bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Effects of Cigarette Smoking and Smoking Cessation on Aortic Wave Reflections, Pulse Wave Velocity, and Carotid Artery Distensibility
Authors: Schmidt Kelly M. T. , Hansen Kristin M. , Johnson Adrienne L. , Gepner Adam D. , Korcarz Claudia E. , Fiore Michael C. , Baker Timothy B. , Piper Megan E. , Stein James H. 
Published: December 2019

Background
We evaluated the effects of smoking and smoking cessation on aortic wave reflections (augmentation index), aortic pulse wave velocity, and carotid artery distensibility and stiffness (distensibility coefficient, Young's elastic modulus).

Methods and Results

Current smokers underwent carotid, radial, and femoral artery tonometry and carotid ultrasound at baseline and 3 years after a quit attempt. Baseline associations of smoking heaviness markers (exhaled carbon monoxide and cigarettes smoked/d) and effects of smoking cessation at year 3 on changes in arterial measures were assessed using multivariable linear regression models. The 1417 smokers (54% female) were mean (SD) 49.3 (11.6) years old and smoked 17.2 (8.3) cigarettes/d (exhaled carbon monoxide 14.7 [8.2] parts per million). Arterial measures were associated more strongly with age, blood pressure (BP), and waist circumference than with smoking heaviness markers. Augmentation index was associated independently with carbon monoxide (
P
=0.004). Pulse wave velocity, distensibility coefficient, and Young's elastic modulus had small, inconsistent associations with smoking heaviness markers. At year 3, augmentation index improved with smoking cessation (
P
=0.006) despite more weight gain (2.54 vs 0.36 kg,
P
<0.001) and insulin resistance (
P
=0.001) among abstainers, but distensibility coefficient decreased (
P
=0.004). Changes in arterial measures were related more strongly to changes in BP than smoking cessation.

Conclusions
Arterial wave reflection and stiffness measures were associated more strongly with age, BP, and waist circumference than smoking heaviness. Smoking cessation was associated with weight gain and increased insulin resistance. Changes in arterial measures were predicted by changes in BP, highlighting the need to address weight gain and BP changes during a quit attempt.
Tissue Protrusion With Attenuation Is Associated With Ischemic Brain Lesions After Carotid Artery Stenting
Authors: Funatsu Naoko , Enomoto Yukiko , Egashira Yusuke , Yamauchi Keita , Nakayama Noriyuki , Kawasaki Masanori , Iwama Toru 
Published: December 2019

Background and Purpose—
Tissue protrusion between stent struts is frequently observed on optical frequency domain imaging evaluation after carotid artery stenting, but its clinical relevance is unclear. We aimed to investigate the association between the characteristics of tissue protrusion assessed by optical frequency domain imaging and brain lesions identified by diffusion-weighted imaging after carotid artery stenting.

Methods—
Sixty-five consecutive patients who underwent optical frequency domain imaging after protected carotid artery stenting were enrolled in the study. Cross-sectional optical frequency domain images within the stented segments were evaluated at 0.125-mm intervals. Magnetic resonance imaging was performed 1 to 10 days after treatment. The characteristics of tissue protrusion were compared between patients with and without new ipsilateral brain lesions on posttreatment magnetic resonance imaging.

Results—

Tissue protrusion was observed in 62 patients (95%). New brain lesions were observed in 24 patients (37%). In the multivariate analysis, the presence of protrusion with attenuation (odds ratio, 2.94 [95% CI, 1.05–8.68]
P
=0.04) was associated with new brain lesions after carotid artery stenting.

Conclusions—
The presence of protrusion with attenuation assessed by optical frequency domain imaging was associated with ipsilateral brain lesions after carotid artery stenting. Prevention or treatment of protrusions with attenuation may reduce ischemic brain lesions after carotid artery stenting.
What Is It Like to Self-Rescue from a Building Collapse as a Firefighter: a Phenomenological Inquiry
Authors: Broomé Rodger E. , Russell Eric J. 
Published: December 2019

Abstract
This descriptive scientific-phenomenological study set forth to discover what is like to survive a building collapse as a firefighter. The participants of the study were 3 uniformed and sworn professional firefighters performing interior operations at a commercial building structure fire. The 3 participants all become trapped and had to self-rescue as a result of a structural collapse. The data collected from the participant interviews was analyzed and transformed so as to form the structure of the study.
Parzival auf dem Zauberberg?
Authors: Friedrich Kathrin 
Published: December 2019

