bluuebunny/crossref_metadata_2025 huggingface dataset:
They discourse with an old man
Authors: Johnson Samuel
Published: February 2022

The evening was now far past, and they rose to return home. As they walked along the bank of the Nile, delighted with the beams of the moon quivering on the water, they saw at a small distance an old man, whom the prince had often heard in the assembly of the sages. ‘Yonder, said he, is one whose years have calmed his passions, but not clouded his reason: let us close the disquisitions of the night, by enquiring what are his sentiments of his own state, that we may know whether youth alone is to struggle with vexation, and whether any better hope remains for the latter part of life.’
The prince enters and brings a new topick
Authors: Johnson Samuel
Published: February 2022

‘All this, said the astronomer, I have often thought, but my reason has been so long subjugated by an uncontrolable and overwhelming idea, that it durst not confide in its own decisions. I now see how fatally I betrayed my quiet, by suffering chimeras to prey upon me in secret; but melancholy shrinks from communication, and I never found a man before, to whom I could impart my troubles, though I had been certain of relief. I rejoice to find my own sentiments confirmed by yours, who are not easily deceived, and can have no motive or purpose to deceive. I hope that time and variety will dissipate the gloom that has so long surrounded me,* and the latter part of my days will be spent in peace.’
The description of the family of Wakefield; in which a kindred likeness prevails as well of minds as of persons
Authors: Goldsmith Oliver
Published: February 2022

I was ever of opinion, that the honest man who married and brought up a large family, did more service than he who continued single, and only talked of population. For this motive, I had scarce taken orders a year before I began to think seriously of matrimony, and chose my wife as she did her wedding gown, not for a fine glossy surface, but such qualities as would wear well. To do her justice, she was a good-natured notable woman; and as for breeding, there were few country ladies who could shew more. She could read any English book without much spelling, but for pickling, preserving, and cookery, none could excel her. She prided herself also upon being an excellent contriver in housekeeping; tho’ I could never find that we grew richer with all her contrivances.
Family misfortunes. The loss of fortune only serves to encrease the pride of the worthy
Authors: Goldsmith Oliver
Published: February 2022

The temporal concerns of our family were chiefly committed to my wife’s management, as to the spiritual I took them entirely under my own direction. The profits of my living, which amounted to but thirty-five pounds a year,* I made over to the orphans and widows of the clergy of our diocese;* for having a sufficient fortune of my own, I was careless of temporalities, and felt a secret pleasure in doing my duty without reward. I also set a resolution of keeping no curate,* and of being acquainted with every man in the parish, exhorting the married men to temperance and the bachelors to matrimony; so that in a few years it was a common saying, that there were three strange wants at Wakefield, a parson wanting pride, young men wanting wives, and ale-houses wanting customers.
No situation, however wretched it seems, but has some sort of comfort attending it
Authors: Goldsmith Oliver
Published: February 2022

We set forward from this peaceful neighbourhood, and walked on slowly. My eldest daughter being enfeebled by a slow fever, which had begun for some days to undermine her constitution, one of the officers, who had an horse, kindly took her behind him; for even these men cannot entirely divest themselves of humanity. My son led one of the little ones by the hand, and my wife the other, while I leaned upon my youngest girl, whose tears fell not for her own but my distresses.
The same subject continued
Authors: Goldsmith Oliver
Published: February 2022

The next morning I communicated to my wife and children the scheme I had planned of reforming the prisoners, which they received with universal disapprobation, alledging the impossibility and impropriety of it; adding, that my endeavours would no way contribute to their amendment, but might probably disgrace my calling.
Happiness and misery rather the result of prudence than of virtue in this life. Temporal evils or felicities being regarded by heaven as things merely in themselves trifling and unworthy its care in the distribution
Authors: Goldsmith Oliver
Published: February 2022

I had now been confined more than a fortnight, but had not since my arrival been visited by my dear Olivia, and I greatly longed to see her. Having communicated my wishes to my wife, the next morning the poor girl entered my apartment, leaning on her sister’s arm. The change which I saw in her countenance struck me. The numberless graces that once resided there were now fled, and the hand of death seemed to have molded every feature to alarm me. Her temples were sunk, her forehead was tense, and a fatal paleness sate upon her cheek.
The Conclusion
Authors: Goldsmith Oliver
Published: February 2022

