bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and patterns of adult and pediatric deep neck space infection in a tertiary care institute
Authors: Nassar Ahmed Amin , Othman Hazem , Eltelety Ahmad Mohamed 
Published: April 2022

Abstract
Background
Deep neck space infections are a serious but treatable group of infections affecting the fascial planes of the neck. The objective of this study is to determine various etiological causes, common sites, bacteriology, and complications in adult and pediatric patients suffering from deep neck space infections.

Results
We studied 80 patients retrospectively who were admitted and treated for deep neck space infections in the otolaryngology department in a tertiary care institute over 2 years between March 2019 and March 2021. The study cohort was divided into two major age groups; 20 patients belonged to the pediatric group, while 60 patients belonged to the adult group. In this study, odontogenic infection was the most common etiological factor, Ludwig’s angina and submandibular space abscess were the common sites of presentation. Methicillin-resistant Staphylococcus aureus was the most common isolated microorganism. Septicemia was the most common complication developed after drainage of deep neck space infections.

Conclusion
In the wake of an increase in the prevalence of deep neck space infections, close attention must be paid to the management of patients with deep neck space infections to prevent the complications.
Severe Hypoglycemia and Incidence of QT Interval Prolongation Among Adults With Type 2 Diabetes
Authors: Kaze Arnaud D , Yuyun Matthew F , Erqou Sebhat , Fonarow Gregg C , Echouffo-Tcheugui Justin B 
Published: April 2022

Abstract

Context
There is a paucity of large-scale epidemiological studies on the link between severe hypoglycemia (SH) and corrected QT (QTc) interval prolongation in type 2 diabetes (T2DM).

Objective
To evaluate the association of SH with QTc prolongation in adults with T2DM.

Methods
Prospective cohort analysis of participants enrolled in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study without QTc prolongation at baseline. SH was assessed over a 24-month period. Incident QTc prolongation was ascertained using follow-up electrocardiograms. Modified Poisson regression was used to generate the risk ratio (RR) and 95% CI for QTc prolongation.

Results
Among 8277 participants (mean age 62.6 years [SD 6.5], 38.7% women, 62.8% White), 324 had ≥1 SH episode (3.9%). Over a median of 5 years, 517 individuals developed QTc prolongation (6.3%). Participants with SH had a 66% higher risk of QTc prolongation (RR 1.66, 95% CI 1.16-2.38). The incidence of QTc prolongation was 10.3% (27/261) and 14.3% (9/63) for participants with 1 and ≥2 SH, respectively. Compared with no SH, RRs for patients with 1 and ≥2 SH episodes were 1.57 (95% CI 1.04-2.39) and 2.01 (95% CI 1.07-3.78), respectively. Age modified the association of SH with QTc prolongation (PInteraction = .008). The association remained significant among younger participants (&lt;61.9 years [median age]: RR 2.63, 95% CI 1.49-4.64), but was nonsignificant among older participants (≥61.9 years: RR 1.37, 95% CI 0.87-2.17).

Conclusion
In a large population with T2DM, SH was associated with an increased risk of QTc prolongation independently of other risk factors such as cardiac autonomic neuropathy. The association was strongest among younger participants.
Cardiovascular Benefits of Empagliflozin Are Associated With Gut Microbiota and Plasma Metabolites in Type 2 Diabetes
Authors: Deng Xinru , Zhang Chenhong , Wang Pengxu , Wei Wei , Shi Xiaoyang , Wang Pingping , Yang Junpeng , Wang Limin , Tang Shasha , Fang Yuanyuan , Liu Yalei , Chen Yiqi , Zhang Yun , Yuan Qian , Shang Jing , Kan Quane , Yang Huihui , Man Hua , Wang Danyu , Yuan Huijuan 
Published: April 2022

Abstract

Context
Cardiovascular benefits of empagliflozin in patients with type 2 diabetes mellitus (T2DM) have been reported; however, the underlying mechanism remains unknown.

Objective
We hypothesized that the cardiovascular benefits of empagliflozin are associated with altered gut microbiota and plasma metabolites, and that empagliflozin may be used as an initial treatment for patients with T2DM at risk of cardiovascular diseases (CVDs).

