bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Medicaid Expansion With Rates of Utilization of Cardiovascular Therapies Among Medicaid Beneficiaries Between 2011 and 2018
Authors: Sumarsono Andrew , Lalani Hussain , Segar Matthew W. , Rao Shreya , Vaduganathan Muthiah , Wadhera Rishi K. , Das Sandeep R. , Navar Ann Marie , Fonarow Gregg C. , Pandey Ambarish 
Published: November 2020

Background:
The Affordable Care Act expanded Medicaid eligibility allowing low-income individuals greater access to health care. However, the uptake of state Medicaid expansion has been variable. It remains unclear how the Medicaid expansion was associated with the temporal trends in use of evidence-based cardiovascular drugs.

Methods:
We used the publicly available Medicaid Drug Utilization and Current Population Survey to extract filled prescription rates per 1000 Medicaid beneficiaries of statins, antihypertensives, P2Y12 inhibitors, and direct oral anticoagulants. We defined expander states as those who expanded Medicaid on or before January 1, 2014, and nonexpander states as those who had not expanded by December 31, 2018. Difference-in-differences (DID) analyses were performed to compare the association of the Medicaid expansion with per-capita cardiovascular drug prescription rates in expander versus nonexpander states.

Results:

Between 2011 and 2018, the total number of prescriptions among all Medicaid beneficiaries increased, with gains of 89.7% in statins (11.0 to 20.8 million), 76% in antihypertensives (35.3 to 62.2 million), and 37% in P2Y12 inhibitors (1.7 to 2.3 million). Medicaid expansion was associated with significantly greater increases in quarterly prescriptions (per 1000 Medicaid beneficiaries) of statins (DID estimate [95% CI]: 22.5 [16.5–28.6],
P
<0.001), antihypertensives (DID estimate [95% CI]: 63.2 [47.3–79.1],
P
<0.001), and P2Y12 inhibitors (DID estimate [95% CI]: 1.7 [1.2–2.2],
P
<0.001). Between 2013 and 2018, >75% of the expander states had increases in prescription rates of both statins and antihypertensives. In contrast, 44% of nonexpander states saw declines in statins and antihypertensives. The Medicaid expansion was not associated with higher direct oral anticoagulants prescription rates (DID estimate [95% CI] 0.9 [−0.3 to 2.1],
P
=0.142).

Conclusions:
The 2014 Medicaid expansion was associated with a significant increase in per-capita utilization of cardiovascular prescription drugs among Medicaid beneficiaries. These gains in utilization may contribute to long-term cardiovascular benefits to lower-income and previously underinsured populations.
Association of Baseline and Longitudinal Changes in Body Composition Measures With Risk of Heart Failure and Myocardial Infarction in Type 2 Diabetes
Authors: Patel Kershaw V. , Bahnson Judy L. , Gaussoin Sarah A. , Johnson Karen C. , Pi-Sunyer Xavier , White Ursula , Olson KayLoni L. , Bertoni Alain G. , Kitzman Dalane W. , Berry Jarett D. , Pandey Ambarish ,   On behalf of the Look AHEAD Research Group
Published: November 2020

Background:
Intentional weight loss is associated with lower risk of heart failure (HF) and atherosclerotic cardiovascular disease among patients with type 2 diabetes. However, the contribution of baseline measures and longitudinal changes in fat mass (FM), lean mass (LM), and waist circumference (WC) to the risk of HF and myocardial infarction (MI) in type 2 diabetes is not well established.

Methods:
Adults from the Look AHEAD trial (Action for Health in Diabetes) without prevalent HF were included. FM and LM were predicted using validated equations and compared with dual-energy x-ray absorptiometry measurements in a subgroup. Adjusted Cox models were used to evaluate the associations of baseline and longitudinal changes in FM, LM, and WC over 1- and 4-year follow-up with risk of overall HF, HF with preserved ejection fraction (EF; EF ≥50%), HF with reduced EF (EF <50%), and MI.

