as a leader has taken place in the human resource development literature. Hence, racialization, the process of constructing and attaching meaning to racial identity, is an under-studied topic. Further problematic, traditional leadership theories advance a race-neutral, universalized mainstream view of leaders, and do not consider the multiple ways that race changes the master narrative. A direct result of this shortcoming is the lack of research and theories that inform the experiences of Black males in Historical White Institutions (HWIs). The Solution In this article, an autoethnography approach is used to counter the master narrative that has concealed the everyday, lived experience of Black males in higher education faculty and leadership roles. Critical race theory is applied as a framework for viewing lived experience as a legitimate and appropriate source of analysis. Socio-cultural theory is used to explain how cultural competence is needed to appropriately identify racism as an enduring problem that is a product of its culture and environment. The Stakeholders HRD faculty, HWIs administrators, hiring committees, diversity, equity and inclusion practitioners, search committees, and Black males in faculty roles in HWIs.
The Trenches and Valleys of Corporate America: A Black Male Human Resource Leader’s Autoethnographic Account
Authors: Wicker Cory J. 
Published: August 2021

The Problem In predominantly White organizational contexts and professions, such as human resources, that are significantly occupied by non-Blacks, Black male leaders struggle with achieving career success due to a lack of organizational support. Although existing research in human resource development (HRD) and career development provides a holistic representation of minoritized groups, there is a dearth of research that addresses the professional development of Black males. The Solution This article is an autoethnographic exploration of my experiences as a Black male leader in a predominantly White organization and profession (human resources). This article leverages autoethnography and critical race theory (CRT) as appropriate lenses to view my experiences as a Black male leader in this organizational/professional context. I utilize a layered account approach to position and deconstruct my experiences to provide an insider perspective of power structures that impede the leadership development of Black males. The Stakeholders HRD scholars, practitioners, organizational leaders, and Black males who are embarking upon and/or establishing their professional careers in predominantly White organizations.
Extensive deep vein thrombosis and pulmonary embolism as a unique clinical manifestation of COVID-19 in a young healthy patient
Authors: Llausas-Villarreal Alejandro , Mendoza-Silva Marycarmen , Gómez-Gutiérrez Oliver Antonio , Gonzalez-Urquijo Mauricio , Fabiani Mario Alejandro 
Published: August 2021

Background/Objective Deep vein thrombosis and pulmonary embolism have been described as complications in previously diagnosed COVID-19 patients, especially in those admitted in critical ill units, but, to our knowledge, there is no report of venous thromboembolism in an otherwise asymptomatic COVID-19 patient. Methods We report the case of a 22-year-old female, healthy patient with pulmonary embolism (Pulmonary Embolism Severity Index Score 22 points, low risk) and extensive proximal deep vein thrombosis as a unique clinical manifestation of the new coronavirus disease. Results The patient had no risk factors and no familial history of venous thromboembolism. All thrombophilia markers were negative. The patient was treated as first by an independent vascular team, performing vena cava filter placement and open thrombectomy. Her symptoms worsened, and after 3 weeks, she underwent US-enhanced thrombolysis and mechanical thrombectomy. She was isolated for 10 days and did not develop any other clinical manifestation of COVID-19 disease. During follow-up, she remained asymptomatic and complete patency of the venous system was achieved. Full oral anticoagulation was conducted for 6 months. Conclusion COVID-19 appears to be a multi-symptomatic disease, and venous thromboembolism without any other previous described COVID-19 symptom could be considered one of its diverse clinical presentations and RT-PCR for SARS-CoV-2 tests emerge to be mandatory in patients with otherwise unexpected venous thrombosis.
Dynamics of serum concentrations of antibodies to infliximab: a new approach for predicting secondary loss of response in inflammatory bowel diseases
Authors: Grasmeier Melina K. , Langmann Anna F. , Langmann Peter , Treiber Matthias , Thaler Markus A. , Luppa Peter B. 
Published: August 2021

