bluuebunny/crossref_metadata_2025_split huggingface dataset:
Test-retest reliability of the twenty-five-hole peg test in patients who had a stroke
Authors: Granström Fredrik , Hedlund Mattias , Lindström Britta , Eriksson Staffan 
Published: December 2019

ObjectivesWeaknesses of the nine-hole peg test include high floor effects and a result that might be difficult to interpret. In the twenty-five-hole peg test (TFHPT), the larger number of available pegs allows for the straightforward counting of the number of pegs inserted as the result. The TFHPT provides a comprehensible result and low floor effects. The objective was to assess the test-retest reliability of the TFHPT when testing persons with stroke. A particular focus was placed on the absolute reliability, as quantified by the smallest real difference (SRD). Complementary aims were to investigate possible implications for how the TFHPT should be used and for how the SRD of the TFHPT performance should be expressed.DesignThis study employed a test-retest design including three trials. The pause between trials was approximately 10–120 s.Participants, setting and outcome measureThirty-one participants who had suffered a stroke were recruited from a group designated for constraint-induced movement therapy at outpatient clinics. The TFHPT result was expressed as the number of pegs inserted.MethodsAbsolute reliability was quantified by the SRD, including random and systematic error for a single trial, SRD2.1, and for an average of three trials, SRD2.3. For the SRD measures, the corresponding SRD percentage (SRD%) measure was also reported.ResultsThe differences in the number of pegs necessary to detect a change in the TFHPT for SRD2.1 and SRD2.3 were 4.0 and 2.3, respectively. The corresponding SRD% values for SRD2.1 and SRD2.3 were 36.5% and 21.3%, respectively.ConclusionsThe smallest change that can be detected in the TFHPT should be just above two pegs for a test procedure including an average of three trials. The use of an average of three trials compared with a single trial substantially reduces the measurement error.Trial registration numberISRCTN registry, reference number ISRCTN24868616.
The relationship between off-hours admissions for primary percutaneous coronary intervention, door-to-balloon time and mortality for patients with ST-elevation myocardial infarction in England: a registry-based prospective national cohort study
Authors: Jayawardana Sahan , Salas-Vega Sebastian , Cornehl Felix , Krumholz Harlan M , Mossialos Elias 
Published: December 2019

BackgroundThe degree to which elevated mortality associated with weekend or night-time hospital admissions reflects poorer quality of care (‘off-hours effect’) is a contentious issue. We examined if off-hours admissions for primary percutaneous coronary intervention (PPCI) were associated with higher adjusted mortality and estimated the extent to which potential differences in door-to-balloon (DTB) times—a key indicator of care quality for ST elevation myocardial infarction (STEMI) patients—could explain this association.MethodsNationwide registry-based prospective observational study using Myocardial Ischemia National Audit Project data in England. We examined how off-hours admissions and DTB times were associated with our primary outcome measure, 30-day mortality, using hierarchical logistic regression models that adjusted for STEMI patient risk factors. In-hospital mortality was assessed as a secondary outcome.ResultsFrom 76 648 records of patients undergoing PPCI between January 2007 and December 2012, we included 42 677 admissions in our analysis. Fifty-six per cent of admissions for PPCI occurred during off-hours. PPCI admissions during off-hours were associated with a higher likelihood of adjusted 30-day mortality (OR 1.13; 95% CI 1.01 to 1.25). The median DTB time was longer for off-hours admissions (45 min; IQR 30–68) than regular hours (38 min; IQR 27–58; p<0.001). After adjusting for DTB time, the difference in adjusted 30-day mortality between regular and off-hours admissions for PPCI was attenuated and no longer statistically significant (OR 1.08; CI 0.97 to 1.20).ConclusionHigher adjusted mortality associated with off-hours admissions for PPCI could be partly explained by differences in DTB times. Further investigations to understand the off-hours effect should focus on conditions likely to be sensitive to the rapid availability of services, where timeliness of care is a significant determinant of outcomes.
A symmetrical WENO-Z scheme for solving Hamilton–Jacobi equations
Authors: Abedian Rooholah 
Published: December 2019