Results:

Among 5103 participants, there were 257 incident HF events over 12.4 years of follow-up. Predicted and measured FM/LM were highly correlated (
R
2
=0.87–0.90; n=1369). FM and LM decreased over 4-year follow-up with greater declines in the intensive lifestyle intervention arm. In adjusted analysis, baseline body composition measures were not significantly associated with HF risk. Decline in FM and WC, but not LM, over 1 year were each significantly associated with lower risk of overall HF (adjusted hazard ratio per 10% decrease in FM, 0.80 [95% CI, 0.68–0.95]; adjusted hazard ratio per 10% decrease in WC, 0.77 [95% CI, 0.62–0.95]). Decline in FM was significantly associated with lower risk of both HF subtypes. In contrast, decline in WC was significantly associated with lower risk of HF with preserved EF but not HF with reduced EF. Similar patterns of association were observed for 4-year changes in body composition and HF risk. Longitudinal changes in body composition were not significantly associated with risk of MI.

Conclusions:
In adults with type 2 diabetes, a lifestyle intervention is associated with significant loss of FM and LM. Declines in FM and WC, but not LM, were each significantly associated with lower risk of HF but not MI. Furthermore, decline in WC was significantly associated with lower risk of HF with preserved EF but not HF with reduced EF.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00017953.
Flow-Mediated Susceptibility and Molecular Response of Cerebral Endothelia to SARS-CoV-2 Infection
Authors: Kaneko Naoki , Satta Sandro , Komuro Yutaro , Muthukrishnan Sree Deepthi , Kakarla Visesha , Guo Lea , An Jennifer , Elahi Fanny , Kornblum Harley I. , Liebeskind David S. , Hsiai Tzung , Hinman Jason D. 
Published: November 2020

Background and Purpose:
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with an increased rate of cerebrovascular events including ischemic stroke and intracerebral hemorrhage. The mechanisms underlying cerebral endothelial susceptibility and response to SARS-CoV-2 are unknown yet critical to understanding the association of SARS-CoV-2 infection with cerebrovascular events.

Methods:
Endothelial cells were isolated from human brain and analyzed by RNA sequencing. Human umbilical vein and human brain microvascular cells were used in both monolayer culture and endothelialized within a 3-dimensional printed vascular model of the middle cerebral artery. Gene expression levels were measured by quantitative polymerase chain reaction and direct RNA hybridization. Recombinant SARS-CoV-2 S protein and S protein–containing liposomes were used to measure endothelial binding by immunocytochemistry.

Results:

ACE2
(angiotensin-converting enzyme-2) mRNA levels were low in human brain and monolayer endothelial cell culture. Within the 3-dimensional printed vascular model,
ACE2
gene expression and protein levels were progressively increased by vessel size and flow rates. SARS-CoV-2 S protein–containing liposomes were detected in human umbilical vein endothelial cells and human brain microvascular endothelial cells in 3-dimensional middle cerebral artery models but not in monolayer culture consistent with flow dependency of ACE2 expression. Binding of SARS-CoV-2 S protein triggered 83 unique genes in human brain endothelial cells including upregulation of complement component C3.

Conclusions:
Brain endothelial cells are susceptible to direct SARS-CoV-2 infection through flow-dependent expression of ACE2. Viral S protein binding triggers a unique gene expression profile in brain endothelia that may explain the association of SARS-CoV-2 infection with cerebrovascular events.
How Did Japan Cope with COVID-19? Big Data and Purchasing Behavior*
Authors: Konishi Yoko , Saito Takashi , Ishikawa Toshiki , Kanai Hajime , Igei Naoya 
Published: November 2020

Abstract
Japan has been recognized as having successfully controlled the spread of COVID-19. This study aims to gather insights to combat the spread of infection in our daily lives by observing our purchasing behavior. We use point of sales (POS) data from supermarkets, convenience stores, home centers, drug stores, and electronics retail stores for a nationwide analysis. Our analysis revealed the following. First, the Japanese actively prevented the spread of infection by voluntarily wearing masks, using alcohol-based disinfectants, and gargling. Second, they willingly stayed home during the semi-lockdown. Third, they continued to purchase infection prevention essentials during periods of both low and high levels of infection. We conclude that continuing to wear masks, wash and sanitize hands, and gargle, along with spending more time at home to maintain safe distancing, will be effective in reducing the spread of the virus and combatting the pandemic. Finally, infections and deaths were primarily concentrated in the Tokyo metropolitan area and the Kansai region, where the nature of the spread of the infection was different from that in small and middle-sized prefectures.
How China Managed the COVID-19 Pandemic*
Authors: Tian Wei 
Published: November 2020