Background: Antibodies to infliximab (ATI) in serum are associated with secondary loss of response (LOR) to infliximab (IFX) therapy in patients with inflammatory bowel disease (IBD). However, feasible ATI-related predictors of therapy success are lacking and knowledge about individual ATI dynamics is limited. Therefore, this study analyzed whether ATI dynamics are able to predict LOR to IFX therapy and compared their predictive power with known predictors of LOR to IFX. Methods: This was a retrospective study of patients with Crohn’s disease (CD) or ulcerative colitis (UC) on IFX maintenance therapy and proactive IFX and immunogenicity monitoring in an outpatient clinic in Germany. Slopes of ATI ( SATI) and IFX levels (dynamic parameters) and medians of ATI, IFX, C-reactive protein, and fecal calprotectin (static parameters) were calculated over a defined period of time after ATI emergence. Dynamic and static parameters were analyzed for associations with end points infliximab discontinuation due to secondary LOR and total IFX discontinuation. Results: In all, 500 visits from 38 IBD patients (28 CD, 10 UC) with a median IFX maintenance duration of 68.2 weeks were evaluated. Grouping by SATI (ATI-N = ATI nondetectable, ATI- ↓ = negative SATI, ATI- ↑ = positive SATI) yielded significant differences for outcomes LOR ( p = 0.004) and total IFX discontinuation ( p = 0.01). Patients in the ATI-↓ group survived significantly longer LOR-free compared with the ATI-↑ group ( p = 0.02). Cox regression confirmed SATI to be a significant risk factor for LOR ( p = 0.002). An SATI cut-off of approximately 2.0 AU mL−1 week−1 was determined to predict LOR with 83.3% sensitivity and 93.8% specificity. Conclusion: The ATI slope-based index SATI is a new feasible diagnostic predictor of LOR in IBD patients. SATI may facilitate quick therapeutic decisions after ATI emerge.
A novel score for evaluating cerebral aneurysms treated with flow diversion: 4F-flow diversion predictive score
Authors: Kang Huibin , Luo Bin , Liu Jian , Wang Anxin , Zhang Hongqi , Li Tianxiao , Song Donglei , Zhao Yuanli , Guan Sheng , Wang Yunyan , Feng Wenfeng , Wang Yang , Shi Huaizhang , Liu Jianmin , Yang Xinjian 
Published: August 2021

Background and purpose: Although grading scales for angiography outcomes following cerebral aneurysm treatment with flow diversion have been published, physicians have not widely adopted these scales in practice. The aim of this study is to propose and validate a novel Flow diversion Predictive Score (4F-FPS) grading scale based on previously established scales that is simple and reliable. Methods: We retrospectively analyzed consecutive patients who underwent endovascular treatment for cerebral aneurysms with flow diversion between January 2014 and September 2019. The included patients were randomly divided into the derivation and validation group in a 70/30 ratio, respectively. Aneurysms were classified as incomplete or complete occlusion based on final angiography outcomes. 4F-FPS was derived to predict aneurysm occlusion from multivariate logistic regression analyses in the derivation group and validated with previously published grading scales in the validation group. Results: Overall, 662 patients [mean age, 53.8 years; 72.5% (480/662) female] with 662 aneurysms treated with the PipelineTM flow diverter were included [69.9% (463/662) derivation group, 30.1% (199/662) validation group]. The incidence of aneurysm occlusion was 82.7%. 4F-FPS demonstrated significant discrimination in 10-fold cross validation [mean receiver operating characteristic (ROC) area, 0.862 ± 0.055] and calibration (Cox & Snell R2, 0.251; Nagelkerke R2, 0.413) in the derivation group. The ROC area of 4F-FPS score in both the derivation and validation groups is the largest compared with previously published grading scales/scores ( p < 0.05), which shows better sensitivity and specificity. The 4F-FPS score showed excellent prediction, discrimination, and calibration properties. Conclusion: The 4F-FPS score is a simple and reliable tool to predict angiography outcome after flow diversion treatment. If widely adopted, it may provide a common language to be used in future reporting of flow diversion results for clinical trials and daily practice. Clinical trial registration: http://www.clinicaltrials.gov . Unique identifier: NCT03831672