bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilaterally Asymmetric Associations Between Extracranial Carotid Artery Atherosclerosis and Ipsilateral Middle Cerebral Artery Stenosis in Symptomatic Patients
Authors: Shi Honglu , Shao Sai , Wang Guangbin , Zhao Xihai , Li Rui , Yao Bin , Sun Qinjian , Watase Hiroko , Hippe Daniel S. , Yuan Chun ,   CARE-II Investigators
Published: October 2020

Objective:
To determine the bilaterally asymmetrical associations between extracranial carotid artery atherosclerosis and ipsilateral middle cerebral artery (MCA) stenosis in symptomatic patients using magnetic resonance vessel wall imaging.

Approach and Results:

Patients with symptomatic carotid artery atherosclerosis were recruited from the Chinese Atherosclerosis Risk Evaluation, a multicenter study. All subjects underwent intracranial magnetic resonance angiography and extracranial carotid artery magnetic resonance imaging. Severe stenosis (stenosis ≥50%) of MCA, carotid moderate-to-severe stenosis (stenosis ≥50%), plaque compositions, and high-risk plaque on symptomatic side were evaluated in all subjects. Associations between ipsilateral MCA stenosis and extracranial carotid plaque features were evaluated. A total of 363 patients (mean age: 61.2±10.4 years old; 254 males) were included. In the left symptomatic cerebrovascular group (n=186), carotid moderate-to-severe stenosis (odds ratio [OR], 3.00 [95% CI, 1.03–8.79];
P
=0.045), intraplaque hemorrhage (OR, 3.68 [95% CI, 1.21–11.19];
P
=0.021), fibrous cap rupture (OR, 5.70 [95% CI, 1.60–20.31];
P
=0.007), and high-risk plaque (OR, 2.95 [95% CI, 1.19–7.35];
P
=0.020) were significantly associated with ipsilateral severe MCA stenosis, after adjusting for confounding factors. In the right symptomatic cerebrovascular group (n=177), severe MCA stenosis was significantly associated with ipsilateral carotid moderate-to-severe stenosis (OR, 3.98 [95% CI, 1.54–10.32];
P
=0.004) but not with other extracranial carotid plaque features (all
P
>0.05), after adjusting for confounding factors.

Conclusions:
In the symptomatic arteries, vulnerable plaque features are independently associated with ipsilateral severe MCA stenosis on the left side, but this association is not found on the right side, indicating the associations of atherosclerotic disease between intracranial and extracranial carotid arteries are asymmetrical.
Cross-Center Virtual Education Fellowship Program for Early-Career Researchers in Atrial Fibrillation
Authors: Ajayi Tinuola B. , Remein Christy D. , Stafford Randall S. , Fagerlin Angela , Chung Mina K. , Childs Ellen , Benjamin Emelia J. 
Published: October 2020

Background:
It is estimated that over 46 million individuals have atrial fibrillation (AF) worldwide, and the incidence and prevalence of AF are increasing globally. There is an urgent need to accelerate the academic development of scientists possessing the skills to conduct innovative, collaborative AF research.

Methods:
We designed and implemented a virtual AF Strategically Focused Research Network Cross-Center Fellowship program to enhance the competencies of early-stage AF basic, clinical, and population health researchers through experiential education and mentorship. The pedagogical model involves significant cross-center collaboration to produce a curriculum focused on enhancing AF scientific competencies, fostering career/professional development, and cultivating grant writing skills. Outcomes for success involve clear expectations for fellows to produce manuscripts, presentations, and—for those at the appropriate career stage–grant applications. We evaluated the effectiveness of the fellowship model via mixed methods formative and summative surveys.

Results:
In 2 years of the fellowship, fellows generally achieved the productivity metrics sought by our pedagogical model, with outcomes for the 12 fellows including 50 AF-related manuscripts, 7 publications, 28 presentations, and 3 grant awards applications. Participant evaluations reported that the fellowship effectively met its educational objectives. All fellows reported medium to high satisfaction with the overall fellowship, webinar content and facilitation, staff communication and support, and program organization.