In this paper, a new WENO procedure is proposed to approximate the viscosity solution of the Hamilton–Jacobi (HJ) equations. In the one-dimensional (1D) case, an optimum polynomial on a six-point stencil is obtained. This optimum polynomial is fifth-order accurate in regions of smoothness. Then, this optimum polynomial is considered as a symmetric and convex combination of four polynomials with ideal weights. Following the methodology of the classic WENO-Z procedure [Borges et al., J. Comput. Phys. 227, 3191 (2008)], the new nonoscillatory weights are calculated with the ideal weights. Several numerical experiments in 1D, 2D and 3D are performed to illustrate the capability of the scheme.
Adherence to WHO 2010 Recommendations in Relation to Semen Analysis Reports in the Laboratories of West Bengal
Authors: Dasgupta Sujoy 
Published: December 2019

Background: In 2010, The World Health Organization (WHO) suggested the standards of reporting of semen analysis and the reference values. We tried to determine the adherence to the WHO 2010 standard regarding semen analysis among the laboratories of West Bengal. Methods: An observational study was carried out by collecting the semen analysis reports from different laboratories. Compliance with the WHO 2010 recommendations regarding the reporting of semen analysis and references mentioned was subsequently analyzed. Results: A total of 211 laboratory reports were collected; of which 15 were ART (Assisted Reproductive Technology)-laboratories (7%) and 196 were non-ART-laboratories (93%). More than half of the laboratories did not mention any reference values. Only 7.5% used the phrase “WHO 2010” as the reference. Only 3% of the laboratories reported all the six “important” parameters (volume, pH, sperm concentration, motility, morphology and vitality) and used the WHO 2010 references for all of them. The ART laboratories performed significantly better than their non-ART counterparts in reporting and quoting the WHO 2010 reference values. Conclusion: Even nine years after its introduction, the compliance with the WHO 2010 recommendations on semen analysis was still low among our laboratories. There is need for increased awareness for the laboratory persons in this regard.
Skeletal muscle transcriptional networks linked to type I myofiber grouping in Parkinson’s disease
Authors: Lavin Kaleen M. , Sealfon Stuart C. , McDonald Merry-Lynn N. , Roberts Brandon M. , Wilk Katarzyna , Nair Venugopalan D. , Ge Yongchao , Lakshman Kumar Preeti , Windham Samuel T. , Bamman Marcas M. 
Published: December 2019

Parkinson’s disease (PD) is a common neurodegenerative disorder impacting cognition, movement, and quality of life in >10 million individuals worldwide. We recently characterized and quantified a skeletal muscle pathology in PD represented by exaggerated type I myofiber grouping presumed to result from denervation-reinnervation processes. Our previous findings indicated that impaired neuromuscular junction integrity may be involved in type I grouping, which is associated with excessive motor unit activation during weight-bearing tasks. In this study, we performed transcriptional profiling to test the hypothesis that type I grouping severity would link to distinct gene expression networks. We generated transcriptome-wide poly(A) RNA-Seq data from skeletal muscle of individuals with PD [ n = 12 (9 men, 3 women); 67 ± 2 yr], age- and sex-matched older adults ( n = 12; 68 ± 2 yr), and sex-matched young adults ( n = 12; 30 ± 1 yr). Differentially expressed genes were evaluated across cohorts. Weighted gene correlation network analysis (WGCNA) was performed to identify gene networks most correlated with indicators of abnormal type I grouping. Among coexpression networks mapping to phenotypes pathologically increased in PD muscle, one network was highly significantly correlated to type I myofiber group size and another to percentage of type I myofibers found in groups. Annotation of coexpressed networks revealed that type I grouping is associated with altered expression of genes involved in neural development, postsynaptic signaling, cell cycle regulation and cell survival, protein and energy metabolism, inflammation/immunity, and posttranscriptional regulation (microRNAs). These transcriptomic findings suggest that skeletal muscle may play an active role in signaling to promote myofiber survival, reinnervation, and remodeling, perhaps to an extreme in PD. NEW & NOTEWORTHY Despite our awareness of the impact of Parkinson’s disease (PD) on motor function for over two centuries, limited attention has focused on skeletal muscle. We previously identified type I myofiber grouping, a novel indicator of muscle dysfunction in PD, presumably a result of heightened rates of denervation/reinnervation. Using transcriptional profiling to identify networks associated with this phenotype, we provide insight into potential mechanistic roles of skeletal muscle in signaling to promote its survival in PD.
Impact of TCR Diversity on the Development of Transplanted or Chemically Induced Tumors
Authors: Schreiber Karin , Karrison Theodore G. , Wolf Steven P. , Kiyotani Kazuma , Steiner Madeline , Littmann Eric R. , Pamer Eric G. , Kammertoens Thomas , Schreiber Hans , Leisegang Matthias 
Published: December 2019