The next morning as soon as I awaked I found my eldest son sitting by my bedside, who came to encrease my joy with another turn of fortune in my favour. First having released me from the settlement that I had made the day before in his favour, he let me know that my merchant who had failed in town was arrested at Antwerp, and there had given up effects to a much greater amount than what was due to his creditors. My boy’s generosity pleased me almost as much as this unlooked for good fortune. But I had some doubts whether I ought in justice to accept his offer. While I was pondering upon this, Sir William entered the room, to whom I communicated my doubts. His opinion was, that as my son was already possessed of a very affluent fortune by his marriage, I might accept his offer without any hesitation. His business, however, was to inform me that as he had the night before sent for the licences, and expected them every hour, he hoped that I would not refuse my assistance in making all the company happy that morning. A footman entered while we were speaking, to tell us that the messenger was returned, and as I was by this time ready, I went down, where I found the whole company as merry as affluence and innocence could make them. However, as they were now preparing for a very solemn ceremony, their laughter entirely displeased me. I told them of the grave, becoming and sublime deportment they should assume upon this mystical occasion, and read them two homilies and a thesis of my own composing, in order to prepare them. Yet they still seemed perfectly refractory and ungovernable. Even as we were going along to church, to which I led the way, all gravity had quite forsaken them, and I was often tempted to turn back in indignation. In church a new dilemma arose, which promised no easy solution. This was, which couple should be married first; my son’s bride warmly insisted, that Lady Thornhill, (that was to be) should take the lead; but this the other refused with equal ardour, protesting she would not be guilty of such rudeness for the world. The argument was supported for some time between both with equal obstinacy and good breeding. But as I stood all this time with my book ready, I was at last quite tired of the contest, and shutting it, ‘I perceive,’ cried I, ‘that none of you have a mind to be married, and I think we had as good go back again; for I suppose there will be no business done here to-day’—This at once reduced them to reason. The Baronet and his Lady were first married, and then my son and his lovely partner.
Reply to Malthus
Authors: Hazlitt William
Published: February 2022

This excellent saying of a great man was never more strictly applicable to any system than it is to Mr. Malthus’s paradox, and his explanation of it. It seemed, on the first publication of the Essay on Population,* if the whole world was going to be turned topsy-turvy; all our ideas of moral good and evil were in a manner confounded, we scarcely knew whether we stood on our head or our heels; but, after exciting considerable expectation, giving us a good shake, and making us a little dizzy, Mr. M. does, as we do when we shew the children London — sets us on our feet again, and every thing goes on as before.
On Imitation
Authors: Hazlitt William
Published: February 2022

Objects in themselves disgusting or indifferent often please in the imitation. A brick-floor, a pewter-plate, an ugly cur barking, a Dutch boor smoking or playing at skittles, the inside of a shambles, a fishmonger’s or a greengrocer’s stall, have been made very interesting pictures by the fidelity, truth, and spirit, with which they have been copied. One source of the pleasure thus received is undoubtedly the surprise or feeling of admiration, occasioned by the unexpected coincidence between the imitation and the object. The deception however not only pleases at first sight, or from mere novelty; but it continues to please upon farther acquaintance, and in proportion to the insight we acquire into the distinctions of nature and of art.
On the Elgin Marbles
Authors: Hazlitt William
Published: February 2022

The Elgin Marbles* are the best answer to Sir Joshua Reynolds’s Discourses.* Considered in that point of view, they are invaluable: in any other, they are not worth so much as has been said. Nothing remains of them but their style; but that is every thing, for it is the style of nature. Art is the imitation of nature: and the Elgin Marbles are in their essence and their perfection casts from nature, — from fine nature, it is true, but from real, living, moving nature: from objects in nature, answering to an idea in the artist’s mind, not from an idea in the artist’s mind abstracted from all objects in nature.
Coriolanus
Authors: Hazlitt William
Published: February 2022

Coriolanus has of late been repeatedly acted here. Shakespear has in this play shewn himself well versed in history and state-affairs. Coriolanus is a store-house of political common-places. Any one who studies it may save himself the trouble of reading Burke’s Reflections or Paine’s Rights of Man, or the Debates in both Houses of Parliament since the French Revolution or our own. The arguments for and against aristocracy or democracy, on the privileges of the few and the claims of the many, on liberty and slavery, power and the abuse of it, peace and war, are here very ably handled, with the spirit of a poet and the acuteness of a philosopher. Shakespear himself seems to have had a leaning to the arbitrary side of the question, perhaps from some feeling of contempt for his own origin; and to have spared no occasion of baiting the rabble. What he says of them is very true: what he says of their betters is also very true, though he dwells less upon it.
Hamlet
Authors: Hazlitt William
Published: February 2022

This is that Hamlet the Dane, whom we read of in our youth, and whom we seem almost to remember in our after-years; he who made that famous soliloquy on life, who gave the advice to the players, who thought ‘this goodly frame, the earth, a steril promontory, and this brave o’er-hanging firmament, the air, this majestical roof fretted with golden fire, a foul and pestilent congregation of vapours;’* whom ‘man delighted not, nor woman neither;’* he who talked with the grave-diggers, and moralised on Yorick’s skull; the school-fellow of Rosencraus and Guildenstern at Wittenberg; the friend of Horatio; the lover of Ophelia; he that was mad and sent to England; the slow avenger of his father’s death; who lived at the court of Horwendillus five hundred years before we were born, but all whose thoughts we seem to know as well as we do our own, because we have read them in Shakespear.
What is the People?
Authors: Hazlitt William
Published: February 2022

— And who are you that ask the question? One of the people. And yet you would be something! Then you would not have the People nothing. For what is the People? Millions of men, like you, with hearts beating in their bosoms, with thoughts stirring in their minds, with the blood circulating in their veins, with wants and appetites, with passions and anxious cares, and busy purposes and affections for others and a respect for themselves, and a desire of happiness, and a right to freedom and a will to be free.
On Fashion
Authors: Hazlitt William
Published: February 2022