Abstract
Medieval German literature had a deeper impact on Thomas Mann than is typically assumed. The comparison between Wolfram’s von Eschenbach Parzival and Thomas Mann’s The Magic Mountain illustrates this influence. Nearly 700 years separate both novels, nevertheless, they show amazing parallels. Especially as their narrators are very much alike. Both appear exposed in their stories, utilise Wolfram’s Bogengleichnis, and are unreliable. In addition, they both reflect on their narrations as literary constructs. While Wolfram’s narrator defends his protagonist Parzival for his misdeeds Mann does not bother to do so for Hans Castorp. The heroes and other characters are comparable, but develop differently. Parzival gains knowledge and his identity, whereas Hans Castorp loses both. Parzival fails his first encounter with the grail. Castorp, in contrast, wins a deep insight into life in his Schneetraum; but forgets it immediately. Castorp is as foolish as Parzival when he begins his journey. He is, however, not a grail-quester although Howard Nemerov concludes this in his 1939 dissertation. Yet, the Magic Mountain seems strongly influenced by Parzival. But while the characters in Parzival seek to help the central protagonist, egoism is predominant in the Magic Mountain, the hero stagnates and fails to successfully finish the hero’s journey.
Flesh and Blood
Authors: Beit-Hallahmi Benjamin 
Published: December 2019

Abstract
Fears and stories about an underground religion devoted to Satan, which demands and carries out child sacrifice, appeared in the United States in the late twentieth century and became the subject of media reports supported by some mental health professionals. Looking at these modern fantasies leads us back to ancient stories which in some cases believers consider the height of religious devotion. Horrifying ideas about human sacrifice, child sacrifice, and the offering to the gods of a beloved only son by his father appear repeatedly in Western traditions, starting with the Greeks and the Hebrews. This publication focuses on rituals of violence tied to religion, both imagined and real. The main question of this work is the meaning of blood and ritual killing in the history of religion. The publication examines the encounter with the idea of child sacrifice in the context of human hopes for salvation.
Tracking Mesoscale Convective Systems that are Potential Candidates for Tropical Cyclogenesis
Authors: Núñez Ocasio Kelly M. , Evans Jenni L. , Young George S. 
Published: December 2019

AbstractThis study introduces the development of the Tracking Algorithm for Mesoscale Convective Systems (TAMS), an algorithm that allows for the identifying, tracking, classifying, and assigning of rainfall to mesoscale convective systems (MCSs). TAMS combines area-overlapping and projected-cloud-edge tracking techniques to maximize the probability of detecting the progression of a convective system through time, accounting for splits and mergers. The combination of projection on area overlapping is equivalent to setting the background flow in which MCSs are moving on. Sensitivity tests show that area-overlapping technique with no projection (thus, no background flow) underestimates the real propagation speed of MCSs over Africa. The MCS life cycles and propagation derived using TAMS are consistent with climatology. The rainfall assignment is also more reliable than with previous methods as it utilizes a combination of regridding through linear interpolation with high temporal and spatial resolution data. This makes possible the identification of extreme rainfall events associated with intense MCSs more effectively. TAMS will be utilized in future work to build an AEW–MCS dataset to study tropical cyclogenesis.
Quality of life: A universal or a disability specific concept?
Authors: Erez Asnat Bar-Haim , Gal Eynat 
Published: December 2019

Background. Quality of life (QoL) is an important outcome of occupational therapy practice. Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts the individual throughout their lifespan and may substantially affect QoL. Measuring QoL of people with ASD presents a challenge and a debate whether to use general versus disability-specific adapted measures. Purpose. This paper aims to (a) revisit the construct of QoL and discuss specific dilemmas pertaining to its measurement, and (b) discuss implications to the assessment of QoL in individuals with ASD while highlighting the potential contribution of occupational therapy to the development of measures. Key Issues. We suggest adding the domain of accessibility into QoL assessments, including, physical, sensory, social, and cognitive aspects, and to use disability-specific QoL measures. Implications. The paper presents a call for occupational therapists to be involved in developing specific ASD disability-oriented measures that consider the unique characteristics of the disorder and environmental supports.
An Exploratory Analysis of Factors Associated With Interest in Postpartum Intrauterine Device Uptake Among Pregnant Women and Couples in Kigali, Rwanda
Authors: Da Costa Vanessa , Ingabire Rosine , Sinabamenye Robertine , Karita Etienne , Umutoni Victoria , Hoagland Alexandra , Allen Susan , Mork Ellen , Parker Rachel , Mukamuyango Jeannine , Haddad Lisa , Nyombayire Julien , Wall Kristin M 
Published: December 2019