AbstractBurnet postulated that the diversity of T-cell receptors (TCR) allows T cells to protect against the development of cancers that display antigens with a similar, seemingly endless diversity. To test this hypothesis, we developed a strategy in which a single breeding pair of mice gives rise to four groups of sibling mice. Three of the four groups had a similar number of CD8+ T cells, but TCR diversity was either broad, significantly reduced, or absent when expressing only one type of TCR. The fourth group had no T cells. All mice shared the same housing, and, therefore, their microbial environment was similar. Only slight differences in the intestinal flora were observed under these conditions. An undisturbed broad TCR repertoire was required for the rejection of inoculated cancers displaying the natural antigenic heterogeneity of primary tumors, whereas even one type of TCR was sufficient to protect against artificial cancers stably expressing cognate antigens. The three groups of mice with limited or no TCR repertoire showed an increased risk of developing primary tumors after chemical induction. However, the risk of early death or morbidity in these cohorts of mice was significantly higher than in mice with a diverse TCR repertoire, and it remains unknown whether mice with reduced TCR diversity, who died early without cancer, would have developed tumors with higher, lower, or equal probability after induction. Together, TCR diversity seems crucial to overcome the natural genetic instability of cancers and their antigenic heterogeneity, which impacts the design of cellular therapies.
Intercellular Conduction Optimizes Arterial Network Function and Conserves Blood Flow Homeostasis During Cerebrovascular Challenges
Authors: Zechariah Anil , Tran Cam Ha T. , Hald Bjorn O. , Sandow Shaun L. , Sancho Maria , Kim Michelle Sun Mi , Fabris Sergio , Tuor Ursula I. , Gordon Grant R.J. , Welsh Donald G. 
Published: December 2019

Objective:
Cerebral arterial networks match blood flow delivery with neural activity. Neurovascular response begins with a stimulus and a focal change in vessel diameter, which by themselves is inconsequential to blood flow magnitude, until they spread and alter the contractile status of neighboring arterial segments. We sought to define the mechanisms underlying integrated vascular behavior and considered the role of intercellular electrical signaling in this phenomenon.

Approach and Results:
Electron microscopic and histochemical analysis revealed the structural coupling of cerebrovascular cells and the expression of gap junctional subunits at the cell interfaces, enabling intercellular signaling among vascular cells. Indeed, robust vasomotor conduction was detected in human and mice cerebral arteries after focal vessel stimulation: a response attributed to endothelial gap junctional communication, as its genetic alteration attenuated this behavior. Conducted responses were observed to ascend from the penetrating arterioles, influencing the contractile status of cortical surface vessels, in a simulated model of cerebral arterial network. Ascending responses recognized in vivo after whisker stimulation were significantly attenuated in mice with altered endothelial gap junctional signaling confirming that gap junctional communication drives integrated vessel responses. The diminishment in vascular communication also impaired the critical ability of the cerebral vasculature to maintain blood flow homeostasis and hence tissue viability after stroke.

Conclusions:
Our findings highlight the integral role of intercellular electrical signaling in transcribing focal stimuli into coordinated changes in cerebrovascular contractile activity and expose, a hitherto unknown mechanism for flow regulation after stroke.
Shear Stress Regulation of Endothelial Glycocalyx Structure Is Determined by Glucobiosynthesis
Authors: Wang Gangqi , Kostidis Sarantos , Tiemeier Gesa L. , Sol Wendy M.P.J. , de Vries Margreet R. , Giera Martin , Carmeliet Peter , van den Berg Bernard M. , Rabelink Ton J. 
Published: December 2019

Objective:
Endothelial cells exposed to laminar shear stress express a thick glycocalyx on their surface that plays an important role in reducing vascular permeability and endothelial anti-inflammatory, antithrombotic, and antiangiogenic properties. Production and maintenance of this glycocalyx layer is dependent on cellular carbohydrate synthesis, but its regulation is still unknown.