Abstract
The COVID-19 pandemic has swept across China and the world, causing more than 30 million infections and incalculable damage. China was seriously damaged and threatened by the disease in the first quarter of 2020, but finally succeeded in halting its spread in a short period. This was achieved through quick and strong measures in self-protection, mobility control, resource allocation, professional health care, and disinfection, under the organization of the government and the cooperation of all the Chinese people. The measures that were taken to prevent the spread of COVID-19 proved to be efficient in fighting the outbreak in Beijing in June 2020. This paper reviews China's experience with COVID-19, the Chinese economy's performance during the pandemic, and the government's policies to protect lives, maintain markets, and promote the economy. The data show that strong monetary and fiscal policies accelerated the country's economic recovery. These policies, including tax reductions and credit support, targeting small- and medium-size enterprises (SMEs) and industries and regions that were severely damaged, have helped to create jobs and encourage production and investment.
Variability in Wind Energy Generation across the Contiguous United States
Authors: Pryor S. C. , Letson F.W. , Barthelmie R. J. 
Published: November 2020

AbstractERA5 provides high-resolution, high-quality hourly wind speeds at 100 m and is a unique resource for quantifying temporal variability in likely wind-derived power production across the United States. Gross capacity factors (CF) in seven independent system operators (ISOs) are estimated using the location and rated power of each wind turbine, a simplified power curve, and ERA5 output from 1979 to 2018. Excluding the California ISO, the marginal probability of a calm (zero power production) is less than 0.1 in any ERA5 grid cell. When a calm occurs, the mean co-occurrence across wind-turbine-containing grid cells ranges from 0.38 to 0.39 for ISOs in the Midwest and central plains [Midcontinent (or Midwest) ISO (MISO), Southwest Power Pool (SPP), and the Electric Reliability Council of Texas (ERCOT) region], increasing to 0.54–0.58 for ISOs in the eastern United States [Pennsylvania–New Jersey–Maryland interconnection (PJM), New York ISO (NYISO), and New England ISO (NEISO)]. Periods with low gross CF have a median duration of ≤6 h, except in California, and are most likely during summer. Gross CF exhibit highest variance at periods of 1 day in ERCOT and SPP; on synoptic scales in MISO, NEISO, and NYISO; and on interannual time scales in PJM. This implies differences in optimal strategies for ensuring resilience of supply. Theoretical scenarios show adding wind energy capacity near existing wind farms is advantageous even in areas with high existing installed capacity (IC), while expanding into areas with lower IC is more beneficial to reducing ramps and the probability of gross CF falling below 20%. These results emphasize the benefits of large balancing areas and aggregation in reducing wind power variability and the likelihood of wind droughts.
Mechanisms of Decadal North Atlantic Climate Variability and Implications for the Recent Cold Anomaly
Authors: Årthun Marius , Wills Robert C. J. , Johnson Helen L. , Chafik Léon , Langehaug Helene R. 
Published: November 2020

