bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermodynamic properties of novel black hole solutions in the Einstein–Born–Infeld-dilaton gravity theory
Authors: Dehghani M. 
Published: October 2020

AbstractThe exact solutions of coupled scalar, electromagnetic and gravitational field equations have been obtained in the framework of Einstein-dilaton gravity theory which is coupled to the Born–Infeld nonlinear electrodynamics. The solutions show that Einstein–Born–Infeld-dilaton gravity theory admits three novel classes of nonlinearly charged black hole solutions with the non-flat and non-AdS asymptotic behavior. Some of the solutions, in addition to the naked singularity, extreme and two-horizon black holes, produce one- and multi-horizon black holes too. The electric charge, mass and other thermodynamic quantities of the black holes have been calculated and it has been proved that they satisfy the standard form of the thermodynamical first law. The black hole local stability has been investigated by use of the canonical ensemble method. Noting the black hole heat capacity the points of type-one and type-two phase transitions and the locally stable black holes have been identified exactly. By use of the thermodynamic geometry, and noting the divergent points of the thermodynamic metric proposed by HEPM, it has been shown that the results of this method are consistent with those of canonical ensemble method. Global stability and Hawking–Page phase transition points have been studied by use of the grand canonical ensemble method and regarding the Gibbs free energy of the black holes. By calculating the Gibbs free energies, we characterized the ranges of horizon radii in which the black holes remain globally stable or prefer the radiation phase.
Hypoxia Induces Transcriptional and Translational Downregulation of the Type I IFN Pathway in Multiple Cancer Cell Types
Authors: Miar Ana , Arnaiz Esther , Bridges Esther , Beedie Shaunna , Cribbs Adam P. , Downes Damien J. , Beagrie Robert A. , Rehwinkel Jan , Harris Adrian L. 
Published: October 2020

Abstract

Hypoxia is a common phenomenon in solid tumors and is strongly linked to hallmarks of cancer. Recent evidence has shown that hypoxia promotes local immune suppression. Type I IFN supports cytotoxic T lymphocytes by stimulating the maturation of dendritic cells and enhancing their capacity to process and present antigens. However, little is known about the relationship between hypoxia and the type I IFN pathway, which comprises the sensing of double-stranded RNA and DNA (dsRNA/dsDNA) followed by IFNα/β secretion and transcriptional activation of IFN-stimulated genes (ISG). In this study, we determined the effects of hypoxia on the type I IFN pathway in breast cancer and the mechanisms involved. In cancer cell lines and xenograft models, mRNA and protein expressions of the type I IFN pathway were downregulated under hypoxic conditions. This pathway was suppressed at each level of signaling, from the dsRNA sensors RIG-I and MDA5, the adaptor MAVS, transcription factors IRF3, IRF7, and STAT1, and several ISG including RIG-I, IRF7, STAT1, and ADAR-p150. Importantly, IFN secretion was reduced under hypoxic conditions. HIF1α- and HIF2α-mediated regulation of gene expression did not explain most of the effects. However, ATAC-seq data revealed in hypoxia that peaks with STAT1 and IRF3 motifs had decreased accessibility. Collectively, these results indicate that hypoxia leads to an overall downregulation of the type I IFN pathway due to repressed transcription and lower chromatin accessibility in an HIF1/2α-independent manner, which could contribute to immunosuppression in hypoxic tumors.

Significance:
These findings characterize a new mechanism of immunosuppression by hypoxia via downregulation of the type I IFN pathway and its autocrine/paracrine effects on tumor growth.
Increased local expression of P-glycoprotein on CD4+ T-cells in vitreous of patients with non-infectious uveitis: a pilot study
Authors: Tagirasa Ravichandra , Kaza Hrishikesh , Basu Soumyava 
Published: October 2020

