bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Hospital Value‐Based Purchasing Program: Do hospitalists improve health care value
Authors: Spaulding Aaron , Tafili Aurora , Dunn Ajani , Hamadi Hanadi 
Published: June 2022

AbstractIntroductionAs healthcare organizations examine the associated benefits of employing a larger hospitalist workforce, there is a need to better understand the association with patients' quality, experience, and efficiency. However, there is a lack of information regarding how hospital use of hospitalists over time influences hospital scoring on quality programs, such as the Center for Medicare and Medicaid Services (CMS) Hospital Inpatient Value‐Based Purchasing (HVBP) Program. This study examines the association between hospitalist staffing between 2014 and 2019 and HVBP scores.MethodsWe used a cross‐sectional panel study design. Total Performance Score (TPS) and its domains were obtained from CMS from 2014 to 2019 and merged with the American Hospital Association Annual Survey Database. We utilized random‐effects multivariable panel regression models and zero‐inflated negative binomial regression to examine the association between the hospitalist‐staffing ratio and the HVBP Program. All models were adjusted for hospital characteristics.ResultsA total of 2126 hospitals were included in the study. The average ratio of hospitalists per staffed bed was 0.06, with a standard deviation of 0.15. This study suggests that hospitals that employ a higher percentage of hospitalists see improvement in their overall TPS (β = 5.40; p < .001), Patient Experience (β = 2.49; p <.05), and Efficiency (incidence‐rate ratio= 1.41; p < .001) domain. However, the Clinical Care domain was no different in organizations employing more hospitalists.ConclusionThere are benefits associated with TPS, Patient Experience, and Efficiency from employing hospitalists. Managers should seek opportunities to leverage hospitalists' expertise in providing care, particularly in improving care processes.
Early treatment with thiamine and mortality among patients with alcohol use disorder who are hospitalized for pneumonia
Authors: Baron Sarah W. , Yu Pei‐Chun , Imrey Peter B. , Southern William N. , Deshpande Abhishek , Rothberg Michael B. 
Published: June 2022

AbstractBackgroundThe paucity of research linking thiamine treatment with improved outcomes may be driving its underutilization among patients at risk for Wernicke encephalopathy.ObjectiveTo assess relationships of thiamine usage to outcomes of patients hospitalized with alcohol use disorder and pneumonia.Design, Setting and ParticipantsThis is a retrospective cohort study of adult patients hospitalized with pneumonia who also have alcohol use disorder and were treated with benzodiazepines during the initial two hospital days, between 2010 and 2015 at hospitals participating in the Premier Healthcare Database.ExposureAny thiamine treatment, and, among those treated, high‐dose thiamine treatment, during the initial two hospital days.Main Outcome and MeasuresDeath on days 3–14 of hospitalization (primary); discharge home; transfer to intensive care unit; length of stay (LOS). We used propensity‐weighted models to estimate treatment effects.ResultsAmong 36,732 patients from 625 hospitals, 26,520 (72.2%) patients received thiamine, with mortality of 6.5% and 8.1% among recipients and nonrecipients, respectively. With propensity score adjustment, thiamine was associated with reduced mortality (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.75–0.85) and more frequent discharges to home (OR: 1.10, 95% CI: 1.06–1.14). Other outcomes were similar. Relative to low‐dose thiamine, high‐dose thiamine was not associated with mortality (adjusted OR: 0.99, 95% CI: 0.89–1.10), but LOS was longer (ratio of means: 1.06, 95% CI: 1.04–1.08), and discharges to home were less frequent (OR: 0.92, 95% CI: 0.87–0.97).ConclusionThiamine is not reliably given to patients with pneumonia and alcohol use disorder receiving benzodiazepines. Improving thiamine administration may represent an opportunity to save lives in this high‐risk group of inpatients.
Fracture analysis of healthy and osteoporotic femora using clinical CT images, phantomless densitometry, and linear FE method
Authors: Mirzaei Majid , Jafari Reyhaneh , Allaveisi Farzaneh , Jafari Hamed , Alavi Fatemeh 
Published: June 2022