Approach and Results:

Here, we show that biosynthesis of the major structural component of the endothelial glycocalyx, hyaluronan, is regulated by shear. Both in vitro as well as in in vivo, hyaluronan expression on the endothelial surface is increased on laminar shear and reduced when exposed to oscillatory flow, which is regulated by KLF2 (Krüppel-like Factor 2). Using a CRISPR-CAS9 edited small tetracysteine tag to endogenous HAS2 (hyaluronan synthase 2), we demonstrated increased translocation of HAS2 to the endothelial cell membrane during laminar shear. Hyaluronan production by HAS2 was shown to be further driven by availability of the hyaluronan substrates UDP-glucosamine and UDP-glucuronic acid. KLF2 inhibits endothelial glycolysis and allows for glucose intermediates to shuttle into the hexosamine- and glucuronic acid biosynthesis pathways, as measured using nuclear magnetic resonance analysis in combination with
13
C-labeled glucose.

Conclusions:
These data demonstrate how endothelial glycocalyx function and functional adaptation to shear is coupled to KLF2-mediated regulation of endothelial glycolysis.
Hybrid Coronary Revascularization Versus Off‐Pump Coronary Artery Bypass Grafting: Comparative Effectiveness Analysis With Long‐Term Follow‐up
Authors: Hage Ali , Giambruno Vincenzo , Jones Philip , Chu Michael W. , Fox Stephanie , Teefy Patrick , Lavi Shahar , Bainbridge Daniel , Harle Christopher , Iglesias Ivan , Dobkowski Woijtecj , Kiaii Bob 
Published: December 2019

Background

Hybrid coronary revascularization (
HCR
) involves the integration of coronary artery bypass grafting (
CABG
) and percutaneous coronary intervention to treat multivessel coronary artery disease. Our objective was to perform a comparative analysis with long‐term follow‐up between
HCR
and conventional off‐pump
CABG
.

Methods and Results

We compared all double off‐pump
CABG
(n=216) and
HCR
(n=147; robotic‐assisted minimally invasive direct
CABG
of the left internal thoracic artery to the left anterior descending artery and percutaneous coronary intervention to one of the non–left anterior descending vessels) performed at a single institution between March 2004 and November 2015. To adjust for the selection bias of receiving either off‐pump
CABG
or
HCR
, we performed a propensity score analysis using inverse‐probability weighting. Both groups had similar results in terms of re‐exploration for bleeding, perioperative myocardial infarction, stroke, blood transfusion, in‐hospital mortality, and intensive care unit length of stay.
HCR
was associated with a higher in‐hospital reintervention rate (
CABG
0% versus
HCR
3.4%;
P
=0.03), lower prolonged mechanical ventilation (>24 hours) rate (4% versus 0.7%;
P
=0.02), and shorter hospital length of stay (8.1±5.8 versus 4.5±2.1 days;
P
<0.001). After a median follow‐up of 81 (48–113) months for the off‐pump
CABG
and 96 (53–115) months for
HCR
, the
HCR
group of patients had a trend toward improved survival (85% versus 96%;
P
=0.054). Freedom from any form of revascularization was similar between the 2 groups (92% versus 91%;
P
=0.80). Freedom from angina was better in the
HCR
group (73% versus 90%;
P
<0.001).

Conclusions

HCR
seems to provide, in selected patients, a shorter postoperative recovery, with similar excellent short‐ and long‐term outcomes when compared with standard off‐pump
CABG
.
Intravenously Transplanted Human Multilineage-Differentiating Stress-Enduring Cells Afford Brain Repair in a Mouse Lacunar Stroke Model
Authors: Abe Takatsugu , Aburakawa Daiki , Niizuma Kuniyasu , Iwabuchi Naoya , Kajitani Takumi , Wakao Shohei , Kushida Yoshihiro , Dezawa Mari , Borlongan Cesar V. , Tominaga Teiji 
Published: December 2019

Background and Purpose—
Multilineage-differentiating stress-enduring cells are endogenous nontumorigenic reparative pluripotent-like stem cells found in bone marrow, peripheral blood, and connective tissues. Topically administered human multilineage-differentiating stress-enduring cells into rat/mouse stroke models differentiated into neural cells and promoted clinically relevant functional recovery. However, critical questions on the appropriate timing and dose, and safety of the less invasive intravenous administration of clinical-grade multilineage-differentiating stress-enduring cell–based product CL2020 remain unanswered.

