bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute cerebrovascular effects in juvenile coho salmon exposed to roadway runoff
Authors: Blair Stephanie I. , Barlow Clyde H. , McIntyre Jenifer K. 
Published: December 2020

Urban stormwater is responsible for recurrent mortality events of coho salmon (Oncorhynchus kisutch) documented in the US Pacific Northwest. Currently, the toxic mode of action is unknown; however, mortality is often associated with large increases in hematocrit (Hct). We found that hemoconcentration and red cell swelling may offer a partial explanation for increased Hct, based on increased total hemoglobin and reduced mean cell hemoglobin concentration of the blood in runoff-exposed juvenile coho salmon, relative to controls. No significant changes were seen in plasma total thiols or antioxidant power, discounting osmoregulatory dysfunction and plasma dehydration as a driver of hemoconcentration. To test for plasma leakage, we injected Evans blue dye complexed with bovine serum albumin (EBD–BSA) intracardially and circulated for 5 min, followed by a 15 min washout with saline. Coho salmon exposed to roadway runoff showed significant accumulation of EBD–BSA in brain and olfactory rosette regions compared with controls, demonstrating plasma leakage from the cerebrovasculature. Our results suggest blood–brain barrier disruption underlies symptom development in coho salmon exposed to roadway runoff.
A Cross-Sectional Study on the Affordable Care Act from the Perspective of People Living with HIV: The Interplay between Knowledge, Stigma, Trust, and Attitudes
Authors: Kaperak Christopher , Elwood Sarah , Saint-Surin Tamara , Winstead-Derlega Christopher , Brennan Robert O. , Dillingham Rebecca , McManus Kathleen A. 
Published: December 2020

Background. Many AIDS Drug Assistance Programs (ADAPs) purchased Affordable Care Act (ACA) Qualified Health Plans (QHPs) for low-income people living with HIV (PLWH). To date, little has been published about PLWH’s perspective on the ACA. We explored ACA knowledge, HIV stigma, trust in the healthcare system, and ACA attitudes among PLWH with ADAP-funded QHPs in Virginia. Methods. Participants were surveyed about demographic characteristics, ACA knowledge, HIV stigma, trust in various healthcare and government entities, and attitudes toward the ACA. Descriptive statistics were used. We assessed for associations (1) between baseline characteristics and correct ACA knowledge, HIV-related stigma, trust, and ACA attitudes and (2) between correct ACA knowledge and the following data: sources of ACA knowledge, HIV stigma, and trust. Results. Participants (n = 53) were a vulnerable population based on the assessment of social determinants of health, and 30% had correct ACA knowledge. Almost three-fourths of participants used HIV clinic case managers for ACA information. Participants who used websites for ACA information had correct ACA knowledge more often compared to those that did not (71% vs. 15%;

p

= 0.001). Those with correct ACA knowledge had lower stigma scores compared to those without correct ACA knowledge (93.8; SD: 15.4 vs. 108; SD: 20.3;

p

= 0.01). Participants trusted HIV clinicians more than general clinicians and insurance companies. No association was found between having correct ACA knowledge and endorsing having enough information about the ACA to understand how it will impact their HIV care. Conclusions. Websites imparted accurate ACA information. HIV clinic case managers were the most used source, and HIV clinicians were a trusted source of information. HIV clinicians and case managers should consider disseminating information about the ACA and its impact on HIV care delivery via internet videos. Lack of internet and stigma are a threat to PLWH gaining actionable healthcare information.
Inter-rater Variability in Malaria Microscopy at the LEKMA Hospital, Ghana
Authors: Bekoe Andrew Nii Adzei , Allotey Emmanuel Alote , Akorsu Elliot Elikplim , Abaka-Yawson Albert , Adusei Samuel , Kpene Godsway Edem , Kwadzokpui Precious Kwablah 
Published: December 2020

