bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of tight glycemic control based on frailty status and associated factors in community-dwelling older adults
Authors: Tan Li Feng , Merchant Reshma Aziz 
Published: June 2024

Abstract

Background
Tight control of type 2 diabetes (T2DM) in frail older adults has shown to be associated with adverse outcomes. The objective of this study is to determine the prevalence of tight glycemic control based on underlying frailty status and its association with functional and cognitive measures in community-dwelling older adults.

Methodology
Ancillary study of the Singapore Population Health Studies on older adults aged ≥65 years with T2DM. Tight glycemic control cut-offs were based on the 2019 Endocrine Society guideline using HbA1c target range based on a patient’s overall health status measured by the FRAIL scale. Data on basic demographics, frailty, cognitive, and functional statuses were collected. Multivariable regression was used to assess potential factors associated with tight glycemic control.

Results
Of 172 community-dwelling older adults with diabetes mellitus and HbA1c done, frail (65%) and pre-frail (64.4%) participants were more likely to have tight glycemic control than robust participants (31.6%, P &lt; 0.001). In multi-variate analysis, frailty (OR 6.43, 95% CI 1.08–38.1, P = 0.041), better cognition (OR 1.15, 95% CI 1.02–1.32, P = 0.028), and multi-morbidity (OR 7.36, 95% CI 1.07–50.4, P = 0.042) were found to be significantly associated with increased odds of tight glycemic control.

Conclusion
Tight glycemic control was highly prevalent in frail and pre-frail older adults, especially in those with multi-morbidity and better cognition. Future prospective longitudinal studies are required to evaluate effectiveness of frailty screening in making treatment decisions and long-term outcomes.
Key messages What is already known on this topic: There is growing recognition that glycemic targets should be adjusted based on health or frailty status. However, there is no consensus on how health status or frailty should be defined when determining glycemic control targets. What this study adds: Our study found that tight glycemic control was highly prevalent in frail and pre-frail older adults. Our findings highlight the importance of assessing for tight glycemic control based on frailty status and further work is needed to aid implementation of screening and intervention policies to avoid the attendant harms of tight glycemic control.
Design and performance of double-layered artificial chordae
Authors: Zhang Tingchao , Dou Yichen , Li Yang , Luo Rifang , Yang Li , Zhang Weiwei , Wang Yunbing , Zhang Xingdong 
Published: June 2024

Abstract
Surgical repair with artificial chordae replacement has emerged as a standard treatment for mitral regurgitation. Expanded polytetrafluoroethylene (ePTFE) sutures are commonly employed as artificial chordae; however, they have certain limitations, such as potential long-term rupture and undesired material/tissue response. This study introduces a novel approach to artificial chordae design, termed the New Artificial Chordae (NAC), which incorporates a double-layered structure. The NAC comprises a multi-strand braided core composed of ultra-high molecular weight polyethylene (UHMWPE) fibers as the inner core, and an outer tube made of hydrophobic porous ePTFE. Compared to traditional ePTFE sutures, NAC exhibits increased flexibility, enhanced tensile strength, longer elongation and improved fatigue resistance. Moreover, NAC exhibits a more hydrophobic surface, which contributes to enhanced hemocompatibility. The study also includes in vivo investigations conducted on animal models to evaluate the biocompatibility and functional efficacy of the artificial chordae. These experiments demonstrate the enhanced durability and biocompatibility of the NAC, characterized by improved mechanical strength, minimal tissue response and reduced thrombus formation. These findings suggest the potential application of NAC as a prosthetic chordae replacement, offering promising prospects to address the limitations associated with current artificial chordae materials and providing novel ideas and approaches for the development of sustainable and biocompatible regenerative biomaterials.
Phylo2Vec: A Vector Representation for Binary Trees
Authors: Penn Matthew J , Scheidwasser Neil , Khurana Mark P , Duchêne David A , Donnelly Christl A , Bhatt Samir 
Published: June 2024