Nearly a third of uveitis patients are unable to achieve adequate inflammation control with conventional anti-inflammatory therapy. Several factors are known to influence responsiveness to anti-inflammatory therapy. In this pilot study, we have investigated the local expression of P-glycoprotein, an efflux-transport protein with role in multi-drug resistance, in vitreous CD4+ T-cells of patients with non-infectious uveitis (NIU).	CD4+ T-cells were isolated from vitreous and peripheral venous blood samples of NIU patients undergoing therapeutic vitrectomy. Rhodamine-123, a substrate of P-glycoprotein, whose retention inside cells is inversely proportional to P-glycoprotein function, was used to assay this transporter protein. In addition, cells were stained with IFN-γ, IL-17, GM-CSF and FoxP3, and analysed by flow cytometry. T-cell mitochondria were imaged by Mitotracker Red and confocal microscopy. Vitreous CD4+ T-cells expressed significantly higher P-gp and pro-inflammatory (IL-17+, IFNγ+IL17+) cytokine expression than matching blood samples. Mitochondrial fission was noted in vitreous T-cells and fusion in blood. We concluded that NIU is associated with higher P-glycoprotein expression and pro-inflammatory state in vitreous than in blood. This supports P-glycoprotein inhibition and adjunctive local anti-inflammatory treatment in management of NIU.
Epigenetic Reader BRD4 (Bromodomain-Containing Protein 4) Governs Nucleus-Encoded Mitochondrial Transcriptome to Regulate Cardiac Function
Authors: Kim Soo Young , Zhang Xin , Schiattarella Gabriele G. , Altamirano Francisco , Ramos Thais A.R. , French Kristin M. , Jiang Nan , Szweda Pamela A. , Evers Bret M. , May Herman I. , Luo Xiang , Li Hongliang , Szweda Luke I. , Maracaja-Coutinho Vinicius , Lavandero Sergio , Gillette Thomas G. , Hill Joseph A. 
Published: October 2020

Background:
BET (bromodomain and extraterminal) epigenetic reader proteins, in particular BRD4 (bromodomain-containing protein 4), have emerged as potential therapeutic targets in a number of pathological conditions, including cancer and cardiovascular disease. Small-molecule BET protein inhibitors such as JQ1 have demonstrated efficacy in reversing cardiac hypertrophy and heart failure in preclinical models. Yet, genetic studies elucidating the biology of BET proteins in the heart have not been conducted to validate pharmacological findings and to unveil potential pharmacological side effects.

Methods:
By engineering a cardiomyocyte-specific BRD4 knockout mouse, we investigated the role of BRD4 in cardiac pathophysiology. We performed functional, transcriptomic, and mitochondrial analyses to evaluate BRD4 function in developing and mature hearts.

Results:
Unlike pharmacological inhibition, loss of BRD4 protein triggered progressive declines in myocardial function, culminating in dilated cardiomyopathy. Transcriptome analysis of BRD4 knockout mouse heart tissue identified early and specific disruption of genes essential to mitochondrial energy production and homeostasis. Functional analysis of isolated mitochondria from these hearts confirmed that BRD4 ablation triggered significant changes in mitochondrial electron transport chain protein expression and activity. Computational analysis identified candidate transcription factors participating in the BRD4-regulated transcriptome. In particular, estrogen-related receptor α, a key nuclear receptor in metabolic gene regulation, was enriched in promoters of BRD4-regulated mitochondrial genes.

Conclusions:
In aggregate, we describe a previously unrecognized role for BRD4 in regulating cardiomyocyte mitochondrial homeostasis, observing that its function is indispensable to the maintenance of normal cardiac function.
Hybrid Ensemble–Variational Filter: A Spatially and Temporally Varying Adaptive Algorithm to Estimate Relative Weighting
Authors: El Gharamti Mohamad 
Published: October 2020

AbstractModel errors and sampling errors produce inaccurate sample covariances that limit the performance of ensemble Kalman filters. Linearly hybridizing the flow-dependent ensemble-based covariance with a time-invariant background covariance matrix gives a better estimate of the true error covariance. Previous studies have shown this, both in theory and in practice. How to choose the weight for each covariance remains an open question especially in the presence of model biases. This study assumes the weighting coefficient to be a random variable and then introduces a Bayesian scheme to estimate it using the available data. The scheme takes into account the discrepancy between the ensemble mean and the observations, the ensemble variance, the static background variance, and the uncertainties in the observations. The proposed algorithm is first derived for a spatially constant weight and then this assumption is relaxed by estimating a unique scalar weight for each state variable. Using twin experiments with the 40-variable Lorenz 96 system, it is shown that the proposed scheme is able to produce quality forecasts even in the presence of severe sampling errors. The adaptive algorithm allows the hybrid filter to switch between an EnKF and a simple EnOI depending on the statistics of the ensemble. In the presence of model errors, the adaptive scheme demonstrates additional improvements compared with standard enhancements alone, such as inflation and localization. Finally, the potential of the spatially varying variant to accommodate challenging sparse observation networks is demonstrated. The computational efficiency and storage of the proposed scheme, which remain an obstacle, are discussed.
Helicopter Transport of Trauma Patients Improves Survival Irrespective of Transport Time
Authors: Schneider Andrew M. , Ewing Joseph A. , Cull John D. 
Published: October 2020