Background. Malaria remains a major cause of morbidity and mortality worldwide and particularly in sub-Saharan Africa where it is endemic. As such, it is important that a proper diagnosis is made before treatment is initiated. Malaria parasite count plays a key role in the diagnosis and management of malaria. Variations in ratings by laboratory personnel can impact negatively on the treatment regimen for malaria-infected patients. The study is thus aimed at evaluating and comparing the proficiency and parasitaemia counts by two different categories of laboratory staff at the LEKMA Hospital, Ghana. Materials and Methods. A total of 200 confirmed malaria-positive samples were used in the study. Six thick and thin films were prepared from each sample and uniquely labelled. Two of the six slides were given to two WHO-accredited malaria microscopists to examine and report their respective parasite count/μl (

parasite

count
/
WBC
×
8000

). These were used as the reference for the two categories of laboratory staffs: rater A being diploma holders (Technical Officers referred to as untrained rater) and rater B being degree holders (Medical Laboratory Scientist referred to as trained rater) at the LEKMA Hospital. Results. In comparison to the expected outcome, the parasite count by the rater group A (190 (151-239)]) and the rater group B (177 (140-224)) demonstrated significant positive correlation (

r
=
0.995

,

p
<
0.0001

vs.

r
=
0.995

,

p
<
0.0001

, respectively) with the expected outcome in the cases of heavy parasitaemia. A statistically significant difference (

p
<
0.05

) between counts by the different raters in low parasitemia was observed in this study. A persistent nosedive inter-rater agreement from

k
=
0.82

to

k
=
0.40

with increasing density cutoff was observed in this study. Conclusion. The study observed that the degree of inter-rater agreement of parasite density count by various categories of laboratory personnel is almost perfect. However, the parasite count between raters varied significantly with very low levels of parasitemia but better correlated with heavy parasitemia.
Targeting Thymidine Phosphorylase With Tipiracil Hydrochloride Attenuates Thrombosis Without Increasing Risk of Bleeding in Mice
Authors: Belcher Adam , Zulfiker Abu Hasanat Md , Li Oliver Qiyue , Yue Hong , Gupta Anirban Sen , Li Wei 
Published: December 2020

Objective:
Current antiplatelet medications increase the risk of bleeding, which leads to a clear clinical need in developing novel mechanism-based antiplatelet drugs. TYMP (Thymidine phosphorylase), a cytoplasm protein that is highly expressed in platelets, facilitates multiple agonist-induced platelet activation, and enhances thrombosis. Tipiracil hydrochloride (TPI), a selective TYMP inhibitor, has been approved by the Food and Drug Administration for clinical use. We tested the hypothesis that TPI is a safe antithrombotic medication.

Approach and Results:
By coexpression of TYMP and Lyn, GST (glutathione S-transferase) tagged Lyn-SH3 domain or Lyn-SH2 domain, we showed the direct evidence that TYMP binds to Lyn through both SH3 and SH2 domains, and TPI diminished the binding. TYMP deficiency significantly inhibits thrombosis in vivo in both sexes. Pretreatment of platelets with TPI rapidly inhibited collagen- and ADP-induced platelet aggregation. Under either normal or hyperlipidemic conditions, treating wild-type mice with TPI via intraperitoneal injection, intravenous injection, or gavage feeding dramatically inhibited thrombosis without inducing significant bleeding. Even at high doses, TPI has a lower bleeding side effect compared with aspirin and clopidogrel. Intravenous delivery of TPI alone or combined with tissue plasminogen activator dramatically inhibited thrombosis. Dual administration of a very low dose of aspirin and TPI, which had no antithrombotic effects when used alone, significantly inhibited thrombosis without disturbing hemostasis.

Conclusions:
This study demonstrated that inhibition of TYMP, a cytoplasmic protein, attenuated multiple signaling pathways that mediate platelet activation, aggregation, and thrombosis. TPI can be used as a novel antithrombotic medication without the increase in risk of bleeding.
Endothelial TFEB (Transcription Factor EB) Improves Glucose Tolerance via Upregulation of IRS (Insulin Receptor Substrate) 1 and IRS2
Authors: Sun Jinjian , Lu Haocheng , Liang Wenying , Zhao Guizhen , Ren Lu , Hu Die , Chang Ziyi , Liu Yuhao , Garcia-Barrio Minerva T. , Zhang Jifeng , Chen Y. Eugene , Fan Yanbo 
Published: December 2020

Objective:
Vascular endothelial cells (ECs) play a critical role in maintaining vascular homeostasis. Aberrant EC metabolism leads to vascular dysfunction and metabolic diseases. TFEB (transcription factor EB), a master regulator of lysosome biogenesis and autophagy, has protective effects on vascular inflammation and atherosclerosis. However, the role of endothelial TFEB in metabolism remains to be explored. In this study, we sought to investigate the role of endothelial TFEB in glucose metabolism and underlying molecular mechanisms.