Methods
This randomized, open-label, 3-month, 2-arm clinical trial included 76 treatment-naïve patients with T2DM and risk factors for CVD who were treated with either empagliflozin (10 mg/d, n = 40) or metformin (1700 mg/d, n = 36). We investigated changes in clinical parameters related to glucose metabolism and CVD risk factors, gut microbiota using 16S rRNA gene sequencing, and plasma metabolites using LC-MS.

Results
We found significant and similar reduction in HbA1c levels and alleviation of glucose metabolism in both groups. However, only empagliflozin improved CVD risk factors. Empagliflozin significantly reshaped the gut microbiota after 1 month of treatment; this alteration was maintained until the end of the trial. Empagliflozin increased the levels of plasma metabolites such as sphingomyelin, but reduced glycochenodeoxycholate, cis-aconitate, and uric acid levels. Concurrently, empagliflozin elevated levels of short-chain fatty acid-producing bacteria such as species from Roseburia, Eubacterium, and Faecalibacterium, and reduced those of several harmful bacteria including Escherichia-Shigella, Bilophila, and Hungatella.

Conclusion
Empagliflozin may be a superior initial therapy for patients with T2DM at risk of CVDs; its cardiovascular benefits may be associated with shifts in gut microbiota and plasma metabolites.
Loss of the Incretin Effect in Type 2 Diabetes: A Systematic Review and Meta-analysis
Authors: Grespan Eleonora , Guolo Annamaria , Muscelli Elza , Ferrannini Ele , Mari Andrea 
Published: April 2022

Abstract

Context
Loss of the incretin effect (IE) in type 2 diabetes (T2D) contributes to hyperglycemia and the mechanisms underlying this impairment are unclear.

Objective
To quantify the IE impairment in T2D and to investigate the factors associated with it using a meta-analytic approach.

Methods
PubMed, Scopus, and Web-of-Science were searched. Studies measuring IE by the gold-standard protocol employing an oral glucose tolerance test (OGTT) and an intravenous glucose infusion at matched glucose levels were selected. We extracted IE, sex, age, body mass index (BMI), and hemoglobin A1c, fasting values, and area under curve (AUC) of glucose, insulin, C-peptide, glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide 1 (GLP-1). In subjects with T2D, we also recorded T2D duration, age at diagnosis, and the percentage of subjects taking antidiabetic medications.

Results
The IE weighted mean difference between subjects with T2D and those with normal glucose tolerance (NGT) was −27.3% (CI –36.5% to –18.1%; P &lt; .001; I2 = 86.6%) and was affected by age (P &lt; .005). By meta-regression of combined NGT and T2D data, IE was inversely associated with glucose tolerance (lower IE in T2D), BMI, and fasting GIP (P &lt; .05). By meta-regression of T2D studies only, IE was associated with the OGTT glucose dose (P &lt; .0001). IE from insulin was larger than IE from C-peptide (weighted mean difference 11.2%, CI 9.2-13.2%; P &lt; .0001; I2 = 28.1%); the IE difference was inversely associated with glucose tolerance and fasting glucose.

Conclusion
The IE impairment in T2D vs NGT is consistent though considerably variable, age being a possible factor affecting the IE difference. Glucose tolerance, BMI, and fasting GIP are independently associated with IE; in subjects with T2D only, the OGTT dose is a significant covariate.
Concurrent Use of Thyroid Hormone Therapy and Interfering Medications in Older US Veterans
Authors: Livecchi Rachel , Coe Antoinette B , Reyes-Gastelum David , Banerjee Mousumi , Haymart Megan R , Papaleontiou Maria 
Published: April 2022

Abstract

Context
Thyroid hormone management in older adults is complicated by comorbidities and polypharmacy.

Objective
Determine the prevalence of concurrent use of thyroid hormone and medications that can interfere with thyroid hormone metabolism (amiodarone, prednisone, prednisolone, carbamazepine, phenytoin, phenobarbital, tamoxifen), and patient characteristics associated with this practice.

Design
Retrospective cohort study between 2004 and 2017 (median follow-up, 56 months).

Setting
Veterans Health Administration Corporate Data Warehouse.

Participants
A total of 538 137 adults ≥ 65 years prescribed thyroid hormone therapy during the study period.

Main Outcome Measure
Concurrent use of thyroid hormone and medications interfering with thyroid hormone metabolism.