Conclusions:
The fellowship model represents an innovative educational strategy by providing a virtual AF training and mentoring curriculum for early-career basic, clinical, and population health scientists working across multiple institutions, which is particularly valuable in the pandemic era.
Histopathologic and Ultrastructural Findings in Human Myocardium After Stereotactic Body Radiation Therapy for Recalcitrant Ventricular Tachycardia
Authors: Kiani Soroosh , Kutob Leila , Schneider Frank , Higgins Kristin A. , Lloyd Michael S. 
Published: October 2020

Background:
Stereotactic body radiation therapy (SBRT) is a novel treatment for refractory ventricular tachycardia (VT). While outcomes have been described in small studies, histological findings after SBRT for VT are unknown.

Methods:
We identified 4 explanted hearts in the context of transplant that received prior SBRT as part of an 11-patient compassionate use series at our institution. Clinical VTs and computed tomography–defined target volume areas of SBRT were correlated to the anatomic specimens. Gross pathological, histological, and ultrastructural examination of tissue in the target area of SBRT was performed.

Results:
All 4 patients had nonischemic cardiomyopathy, and 3 had left ventricular assist devices. In all cases, patients had recurrent sustained VT and had failed multiple antiarrhythmics and radiofrequency ablations. Four patients underwent 5 total SBRT therapy sessions with 25-Gy single-fraction dose delivered to the area of culprit scar. The time from SBRT to explant ranged from 12 to 250 days. Histopathologic features following radiation were comparable in all patients and were characterized by areas of subendocardial necrosis surrounded by a rim of fibrosis. In 1 patient, the surrounding myocardium showed cytoplasmic vacuolization in myocytes and in another patchy interstitial fibrosis. Vascular changes consisted of myointimal thickening with prominence of endothelial cells. Electron microscopy of myocardium showed irregular, convoluted intercalated disc regions, loss of contractile elements with disrupted and haphazardly arranged myofibrils, and edematous mitochondria with loss of cisternae.

Conclusions:
Here, we report the first series of findings in human tissue in 4 patients after SBRT. Histopathologic features were consistent across all 4 patients and were indicative of cell injury, death, and to a lesser extent, fibrosis. Electron microscopy demonstrated features consistent with acute injury. These specimens provide radiobiological mechanisms of acute cellular injury during SBRT for VT, which may have an antiarrhythmic effect before the onset of fibrosis.
Role of Endothelial Nitric Oxide Synthase in Isoflurane Conditioning‐Induced Neurovascular Protection in Subarachnoid Hemorrhage
Authors: Athiraman Umeshkumar , Jayaraman Keshav , Liu Meizi , Giri Tusar , Yuan Jane , Zipfel Gregory J. 
Published: October 2020

Background
Delayed cerebral ischemia remains a common and profound risk factor for poor outcome after subarachnoid hemorrhage (SAH). The aim of our current study is to define the role of endothelial nitric oxide synthase (eNOS) in isoflurane conditioning‐induced neurovascular protection after SAH.

Methods and Results
Ten‐ to 14‐week‐old male wild‐type mice (C57BL/6) as controls and eNOS knockout male mice (strain # 002684) were obtained for the study. Animals underwent either sham surgery, SAH surgery, or SAH with isoflurane conditioning. Anesthetic post conditioning was performed with isoflurane 2% for 1 hour, 1 hour after SAH. Normothermia was maintained with the homeothermic blanket. In a separate cohort, nitric oxide synthase was inhibited by a pan nitric oxide synthase inhibitor, L‐nitroarginine methyl ester. Vasospasm measurement was assessed 72 hours after SAH and neurological function was assessed daily. Isoflurane‐induced changes in the eNOS protein expression were measured. eNOS protein expression was significantly increased by isoflurane conditioning in naïve mice as well as mice subjected to SAH. Vasospasm of the middle cerebral artery and neurological deficits were evident following SAH versus sham surgery, both in wild‐type mice and eNOS knockout mice. Isoflurane conditioning attenuated vasospasm and neurological deficits in wild‐type mice. This delayed cerebral ischemia protection was lost in L‐nitroarginine methyl ester ‐administered mice and eNOS knockout mice.