Background: The desire to space or prevent future pregnancies is high among postpartum women in Rwanda. However, the use of long-acting reversible contraception (LARC), especially the highly effective and cost-effective copper intrauterine device (IUD), is very low, whereas the rates of unintended pregnancy are high. This study aims to identify factors associated with pregnant women’s and couple’s interest in receiving a postpartum intrauterine device (PPIUD) within 6 weeks after delivery. Methods: A total of 150 pregnant women or couples attending antenatal care (ANC) in Kigali, Rwanda participated in this cross-sectional study. After participating in a postpartum LARC counseling session, surveys assessed participants’ demographics, pregnancy experiences and desires, and PPIUD knowledge, attitudes, practices, and interest. Multivariable logistic regression was used to model factors associated PPIUD interest within 6 weeks postpartum. Results: Although only 3% of women had ever used an IUD previously, 124 (83%) women were interested in receiving a PPIUD after counseling. Self-reporting physical side effects (adjusted odds ratio [aOR], 0.21; 95% confidence interval [CI], 0.06-0.75) and infection (aOR, 0.19; 95% CI, 0.04-0.85) as disadvantages to the IUD were significantly associated with no interest in receiving a PPIUD. Interest did not differ by male involvement. Conclusion: Recommendations to increase PPIUD uptake include educating pregnant women and couples about the method during ANC and addressing client myths and misconceptions about the IUD. This strategy allows pregnant women and couples to make informed decisions about their future contraception use, reduce unmet need for family planning, and reduce unintended pregnancy.
Effectiveness of stereotactic ablative radiotherapy in patients with advanced hepatocellular carcinoma unsuitable for transarterial chemoembolization
Authors: Lee Hsin-Lun , Tsai Jo-Ting , Chen Chun-You , Lin Ying-Chun , Ho Chin-Beng , Ting Lai-Lei , Kuo Chia-Chun , Lai I-Chun , Lin Chun-Yu , Tang Jui-Hsiang , Huang Yu-Min , Kao Wei-Yu , Cheng Sheng-Wei , Shen Chia-Ning , Chen Shang-Wen , Chiou Jeng-Fong 
Published: December 2019

Background: Stereotactic ablative radiotherapy (SABR) can deliver tumoricidal doses and achieve long-term control in early hepatocellular carcinoma (HCC). However, limited studies have investigated the safety and effectiveness of SABR in patients with advanced diseases that is unsuitable for transarterial chemoembolization (TACE). Methods: In this observational study, we reviewed the medical records of patients with Barcelona Clinic Liver Cancer (BCLC) stage C disease treated with linear accelerator-based SABR between 2008 and 2016. Their tumors were either refractory to TACE or TACE was contraindicated. Overall survival (OS), in-field progression-free survival (IFPFS), and out-field progression-free survival were calculated using Kaplan–Meier analysis. The Cox regression model was used to examine the effects of variables. Treatment-related toxicities were scored according to the Common Terminology Criteria for Adverse Events (version 4.03) and whether patients developed radiation-induced liver disease (RILD) after SABR. Results: This study included 32 patients. The mean maximal tumor diameter and tumor volumes were 4.7 cm and 135.9 ml, respectively. Patients received linear accelerator-based SABR with a median prescribed dose of 48 Gy (30–60 Gy) in three to six fractions. Based on the assessment of treatment response by using the Response Evaluation Criteria in Solid Tumors (version 1.1), 19% of patients achieved a complete response and 53% achieved a partial response. After a median follow-up of 18.1 months (4.0–65.9 months), 10, 19, and 9 patients experienced in-field failure, out-field hepatic recurrence, and extrahepatic metastases, respectively. The estimated 2-year OS and IFPFS rates were 54.4% and 62.7%, respectively. In a multivariate analysis, a pretreatment Cancer of the Liver Italian Program (CLIP) score of ⩾2 ( p = 0.01) was a prognostic factor for shorter OS, and a biologically effective dose (BED) of < 85 Gy10 ( p = 0.011) and a Child–Pugh score of ⩾6 ( p = 0.014) were prognostic factors for inferior IFPFS. In this study five and eight patients developed classic and nonclassic RILD, respectively. Conclusions: SABR can serve as a salvage treatment for patients with HCC with BCLC stage C disease unsuitable for TACE, in particular, in those with a baseline CLIP score of ⩽1. A BED10 of ⩾85 Gy is an appropriate prescribed dose for tumor control. Because out-field relapse is the major cause of treatment failure, SABR in combination with novel systemic modalities should be investigated in future studies.
The Influence of Visibility on Medical Teamwork in Emergency Departments: A Mixed-Methods Study
Authors: Gharaveis Arsalan , Pati Debajyoti , Hamilton D. Kirk , Shepley Mardelle , Rodiek Susan , Najarian Mohammad 
Published: December 2019