Results
Overall, 168 878 (31.4%) patients were on at least 1 interfering medication while on thyroid hormone during the study period. In multivariable analyses, Black/African-American race (odds ratio [OR], 1.25; 95% CI, 1.21-1.28, compared with White), Hispanic ethnicity (OR, 1.12; 95% CI, 1.09-1.15, compared with non-Hispanic), female (OR, 1.11; 95% CI, 1.08-1.15, compared with male), and presence of comorbidities (eg, Charlson/Deyo Comorbidity Score ≥ 2; OR, 2.50; 95% CI, 2.45-2.54, compared with 0) were more likely to be associated with concurrent use of thyroid hormone and interfering medications. Older age (eg, ≥ 85 years; OR, 0.48; 95% CI, 0.47-0.48, compared with age 65-74 years) was less likely to be associated with this practice.

Conclusions and Relevance
Almost one-third of older adults on thyroid hormone were on medications known to interfere with thyroid hormone metabolism. Our findings highlight the complexity of thyroid hormone management in older adults, especially in women and minorities.
Constitutively Active STAT5b Feminizes Mouse Liver Gene Expression
Authors: Lau-Corona Dana , Ma Hong , Vergato Cameron , Sarmento-Cabral Andre , del Rio-Moreno Mercedes , Kineman Rhonda D , Waxman David J 
Published: April 2022

Abstract
STAT5 is an essential transcriptional regulator of the sex-biased actions of GH in the liver. Delivery of constitutively active STAT5 (STAT5CA) to male mouse liver using an engineered adeno-associated virus with high tropism for the liver is shown to induce widespread feminization of the liver, with extensive induction of female-biased genes and repression of male-biased genes, largely mimicking results obtained when male mice are given GH as a continuous infusion. Many of the STAT5CA-responding genes were associated with nearby (&lt; 50 kb) sites of STAT5 binding to liver chromatin, supporting the proposed direct role of persistently active STAT5 in continuous GH-induced liver feminization. The feminizing effects of STAT5CA were dose-dependent; moreover, at higher levels, STAT5CA overexpression resulted in some histopathology, including hepatocyte hyperplasia, and increased karyomegaly and multinuclear hepatocytes. These findings establish that the persistent activation of STAT5 by GH that characterizes female liver is by itself sufficient to account for the sex-dependent expression of a majority of hepatic sex-biased genes. Moreover, histological changes seen when STAT5CA is overexpressed highlight the importance of carefully evaluating such effects before considering STAT5 derivatives for therapeutic use in treating liver disease.
Determinants of Metabolic Syndrome and Type 2 Diabetes in the Absence of Obesity: The Jackson Heart Study
Authors: Mongraw-Chaffin Morgana , Saldana Santiago , Carnethon Mercedes R , Chen Haiying , Effoe Valery , Golden Sherita Hill , Joseph Joshua , Kalyani Rita R , Bertoni Alain G 
Published: April 2022

Abstract

Context
Multiple studies suggest that adults who were normal weight at diabetes diagnosis are at higher risk for all-cause mortality than those who had overweight or obesity at diagnosis.

Objective
While obesity is a known risk factor for cardiometabolic disease, differences in body fat distribution in those without obesity are understudied, especially in African Americans.

Methods
In 1005 participants of the Jackson Heart Study, without cardiovascular disease at baseline, we used logistic regression to investigate the longitudinal association of body fat distribution by CT scan with metabolic syndrome (MetS) or type 2 diabetes (T2D). We used the harmonized International Diabetes Federation criteria to define MetS. We included only normal weight or overweight participants (BMI: 18.5 to &lt; 30.0 kg/m2). We created separate models for MetS and T2D adjusted for a standard set of covariates. We excluded participants with prevalent MetS or T2D, respectively in sensitivity.

Results
Higher visceral fat, subcutaneous fat, BMI, and insulin resistance (HOMA-IR) were significantly associated with MetS and T2D after adjustment. Visceral fat was strongly associated with both outcomes (MetS OR = 2.07 [1.66-2.68]; T2D OR = 1.51 [1.21-1.88]), and the association for MetS persisted in the normal weight only group. Estimates were robust to sensitivity analysis and were only modestly mediated by insulin resistance. Physical activity was not associated with MetS or T2D.