Objectives Helicopter transport of trauma patients remains controversial. We examined the survival rates of patients undergoing helicopter versus ground transport to a Level 1 trauma center. Methods Retrospective analysis was performed on trauma patients treated between 2014 and 2017. Student’s t-test was used to compare air versus ground transport times. A logistic regression was then used to examine the association of transportation type on survival controlling for demographics, mechanism of injury, transport time, field intubation, and injury severity. Results Of 3967 patients identified, 69.6% (2762) were male, and the average age was 40 years. Most patients suffered blunt injuries (86.8%, 3445), while the remaining had penetrating injuries (11.6%, 459) or burns (1.6%, 63). The majority of patients were transferred by ground (3449) with only 13% (518) transferred by air. Patients transported by air had increased Injury Severity Score (ISS) with a median of 17 (IQR 9-24) versus 9 (IQR 5-14), increased length of stay (LOS) at 6 days versus 3 ( P < .001), and increased mortality at 12.6% vs 6.5% ( P < .001). Patients transported by air arrived 16.6 ± 6.7 minutes faster compared with ground for the zip codes examined. When adjusting for the mechanism of injury, ISS, age, gender, intubation status, and transport time, air transport was associated with an increased likelihood of survival (odds ratio [OR] = 1.57, 95% CI = 1.06-2.40). Conclusion In our analysis of 3967 patients, those transported by air had a significant improvement in the likelihood of survival compared with those transported by ground even when adjusting for both ISS and time.
The Use of a Urinary Balloon Catheter to Control Hemorrhage From Penetrating Torso Trauma: A Single-Center Experience at a Major Inner-City Hospital Trauma Center
Authors: Himmler Amber , Maria Calzetta Ignacio Luis , Potes Andrea , Puyana Juan Carlos , Barillaro Guillermo Fabián 
Published: October 2020

Introduction Use of a urinary catheter balloon tamponade (UCBT) in controlling traumatic hemorrhage is a frequently employed but infrequently described technique. We aim to discuss the experience of balloon tamponade as a bridge to definitive hemorrhage control in the operating room. Methods This is retrospective review at a single institution from January 2008 to December 2018. We identified patients with active bleeding from penetrating torso trauma in whom UCBT was used to tamponade bleeding. We used revised trauma score (RTS), injury severity score (ISS), and new trauma and injury severity score (TRISS) to quantify injury severity. All surviving patients required definitively hemorrhage control in the operating room. Primary endpoint was mortality at 24 hours and 30 days. Results Twenty-nine patients were managed with UCBT. Nine had hemorrhage controlled in the trauma bay, including 4 with neck trauma and 5 with cardiac trauma. Twenty patients had hemorrhage controlled in the operating room, including 15 with cardiac trauma and 5 with intra-abdominal hemorrhage. Mean RTS, ISS, and TRISS in this population were: 5.93, 19.31, and 83.78, respectively. Of the 9 patients treated in the trauma bay, 1 (11.1%) died in the first 24 hours and 2 died in the first 30 days (22.2%). Of the 20 patients treated in the operating room, 0 (0%) patients died in the first 24 hours and 3 died in the first 30 days (15.0%). Conclusion UCBT is an effective tool that can be used to stabilize and bridge an actively bleeding patient to definitive hemorrhage control in the operating room.
The Affordable Care Act and Changes in Women’s Health Insurance Coverage Before, During, and After Pregnancy in California
Authors: Marchi Kristen S. , Dove Melanie S. , Heck Katherine E. , Fan Chuncui 
Published: October 2020