Fashion is an odd jumble of contradictions, of sympathies and antipathies. It exists only by its being participated among a certain number of persons, and its essence is destroyed by being communicated to a greater number. It is a continual struggle between ‘the great vulgar and small,’* to get the start of or keep up with each other in the race of appearances, by an adoption on the part of the one of such external and fantastic symbols as strike the attention and excite the envy or admiration of the beholder, which are no sooner made known and exposed to public view for this purpose, than they are successfully copied by the multitude, the slavish herd of imitators, who do not wish to be behind-hand with their betters in outward show and pretensions, and which then sink, without any farther notice, into disrepute and contempt. Thus fashion lives only in a perpetual round of giddy innovation and restless vanity. To be old fashioned is the greatest crime a coat or a hat can be guilty of.
On the Pleasure of Painting
Authors: Hazlitt William
Published: February 2022

‘There is a pleasure in painting which none but painters know.’* In writing, you have to contend with the world: in painting, you have only to carry on a friendly strife with nature. You sit down to your task, and are happy. From the moment that you take up the pencil, and look nature in the face, you are at peace with your own heart. No angry passions rise to disturb the silent progress of the work, — to shake the hand, or dim the brow: no irritable humours are set afloat: you have no absurd opinions to combat — no point to strain — no adversary to crush — no fool to annoy; you are actuated by fear or favour of no man.
Character of Cobbett
Authors: Hazlitt William
Published: February 2022

People have about as substantial an idea of Cobbett as they have of Cribb.* His blows are as hard, and he himself is as impenetrable. One has no notion of him as making use of a fine pen, but a great mutton-fist; his style stuns his readers, and he ‘fillips the ear of the public with a three-man beetle.’* He is too much for any single newspaper antagonist; ‘lays waste’* a city orator or Member of Parliament, and bears hard upon the government itself. He is a kind of fourth estate* in the politics of the country. He is not only unquestionably the most powerful political writer of the present day, but one of the best writers in the language. He speaks and thinks plain, broad, downright English. He might be said to have the clearness of Swift, the naturalness of Defoe, and the picturesque satirical description of Mandeville; if all such comparisons were not impertinent.
Refreshments for Travellers
Authors: Dickens Charles
Published: February 2022

in the late high winds* I was blown to a great many places—and indeed, wind or no wind, I generally have extensive transactions on hand in the article of Air—but I have not been blown to any English place lately, and I very seldom have blown to any English place in my life, where I could get anything good to eat and drink in five minutes, or where, if I sought it, I was received with a welcome.
Travelling Abroad
Authors: Dickens Charles
Published: February 2022

Immediately, all that W. and S. W. division of London began to slide away at a pace so lively, that I was over the river, and past the Old Kent–road, and out on Blackheath, and even ascending Shooter's Hill,* before I had had time to look about me in the carriage, like a collected traveller.
Tramps
Authors: Dickens Charles
Published: February 2022

The chance use of the word “Tramp” in my last paper, brought that numerous fraternity so vividly before my mind's eye, that I had no sooner laid down my pen than a compulsion was upon me to take it up again, and make notes of the Tramps whom I perceived on all the summer roads in all directions.
Dullborough Town
Authors: Dickens Charles
Published: February 2022

It lately happened that I found myself rambling about the scenes among which my earliest days were passed; scenes from which I departed when I was a child, and which I did not revisit until I was a man. This is no uncommon chance, but one that befals some of us any day; perhaps it may not be quite uninteresting to compare notes with the reader respecting an experience so familiar and a journey so uncommercial.
Medicine Men of Civilisation
Authors: Dickens Charles
Published: February 2022

My voyages (in paper boats) among savages often yield me matter for reflection at home. It is curious to trace the savage in the civilised man, and to detect the hold of some savage customs on conditions of society rather boastful of being high above them.
The Ruffian
Authors: Dickens Charles
Published: February 2022

I entertain so strong an objection to the euphonious softening of Ruffian into Rough, which has lately become popular, that I restore the right word to the heading of this paper; the rather, as my object is to dwell upon the fact that the Ruffian is tolerated among us to an extent that goes beyond all unruffianly endurance. I take the liberty to believe that if the Ruffian besets my life, a professional Ruffian at large in the open streets of a great city, notoriously having no other calling than that of Ruffian, and of disquieting and despoiling me as I go peacefully about my lawful business, interfering with no one, then the Government under which I have the great constitutional privilege, supreme honour and happiness, and all the rest of it, to exist, breaks down in the discharge of any Government’s most simple elementary duty.
A Little Dinner in an Hour
Authors: Dickens Charles
Published: February 2022

it fell out on a day in this last autumn that I had to go down from London to a place of sea-side resort, on an hour’s business, accompanied by my esteemed friend Bullfinch. Let the place of sea-side resort be, for the nonce, called Namelesston.
On an Amateur Beat
Authors: Dickens Charles
Published: February 2022

it is one of my fancies that even my idlest walk must always have its appointed destination. I set myself a task before I leave my lodging in Covent Garden on a street expedition, and should no more think of altering my route by the way, or turning back and leaving a part of it unachieved, than I should think of fraudulently violating an agreement entered into with somebody else. The other day, finding myself under this kind of obligation to proceed to Limehouse, I started punctually at noon, in compliance with the terms of the contract with myself to which my good faith was pledged.
A Plea for total Abstinence
Authors: Dickens Charles
Published: February 2022