Conclusions
Our data indicate isoflurane conditioning provides robust protection against SAH‐induced vasospasm and neurological deficits, and that this delayed cerebral ischemia protection is critically mediated via isoflurane‐induced augmentation of eNOS.
Multiscale Forecasting of High-Impact Weather: Current Status and Future Challenges
Authors: Majumdar Sharanya J. , Sun Juanzhen , Golding Brian , Joe Paul , Dudhia Jimy , Caumont Olivier , Chandra Gouda Krushna , Steinle Peter , Vincendon Béatrice , Wang Jianjie , Yussouf Nusrat 
Published: October 2020

AbstractImproving the forecasting and communication of weather hazards such as urban floods and extreme winds has been recognized by the World Meteorological Organization (WMO) as a priority for international weather research. The WMO has established a 10-yr High-Impact Weather Project (HIWeather) to address global challenges and accelerate progress on scientific and social solutions. In this review, key challenges in hazard forecasting are first illustrated and summarized via four examples of high-impact weather events. Following this, a synthesis of the requirements, current status, and future research in observations, multiscale data assimilation, multiscale ensemble forecasting, and multiscale coupled hazard modeling is provided.
The Impacts of Horizontal Grid Spacing and Cumulus Parameterization on Subseasonal Prediction in a Global Convection-Permitting Model
Authors: Weber Nicholas J. , Mass Clifford F. , Kim Daehyun 
Published: October 2020

AbstractMonthlong simulations targeting four Madden–Julian oscillation events made with several global model configurations are verified against observations to assess the roles of grid spacing and convective parameterization on the representation of tropical convection and midlatitude forecast skill. Specifically, the performance of a global convection-permitting model (CPM) configuration with a uniform 3-km mesh is compared to that of a global 15-km mesh with and without convective parameterization, and of a variable-resolution “channel” simulation using 3-km grid spacing only in the tropics with a scale-aware convection scheme. It is shown that global 3-km simulations produce realistic tropical precipitation statistics, except for an overall wet bias and delayed diurnal cycle. The channel simulation performs similarly, although with an unrealistically higher frequency of heavy rain. The 15-km simulations with and without cumulus schemes produce too much light and heavy tropical precipitation, respectively. Without convection parameterization, the 15-km global model produces unrealistically abundant, short-lived, and intense convection throughout the tropics. Only the global CPM configuration is able to capture eastward-propagating Madden–Julian oscillation events, and the 15-km runs favor stationary or westward-propagating convection organized at the planetary scale. The global 3-km CPM exhibits the highest extratropical forecast skill aloft and at the surface, particularly during week 3 of each hindcast. Although more cases are needed to confirm these results, this study highlights many potential benefits of using global CPMs for subseasonal forecasting. Furthermore, results show that alternatives to global convection-permitting resolution—using coarser or spatially variable resolution—feature compromises that may reduce their predictive performance.
NWP and Radar Extrapolation: Comparisons and Explanation of Errors
Authors: Wilson James , Megenhardt Dan , Pinto James 
Published: October 2020

AbstractThis paper examines nowcasts of precipitation from the High-Resolution Rapid Refresh (HRRRv2) model from the summer of 2017 along the Colorado Front Range. It was found that model nowcasts (2 h or less) of precipitation amount were less skillful than extrapolation of the KFTG WSR-88-D data at a spatial scale of 120 km. It was also found that local-scale (mesoscale) influences on rainfall intensity and amount have a much greater impact on rainfall intensity than large-scale (synoptic) influences. Thus, large-scale trends are not useful for modifying extrapolation nowcasts on the local scale. Errors in the HRRR nowcasts are attributed to an inability of the model and data assimilation to resolve convergence along outflow boundaries and other terrain-influenced mesogamma-scale flows that contribute to storm formation and evolution. While the HRRRv2 1-h nowcasts were strongly correlated with observed precipitation events, the nowcast precipitation amounts were in error by more than a factor of 2 about 50% of the time, with half of the cases being overestimates and half being underestimates. A large fraction of the HRRRv2 overestimates were associated with stratiform rain events. It is speculated that this was a result of misinterpretation of the radar bright band as more intense precipitation aloft by the data assimilation scheme. A large fraction of the HRRRv2 underestimates occurred when the data assimilation and model were unable to fully resolve the low-level convergence along small-scale, narrow boundaries that led to new storm initiation and/or storm growth.
Cerebrovascular effects of glibenclamide investigated using high-resolution magnetic resonance imaging in healthy volunteers
Authors: Al-Karagholi Mohammad Al-Mahdi , Ghanizada Hashmat , Nielsen Cherie Amalie Waldorff , Ansari Assan , Gram Christian , Younis Samaria , Vestergaard Mark B , Larsson Henrik BW , Skovgaard Lene Theil , Amin Faisal Mohammad , Ashina Messoud 
Published: October 2020