Aim: This mixed-methods study delivers empirical evidence on the influence of visibility on healthcare teamwork in Emergency Departments (EDs). This study researchers hypothesized that with changes of visibility in EDs, teamwork among medical staff members will be impacted. Background: Prior research results suggest that visibility can influence health-setting efficacy. Teamwork is one of the components of each healthcare system that can be supported by environmental design. Method: Visibility in four subject sites from the same healthcare system was objectively measured by morphology plan analyses. Teamwork among medical staff members was the behavioral variable of interest and explored through field observations, interviews, and surveys. Results: The qualitative outcomes demonstrated that teamwork can be enhanced by improved visibility, while the quantitative findings supported the idea that some specific measures of visibility were correlated with teamwork. Conclusion: This study provides a model for future research on the association between healthcare staff behavior and ED plan configuration. The enhancement of ED design, considering the significance of visibility, enhances the perceptions of nurses and physicians in terms of teamwork.
Addressing cost and time barriers in chronic disease management through telemedicine: an exploratory research in select low- and middle-income countries
Authors: Sayani Saleem , Muzammil Momina , Saleh Karima , Muqeet Abdul , Zaidi Fabiha , Shaikh Tehniat 
Published: December 2019

Background: Despite evidence supporting telehealth provision in developed countries, there is limited evidence regarding its economic benefits for patients living in areas where access and cost present major barriers to health care, particularly in low- and middle-income countries (LMICs). This study explores the economic benefits of telemedicine for patients, in terms of cost and times savings, and its potential role in improving chronic disease outcomes. Methods: This retrospective cross-sectional study compared telemedicine services with hypothetical in-person consultations, with a focus on patient travel time and travel cost savings. A database containing teleconsultation visits ( N = 25,182) conducted at health facilities in remote regions of Afghanistan, Pakistan, Tajikistan, and the Kyrgyz Republic, was analyzed. A two-sample homoscedastic t test was used to determine differences between the two groups. A one-way sensitivity analysis was also conducted, presuming in-person teleconsultations at 90%, 75%, and 50%. Results: The study extracted data from 25,182 teleconsultation visits (12,814 males; 12,368 females). The cumulative patient savings through the program amounted to USD 9,175,132, and 1,876,146 h, or 213.1 years. A significant difference was seen between the two groups in terms of mean time savings ( p-value <0.05), and a nearly significant difference was observed in terms of mean cost savings ( p-value = 0.05). Conclusions: This study suggests that considerable economic benefits imparted to patients in low-resource settings of LMICs via accessing telemedicine. Telemedicine has great potential to improve chronic disease outcomes in low-resource areas by reducing socioeconomic barriers related to cost and access, and increasing uptake of services, thereby enabling early intervention and long-term management.
Comparison of optical coherence tomography angiography results of adult patients with Familial Mediterranean fever and healthy individuals
Authors: Karaca Emine Esra , Ozek Dilay , Omma Ahmet , Evren Kemer Ozlem 
Published: December 2019