one day this last Whitsuntide, at precisely eleven o’clock in the forenoon, there suddenly rode into the field of view commanded by the windows of my lodging, an equestrian phenomenon. It was a fellow–creature on horseback, dressed in the absurdest manner. The fellow–creature wore high boots, some other (and much larger) fellow–creature’s breeches, of a slack–baked doughy colour and a baggy form, a blue shirt whereof the skirt or tail was puffily tucked into the waistband of the said breeches, no coat, a red shoulder–belt, and a demi–semi–military scarlet hat with a feathered ornament in front, which to the uninstructed human vision had the appearance of a moulting shuttlecock. I laid down the newspaper with which I had been occupied, and surveyed the fellow–man in question, with astonishment.
Smart policing: Abu Dhabi police AI/GPS-based initiative to reduce heavy vehicle driver violations
Authors: Al Shamsi Ahmed Surour , Davies Amanda
Published: February 2022

One of the consequences of a rapidly developing 21st society is management of road traffic. Globally, road traffic collisions are among the most common incidents for which police are required to respond. The research presented in this article discusses an intervention strategy developed and applied by Abu Dhabi Police to reduce the impact of heavy vehicle driver violations and associated impact on collisions, deaths, and injuries in a period of 5 years up to and including April 2020. This article presents the findings from an impact evaluation of the Abu Dhabi Police Smart Traffic Centre Truck Permissions system that is supported by a complex multidimensional intelligent technology-based vehicle tracking system coupled with a driver violation penalty process. Analysis of data indicates a positive reduction rate in truck-caused accidents and resulting deaths and injuries during the post-intervention period. The research indicates effective policing strategies, which incorporate the affordances of smart technology have the potential to continuously improve road traffic management and by association the impact on the humanitarian and economic sustainability of a community and nation.
Resolving the genetics of human tryptases: implications for health, disease, and clinical use as a biomarker
Authors: O’Connell Michael P. , Lyons Jonathan J.
Published: February 2022

Purpose of review

To discuss our evolving understanding of the genetic variation in human tryptases and recent advances in associated clinical phenotypes.

Recent findings

Serum tryptase levels have long been used as biomarkers in clinical practice to diagnose mast cell-associated disorders and mast cell-mediated reactions but the contribution of specific secreted isoforms of human tryptases and their role(s) in health and disease has only recently begun to be illuminated. It is now recognized that hereditary alpha-tryptasemia (HαT) is a common genetic trait and the commonest cause for elevated basal serum tryptase (BST), where it can both contribute to mast cell-associated phenotypes, and potentially confound their correct diagnosis. Expression of different tryptase isoforms is now recognized to be associated with specific clinical phenotypes including clonal and nonclonal mast cell-associated disorders as well as certain asthma endotypes. These disparate impacts on clinical disorders may result from differences in enzymatic activities of mature α-tryptases and β-tryptases, and the unique substrate profile and stability of heterotetrameric mature α/β-tryptases recently described to naturally occur.

Variable copy number and isoform expression of tryptases differentially impact diseases and reactions associated with mast cells in humans. Recent advances in understanding of genetics governing BST levels have refined our understanding and the clinical use of this biomarker. In the future, incorporation of tryptase genotyping will likely be integral to the work-up and trial design of patients with phenotypes impacted by mast cells ranging from asthma to mastocytosis.
Predicting Future Care Requirements Using Machine Learning for Pediatric Intensive and Routine Care Inpatients
Authors: Trujillo Rivera Eduardo A. , Chamberlain James M. , Patel Anita K. , Zeng-Treitler Qing , Bost James E. , Heneghan Julia A. , Morizono Hiroki , Pollack Murray M.
Published: February 2022

OBJECTIVES:

Develop and compare separate prediction models for ICU and non-ICU care for hospitalized children in four future time periods (6–12, 12–18, 18–24, and 24–30 hr) and assess these models in an independent cohort and simulated children’s hospital.

DESIGN:

Predictive modeling used cohorts from the Health Facts database (Cerner Corporation, Kansas City, MO).

SETTING:

Children hospitalized in ICUs.

PATIENTS:

Children with greater than or equal to one ICU admission (n = 20,014) and randomly selected routine care children without ICU admission (n = 20,130) from 2009 to 2016 were used for model development and validation. An independent 2017–2018 cohort consisted of 80,089 children.

INTERVENTIONS:

None.

MEASUREMENT AND MAIN RESULTS:

Initially, we undersampled non-ICU patients for development and comparison of the models. We randomly assigned 64% of patients for training, 8% for validation, and 28% for testing in both clinical groups. Two additional validation cohorts were tested: a simulated children’s hospitals and the 2017–2018 cohort. The main outcome was ICU care or non-ICU care in four future time periods based on physiology, therapy, and care intensity. Four independent, sequential, and fully connected neural networks were calibrated to risk of ICU care at each time period. Performance for all models in the test sample were comparable including sensitivity greater than or equal to 0.727, specificity greater than or equal to 0.885, accuracy greater than 0.850, area under the receiver operating characteristic curves greater than or equal to 0.917, and all had excellent calibration (all R2
s > 0.98). Model performance in the 2017–2018 cohort was sensitivity greater than or equal to 0.545, specificity greater than or equal to 0.972, accuracy greater than or equal to 0.921, area under the receiver operating characteristic curves greater than or equal to 0.946, and R2
s greater than or equal to 0.979. Performance metrics were comparable for the simulated children’s hospital and for hospitals stratified by teaching status, bed numbers, and geographic location.