Conclusion
Visceral fat is strongly associated with developing MetS, even in normal weight individuals, suggesting that excess visceral fat plays a role in cardiometabolic risk beyond that of overall adiposity and obesity in African Americans.
Continuous Glucose Monitoring Profiles in Healthy, Nondiabetic Young Children
Authors: DuBose Stephanie N , Kanapka Lauren G , Bradfield Brenda , Sooy Morgan , Beck Roy W , Steck Andrea K 
Published: April 2022

Abstract

Context
Continuous glucose monitoring (CGM) is increasingly being used both for day-to-day management in patients with diabetes and in clinical research. While data on glycemic profiles of healthy, nondiabetic individuals exist, data on nondiabetic very young children are lacking.

Objective
This work aimed to establish reference sensor glucose ranges in healthy, nondiabetic young children, using a current-generation CGM sensor.

Methods
This prospective observational study took place in an institutional practice with healthy, nondiabetic children aged 1 to 6 years with normal body mass index. A blinded Dexcom G6 Pro CGM was worn for approximately 10 days by each participant. Main outcome measures included CGM metrics of mean glucose, hyperglycemia, hypoglycemia, and glycemic variability.

Results
Thirty-nine participants were included in the analyses. Mean average glucose was 103 mg/dL (5.7 mmol/L). Median percentage time between 70 and 140 mg/dL (3.9-7.8 mmol/L) was 96% (interquartile range, 92%-97%), mean within-individual coefficient of variation was 17 ± 3%, median time spent with glucose levels greater than 140 mg/dL was 3.4% (49 min/day), and median time less than 70 mg/dL (3.9 mmol/L) was 0.4% (6 min/day).

Conclusion
Collecting normative sensor glucose data and describing glycemic measures for young children fill an important informational gap and will be useful as a benchmark for future clinical studies.
Implementation and challenges of portable blood gas measurements in air medical transport
Authors: Murali Anjana , Guyette Francis X. , Martin-Gill Christian , Jones Marion , Kravetsky Matthew , Wheeler Sarah E. 
Published: April 2022

Abstract

Objectives
Ventilator management in prehospital settings using end-tidal CO2 can lead to inappropriate ventilation in the absence of point of care blood gas (POCBG) measurements. Implementation of POCBG testing in helicopter Emergency Medical Services (HEMS) is limited in part because of concern for preanalytical and analytical errors due to altitude, vibration, and other associated environmental factors and due to insufficient documentation of implementation challenges.

Methods
We performed accuracy and precision verification studies using standard materials tested pre-, in-, and post-flight (n=10) in a large HEMS agency. Quality assurance error log data were extracted and summarized for common POCBG errors during the first 31 months of use and air medical transport personnel were surveyed regarding POCBG use (n=63).

Results
No clinically significant differences were found between pre-, in-, and post-flight blood gas measurements. Error log data demonstrated a reduction in device errors over time. Survey participants found troubleshooting device errors and learning new clinical processes to be the largest barriers to implementation. Continued challenges for participants coincided with error log data including temperature and sampling difficulties. Survey participants indicated that POCBG testing improved patient management.

Conclusions
POCBG testing does not appear to be compromised by the HEMS environment. Temperature excursions can be reduced by use of insulated transport bags with heating and cooling packs. Availability of POCBG results in air medical transport appeared to improve ventilator management, increase recognition of ventilation-perfusion mismatch, and improve patient tolerance of ventilation.
Study on Comprehensive Discrimination Method of Fluid Phase Behavior in Low-Permeability Reservoir for Blood Flow Modelling
Authors: Kang Yuanyuan , Lv Jianguo , He Yongyao 
Published: April 2022

Abstract
Taking the low-permeability reservoir of complex sandy conglomerate reservoir of Kongdian Formation in Bozhong structure as the research goal, the comprehensive discrimination method of fluid phase state category of low-permeability reservoir is studied. This article analyzes the division method, genesis, and geological characteristics of low-permeability reservoirs and the distribution law of fluid phase. Based on the gas state equation and gas-liquid phase equilibrium equation, combined with thermodynamic theory, hydrocarbon fluid phase simulation is carried out by calculating bubble point pressure, dew point pressure, and other parameters. Combining the analysis results of fluid composition of typical wells, the fluid types of low-permeability reservoirs in complex glutenite reservoirs of Kongdian Formation in Bozhong structure are comprehensively distinguished by using phase diagram discrimination method and empirical statistical method of hydrocarbon composition combination parameters. The results show that the phase diagram discrimination method is consistent with the empirical statistical method of hydrocarbon composition combination parameters, and the discrimination accuracy of phase state category is close to 100 %. It is concluded that the low-permeability reservoir of complex sandy conglomerate reservoir of Kongdian Formation in Bozhong structure is mainly oil-free condensate gas reservoir.
3D Image Analysis of Sports Technical Features and Sports Training Methods Based on Artificial Intelligence
Authors: Mei Zhu 
Published: April 2022