Abstract
Binary phylogenetic trees inferred from biological data are central to understanding the shared history among evolutionary units. However, inferring the placement of latent nodes in a tree is computationally expensive. State-of-the-art methods rely on carefully designed heuristics for tree search, using different data structures for easy manipulation (e.g., classes in object-oriented programming languages) and readable representation of trees (e.g., Newick-format strings). Here, we present Phylo2Vec, a parsimonious encoding for phylogenetic trees that serves as a unified approach for both manipulating and representing phylogenetic trees. Phylo2Vec maps any binary tree with n leaves to a unique integer vector of length n-1. The advantages of Phylo2Vec are 4-fold: (i) fast tree sampling, (ii) compressed tree representation compared to a Newick string, (iii) quick and unambiguous verification if 2 binary trees are identical topologically, and (iv) systematic ability to traverse tree space in very large or small jumps. As a proof of concept, we use Phylo2Vec for ML inference on 5 real-world datasets and show that a simple hill-climbing-based optimization scheme can efficiently traverse the vastness of tree space from a random to an optimal tree.
LeverAge: A European network to leverage the multi-age workforce
Authors: Marcus Justin , Scheibe Susanne , Kooij Dorien , Truxillo Donald M , Zaniboni Sara , Abuladze Liili , Al Mursi Noura , Bamberger Peter A , Balytska Mariia , Betanzos Norma D , Perek-Białas Jolanta , Boehm Stephan Alexander , Burmeister Anne , Cabib Ignacio , Caon Maurizio , Deller Jürgen , Derous Eva , Drury Lisbeth , Eppler-Hattab Raphael , Fasbender Ulrike , Fülöp Marta , Furunes Trude , Gerpott Fabiola H , Goštautaitė Bernadeta , Halvorsen Cal J , Hernaus Tomislav , Inceoglu Ilke , Iskifoglu Mustafa , Ivanoska Kalina Sotiroska , Kanfer Ruth , Kenig Nikolina , Kiran Sibel , Klimek Sabina , Kunze Florian , Mertan Emete Biran , Varianou-Mikellidou Cleo , Moasa Horia , Ng Yin Lu , Parker Sharon K , Reh Susan , Resuli Vebina , Schmeink Martina , Silberg Slavka , Sousa Inês C , Steiner Dirk D , Stukalina Yulia , Tomas Jasmina , Topa Gabriela , Turek Konrad , Vignoli Michela , von Bonsdorff Monika , Wang Dahua , Wang Mo , Yeung Dannii Yuen-lan , Yildirim Kemal , Zhang Xin , Žnidaršič Jana 
Published: June 2024

Abstract
Bringing together 150+ scholars and practitioners from 50+ countries, and funded by the European Commission, COST Action LeverAge (https://www.cost.eu/actions/CA22120/) is the first network-building project of its kind in the work and organizational psychology and human resource management (WOP/HRM) aspects of work and aging. Focused on the aging workforce, the Action aims to foster interdisciplinary and multinational scientific excellence and the translation of science to practical and societal impact across 4 years. Based on a research synthesis, we identify five broad research directions for work and aging science including work and organizational practices for a multi-age workforce, successful aging at work, the integration of age-diverse workers and knowledge transfer, aging and technology at work, and career development in later life and retirement. We provide key research questions to guide scientific inquiry along these five research directions alongside best practice recommendations to expand scholarly impact in WOP/HRM.
Do Resident Unions Improve Graduate Medical Education Training? Benefits and Potential Pitfalls
Authors: Julian Katherine A. , Baron Robert B. 
Published: June 2024

Abstract
The last 10 years have seen an increase in union representation for residents and fellows across the United States. It is estimated that 15% of residents and fellows are represented by unions. With increasing numbers of U.S. residents and fellows in graduate medical education (GME) programs being represented by unions, the authors contend that it is worthwhile to consider the benefits and potential drawbacks of resident unions and how GME and health system leaders can best work to ensure that the educational needs of residents continue to be emphasized in an era of resident unionization. Union bargaining can be a method to secure salary increases and other benefits for residents. Unionization can also provide a mechanism for more rapidly addressing worker protection issues and allows residents to advocate on behalf of patients. Residents participating as union leaders may develop important leadership and negotiation skills as well as gain beneficial knowledge about health system structure, financing, and priorities. However, with all the possible benefits that may come with resident unionization, there are also potential pitfalls. The collective bargaining process may create an adversarial relationship between program and institution leaders and trainees. Additionally, while residents are considered employees and able to collectively bargain, the National Labor Relations Board has also acknowledged that residents are “students learning their chosen medical craft.” Program and institution leaders have an obligation to prioritize resident education and adhere to accreditation requirements even when these requirements conflict with union demands. Furthermore, because of the obligation to protect the public, program leaders should maintain control of resident academic due process issues. Program and institutional leaders must continue to prioritize resident education. Furthermore, GME leaders have a joint responsibility to create clinical learning environments that are conducive to quality patient care and promote resident learning and well-being.
Characteristics of Patients Hospitalized in Rural and Urban ICUs From 2010 to 2019
Authors: Harlan Emily A. , Ghous Muhammad , Moscovice Ira S. , Valley Thomas S. 
Published: June 2024