CONCLUSIONS:

Machine learning models using physiology, therapy, and care intensity predicting future care needs had promising performance metrics. Notably, performance metrics were similar as the prediction time periods increased from 6–12 hours to 24–30 hours.
Adherence to Lung Protective Ventilation in Patients With Coronavirus Disease 2019
Authors: Levy Elizabeth , Scott Stefania , Tran Teresa , Wang Wei , Mikkelsen Mark E. , Fuchs Barry D. , Kerlin Meeta Prasad
Published: February 2022

OBJECTIVES:

Prior studies have demonstrated suboptimal adherence to lung protective ventilation among patients with acute respiratory distress syndrome. A common barrier to providing this evidence-based practice is diagnostic uncertainty. We sought to test the hypothesis that patients with acute respiratory distress syndrome due to coronavirus disease 2019, in whom acute respiratory distress syndrome is easily recognized, would be more likely to receive low tidal volume ventilation than concurrently admitted acute respiratory distress syndrome patients without coronavirus disease 2019.

DESIGN:

Retrospective cohort study.

SETTING:

Five hospitals of a single health system.

PATIENTS:

Mechanically ventilated patients with coronavirus disease 2019 or noncoronavirus disease 2019 acute respiratory distress syndrome as identified by an automated, electronic acute respiratory distress syndrome finder in clinical use at study hospitals.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Among 333 coronavirus disease 2019 patients and 234 noncoronavirus disease 2019 acute respiratory distress syndrome patients, the average initial tidal volume was 6.4 cc/kg predicted body weight and 6.8 cc/kg predicted body weight, respectively. Patients had tidal volumes less than or equal to 6.5 cc/kg predicted body weight for a mean of 70% of the first 72 hours of mechanical ventilation in the coronavirus disease 2019 cohort, compared with 52% in the noncoronavirus disease 2019 cohort (unadjusted p < 0.001). After adjusting for height, gender, admitting hospital, and whether or not the patient was admitted to a medical specialty ICU, coronavirus disease 2019 diagnosis was associated with a 21% higher percentage of time receiving tidal volumes less than or equal to 6.5 cc/kg predicted body weight within the first 72 hours of mechanical ventilation (95% CI, 14–28%; p < 0.001).

CONCLUSIONS:

Adherence to low tidal volume ventilation during the first 72 hours of mechanical ventilation is higher in patients with coronavirus disease 2019 than with acute respiratory distress syndrome without coronavirus disease 2019. This population may present an opportunity to understand facilitators of implementation of this life-saving evidence-based practice.
A Rare Sequela of Constriction Band Syndrome: Case Report
Authors: Al Basti Habib , Ahmed Mohamed Badie , Sada Ruba , Malki Mohammed Imad , Al Lahham Salim
Published: February 2022

The patient in this case report is a 19-year-old man who presented with left foot cauliflower lesion. He complained of an inability to wear proper shoes, in addition to an unpleasant appearance of his foot. The lesion was present since his birth. Based on history and physical examination, the top 2 differential diagnoses at this stage were pediatric neurofibroma and constriction band syndrome (CBS). Laboratory investigations and x-ray were ordered for the patient. X-ray showed absence of most of the phalanges of the first, second, and third toes, with swelling of the overlying soft tissues of the foot. CBS was confirmed. Excision of the lesion was done along with skin graft applied on the area. Biopsy showed skin with dermal fibrosis and extensive adipose tissue infiltration without any sign of atypia or malignancy. The patient was discharged with regular follow-up appointments.
Effect of long-term antihypertensive therapy on myocardial strain: a meta-analysis
Authors: Tadic Marijana , Gherbesi Elisa , Sala Carla , Carugo Stefano , Cuspidi Cesare
Published: February 2022

Aim:

Evidence on the impact of blood pressure (BP)-lowering drugs on left ventricular (LV) mechanics in hypertension is still limited. We performed a meta-analysis of speckle-tracking echocardiographic studies in order to provide a new piece of information on this topic.

Methods:

The PubMed, OVID-MEDLINE, and Cochrane library databases were analysed to search for articles published from the inception up to 31 October 2021. Studies were identified by using MeSH terms and crossing the following search items: ‘myocardial strain’, ‘left ventricular mechanics’, ‘speckle tracking echocardiography’, ‘systolic dysfunction’, ‘left ventricular hypertrophy’, ‘systemic hypertension’, ‘BP lowering drugs,’ ‘antihypertensive therapy’.