Glibenclamide inhibits sulfonylurea receptor (SUR), which regulates several ion channels including SUR1-transient receptor potential melastatin 4 (SUR1-TRPM4) channel and ATP-sensitive potassium (KATP) channel. Stroke upregulates SURl-TRPM4 channel, which causes a rapid edema formation and brain swelling. Glibenclamide may antagonize the formation of cerebral edema during stroke. Preclinical studies showed that glibenclamide inhibits KATP channel-induced vasodilation without altering the basal vascular tone. The in vivo human cerebrovascular effects of glibenclamide have not previously been investigated. In a randomized, double-blind, placebo-controlled, three-way cross-over study, we used advanced 3 T MRI methods to investigate the effects of glibenclamide and KATP channel opener levcromakalim on mean global cerebral blood flow (CBF) and intra- and extracranial artery circumferences in 15 healthy volunteers. Glibenclamide administration did not alter the mean global CBF and the basal vascular tone. Following levcromakalim infusion, we observed a 14% increase of the mean global CBF and an 8% increase of middle cerebral artery (MCA) circumference, and glibenclamide did not attenuate levcromakalim-induced vascular changes. Collectively, the findings demonstrate the vital role of KATP channels in cerebrovascular hemodynamic and indicate that glibenclamide does not inhibit the protective effects of KATP channel activation during hypoxia and ischemia-induced brain injury.
A Qualitative Exploration of the Attitudes and Experiences of Polish Breastfeeding Mothers in Ireland
Authors: O’Sullivan Elizabeth J. , O’Grady Agnieszka , Pawlak Karolina , Kearney John M. 
Published: October 2020

Background Breastfeeding rates in Ireland are among the lowest in the world. Improving the prevalence of breastfeeding is an objective of the Irish Health Service Executive, with the recognition that this would improve public health. Polish people represent the largest immigrant group in Ireland, and Polish women are more likely to initiate breastfeeding than Irish women. Research aims This study had two aims: (1) to describe the breastfeeding experiences and attitudes among Polish mothers living in Ireland, and (2) to explore similarities and differences in infant feeding experiences, attitudes, and beliefs among Polish and Irish women, as perceived by Polish women. Methods Semi-structured interviews were conducted in Polish with Polish mothers ( N = 16) who had lived in Ireland for 10 years or less. Interviews were audio recorded, transcribed, and translated into English. Data were analyzed using qualitative thematic analysis. Coding was a cyclical process; codes were amended and refined through iterative reading of the transcripts. Themes were developed through categorization of codes and via in-depth discussion between two analysts. Results Three major themes were developed after analyzing the data. First, there is no universal correct way to provide support for infant feeding; women would like individualized support based on their infant-feeding decisions. Second, breastfeeding is an inherent part of Polish culture and formula feeding is part of Irish culture. Finally, the Irish social environment is supportive of breastfeeding and breastfeeding in public is acceptable in Ireland. Conclusions Although the Irish social environment is supportive of breastfeeding, the infant-formula culture is a barrier to breastfeeding. Future research should explore ways to change societal attitudes towards breastfeeding in Ireland.
The Reliability of Visual Ratings of Velopharyngeal Physiology for Speech
Authors: Watterson Thomas , Wendel Jeanne , Grames Lynn M. , Warner Amanda 
Published: October 2020