Methods—

Using an immunodeficient mouse lacunar model, CL2020 was administered via the cervical vein in different doses (high dose=5×10
4
cells/body; medium dose=1×10
4
cells/body; low dose=5×10
3
cells/body) at subacute phase (≈9 days after onset) and chronic phase (≈30 days). Cylinder test, depletion of human cells by diphtheria toxin administration, immunohistochemistry, and human specific-genome detection were performed.

Results—
Tumorigenesis and adverse effects were not detected for up to 22 weeks. The high-dose group displayed significant functional recovery compared with the vehicle group in cylinder test in subacute-phase–treated and chronic-phase–treated animals after 6 weeks and 8 weeks post-injection, respectively. In the high-dose group of subacute-phase–treated animals, robust and stable recovery in cylinder test persisted up to 22 weeks compared with the vehicle group. In both groups, intraperitoneal injection of diphtheria toxin abrogated the functional recovery. Anti-human mitochondria revealed CL2020 distributed mainly in the peri-infarct area at 1, 10, and 22 weeks and expressed NeuN (neuronal nuclei)- and MAP-2 (microtubule-associated protein-2)-immunoreactivity.

Conclusions—
Intravenously administered CL2020 was safe, migrated to the peri-infarct area, and afforded functional recovery in experimental stroke.
External Performance of the HAVOC Score for the Prediction of New Incident Atrial Fibrillation
Authors: Ntaios George , Perlepe Kalliopi , Lambrou Dimitrios , Sirimarco Gaia , Strambo Davide , Eskandari Ashraf , Karagkiozi Efstathia , Vemmou Anastasia , Koroboki Eleni , Manios Efstathios , Makaritsis Konstantinos , Vemmos Konstantinos , Michel Patrik 
Published: December 2019

Background and Purpose—
The HAVOC score (hypertension, age, valvular heart disease, peripheral vascular disease, obesity, congestive heart failure, coronary artery disease) was proposed for the prediction of atrial fibrillation (AF) after cryptogenic stroke. It showed good model discrimination (area under the curve, 0.77). Only 2.5% of patients with a low-risk HAVOC score (ie, 0–4) were diagnosed with new incident AF. We aimed to assess its performance in an external cohort of patients with embolic stroke of undetermined source.

Methods—
In the AF-embolic stroke of undetermined source dataset, we assessed the discriminatory power, calibration, specificity, negative predictive value, and accuracy of the HAVOC score to predict new incident AF. Patients with a HAVOC score of 0 to 4 were considered as low-risk, as proposed in its original publication.

Results—
In 658 embolic stroke of undetermined source patients (median age, 67 years; 44% women), the median HAVOC score was 2 (interquartile range, 3). There were 540 (82%) patients with a HAVOC score of 0 to 4 and 118 (18%) with a score of ≥5. New incident AF was diagnosed in 95 (14.4%) patients (28.8% among patients with HAVOC score ≥5 and 11.3% among patients with HAVOC score 0–4 [age- and sex-adjusted odds ratio, 2.29 (95% CI, 1.37–3.82)]). The specificity of low-risk HAVOC score to identify patients without new incident AF was 88.7%. The negative predictive value of low-risk HAVOC score was 85.1%. The accuracy was 78.0%, and the area under the curve was 68.7% (95% CI, 62.1%–73.3%).

Conclusions—
The previously reported low rate of AF among embolic stroke of undetermined source patients with low-risk HAVOC score was not confirmed in our cohort. Further assessment of the HAVOC score is warranted before it is routinely implemented in clinical practice.
Herodian and the Crisis of Emperorship, 235-238 AD
Authors: Davenport Caillan , Mallan Christopher 
Published: December 2019

Abstract
This article examines Herodian’s portrayal of the rise and fall of Roman emperors and usurpers in Books 7 and 8 of his History (covering the years 235-238 AD). Herodian’s narrative provides its readers with a perceptive account of the challenges faced by Rome’s rulers during the middle decades of the third century AD. Emperors had to defend the frontiers while cultivating the support of the army, the senate, and the people of Rome and the provinces. The historian explores how potential candidates for the purple were likely to succeed or fail based on the support, or lack thereof, of these key constituencies. He shows how even theoretically promising experiments in imperial rule, such as the joint reign of Pupienus and Balbinus, were ultimately doomed to fail because the emperors did not possess a deep and broad consensus among all elements of the Roman state.