Results:

A total of 1140 hypertensive patients (mean age 55.4 years, 50% men, follow-up 6–36 months) were included in eight studies. Pretreatment and posttreatment pooled SBP/DBPs were 148.4 ± 3.5/88.7 ± 2 vs. 127.4 ± 1.9/77.8 ± 0.9 mmHg. Corresponding values for ejection fraction (EF), LV mass (LVM) index, and global longitudinal strain (GLS) were 64 ± 2.3 vs. 65.9 ± 1.7% (SMD: 0.14 ± 0.03, CI 0.08– 0.20, P = 0.001); 108.4 ± 11.2 vs. 100.2 ± 11.0 g/m2 (SMD: −0.27 ± 0.10, CI −0.46 to −0.08, P < 0.01); −17.7 ± 0.6 vs. −19.6 ± 0.4%, (SMD 0.26 ± 0.03, CI 0.20–0.32, P < 0.0001), respectively. A meta-regression analysis showed a significant relation between GLS improvement and the extent of reduction of LVMI (P = 0.0003), but not of SBP (P = 0.27).

Conclusion:

Our meta-analysis suggests that antihypertensive treatment has a clear beneficial effect on LV mechanisms, and the improvement in GLS is mainly related to the reduction in LVMI rather than SBP.
Hypertension-mediated organ damage in masked hypertension
Authors: Hinderliter Alan L. , Lin Feng-Chang , Viera Laura A. , Olsson Emily , Klein J. Larry , Viera Anthony J.
Published: February 2022

Objectives:

Masked hypertension – a blood pressure (BP) phenotype characterized by a clinic BP in the normal range but elevated BP outside the office – is associated with early hypertension-mediated organ damage. This study examined early target organ manifestations of masked hypertension diagnosed by home (HBPM) and ambulatory (ABPM) BP monitoring.

Methods:

Left ventricular (LV) structure and diastolic function measured by echocardiography, microalbuminuria, and coronary artery calcification were evaluated in 420 patients with high clinic BP (SBP 120–150 mmHg or DBP 80–95 mmHg). Evidence of hypertension-mediated organ damage was compared in patients with sustained normotension, masked hypertension, and sustained hypertension based on measurements by HBPM, daytime ABPM, and 24-h ABPM.

Results:

The 420 participants averaged 48 (12) [mean (SD)] years of age; the average clinic BP was 130 (13)/81 (8) mmHg. In individuals with masked hypertension diagnosed by HBPM, indexed LV mass, relative wall thickness, and e′ and E/e′ (indices of LV relaxation), were generally intermediate between values observed in normotensives and sustained hypertensive patients, and were significantly greater in masked hypertension than normotensives. Similar trends were observed when masked hypertension was diagnosed by ABPM but a diagnosis of masked hypertension was not as reliably associated with LV remodeling or impaired LV relaxation in comparison to normotensives. There were trends towards greater likelihoods of detectable urinary microalbumin and coronary calcification in masked hypertension than in normotensives.

Conclusion:

These results support previous studies demonstrating early hypertension-mediated organ damage in patients with masked hypertension, and suggest that HBPM may be superior to ABPM in identifying patients with masked hypertension who have early LV remodeling and diastolic LV dysfunction.
DEVELOPMENT OF FOCAL CHOROIDAL EXCAVATION AFTER ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR POLYPOIDAL CHOROIDAL VASCULOPATHY
Authors: Uemura Akinori , Hamada Takuto , Mihara Naohisa , Yamakiri Keita
Published: February 2022

Purpose:

The purpose of this study was to describe a case of polypoidal choroidal vasculopathy, showing a newly developed focal choroidal excavation during a 4-year follow-up period with multiple intravitreal antivascular endothelial growth factor injections.

Methods:

This study was a case report.

Results:

A 64-year-old man was referred for treatment of age-related macular degeneration in his left eye. His corrected visual acuity at initial presentation was 20/20 in both the right and left eye. Optical coherence tomography of the left eye revealed a steep retinal pigment epithelial detachment and subretinal fluid, and indocyanine green angiography confirmed a polypoidal lesion, leading to the diagnosis of polypoidal choroidal vasculopathy with pachychoroid features. Thereafter, antivascular endothelial growth factor intravitreal injections were continued on a pro re nata basis. Two years after the initial presentation, the sharp pigment epithelial detachment began to shrink, and a novel focal choroidal excavation gradually emerged surrounding the pigment epithelial detachment with an inner choroidal layer attenuation.

Conclusion:

Multiple antivascular endothelial growth factor injections for polypoidal choroidal vasculopathy resulted in atrophy of the polypoidal lesion and a decrease in the blood flow in the adjacent inner choroidal vasculature, leading to the formation of a novel focal choroidal excavation.
Incidence and predictors of sudden cardiac arrest in the immediate post-percutaneous coronary intervention period for ST-elevation myocardial infarction: a single-center study
Authors: Abe Temidayo , Olanipekun Titilope , Igwe Joseph , Ndausung Udongwo , Amah Chidi , Chang Albert , Effoe Valery , Egbuche Obiora , Ogunbayo Gbolahan , Onwuanyi Anekwe
Published: February 2022

Background

Data on the incidence, predictors, and outcomes of sudden cardiac arrest (SCA) in the immediate post-percutaneous coronary intervention (PCI) period for ST-elevation myocardial infarction (STEMI) are limited.

Objectives

The study aimed to investigate the trends and predictors of SCA occurring within 48 h post PCI for STEMI.