Approach and Results:
To determine whether endothelial TFEB is critical for glucose metabolism in vivo, we utilized EC-selective TFEB knockout and EC-selective TFEB transgenic mice fed a high-fat diet. EC-selective TFEB knockout mice exhibited significantly impaired glucose tolerance compared with control mice. Consistently, EC-selective TFEB transgenic mice showed improved glucose tolerance. In primary human ECs, small interfering RNA-mediated TFEB knockdown blunts Akt (AKT serine/threonine kinase) signaling. Adenovirus-mediated overexpression of TFEB consistently activates Akt and significantly increases glucose uptake in ECs. Mechanistically, TFEB upregulates IRS1 and IRS2 (insulin receptor substrate 1 and 2). TFEB increases IRS2 transcription measured by reporter gene and chromatin immunoprecipitation assays. Furthermore, we found that TFEB increases IRS1 protein via downregulation of microRNAs (miR-335, miR-495, and miR-548o). In vivo, Akt signaling in the skeletal muscle and adipose tissue was significantly impaired in EC-selective TFEB knockout mice and consistently improved in EC-selective TFEB transgenic mice on high-fat diet.

Conclusions:
Our data revealed a critical role of TFEB in endothelial metabolism and suggest that TFEB constitutes a potential molecular target for the treatment of vascular and metabolic diseases.
Endoplasmic Reticulum Stress Mediates Vascular Smooth Muscle Cell Calcification via Increased Release of Grp78 (Glucose-Regulated Protein, 78 kDa)-Loaded Extracellular Vesicles
Authors: Furmanik Malgorzata , van Gorp Rick , Whitehead Meredith , Ahmad Sadia , Bordoloi Jayanta , Kapustin Alexander , Schurgers Leon J. , Shanahan Catherine M. 
Published: December 2020

Objective:
Vascular calcification is common among aging populations and mediated by vascular smooth muscle cells (VSMCs). The endoplasmic reticulum (ER) is involved in protein folding and ER stress has been implicated in bone mineralization. The role of ER stress in VSMC-mediated calcification is less clear.

Approach and Results:
mRNA expression of the ER stress markers PERK (PKR (protein kinase RNA)-like ER kinase), ATF (activating transcription factor) 4, ATF6, and Grp78 (glucose-regulated protein, 78 kDa) was detectable in human vessels with levels of PERK decreased in calcified plaques compared to healthy vessels. Protein deposition of Grp78/Grp94 was increased in the matrix of calcified arteries. Induction of ER stress accelerated human primary VSMC-mediated calcification, elevated expression of some osteogenic markers (Runx2 [RUNX family transcription factor 2], OSX [Osterix], ALP [alkaline phosphatse], BSP [bone sialoprotein], and OPG [osteoprotegerin]), and decreased expression of SMC markers. ER stress potentiated extracellular vesicle (EV) release via SMPD3 (sphingomyelin phosphodiesterase 3). EVs from ER stress-treated VSMCs showed increased Grp78 levels and calcification. Electron microscopy confirmed the presence of Grp78/Grp94 in EVs. siRNA (short interfering RNA) knock-down of Grp78 decreased calcification. Warfarin-induced Grp78 and ATF4 expression in rat aortas and VSMCs and increased calcification in an ER stress-dependent manner via increased EV release.

Conclusions:
ER stress induces vascular calcification by increasing release of Grp78-loaded EVs. Our results reveal a novel mechanism of action of warfarin, involving increased EV release via the PERK-ATF4 pathway, contributing to calcification. This study is the first to show that warfarin induces ER stress and to link ER stress to cargo loading of EVs.
Best Practices in the Measurement and Evaluation of Track Two Dialogues: Towards a “Reflective Practice Model”
Authors: Shillings Elizabeth , Jones Peter 
Published: December 2020

Abstract
Measuring the impact of Track Two dialogues has proven a difficult challenge for the field over many years. Each dialogue is different, which makes a standardized test difficult to achieve. Moreover, different actors wish to measure different things: “value” for money; impact on the conflict; how certain facilitation techniques work; and others. In this article, we present a model that can be used to measure the impact of a dialogue over time, while also encouraging reflective practice in the field. This “Reflective Practice Model” can be used to provide a snapshot of a particular moment – or as a vehicle for the accumulation of a series of such moments – thereby providing a means to observe and measure changes as the dialogue goes on.
Introduction
Authors: Brooks Lisa Allette , Cerulli Anthony , Sheldon Victoria 
Published: December 2020