Abstract
This article studies the three-dimensional (3D) image analysis and sports training methods of sports technical characteristics. This research uses the current sports technology diagnostic 3D video analysis system as a platform to build a database and knowledge base based on athletes’ 3D sports information and sports parameters and uses algorithms based on artificial intelligence machine-learning machines to analyze sports data, learn from it, and learn from sports technology. Actions make analytical decisions and predictions. Then, it analyzes the human-motion behavior with the concept of traditional and virtual reality technology. The effectiveness of athletes’ technical movements, using mathematical statistics, artificial intelligence, and other research methods, integrates and draws on the research methods of sports biomechanics, graphical imaging, human anatomy, expert systems, and neural networks. A neural network not only inherits certain characteristics of biology but also has its own unique characteristics, such as large-scale parallel processing, strong fault tolerance, and self-learning functions. Neural networks have a wide range of applications in information processing, pattern recognition, optimization, and other issues. By analyzing the application status of artificial intelligence technology in sports, the development prospects of sports training based on artificial intelligence can be inferred. Based on the acquisition of sports-related data, the evaluation of functional action modes, sports techniques, etc., is established. The multi-target feedback training method ultimately helps athletes improve their training level. Experimental data show that for the human body walking toward the camera, the rotation angle between adjacent frames is close to 0°, and the translational position is basically 5 cm. The experimental results show that 3D image analysis and related sports training methods based on specific sports technical characteristics are conducive to athletes’ performance improvement.
The geographical location, current state and forecasting of development of renewable energy facilities within Lviv region
Authors: Ivanov Yevhen A. , Krychevska Diana A. , Lopushanska Mariia R. , Pylypovych Olga V. 
Published: April 2022

Ukraine, as a member of the European Energy Community, has committed itself to achieve a share of 12 % renewables in its final energy generation by 2025 and a share of at least 25 % by 2035 (including all hydropower and thermal energy capacities). In 2019, the share of renewables in electricity generation in Ukraine was only 4 %. Renewables produce 4 % of total electricity production in Lviv region. According to this indicator, the region is the leader in the Western Ukraine. The paper analyzes the geographical location and the current state of renewable energy facilities in the Lviv region and forecasting their further development. As of July 1, 2020, in Lviv region there are 67 renewable energy facilities with a total capacity of over 310 MW. Most of the renewables supply electricity to the integrated energy system at a “green” tariff. They include two wind power plants with a total capacity of 33.9 MW in Staryy Sambir district; 59 industrial solar power plants with a total capacity of over than 275 MW in 15 administrative districts of Lviv region, Boryslav and Chervonohrad cities; two mini hydropower plants with a total capacity of 0.576 MW in Drohobych and Turka districts; three mini heat and electricity production plants running on biomass and producing electricity and thermal energy (Radekhiv heat and electricity production plant with a capacity of 2.4 MW, other heat and electricity production plants with a total capacity of 3.66 MW); one biomass electricity production plant operating in the Eco-Mit LLC pig farm in the village of Batyatychi in Kamianka-Buzka district. In addition, 985 solar electricity production plants at private households were built in 20 administrative districts and 9 cities in the region. Their total capacity is over 19 MW, which is equivalent to average capacity of one industrial solar electricity production plant. The leader in the number of industrial facilities for renewable energy is Yavoriv district, where almost half of the total renewables’ capacity of Lviv region is concentrated. The largest number of solar electricity production plants of private households is located in Pustomyty and Yavoriv districts, and Lviv city, whereas the lowest number in mountainous areas, particular in Turka and Skole districts. As of January 1, 2020, solar energy constituted 70 % of renewable energy in Lviv region. At the same time, according to the Development Strategy of Lviv region for the period of 2021–2027, the largest share in the structure of electricity production belongs to wind energy. The development of renewable energy in Ukraine depends on the rate of “green” tariff. The actual financial stimulus has led to a rapid increase in the share of renewables in total electricity generation in Ukraine and Lviv region in particular. Promising areas for renewable energy in Lviv region are wind and bioenergy developments.