Background: Analyze intrarater and interrater reliability for evaluating endoscopic images of velopharyngeal (VP) physiology. Method: Speakers produced 9 speech stimuli representing 4 stimulus types: sustained phonemes, repetitions of “puh,” single words, and short phrases. The 37-speaker participants included 16 patients with VP dysfunction and 21 control participants. Five raters independently rated the video images for degree of VP opening, location of opening, and pattern of closure. Outcome measures included intrarater and interrater measures of reliability and the effects of raters and stimulus type on ratings. Results: Intrarater reliability was acceptable, and ratings were logically consistent. Fixed effects regression coefficients for the patient and the control groups showed that raters were a significant source of variability for degree of opening and pattern of closing. Stimulus type was not a significant source of variation for any metric for the controls, but stimulus type was a significant determinant for degree of opening for patients. The degree of opening was larger for sustained phonemes than for the other speech stimuli. Ratings for degree of opening were most similar for repeated “puh.” Conclusions: Interrater reliability needs to be improved so that the assessment procedure produces more consistent findings among clinicians, thus strengthening our evidence base for this procedure. Interrater additional research is needed to understand how the stimulus affects ratings of VP physiology, to identify stimuli that yield the most useful clinical information, and to understand how training affects the ratings of VP physiology.
Laryngoscopy Grade Improvement and Difficult Airway Resolution in Infants With Robin Sequence Undergoing Mandibular Distraction Osteogenesis: A Multi-Institutional Study
Authors: Siegel Nicholas , Lopez Joseph , Shi Aria C. , Neimanis Sara , Jodeh Diana , Khavanin Nima , Redett Richard J. , Sterni Laura M. , Walsh Jonathan M. , Dalesio Nicholas M. , Rottgers S. Alex , Morrison Clinton S. , Steinberg Jordan P. 
Published: October 2020

Objective: Mandibular distraction osteogenesis (MDO) aims to relieve tongue-based airway obstruction in Robin Sequence (RS). We investigated direct laryngoscopy grade (DLG) improvement and difficult airway (DA) resolution following MDO. Design: Retrospective cohort analysis. Setting: Three tertiary care institutions. Patients: Sixty-four infants with RS who underwent a single MDO procedure in their first year of life were identified from January 2010 to January 2019. Main Outcome Measures: The primary outcome was DLG pre- and post-MDO. Secondary outcomes included DA designation, pre- and post-MDO polysomnographic assessment for obstructive sleep apnea (OSA), length of stay, need for gastrostomy, and major/minor adverse events. Results: Median DLG improved from II pre-MDO to I at the time of distractor removal (n = 43, P < .001). No significant change was seen in patients with a third recorded time point (eg, palatoplasty; n = 78, P = .52). Twenty-six (47%) of 55 patients were designated as DA pre-MDO, and 10 (18%) of 55 patients retained the label post-MDO ( P < .01). Five (50%) of these 10 patients appeared to be inappropriately retained. Median obstructive apnea–hypopnea index improved from 38.6 (range 31.2-62.8) pre-MDO to 2.9 (range 1-3.9) post-MDO (n = 12; P = .002). Conclusion: Mandibular distraction osteogenesis allowed for DLG improvement that was stably maintained as well as functional improvement in OSA, with minimal morbidity. Difficult airway designation persisted in the electronic record of some infants despite clinical resolution.
Comparison of Botulinum Toxin A, Corticosteroid, and Anesthetic Injection for Plantar Fasciitis
Authors: Elizondo-Rodríguez Jorge , Simental-Mendía Mario , Peña-Martínez Victor , Vilchez-Cavazos Félix , Tamez-Mata Yadira , Acosta-Olivo Carlos 
Published: October 2020

Background: Plantar fasciitis is the most common cause of heel pain, and injection therapies are part of the treatment modalities. This study aimed to compare 2 intralesional injection therapies for plantar fasciitis: corticosteroid and botulinum toxin A, compared with a third control group using a local anesthetic. The clinical evolution, as well as changes in the thickness of the plantar fascia and ankle dorsiflexion, was evaluated. Methods: A randomized, controlled, double-blind trial design was used. Patients were divided into 3 groups: group 1, anesthetic only; group 2, corticosteroid; and group 3, botulinum toxin A (BoNT-A). We used an ultrasonographic evaluation to measure the plantar fascia thickness. The results were evaluated using the Maryland Foot Score and a 10-cm visual analog scale. Clinical scores were recorded at the beginning of the study, at 2 weeks, and at 1, 3, and 6 months. We evaluated 78 patients for study eligibility. The 3 intervention groups were homogeneous. Results: All patients showed better clinical outcomes compared with their initial evaluations, without differences between groups at the end of follow-up. The thickness of plantar fascia diminished at the final evaluation, and ankle dorsiflexion was better compared with the initial values without difference between treatment groups. Conclusion: Considering all the evaluated outcomes, no significant differences between treatment groups were observed. The pain relief and functional improvement obtained with the different treatments was maintained during the 6-month follow-up. Level of Evidence: Level I, therapeutic study.