Methods

We systematically reviewed data from the electronic medical records of 403 patients who underwent PCI for STEMI between January 2014 and December 2019. Trends in the incidence of SCA 48 h post PCI for STEMI were assessed using the Cochrane–Armitage test. Multivariable logistic regression was used to determine the predictors of SCA within 48 h post PCI for STEMI.

Results

Of the 403 patients who underwent PCI for STEMI, 44 (11%) had SCA within 48 h post PCI. The incidence of SCA within 48 h post PCI decreased from 22% in 2014 to 8% in 2019; P = 0.03. After adjusting for underlying confounding variables in the multivariable logistic regression models, out of hospital cardiac arrest [adjusted odds ratio (aOR), 23.9; confidence interval (CI), 10.2–56.1], left main coronary artery disease (aOR, 3.1; CI, 1.1–9.4), left main PCI (aOR, 6.6; CI: 1.4–31.7), new-onset heart failure (aOR, 2.0; CI, 4.3–9.4), and cardiogenic shock (aOR, 5.8; CI, 1.7–20.2) were statistically significant predictors of SCA within 48 h post PCI for STEMI.

Conclusion

We identified essential factors associated with SCA within 48 h post PCI for STEMI. Future studies are needed to devise effective strategies to decrease the risk of SCA in the early post-PCI period.
Impact of psoas muscle index assessed by a simple measurement method on tolerability and duration of continued treatment with sorafenib in hepatocellular carcinoma patients
Authors: Ogushi Katsuaki , Chuma Makoto , Numata Kazushi , Nozaki Akito , Moriya Satoshi , Uojima Haruki , Kondo Masaki , Morimoto Manabu , Maeda Shin
Published: February 2022

Background

In this study, we investigated the impact of simple measurement of psoas muscle index (PMI) on the tolerability of sorafenib treatment of switch from sorafenib to regorafenib.

Method

This retrospective study enrolled 109 patients with Child–Pugh A hepatocellular carcinoma (HCC) treated with sorafenib. Pretreatment PMI was calculated by measuring and multiplying the greatest anterior/posterior and transverse diameters of the psoas muscles on axial computed tomography images at the L3 vertebral level, and normalizing the sum of bilateral psoas muscle areas by the square of the height in meters. We, then, statistically analyzed the association between PMI and adverse events (AEs) to treatment, tolerability of sorafenib, time to treatment failure (TTF), and prognosis in patients stratified according to PMI.

Result

Patients were divided into high PMI (n = 41) and low PMI (n = 68) groups based on the cutoff PMI values (men: 7.04 cm2/m2; women: 4.40 cm2/m2) determined by receiver operating characteristic curve analysis to determine sorafenib tolerability. Frequencies of all types of severe AEs were higher in the low PMI group (50.0%) than in the high PMI group (29.3%; P = 0.045). The high PMI group (51.2%) had greater tolerance to sorafenib than the low PMI group (25.0%; P = 0.007). Moreover, in multivariable analysis, PMI was associated with sorafenib tolerability (odds ratio 0.26; P = 0.008) and was a prognostic factor affecting TTF (hazard ratio 1.77; P = 0.021).

Conclusion

PMI might be a predictive marker of tolerance to treatment and TTF in HCC patients receiving sorafenib treatment.
Effectiveness and safety of an on-demand ferric carboxymaltose infusion strategy in patients with inflammatory bowel disease: a real world experience
Authors: Grova Mauro , Crispino Federica , Maida Marcello , Renna Sara , Mannino Mariella , Casà Angelo , Rizzuto Giulia , Macaluso Fabio Salvatore , Orlando Ambrogio
Published: February 2022

Background

We evaluated an on-demand ferric carboxymaltose (FCM) infusion strategy in inflammatory bowel disease (IBD) patients with iron deficiency anemia (IDA).

Aims

The primary outcome was the response rate to single or multiple FCM infusions after 12 months. Secondary outcomes were the response rate to a single FCM infusion after 3 months and the FCM safety profile.

Methods

We retrospectively included 185 IBD patients who received at least one FCM infusion of 500 mg, between 2015 and 2018. FCM was administered to patients with Hb ≤10 g/dL and hypoferritinemia and repeated according to the physician’s assessment. Complete response (CR) was defined as Hb ≥12 g/dL (≥13 g/dL for men) or Hb increase ≥2 g/dL. Partial response (PR) was defined as an Hb increase between 1 and 2 g/dL. A univariate analysis was performed at 3 and 12 months.

Results

After 12 months, the response rate was 75.1% (CR, 48.6%; PR, 26.4%; mean number of FCM infusions, 1.7 ± 1.1). In total 169/185 patients received a single FCM infusion during the first 3 months and 79.2% achieved response (CR, 56.8%; PR, 22.4%). At univariate analysis, no variable was associated with response. No adverse events were reported.

Conclusions

An on-demand strategy was effective and well-tolerated in treating IDA in IBD patients.
Suppression of joint pain in transient receptor potential vanilloid 4 knockout rats with monoiodoacetate-induced osteoarthritis
Authors: Soga Masahiko , Izumi Takaya , Nanchi Isamu , Horita Narumi , Yamamoto Miyuki , Kawasaki Shiori , Ogawa Koichi , Fujita Masahide , Morioka Yasuhide
Published: February 2022

Introduction:

Transient receptor potential vanilloid 4 (TRPV4) modulates osteoarthritic (OA) pain in animal models. However, the pathophysiological function of TRPV4 in regulating OA pain remains poorly understood.