AbstractDecadal sea surface temperature (SST) fluctuations in the North Atlantic Ocean influence climate over adjacent land areas and are a major source of skill in climate predictions. However, the mechanisms underlying decadal SST variability remain to be fully understood. This study isolates the mechanisms driving North Atlantic SST variability on decadal time scales using low-frequency component analysis, which identifies the spatial and temporal structure of low-frequency variability. Based on observations, large ensemble historical simulations, and preindustrial control simulations, we identify a decadal mode of atmosphere–ocean variability in the North Atlantic with a dominant time scale of 13–18 years. Large-scale atmospheric circulation anomalies drive SST anomalies both through contemporaneous air–sea heat fluxes and through delayed ocean circulation changes, the latter involving both the meridional overturning circulation and the horizontal gyre circulation. The decadal SST anomalies alter the atmospheric meridional temperature gradient, leading to a reversal of the initial atmospheric circulation anomaly. The time scale of variability is consistent with westward propagation of baroclinic Rossby waves across the subtropical North Atlantic. The temporal development and spatial pattern of observed decadal SST variability are consistent with the recent observed cooling in the subpolar North Atlantic. This suggests that the recent cold anomaly in the subpolar North Atlantic is, in part, a result of decadal SST variability.
Dryness over the U.S. Southwest, a Springboard for Cold Season Pacific SST to Influence Warm Season Drought over the U.S. Great Plains
Authors: Zhuang Yizhou , Erfanian Amir , Fu Rong 
Published: November 2020

AbstractAlthough the influence of sea surface temperature (SST) forcing and large-scale teleconnection on summer droughts over the U.S. Great Plains has been suggested for decades, the underlying mechanisms are still not fully understood. Here we show a significant correlation between low-level moisture condition over the U.S. Southwest in spring and rainfall variability over the Great Plains in summer. Such a connection is due to the strong influence of the Southwest dryness on the zonal moisture advection to the Great Plains from spring to summer. This advection is an important contributor for the moisture deficit during spring to early summer, and so can initiate warm season drought over the Great Plains. In other words, the well-documented influence of cold season Pacific SST on the Southwest rainfall in spring, and the influence of the latter on the zonal moisture advection to the Great Plains from spring to summer, allows the Pacific climate variability in winter and spring to explain over 35% of the variance of the summer precipitation over the Great Plains, more than that can be explained by the previous documented west Pacific–North America (WPNA) teleconnection forced by tropical Pacific SST in early summer. Thus, this remote land surface feedback due to the Southwest dryness can potentially improve the predictability of summer precipitation and drought onsets over the Great Plains.
Submesoscale Currents in the Subtropical Upper Ocean Observed by Long-Term High-Resolution Mooring Arrays
Authors: Zhang Zhiwei , Zhang Xincheng , Qiu Bo , Zhao Wei , Zhou Chun , Huang Xiaodong , Tian Jiwei 
Published: November 2020

AbstractAlthough observational efforts have been made to detect submesoscale currents (submesoscales) in regions with deep mixed layers and/or strong mesoscale kinetic energy (KE), there have been no long-term submesoscale observations in subtropical gyres, which are characterized by moderate values of both mixed layer depths and mesoscale KE. To explore submesoscale dynamics in this oceanic regime, two nested mesoscale- and submesoscale-resolving mooring arrays were deployed in the northwestern Pacific subtropical countercurrent region during 2017–19. Based on the 2 years of data, submesoscales featuring order one Rossby numbers, large vertical velocities (with magnitude of 10–50 m day−1) and vertical heat flux, and strong ageostrophic KE are revealed in the upper 150 m. Although most of the submesoscales are surface intensified, they are found to penetrate far beneath the mixed layer. They are most energetic during strong mesoscale strain periods in the winter–spring season but are generally weak in the summer–autumn season. Energetics analysis suggests that the submesoscales receive KE from potential energy release but lose a portion of it through inverse cascade. Because this KE sink is smaller than the source term, a forward cascade must occur to balance the submesoscale KE budget, for which symmetric instability may be a candidate mechanism. By synthesizing observations and theories, we argue that the submesoscales are generated through a combination of baroclinic instability in the upper mixed and transitional layers and mesoscale strain-induced frontogenesis, among which the former should play a more dominant role in their final generation stage.
XMET—An Unattended Meteorological Sensing System for Austere Environments
Authors: Rogowski Peter , Otero Mark , Hazard Joel , Muschamp Thomas , Katz Scott , Terrill Eric 
Published: November 2020