Objectives Having health insurance is associated with improvements in health care access and use, health behaviors, and outcomes. We examined changes in health insurance coverage for California women before, during, and after pregnancy after implementation of the Affordable Care Act (ACA). Methods We used data from the 2011-2017 California Maternal and Infant Health Assessment, an annual representative survey of women sampled from birth certificates (n = 47 487). We examined health insurance coverage at baseline before ACA implementation (2011-2013) and in each survey year from 2014 to 2017 for 3 periods (before, during, and after pregnancy). We calculated prevalence ratios to evaluate changes in health insurance coverage, adjusting for changes in demographic characteristics. Few women were uninsured during pregnancy before implementation of the ACA; therefore, analyses focused on health insurance before pregnancy and postpartum. Results Before ACA implementation, 24.4% of women reported being uninsured before pregnancy, which decreased to 10.1% in 2017. About 17% of women reported being uninsured postpartum before ACA implementation, and this percentage decreased to 7.5% in 2017. ACA implementation resulted in a >50% adjusted decline in the likelihood of being uninsured before pregnancy or postpartum, primarily because of substantial increases in Medicaid coverage. Conclusions ACA implementation resulted in a dramatic reduction in mothers in California who were uninsured before and after pregnancy. Medicaid expansion played a major role in this improvement.
Inhaled versus intravenous milrinone in mitral stenosis with pulmonary hypertension
Authors: Patel Jigar , Patel Kartik , Garg Pankaj , Patel Sanjay 
Published: October 2020

Objective To evaluate and compare the hemodynamic effects of intraoperative intravenous milrinone versus inhalational milrinone at two timepoints in patients with severe pulmonary hypertension undergoing mitral valve surgery. Methods A prospective observational study was performed in 100 patients with severe rheumatic mitral stenosis (with/without regurgitation) and right ventricular systolic pressure > 50 mm Hg. They were divided into two groups based on the strategy used to reduce pulmonary hypertension. Fifty patients had inhalational milrinone after sternotomy until initiation of cardiopulmonary bypass and after release of the aortic crossclamp until weaning off cardiopulmonary bypass. The other 50 patients received an intravenous loading dose of milrinone 50 µg·kg−1 over 10 min on release of the aortic crossclamp. Both groups received intravenous milrinone 0.5 µg·kg−1 during weaning from cardiopulmonary bypass. Hemodynamic data were evaluated at the 3 timepoints. Results Pulmonary artery pressures, central venous pressure, and pulmonary capillary wedge pressure decreased significantly in the inhalational milrinone group compared to the intravenous milrinone group. Systemic vascular resistance index and cardiac index were significantly higher and pulmonary vascular resistance index was significantly lower in the inhalational milrinone group. The mean arterial pressure-to-mean pulmonary artery pressure ratio was significantly lower in the intravenous milrinone group. Tricuspid annular plane systolic excursion and right ventricular fractional area change were increased significantly in the inhalational milrinone group. Conclusion Intraoperative inhalational milrinone before and after cardiopulmonary bypass is safe, easy to administer, and results in significant improvements in right ventricular hemodynamics, right ventricular function, and systemic hemodynamics.
Caring precariously: An interpretive description of palliative care and welfare worker perspectives on end of life carers navigating social welfare
Authors: Bindley Kristin , Lewis Joanne , Travaglia Joanne , DiGiacomo Michelle 
Published: October 2020

Background: Caring at end-of-life is associated with financial burden, economic disadvantage, and psychosocial sequelae. Health and social welfare systems play a significant role in coordinating practical resources and support in this context. However, little is known about social policy and interactions with public institutions that shape experiences of informal carers with social welfare needs at end-of-life. Aim: To explore ways in which palliative care and welfare sector workers perceive and approach experiences and needs of the carers of people with life-limiting illnesses who receive government income support or housing assistance, in an area of recognised socioeconomic disadvantage. Design: An interpretive descriptive study employed in-depth, qualitative interviews to explore participants’ reflections on working with carers of someone with a life-limiting illness. Data were analysed using the framework approach. Setting/participants: Twenty-one workers employed within three public services in Western Sydney were recruited. Results: Workers articulated understandings of welfare policy and its consequences for carers at end-of-life, including precariousness in relation to financial and housing circumstances. Identified resources and barriers to the navigation of social welfare needs by carers were categorised as personal, interpersonal and structural. Conclusions: Caring at end-of-life while navigating welfare needs was seen to be associated with precariousness by participants, particularly for carers positioned in vulnerable social locations. Findings highlighted experiences of burdensome system navigation, inconsistent processes and inequity. Further exploration of structural determinants of experience is needed, including aspects of palliative care and welfare practice and investment in inter-agency infrastructure for supporting carers at end-of-life.
End-of-life care after the legal introduction of advance directives: A qualitative study involving healthcare professionals and family caregivers of patients with amyotrophic lateral sclerosis
Authors: Cipolletta Sabrina , Reggiani Margherita 
Published: October 2020