Abstract
This opening piece introduces the eight articles in this special issue of Asian Medicine, all of which emerged out of the daylong Science, Technology, and Medicine in South Asia Symposium: Medicine and Memory, at the 2018 Annual Conference on South Asia in Madison, Wisconsin. These articles are concerned with the ways in which time and healing entangle across regions and healing traditions in South Asia, including Unani, Ayurveda, Naturopathy, and biomedicine. Linking the findings from these articles with recent scholarship, our conversation in the symposium moved beyond the notion of medical pluralisms to a notion of dynamic plurals, through historicizing regional and local diversities in practices and philosophies, often grouped under a single name by communities and practitioners. In an increasingly communalist and politically fractured modern South Asia, we suggest that the discussions in this special issue make a critical contribution to understanding how cultural institutions of knowledge function in society.
A Surgeon’s Hand
Authors: Brooks Lisa Allette 
Published: December 2020

Abstract
The Suśrutasaṃhitā, an early first-millennium Ayurvedic treatise with an emphasis on surgery, recommends a procedure for examining a corpse after first submerging it in a river. Prompted by the sensory insights of a contemporary Ayurvedic physician who simulated “hydro-dissection” on a human hand, I offer a sensory reading of representations of surgeons and surgical tactility in early South Asia. This study demonstrates that surgeons are represented in early first-millennium treatises as possessing specialized medical knowledge, performing dangerous procedures, and having greater sensory and bodily intimacy in their engagement with patients than general physicians. First, I compare passages describing physicians’ sensory engagements in diagnostic examination in the Carakasaṃhitā and Suśrutasaṃhitā. Then I examine representations of surgeons and surgical practice in the Carakasaṃhitā, a general medical compendium. Finally, I demonstrate that surgical tactility is represented in the Suśrutasaṃhitā as an interplay of sensory knowledge, technical skill, experience, and judgment, constituting the surgeon’s hand.
Imagining Indian Medicine
Authors: Datoo Sabrina 
Published: December 2020

Abstract
In 1923, the Presidency of Madras published The Report of the Committee on the Indigenous Systems of Medicine, the first of many Indian policy documents to regulate indigenous medicine. At first glance, the report seems to offer more evidence of the increasing entrenchment of religious nationalist positions within medical networks in the colonial period. Scholars have analyzed its main text, and a significant “Memorandum” associated with it, and found them emblematic of the formation of Hindu science in the early twentieth century. In this article, drawing on the methods of intellectual and cultural history, I conduct a close analysis of the unstudied Urdu-language sections of the report, which suggest a different interpretation. I argue that within the Urdu-language testimonies written by Hindu men, one finds a continuity with early modern medical courtly culture, whose resonances in the colonial period have largely been elided by modern historiography.
To Do Nothing
Authors: Sheldon Victoria 
Published: December 2020

Abstract
In Kerala, South India, individual pursuits of nature cure (prakr̥ti cikitsa) invoke ethical narratives about an idealized purer past, contrasting a dangerous present saturated with social and environmental toxins. While first popularized in India by M. K. Gandhi, nature cure has gained contemporary fame as a low-cost intervention for Kerala’s purported health crisis: chronic lifestyle diseases. Nonprofessionalized natural healers identify as public health activists, teaching predominantly urban, middle-class patients how to revive local lifeways of self-doctorhood. This article narrates how two aging patients internalize their naturopathic doctors’ advice to detoxify and “do nothing” rather than strive for biomedical cure. By naturally revitalizing their bodies, they cultivate feelings of intense independence and ecological attachment that reconfigure experiences of migrated-kin isolation. In counterpoint to literature that frames biopolitical and medical discourses as causally producing moral subjectivities, this article demonstrates how persons agentively craft counternormative, vitalistic models of aging and health, contributing to broader localist imaginaries of reviving pre-toxic lifeways.
Radar-Based Bayesian Estimation of Ice Crystal Growth Parameters within a Microphysical Model
Authors: Schrom Robert S. , van Lier-Walqui Marcus , Kumjian Matthew R. , Harrington Jerry Y. , Jensen Anders A. , Chen Yao-Sheng 
Published: December 2020