OBJECTIVES:
Rural hospitals are threatened by workforce shortages and financial strain. To optimize regional critical care delivery, it is essential to understand what types of patients receive intensive care in rural and urban hospitals.

DESIGN:
A retrospective cohort study.

SETTING AND PATIENTS:
All fee-for-service Medicare beneficiaries in the United States who were 65 years old or older hospitalized in an ICU between 2010 and 2019 were included. Rural and urban hospitals were classified according to the 2013 National Center For Health Statistics Urban-Rural Classification Scheme for Counties. Patient comorbidities, primary diagnoses, organ dysfunction, and procedures were measured using the International Classification of Diseases, 9th and 10th revisions diagnosis and procedure codes. Standardized differences were used to compare rural and urban patient admission characteristics.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
There were 12,224,097 ICU admissions between 2010 and 2019, and 1,488,347 admissions (12.2%) were to rural hospitals. The most common diagnoses in rural hospitals were cardiac (30.3%), infectious (24.6%), and respiratory (10.9%). Patients in rural ICUs had similar organ dysfunction compared with urban hospitals (mean organ failures in rural ICUs 0.5, sd 0.8; mean organ failures in urban ICUs 0.6, sd 0.9, absolute standardized mean difference 0.096). Organ dysfunction among rural ICU admissions increased over time (0.4 mean organ failures in 2010 to 0.7 in 2019, p < 0.001).

CONCLUSIONS:
Rural hospitals care for an increasingly complex critically ill patient population with similar organ dysfunction as urban hospitals. There is a pressing need to develop policies at federal and regional healthcare system levels to support the continued provision of high-quality ICU care within rural hospitals.
Paired Treatment Using Radiofrequency Microneedling and 755-nm Picosecond Laser With Fractionated Lens Array for Facial Rejuvenation
Authors: Tao Joy , Hashemi David A. , Bajaj Shirin , Wang Jordan V. , Geronemus Roy G. 
Published: June 2024

BACKGROUND
Patients frequently complain about fine lines, wrinkles, dyschromia, and photoaging, for which lasers and energy-based devices can treat each of these. Pairing various devices in a single treatment session can be safe and effective, but different technologies, mechanisms, histologies, parameters, and techniques must be considered.

OBJECTIVE
To examine the utility of a paired treatment regimen using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array to improve the clinical appearance of facial wrinkles and photoaging.

MATERIALS AND METHODS
A prospective clinical study investigated this paired treatment regimen using 4 monthly sessions.

RESULTS
Twenty-five subjects were enrolled, while 18 subjects completed 3-month follow-up. The mean age was 54 years, and 92% were women. Fitzpatrick Skin Types I to IV were represented. Assessments compared baseline with the 3-month follow-up. Two of 3 blinded reviewers agreed in identifying pretreatment and post-treatment photographs for 94.4% of cases. For physician Global Aesthetic Improvement Scale, 100% of subjects had clinical improvement. Overall, 88.9% of subjects were considered to be satisfied with their treatment. No serious or unanticipated adverse events occurred.

CONCLUSION
Paired treatment using radiofrequency microneedling and 755-nm picosecond laser with fractionated lens array can safely and effectively improve facial wrinkles and photoaging.
Contact Lens–Assisted DMEK for Corneal Decompensation With an Anterior Chamber Intraocular Lens: A Novel Technique
Authors: Tan Reginald Robert G. 
Published: June 2024

Purpose:
To describe a novel technique in which a contact lens was used to facilitate Descemet membrane endothelial keratoplasty (DMEK) in an eye with an anterior chamber intraocular lens (ACIOL).

Methods:
A 71-year-old man with a long-standing ACIOL developed bullous keratopathy. As the patient was at high risk of complications due to multiple ocular comorbidities, DMEK was performed with the ACIOL left in the anterior chamber. An inserted cosmetic contact lens was used as a platform for the graft unfolding.