AbstractComputational fracture analysis has become a growing branch of orthopedic research. Particularly, the associated methods provide reliable tools for the analysis of 3D CT‐based models of bone. This paper reports the results of such analyses for 15 human femora (healthy and osteoporotic) under different loading orientations (85 different analysis cases). A new method was developed for the calculation of the density distribution in the models from ordinary clinical CT images without calibration phantom. This method, along with a strain‐energy‐based linear finite element (FE) analysis scheme, was used to predict the fracture strength and pattern of 10 cadaveric femora, for which the mechanical testing results and calibrated FE models were already available. The very good agreement and consistency between different sets of results showed the reliability and accuracy of the new density calibration method, as well as the linear analysis scheme. Accordingly, the method was applied to five new clinical images, gathered from two clinics that used different scanners with different protocols. The strength and fracture pattern of each one of these specimens were analyzed under 15 different loading conditions. A consistent behavior was found for variation of the fracture load and pattern of all specimens with the loading orientations, while very clear contrasts were observed between the strength amplitudes of healthy and osteoporotic specimens. The proposed methods can be easily applied to ordinary daily (even archived) clinical CT scans to conduct fast and reliable fracture analysis of human femora for general bone research and opportunistic studies of osteoporosis and trauma.
Stability analysis of tranexamic acid in the presence of various antiseptic solutions
Authors: Heckmann Nathanael D. , Chung Brian C. , Kang Hyunwoo P. , Chang Myles W. , Wang Jennifer C. , Weber Alexander E. , Omid Reza , Evseenko Denis 
Published: June 2022

AbstractTranexamic acid (TXA) effectively reduces blood loss and transfusion risk during total joint arthroplasty. Additionally, intraoperative irrigation with various antiseptic solutions is often utilized for the management and prevention of surgical site infection. However, interactions between various antiseptic solutions and TXA have not been investigated. The purpose of this in vitro study is to evaluate the stability of TXA in the presence of common orthopedic antiseptic solutions. Five antiseptic solutions—0.1% chlorhexidine (CHX) gluconate, 10% povidone‐iodine (BTD), 0.5% sodium hypochlorite (Dakin's), 3% hydrogen peroxide (H2O2), and 1.5% H2O2—and a 0.9% normal saline (NS) control were obtained. A stock 100 mg/ml TXA solution was diluted in each antiseptic solution to a concentration of 10.0 mg/ml to generate reference standard and stability samples. TXA stability in each solution was measured using high performance liquid chromatography at t = 0 and t = 120 min and reported as mean percent of theoretical concentration (MPT) with associated relative standard deviation (RSD). All experiments were performed in triplicate at room temperature. At t = 0 min, TXA remained stable when mixed with 0.9% NS, 0.1% CHX, 10% BTD, 3% H2O2, and 1.5% H2O2 (MPT range: 102.0%−105.0%, RSD range: 0.80%−2.92%). Only 0.5% Dakin's led to significant degradation of TXA at t = 0 min (MPT: 14.3%, RSD:1.28%). At t = 120 min, TXA stability persisted for all compounds except Dakin's 0.5% (MPT: 18.4%, RSD: 28.7%). TXA efficacy may be significantly diminished when 0.5% Dakin's is used as an intraoperative irrigation solution. CHX, BTD, and H2O2 do not degrade TXA.
Lactobacillus plantarum supplementation alleviates liver and intestinal injury in parenteral nutrition‐fed piglets
Authors: Wang Weipeng , Wang Ying , Liu Yang , Tian Xinbei , Chen Shanshan , Lu Ying , Wu Bo , Xiao Yongtao , Cai Wei 
Published: June 2022