Purpose: The aim of this study is to assess the macular ultrastructure measuring by optical coherence tomography angiography in adult patients with Familial Mediterranean fever. Methods: Participants were 62 Familial Mediterranean fever patients and 54 healthy individuals in control group with similar age and sex. The superficial and deep vascular plexus structures covering the central fovea in an area of 6 mm × 6 mm were measured using AngioVue images taken with optical coherence tomography angiography. Vasculature structure, foveal avascular zone, acircularity index of foveal avascular zone (the ratio of the perimeter of foveal avascular zone and the perimeter of a circle with the equal area), and superficial and deep retinal plexus densities were measured. Results: The inferior deep vascular density was measured: 49.17% ± 8.59% in Familial Mediterranean fever patients, 55.56% ± 5.92% in the control group. The deep inferior-hemi vascular density was measured: 48.59% ± 10.34% in Familial Mediterranean fever patients, 56.54% ± 8.05% in the control group. Deep inferior and deep inferior-hemi vascular density was significantly reduced in Familial Mediterranean fever patients compared with healthy controls ( p = 0.04 and p = 0.03, respectively). Conclusion: The vascular abnormalities in optical coherence tomography angiography show subclinical signs of microangiopathy in Familial Mediterranean fever patients. This observation, which can be obtained only through optical coherence tomography angiography, may be an ocular hallmark for Familial Mediterranean fever disease.
Platelet necrosis mediates ischemic stroke outcome in mice
Authors: Denorme Frederik , Manne Bhanu Kanth , Portier Irina , Eustes Alicia S. , Kosaka Yasuhiro , Kile Benjamin T. , Rondina Matthew T. , Campbell Robert A. 
Published: December 2019

Abstract
Dysregulated platelet functions contribute to the development and progression of ischemic stroke. Utilizing mice with a platelet-specific deletion of cyclophilin D (CypD), a mediator of necrosis, we found that platelet necrosis regulates tissue damage and outcomes during ischemic stroke in vivo. Mice with loss of CypD in platelets (CypDplt−/−mice) exhibited significantly enhanced cerebral blood flow, improved neurological and motor functions, and reduced ischemic stroke infarct volume after cerebral ischemia-reperfusion injury. These effects were attributable, at least in part, to platelet-neutrophil interactions. Twenty-four hours after stroke, significantly more circulating platelet-neutrophil aggregates (PNAs) were found in CypDplt+/+ mice. Underscoring the role of platelet necrosis in PNA formation, we observed a significant number of phosphatidylserine (PS)+ platelets in PNAs in CypDplt+/+ mice. In contrast, significantly fewer platelets in PNAs were PS+ in CypDplt−/− counterparts. Accordingly, mice with CypD-deficient platelets had fewer neutrophils and PNAs recruited to their brain following stroke relative to wild-type counterparts. Neutrophil depletion in wild-type mice conferred protection from ischemic stroke to a similar degree as observed in mice with CypD-deficient platelets. Neutrophil depletion in CypDplt−/− mice did not further reduce infarct size. Transmission electron microscopy of ex vivo–formed PNAs revealed a propensity of necrotic platelets to interact with neutrophils. These results suggest that necrotic platelets interact with neutrophils to exacerbate brain injury during ischemic stroke. Because inhibiting platelet necrosis does not compromise hemostasis, targeting platelet CypD may be a potential therapeutic strategy to limit brain damage following ischemic stroke.
Targeting CD20: teaching an old dog new tricks
Authors: Sharman Jeff P. 
Published: December 2019

AbstractRituximab was the first monoclonal antibody used for the treatment of a malignancy. In the 22 years since initial approval, it has become a vital component of therapy for a multitude of B-cell malignancies. Within the last several years, however, there has been a robust development of novel agents targeting CD20, including second generation anti-CD20 antibodies, biosimilar antibodies, and subcutaneous formulations that have been approved. The era of passive immunotherapy is now yielding to therapeutic approaches that actively engage the immune system. Emerging approaches leverage immunomodulatory drugs or novel checkpoint inhibitors to enhance CD20 therapy. Recent data sets on bispecific CD3/CD20 antibodies demonstrate exciting early findings, and CD20-directed chimeric antigen receptor T-cell therapies are now entering clinical trials. Anti-CD20 therapies are a vital component of the treatment of B-cell malignancies, and there is a dynamic therapeutic environment with multiple new data sets reviewed here.