Results:
Partial graft detachment on the third postoperative day required rebubbling. This successfully cleared up the cornea after a few weeks. At the one-month follow-up, the uncorrected distance visual acuity improved to 20/50, with an endothelial cell loss of 35.2%. Steroid-induced ocular hypertension necessitated a trabeculectomy by the fifth postoperative month. At the sixth follow-up month, endothelial cell loss was 64%.

Conclusions:
Contact lens–assisted DMEK is a safe procedure for eyes with an ACIOL. However, good foresight is needed regarding whether the ACIOL should be kept or exchanged.
Flavonoids as dual-action agents for anticancer and anti-tooth caries: a molecular docking and dynamics simulation on MMP2 inhibition
Authors: Yarmohammadi Ebrahim , Naimiyan Atiyeh , Taherkhani Amir 
Published: June 2024

Objective:
Cancer pathogenesis is linked to matrix metalloproteinase-2 (MMP2). Numerous studies have indicated an elevated expression of MMP2 in the tissue microenvironment of different cancers, including breast, oral, prostate, ovarian, colorectal, bladder, lung, and hepatocellular carcinoma. The significant role of MMP2 in the degradation of organic compounds in dentin, causing dental caries, has been indicated by accumulating evidence. This study explored the possibility of using flavonoids as natural compounds capable of inhibiting MMP2 to meet the need for new and potent MMP2 inhibitors.

Methods:
The AutoDock software evaluated the binding energies between selected flavonoids and the MMP2 catalytic domain and ranked the ligands based on their inhibition constant (Ki) values and Gibbs free binding energy scores. The Discovery Studio Visualizer tool demonstrated how the highest-ranked flavonoids interact with the MMP2. Molecular dynamics was conducted for the most potent MMP2 inhibitor in a 100 ns computer simulation.

Results:
Kaempferol 3-rutinoside-7-sophoroside demonstrated an inhibitory effect against MMP2 with a Ki value and ΔGbinding score of 209.92 fM and −17.30 kcal/mol, respectively. This flavonoid was able to restrict MMP2 activity within a femtomolar range. This study identified eight flavonoids with Ki values in the picomolar range. According to the study, the docked pose of kaempferol 3-rutinoside-7-sophoroside within the MMP2 catalytic domain reached stability after a simulation of ~60 nanoseconds.

Conclusion:
Inhibition of MMP2 by flavonoids, notably kaempferol derivatives, might be an effective therapeutic strategy for cancer treatment.
Extraosseous osteosarcoma of the larynx: an unusual tumor managed with radical surgery – case report
Authors: Martín Pérez Jesús A. , Gurrola Machuca Hector , Domínguez Páez Casandra , Cortázar Sánchez Carlos A. , Nagore Ancona Jesús F. , Ramírez Gómez Julio I. , Navarrete Tolentino Juan C. , Hernández Hernández Regina C. , Burgos Morales Itzel 
Published: June 2024

Introduction and importance:
Extraosseous osteosarcoma (EOO) is a malignant tumor that arises in soft tissue without affecting bone or periosteum but produces osteoid, osseous, or chondroid material. It is a very rare malignancy that accounts for approximately less than 1% of all tissue sarcomas and ~2–4% of all osteosarcomas. EOO in the head and neck region is extremely rare; however, in the larynx, it is exceptional, with only one case reported worldwide in the literature to date.

Case presentation:
A 72-year-old male with no personal history of interest in the current condition presented with dysphonia, hoarseness, and dyspnea for 6 months. A flexible nasofibrolaryngoscopy (FNFL) and computed tomography (CT) scan exhibited a glottic tumor with a lumen obstruction of 90%. An endoscopic resection was performed, reporting an EOO, osteoblastic, and ulcerated type. During follow-up, tumoral persistence was detected, leading to the decision to perform a definitive radical treatment with a total laryngectomy.

Clinical discussion:
Its presentation in the head and neck region is exceptional, with only a few isolated cases reported in the literature. Available data on treatment recommendations have emphasized the importance of timely surgical intervention with adjuvant radiation therapy if necessary for the head and neck.