AbstractObjectiveLong‐term parenteral nutrition (PN) causes PN‐associated liver disease, for which therapeutic approaches are limited. This study aimed to investigate the effects of Lactobacillus plantarum CGMCC 1258 (LP) on liver and intestinal injury in PN‐fed neonatal piglets.MethodsThe piglets received PN with or without oral LP for 14 days. The levels of liver enzymes and inflammatory markers were measured using biochemical kits and quantitative real‐time polymerase chain reaction. Serum fibroblast growth factor 19 (FGF19) was detected using an enzyme‐linked immunosorbent assay. The bile acid (BA) profiles in the liver, serum, and intestinal contents were determined using ultraperformance liquid chromatography coupled with mass spectrometry. The composition of intestinal bacteria was analyzed with 16S rRNA gene amplicon sequencing.ResultsLP supplementation was associated with improved markers of liver disease, inflammation, and oxidative stress in PN‐fed piglets. Moreover, markers of intestinal injury and inflammation were alleviated by LP in PN‐fed piglets. Mechanistically, LP increased the abundance of Lactobacillus in ileal contents and stimulated FGF19 expression in ileal mucosa. Subsequently, it increased the expression of small heterodimer partner (SHP) and inhibited cholesterol 7α‐hydroxylase (CYP7A1) expression in the liver. Additionally, LP altered the systemic composition and metabolism of BAs.ConclusionsLP alleviated liver and intestinal injury in PN‐fed neonatal piglets by altering the composition of intestinal bacteria and BAs.
Potassium deficiency reduces sugar yield in sugar beet through decreased growth of young plants
Authors: Füllgrabe Henrik , Claassen Norbert , Hilmer Reinhard , Koch Heinz‐Josef , Dittert Klaus , Kreszies Tino 
Published: June 2022

AbstractBackgroundOptimum potassium (K) nutrition is essential for high sugar yield and quality of beet crops.AimsWe quantified the effect of potassium deficiency on sugar beet dry matter and sugar yield formation during the growing season.MethodsSugar beets were grown on low, medium, and high soil K concentrations in a long‐term K fertilizer field experiment on a silt loam alluvial soil. Plants were harvested at four time points during the growing season, including the final harvest. At each harvest, the dry matter yield and K concentration of leaves and beets (when applicable) were recorded, allowing us to study their growth rates in different growth phases. At the final harvest, sugar concentration and internal beet quality were measured.ResultsLow soil K concentrations resulted in an approximately 10% lower sugar yield compared to high soil K supply. Interestingly, retarded growth of low K plants already occurred during the germination phase and in the first weeks thereafter, whereas later on, growth rates were similar. Higher soil K levels led to an increased K uptake rate and thus a higher final total K uptake. High K plants showed rapid youth growth and reached their maximum growth rates earlier than plants grown under low K conditions. The initial differentiation between the low and high K treatments persisted because the plants subsequently grew at similar growth rates at both low and high soil K supplies.ConclusionThe early growth reduction in the low K treatment was probably caused by the low amount of K stored in sugar beet seeds in combination with low K availability in the soil. It is concluded that under overall low soil K conditions, adequate amounts of K fertilizer should be applied to meet the demand of sugar beet seedlings for maximum growth and final sugar yield. Banded K fertilizer application next to the plant rows is supposed to be efficient for this purpose.
Clinical Application of Shear Wave Elastography With Shear Wave Dispersion Imaging in the Preoperative Evaluation of Hepatic Parenchyma in Patients With Liver Tumors
Authors: Wang Kun , Zhang Shuchen , Zhou Wenyan , Wen Li , Zhang Shanshan , Yu Dong 
Published: June 2022

ObjectivesThis study aimed to compare the diagnostic accuracy of shear wave elastography (SWE) with that of shear wave dispersion (SWD) in evaluation of hepatic parenchyma in patients with liver tumors before resection.MethodsA total of 174 patients with liver tumors were prospectively enrolled. SWE and SWD examinations were performed. Fibrosis stage and necroinflammatory activity were determined histopathologically according to the Scheuer standard. We compared the diagnostic accuracy of SWE and SWD.ResultsBoth SWE and SWD values of the liver were highly correlated with liver fibrosis stage (P < .05, respectively). Both SWE and SWD values of the liver were moderately correlated with necroinflammatory activity (P < .05, respectively). Both SWE and SWD values of the liver were not correlated with steatosis (P > .05, respectively). Both SWE and SWD values were significantly different among the patients with different stages of liver fibrosis (P < .001, respectively). The area under the receiver operating characteristic (ROC) curve of SWE value was 0.982, 0.977, 0.969, and 0.984 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWE values were 6.9, 7.9, 8.7, and 10.6 kPa for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The area under the ROC curve of SWD value was 0.967, 0.960, 0.925, and 0.954 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWD values were 11.2, 12.0, 13.2, and 16.0 m/s/kHz for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively.ConclusionsSWE and SWD could be noninvasive and accurate for predicting the stage of liver fibrosis in patients with liver tumors before surgery. SWE was more accurate than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).
De‐Novo Depression, Prophylactic Antidepressant, and Survival in Patients With Head and Neck Cancer
Authors: Panwar Aru , McGill Trevon , Lydiatt Daniel , Militsakh Oleg , Lindau Robert , Coughlin Andrew , Sayles Harlan , Smith Russell , Lydiatt William 
Published: June 2022