Background: Advance care planning and advance directives play a key role in the care of life-threatening illnesses such as amyotrophic lateral sclerosis. Aim: The aim of the present study is to explore how the introduction of these features by law improves the experience of end-of-life care. Design: Five focus groups were conducted in Italy 1 year after the new law on advance directives was introduced. Setting/Participants: Purposive sampling was used to recruit 24 health professionals and 23 family caregivers of patients with amyotrophic lateral sclerosis, for a total of 47 participants. Results: The thematic analysis, conducted through the use of ATLAS.ti software, identified four thematic areas: best practices, managing difficulties, care relationships and proposals. The results indicated a lack of organization, collaboration and continuity on the part of healthcare services and professionals, a lack of information on palliative care, advance care planning, and advance directives. End-of-life care is often left to the good will of the individual professional. Difficulties can also derive from ethical dilemmas concerning end-of-life decision-making and from a lack of communication and relationships between health professionals, patients and their families. Conclusion: The introduction of advance directives by law has not been sufficient to improve end-of-life care. In order to make legal regulation effective, the organization of healthcare services needs to be improved and clearer procedures have to be implemented and shared with patients and families.
T2 mapping of the acetabular cartilage in infants and children with developmental dysplasia of the hip
Authors: Lu Zhao , Pan Shinong , Wang Baijun , Liu Jiahui , Gao Tianyang , Lyu Xiaohong 
Published: October 2020

Background T2 mapping is useful for evaluating the cartilage matrix. Purpose To determine the variations in the acetabular cartilage T2 relaxation values between healthy individuals and those with developmental dysplasia of the hip (DDH). Material and Methods Thirty-three patients with unilateral DDH underwent 3-T magnetic resonance imaging (MRI) between January 2018 and February 2019. Fifteen volunteers (30 hips) were enrolled as controls. T2 values were measured with the T2 mapping sequence in all layers and were equally divided into three layers (deep, middle, and superficial) with equal thickness. We calculated the mean T2 relaxation values for the full thickness, deep, middle, and superficial layers and compared the values between the different groups. In addition, the inter- and intra-observer agreements were calculated. Results The T2 relaxation values in the DDH arm were significantly lower in the middle, superficial, and full thickness layers compared with those of the volunteers and contralateral hips. The T2 relaxation values of the deep layers showed no significant difference between the different groups. The acetabular cartilage T2 relaxation values increased from the deep layer to the superficial layer in the control and contralateral groups. Both inter- and intra-observer agreements were good. Conclusion MRI T2 mapping may help to diagnose developmental disorders of the acetabular cartilage matrix in infants and children with DDH. Abnormal acetabular cartilage T2 relaxation values may be due to the extraordinary stress load of the femoral head.
Analysis of pancreatic fistula risk in patients with laparoscopic pancreatoduodenectomy: what matters
Authors: Nong Kate , Zhang Yue , Liu Shengyong , Yang Yue , Sun Donglin , Chen Xuemin 
Published: October 2020

Objective To analyse potential risk factors for postoperative pancreatic fistula (POPF). Methods A retrospective study on risk factors for POPF was conducted in patients undergoing laparoscopic pancreatoduodenectomy. Basic characteristics, and preoperative, intraoperative and postoperative patient data were collected and analysed. Results A total of 268 patients were enrolled in this study, including 54 patients with POPF following surgery (POPF incidence, 20.15%). Univariate analysis indicated that patient’s age, body mass index (BMI), preoperative bilirubin level, pancreas texture, and drainage fluid amylase level on day 1 following surgery were associated with POPF. Multiple logistic regression analysis indicated that preoperative bilirubin level ≥170 µmol/l, soft pancreas texture, BMI ≥25, and age ≥65 years were independent risk factors associated with POPF. Conclusions For patients with preoperative bilirubin level ≥170 µmol/l, soft pancreas texture, BMI ≥25 and age ≥65 years, clinically relevant measures should be taken as early as possible for the prophylaxis of POPF.