Methods:

We developed TRPV4-knockout (TRPV4-KO) rats and assessed the effects of Trpv4 gene deficiency in a monoiodoacetate (MIA)-induced OA pain model (MIA rats) by examining pain-related behavior, pathological changes, and electrophysiological changes in dorsal root ganglion (DRG) neurons. The changes detected in TRPV4-KO rats were confirmed in wild-type rats using a TRPV4 antagonist.

Results:

Transient receptor potential vanilloid 4–KO rats showed the same pain threshold as wild-type rats for thermal or pressure stimuli under normal conditions. Trpv4 gene deletion did not suppress the development of osteoarthritis pathologically in MIA rats. However, the OA-related mechanical pain behaviors observed in MIA rats, including decreased grip strength, increased mechanical allodynia, and reduced weight-bearing on the ipsilateral side, were completely suppressed in TRPV4-KO rats. The DRG neurons in wild-type but not TRPV4-KO MIA rats were depolarized with increased action potentials. Transient receptor potential vanilloid 4 antagonist treatments recapitulated the effects of genetic Trpv4 deletion.

Conclusion:

Transient receptor potential vanilloid 4 was sensitized in the DRG neurons of MIA rats and played a critical role in the development of OA pain. These results suggest that the inhibition of TRPV4 might be a novel potent analgesic strategy for treating OA pain.
Blue-light treatment reduces spontaneous and evoked pain in a human experimental pain model
Authors: Reuss Anna Maria , Groos Dominik , Scholl Robert , Schröter Marco , Maihöfner Christian
Published: February 2022

Introduction:

Chronic pain is a frequent severe disease and often associated with anxiety, depression, insomnia, disability, and reduced quality of life. This maladaptive condition is further characterized by sensory loss, hyperalgesia, and allodynia. Blue light has been hypothesized to modulate sensory neurons and thereby influence nociception.

Objectives:

Here, we compared the effects of blue light vs red light and thermal control on pain sensation in a human experimental pain model.

Methods:

Pain, hyperalgesia, and allodynia were induced in 30 healthy volunteers through high-density transcutaneous electrical stimulation. Subsequently, blue light, red light, or thermal control treatment was applied in a cross-over design. The nonvisual effects of the respective light treatments were examined using a well-established quantitative sensory testing protocol. Somatosensory parameters as well as pain intensity and quality were scored.

Results:

Blue light substantially reduced spontaneous pain as assessed by numeric rating scale pain scoring. Similarly, pain quality was significantly altered as assessed by the German counterpart of the McGill Pain Questionnaire. Furthermore, blue light showed antihyperalgesic, antiallodynic, and antihypesthesic effects in contrast to red light or thermal control treatment.

Conclusion:

Blue-light phototherapy ameliorates pain intensity and quality in a human experimental pain model and reveals antihyperalgesic, antiallodynic, and antihypesthesic effects. Therefore, blue-light phototherapy may be a novel approach to treat pain in multiple conditions.
Revisiting Management Strategies for Popliteal Artery Injuries
Authors: Lin Cen-Hung , Consuegra Ma. Dulce Lafuente , Lin Tsan-Shiun
Published: February 2022

Background

Popliteal artery injuries (PAIs) were reported to own the highest rates of limb loss in vascular injuries of extremities. The complex nature of PAIs makes the treatment more difficult. We aimed to present our cases using our proposed algorithm and revisit the strategies for management.

Patients and Methods

A retrospective study of 45 cases with PAIs managed at the Kaohsiung Chang Gung Memorial Hospital over a 10-year period was conducted. The proposed algorithm for decision making was applied, which contains variables including the interval before surgery, the revascularization being delayed or not, the presence of fasciotomy, the acquisition of preoperative angiography, and the existence of collateral circulation. Whether the injured limbs were salvaged successfully avoiding amputation was recorded.

Results

Of all the included 45 patients, the rate of a successful salvage of the injured limb from amputation was 71.1%. Six patients did not receive revascularization because of their poor conditions of the injured limbs. In terms of limb salvage in PAIs, the interval before surgery, the revascularization being delayed or not, the presence of fasciotomy, or the acquisition of preoperative angiography did not make a significant difference (P > 0.05). Instead, an existence of collateral circulation at the distal injured limb was correlated to a significant higher rate of salvage, regardless of having revascularization or not (P = 0.001 and < 0.001, respectively). Seven patients had the injured vessels repaired directly and all were prevented from amputation. In other patients who underwent vascular repair using a graft, vein graft (n = 20) showed a higher successful rate in salvage significantly than Gore-Tex graft (n = 9, P < 0.001).

Conclusions

Collateral circulation determines much of the fate of limb salvage in PAIs. As a result, a delayed revascularization could be accepted as long as there is existence of collateral circulation at the distal injured limb. An autologous vein graft is favored when a direct repair is not able to be performed for revascularization. Although fasciotomy was not found to be associated with a successful salvage in this study, its importance could not be neglected and it should be performed when there is an observed or impending compartment syndrome.