AbstractAccurate surface meteorological (MET) observations reported reliably and in near–real time remain a critical component of on-scene environmental observation systems. Presented is a system developed by Scripps Institution of Oceanography that allows for rapid, global deployment of ground-based weather observations to support both timely decision-making and collection of high-quality weather time series for science or military applications in austere environments. Named the Expeditionary Meteorological (XMET), these weather stations have been deployed in extreme conditions devoid of infrastructure ranging from tropical, polar, maritime, and desert environments where near continuous observations were reported. To date, over 1 million weather observations have been collected during 225 deployments around the world with a data report success rate of 99.5%. XMET had its genesis during Operation Iraqi Freedom (OIF), when the U.S. Marine Corps 3rd Marine Aircraft Wing identified an immediate capability gap in environmental monitoring of their operation area due to high spatiotemporal variability of dust storms in the region. To address the sensing gap, XMET was developed to be a portable, expendable, ruggedized, self-contained, bidirectional, weather observation station that can be quickly deployed anywhere in the world to autonomously sample and report aviation weather observations. This paper provides an overview of the XMETs design, reliability in different environments, and examples of unique meteorological events that highlight both the unit’s reliability and ability to provide quality time series. The overview shows expeditionary MET sensing systems, such as the XMET, are able to provide long-term continuous observational records in remote and austere locations essential for regional spatiotemporal MET characterization.
Toward Unifying Short-Term and Next-Day Convection-Allowing Ensemble Forecast Systems with a Continuously Cycling 3-km Ensemble Kalman Filter over the Entire Conterminous United States
Authors: Schwartz Craig S. , Romine Glen S. , Dowell David C. 
Published: November 2020

AbstractUsing the Weather Research and Forecasting Model, 80-member ensemble Kalman filter (EnKF) analyses with 3-km horizontal grid spacing were produced over the entire conterminous United States (CONUS) for 4 weeks using 1-h continuous cycling. For comparison, similarly configured EnKF analyses with 15-km horizontal grid spacing were also produced. At 0000 UTC, 15- and 3-km EnKF analyses initialized 36-h, 3-km, 10-member ensemble forecasts that were verified with a focus on precipitation. Additionally, forecasts were initialized from operational Global Ensemble Forecast System (GEFS) initial conditions (ICs) and experimental “blended” ICs produced by combining large scales from GEFS ICs with small scales from EnKF analyses using a low-pass filter. The EnKFs had stable climates with generally small biases, and precipitation forecasts initialized from 3-km EnKF analyses were more skillful and reliable than those initialized from downscaled GEFS and 15-km EnKF ICs through 12–18 and 6–12 h, respectively. Conversely, after 18 h, GEFS-initialized precipitation forecasts were better than EnKF-initialized precipitation forecasts. Blended 3-km ICs reflected the respective strengths of both GEFS and high-resolution EnKF ICs and yielded the best performance considering all times: blended 3-km ICs led to short-term forecasts with similar or better skill and reliability than those initialized from unblended 3-km EnKF analyses and ~18–36-h forecasts possessing comparable quality as GEFS-initialized forecasts. This work likely represents the first time a convection-allowing EnKF has been continuously cycled over a region as large as the entire CONUS, and results suggest blending high-resolution EnKF analyses with low-resolution global fields can potentially unify short-term and next-day convection-allowing ensemble forecast systems under a common framework.
Persistent Air Bubble Sequestered at the Silicone Oil–Silicone Intraocular Lens Interface as a Cause of Reversible Visual Distortion
Authors: Agranat Joshua S. , Eliott Dean 
Published: November 2020

Purpose: To report a novel cause of post-operative reversible visual distortion due to a persistent air bubble sequestered at the intraocular lens (IOL)–silicone oil interface. Methods: Two cases of persistent, sequestered air at the IOL-silicone oil interface were identified and reviewed. Relevant clinical information, images and surgical videos were analyzed and described. Results: Resolution of the visual distortion was achieved in both cases after silicone oil removal. Conclusions: Silicone oil adhesion to the posterior surface of silicone IOLs is a known cause of visual degradation. The IOL-silicone oil interface can sequester air that persists and causes visual distortion until the oil is removed. We report the first cases, to our knowledge, of reversible visual distortion due to sequestered air at the IOL-silicone oil interface.