Conclusion:
Extraosseous osteoblastoma of the larynx is an extremely rare and infrequent disease. Correct diagnosis and oncological surgical management of this disease are essential for optimal and even curative treatment of the patient.
Reduced Cochlear MRI Signal and Hearing Outcomes in Conservatively Managed Vestibular Schwannoma Patients
Authors: Jones Arthur , Saputra Lydia , Matthews Timothy 
Published: June 2024

ObjectiveThis study aimed to determine if hypointense cochlear magnetic resonance imaging (MRI) constructive interference in steady-state (CISS) signal correlates with hearing outcomes in conservatively managed vestibular schwannoma (VS) patients.Study DesignRetrospective review of 657 cases from 1992 to 2020.SettingTertiary academic referral center.PatientsA retrospective review was performed to identify conservatively managed VS patients with appropriate baseline MRI, audiology, and at least 12-month audiological follow-up. Patients were excluded if they progressed to surgery or radiotherapy in less than 12 months, bilateral tumors, or surgery on the contralateral ear.InterventionConservatively managed patients with CISS imaging studies and audiology testing.Main Outcome Measure(s)Primary outcome measure change in pure-tone average (PTA) and word recognition score (WRS). Secondary outcome measures tumor size, presence of lateral fluid cap, or cystic changes.ResultsA total of 92 individuals (47% male, 58 ± 11.6 yr) met the inclusion criteria, with 36 (39%) of patients demonstrating abnormal cochlear CISS signal. At baseline, abnormal cochlear CISS signal was associated with higher intracanalicular (IC) length (7.9 versus 6.6 mm,p= 0.0177) and lower WRS (55.7 versus 78.8 dBHL,p= 0.0054). During follow-up, individuals with abnormal cochlear CISS signal had significantly higher PTA (62.4 versus 46.4 dBHL,p= 0.0010). After adjusting for baseline covariates, abnormal cochlear CISS signal was consistently associated with a greater increase in PTA of 8.3 dBHL (95% confidence interval, 2.9–13.7;p= 0.0032) from baseline when compared with the normal group.ConclusionsAbnormal cochlear signal on MRI CISS sequences is associated with poorer hearing outcomes in conservatively managed VS patients.
Clinical Applications for Spread of Excitation Functions Obtained Via Electrically Evoked Compound Action Potentials (eCAP)
Authors: Berg Katelyn A. , DeFreese Andrea J. , Sisler-Dinwiddie Allyson L. , Labadie Robert F. , Tawfik Kareem O. , Gifford René H. 
Published: June 2024

ObjectivesTo assess the clinical utility of spread of excitation (SOE) functions obtained via electrically evoked compound action potentials (eCAP) to 1) identify electrode array tip fold-over, 2) predict electrode placement factors confirmed via postoperative computed tomography (CT) imaging, and 3) predict postoperative speech recognition through the first year post-activation in a large clinical sample.Study DesignRetrospective case reviewSettingCochlear implant (CI) program at a tertiary medical centerPatientsTwo hundred seventy-two ears (238 patients) with Cochlear Ltd. CIs (mean age = 46 yr, range = 9 mo–93 yr, 50% female) implanted between August 2014 and December 2022 were included.Main Outcome MeasureseCAP SOE widths (mm) (probe electrodes 5, 11, and 17), incidence of electrode tip fold-over, CT imaging data (electrode-to-modiolus distance, angular insertion depth, scalar location), and speech recognition outcomes (consonant–nucleus–consonant [CNC], AzBio quiet, and +5 dB SNR) through the first year after CI activation.Results1) eCAP SOE demonstrated a sensitivity of 85.7% for identifying tip fold-over instances that were confirmed by CT imaging. In the current dataset, the tip fold-over incidence rate was 3.1% (7 patients), with all instances involving a precurved electrode array. 2) There was a significant positive relationship between eCAP SOE and mean electrode-to-modiolus distance for precurved arrays, and a significant positive relationship between eCAP SOE and angular insertion depth for straight arrays. No relationships between eCAP SOE and scalar location or cochlea diameter were found in this sample. 3) There were no significant relationships between eCAP SOE and speech recognition outcomes for any measure or time point, except for a weak negative correlation between average eCAP SOE widths and CNC word scores at 6 months post-activation for precurved arrays.ConclusionsIn the absence of intraoperative CT or fluoroscopic imaging, eCAP SOE is a reasonable alternative method for identifying electrode array tip fold-over and should be routinely measured intraoperatively, especially for precurved electrode arrays with a sheath.