ObjectiveTo study the association between the development of moderate or greater depression during curative‐intent therapy and overall survival (OS) in patients with stages II‐IV head and neck cancer (HNC).MethodsIn this secondary analysis of a randomized double‐blind placebo‐controlled trial, of 148 eligible participants diagnosed with stages II‐IV HNC but without baseline depression, 125 were evaluable and were randomly allocated to prophylactic escitalopram oxalate (n = 60) or placebo (n = 65). Participants were followed for development of moderate or greater depression, using Quick Inventory of Depressive Symptomatology‐Self Report (QIDS‐SR, range 0–27, score ≥11 indicated moderate or greater depression), and were stratified by demographics; cancer site and stage; and primary treatment modality (surgery with or without radiotherapy vs. radiotherapy with or without chemotherapy). Single variable and multivariable Cox proportional‐hazard models were used to evaluate differences in OS.ResultsClinically significant depression developed in 22 of 125 patients (17.6%) during HNC treatment. The mean follow‐up was 5.0 years (SD 2.4). OS was similar for patient groups, when stratified by development of moderate or greater depression (HR 0.54 [CI, 0.21–1.43]) or use of prophylactic antidepressant (HR 0.64 [CI, 0.34–1.21]).ConclusionThere was no significant association between OS and development of moderate or greater depression in patients being treated for stages II‐IV HNC, or between OS and use of prophylactic antidepressant escitalopram. Prophylactic antidepressant may be considered in patients with HNC for prevention of clinically significant depression and may offer improved quality of life outcomes.Level of Evidence2 Laryngoscope, 133:856–862, 2023
Multi‐Institutional Study of Patient‐Reported Outcomes of Paradoxical Vocal Fold Motion
Authors: Schonman Ian , Mudd Pamela A. , Ivancic Ryan , Ryan Marisa A. , Ongkasuwan Julina , Prager Jeremy , Smith Marshall E. , Goudy Steven L. , Rana Md Sohel , Wiet Gregory J. , Bauman Nancy M. 
Published: June 2022

ObjectiveTo explore patient‐reported outcome measures of pediatric paradoxical vocal fold motion through a multi‐institutional study of geographically diverse United States medical facilities to assess long‐term management and outcomes.MethodsEligible participants >8 years of age diagnosed with PVFM over a 10‐year period from 7 tertiary pediatric hospitals were invited to complete a survey addressing study objectives.Results65 participants completed the survey, of whom 80% were female, 75% reported a 3.5 grade point average or better, and 75% identified as competitive athletes or extremely athletic individuals. Participants rated their perceived efficacy of 13 specific treatments. Only five treatments were considered effective by a majority of the participants who tried them. The treatments that participants tried most often were breathing exercises (89.2%), bronchodilator treatments (45%), and allergy medications (35.4%). 78.8% of participants reported receiving more than one treatment and 25% reported receiving a combination of bronchodilators, anticholinergics, and steroids. At the time of PVFM diagnosis, 38% of participants had no idea when their symptoms would completely resolve. 23.3% of participants did not experience symptom resolution until greater than 1 year after diagnosis.ConclusionsTraditional management tools such as breathing exercises and biofeedback treatments may not provide the long‐term benefit that providers anticipate. In addition to these commonly used management strategies, highly efficacious techniques such as counseling and lifestyle management should be incorporated into the long‐term management of patients whose symptoms are refractory to traditional care.Level of Evidence4 Laryngoscope, 133:970–976, 2023
Association of Concurrent Olfactory Dysfunction and Probable Rapid Eye Movement Sleep Behavior Disorder with Early Parkinson's Disease Progression
Authors: Chen Ying , Xue Nai‐Jia , Fang Yi , Jin Chong‐Yao , Li Yao‐Lin , Tian Jun , Yan Ya‐Ping , Yin Xin‐Zhen , Zhang Bao‐Rong , Pu Jia‐Li 
Published: June 2022