Abstract
The potential for polarimetric Doppler radar measurements to improve predictions of ice microphysical processes within an idealized model–observational framework is examined. In an effort to more rigorously constrain ice growth processes (e.g., vapor deposition) with observations of natural clouds, a novel framework is developed to compare simulated and observed radar measurements, coupling a bulk adaptive-habit model of vapor growth to a polarimetric radar forward model. Bayesian inference on key microphysical model parameters is then used, via a Markov chain Monte Carlo sampler, to estimate the probability distribution of the model parameters. The statistical formalism of this method allows for robust estimates of the optimal parameter values, along with (non-Gaussian) estimates of their uncertainty. To demonstrate this framework, observations from Department of Energy radars in the Arctic during a case of pristine ice precipitation are used to constrain vapor deposition parameters in the adaptive habit model. The resulting parameter probability distributions provide physically plausible changes in ice particle density and aspect ratio during growth. A lack of direct constraint on the number concentration produces a range of possible mean particle sizes, with the mean size inversely correlated to number concentration. Consistency is found between the estimated inherent growth ratio and independent laboratory measurements, increasing confidence in the parameter PDFs and demonstrating the effectiveness of the radar measurements in constraining the parameters. The combined Doppler and polarimetric observations produce the highest-confidence estimates of the parameter PDFs, with the Doppler measurements providing a stronger constraint for this case.
Method Uncertainty Is Essential for Reliable Confidence Statements of Precipitation Projections
Authors: Uhe Peter , Mitchell Dann , Bates Paul D. , Allen Myles R. , Betts Richard A. , Huntingford Chris , King Andrew D. , Sanderson Benjamin M. , Shiogama Hideo 
Published: December 2020

AbstractPrecipitation events cause disruption around the world and will be altered by climate change. However, different climate modeling approaches can result in different future precipitation projections. The corresponding “method uncertainty” is rarely explicitly calculated in climate impact studies and major reports but can substantially change estimated precipitation changes. A comparison across five commonly used modeling activities shows that, for changes in mean precipitation, less than half of the regions analyzed had significant changes between the present climate and 1.5°C global warming for the majority of modeling activities. This increases to just over half of the regions for changes between present climate and 2°C global warming. There is much higher confidence in changes in maximum 1-day precipitation than in mean precipitation, indicating the robust influence of thermodynamics in the climate change effect on extremes. We also find that none of the modeling activities captures the full range of estimates from the other methods in all regions. Our results serve as an uncertainty map to help interpret which regions require a multimethod approach. Our analysis highlights the risk of overreliance on any single modeling activity and the need for confidence statements in major synthesis reports to reflect this method uncertainty. Considering multiple sources of climate projections should reduce the risks of policymakers being unprepared for impacts of warmer climates relative to using single-method projections to make decisions.
Is Blush on CT Scan in Patients With Pelvic Fracture Associated With Embolization Rates and Outcomes?
Authors: Koganti Deepika , Grady Zachary J. , Nguyen Jonathan , Butler Caroline C. , Robb Todd S. , Sciarretta Jason , Arroyo-Archer Krystal , Grant April A. 
Published: December 2020

Introduction In trauma patients with pelvic fractures, computed tomography (CT) scans are a critical tool to evaluate life-threatening hemorrhage. Contrast extravasation, or “blush”, on CT may be a sign of bleeding, prompting a consult for angiography and possible embolization. However, the utility of blush on CT is controversial. We sought to evaluate our experience with patients who sustained pelvic fractures and had blush on CT. Method A retrospective review was performed for all patients with blunt pelvic fractures between January 1, 2017 and December 31, 2018. Demographic, clinical, radiographic, and injury data were obtained. Comparison of mortality, hospital length of stay (LOS), and intensive care unit (ICU) LOS was performed for 3 subgroups: angio versus no angio; embo versus no embo; prophylactic embo versus therapeutic embo. We also calculated the sensitivity, specify, positive predictive value (PPV), and negative predictive value (NPV) of CT blush to predict the need for embolization. Results 889 patients were found to have a blunt pelvic fracture. 51 patients had blush on CT scan. 29 (56.9%) underwent angiography. 17 (58.6%) of these 29 patients were found to have extravasation and were embolized. 12 patients had an angio with no extravasation, and 6 of these patients (50%) underwent prophylactic embolization. No significant difference was found for hospital LOS, ICU LOS, or mortality in our 3 groups. Sensitivity, specificity, PPV, and NPV for CT blush were 74%, 96%, 33%, 99%, respectively. Conclusion Patients with active extravasation undergoing embolization had similar outcomes to patients without active extravasation. Blush on CT scan had low sensitivity and low PPV but high specificity and high NPV. Future studies need to include careful attention to the CT protocol utilized as well as patient selection.