ABSTRACTBackgroundParkinson's disease (PD), with either rapid eye movement sleep behavior disorder (RBD) or olfactory dysfunction (OD), has been associated with disease progression. However, there is currently heterogeneity in predicting prognosis.ObjectivesTo identify whether the concurrent presence of OD and probable RBD (pRBD) in PD (Dual hit in PD, PD‐DH) is associated with disease progression.MethodsWe included 420 patients with de novo PD from the Parkinson's Progression Markers Initiative: 180 PD only (PD), 82 PD with OD (PD‐OD), 94 PD with pRBD (PD‐pRBD), and 64 PD with both OD and pRBD (PD‐DH). Participants underwent motor and nonmotor evaluations, dopamine transporter imaging, and cerebrospinal fluid (CSF) assessment. Data were analyzed with generalized estimating equations and Cox proportional hazards analysis.ResultsThe PD‐DH subtype was associated with higher scores and faster progression rates in Movement Disorder Society–Unified PD Rating Scale (MDS‐UPDRS) Parts II and III. Also, patients in PD‐DH group had faster deterioration in nonmotor symptoms, including MDS‐UPDRS Part I score, Montreal Cognitive Assessment, Hopkins Verbal Learning Test–Revised, Wechsler Memory Scale‐Third edition (WMS‐III) Letter Number Sequencing score, Symbol Digit Modalities Test, and Scales for Outcomes in PD–Autonomic scores, with all P values <0.002. Moreover, the PD‐DH subtype had a higher mild cognitive impairment risk (hazard ratio = 1.756, 95% confidence interval [CI] = 1.132–2.722; P = 0.012), faster decline in caudate standard uptake values (β = −0.03, 95% CI = −0.06 to −0.008, P = 0.012), and CSF α‐synuclein levels (β = −77, 95% CI = −149 to −5, P = 0.034) than the PD group.ConclusionCoexisting pRBD and OD in patients with PD may be associated with faster progressions in motor measurements and in cognitive and autonomic symptoms, indicating PD‐DH as a more aggressive subtype for PD.
Reconstruction of the superficial femoral vessels with muscle flap coverage for soft tissue sarcomas of the proximal thigh
Authors: Homsy Pauliina , Kantonen Ilkka , Salo Juho , Albäck Anders , Tukiainen Erkki 
Published: June 2022

AbstractBackgroundSurgical resection of soft tissue sarcoma with a margin of healthy tissue may necessitate resection and reconstruction of major blood vessels together with soft tissues of the proximal thigh to preserve the limb. The long‐term functional outcomes of these reconstructions remain unestablished. The aim of this report was to assess the vascular and functional outcomes of soft tissue sarcoma patients with femoral vessel reconstructions.Patients and MethodsPatients who had undergone oncovascular reconstruction during the treatment of proximal thigh soft tissue sarcoma in 2014–2020 were reviewed for details of the vascular and soft tissue reconstructions, and the oncological and functional outcomes. This included eight patients of a median age 59 (range 19–77) years. All had a reconstruction of at least the superficial femoral artery and vein as well as soft tissue reconstruction with a muscle flap. All vessel reconstructions were done with either autologous vein (six grafts/four patients) or allograft (10 grafts/six patients). A microvascular latissimus dorsi flap, with a skin island, was incorporated to cover the vascular grafts in five patients. A pedicled sartorius or gracilis muscle flap was used to fill the defect in three patients.ResultsGraft patency was assessed in seven patients with a median follow‐up of 48 (1–76) months. The arterial graft was patent in 6/8 and the vein graft in 2/8 patients. The gait had returned to normal in five of the six patients assessed. The median MTSS was 70 (43–87)% and the TESS 90 (75–100)%. No local recurrence of the sarcoma was detected.ConclusionsVascular reconstruction combined with soft tissue reconstruction enables limb‐sparing surgery in patients with soft tissue sarcoma involving proximal femoral vessels. Although the surgeries are complex with high early morbidity, the achieved long‐term functional outcomes are worthwhile.