bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blebs in intracranial aneurysms: prevalence and general characteristics
Authors: Salimi Ashkezari Seyedeh Fatemeh , Detmer Felicitas J , Mut Fernando , Chung Bong Jae , Yu Alexander K , Stapleton Christopher J , See Alfred P , Amin-Hanjani Sepideh , Charbel Fady T , Rezai Jahromi Behnam , Niemelä Mika , Frösen Juhana , Zhou Ji , Maiti Spandan , Robertson Anne M , Cebral Juan R 
Published: July 2020

BackgroundBlebs are rupture risk factors in intracranial aneurysms (IAs), but their prevalence, distribution, and associations with clinical factors as well as their causes and effects on aneurysm vulnerability remain unclear.MethodsA total of 122 blebs in 270 IAs selected for surgery were studied using patient-specific vascular reconstructions from 3D angiographic images. Bleb geometry, location on the aneurysm, and frequency of occurrence in aneurysms at different locations were analyzed. Associations between gender, age, smoking, hypertension, hormone therapy, dental infection, and presence of blebs were investigated.ResultsOf all aneurysms with blebs, 77% had a single bleb and 23% had multiple blebs. Only 6% of blebs were at the neck, while 46% were in the body and 48% in the dome. Aneurysms with blebs were larger (p<0.0001), more elongated (p=0.0002), and with wider necks than aneurysms without blebs. Bleb presence was associated with dental infection (p=0.0426) and negatively associated with hormone therapy (p=0.0426) in women. Anterior and posterior communicating arteries had larger percentages of aneurysms with blebs than internal carotid arteries. Patients with a history of hypertension tended to have a larger percentage of aneurysms with blebs. However, these trends did not reach significance in this sample.ConclusionsBlebs are common in IAs, and most aneurysms harboring blebs have a single bleb. Blebs in the aneurysm neck are rare, but they are equally common in the body and dome. The presence of blebs in IAs was associated with dental infection, and negatively associated with hormone replacement therapy.
Hemodynamic conditions that favor bleb formation in cerebral aneurysms
Authors: Salimi Ashkezari Seyedeh Fatemeh , Mut Fernando , Chung Bong Jae , Robertson Anne M , Cebral Juan R 
Published: July 2020

BackgroundAlthough it is generally believed that blebs represent weaker spots in the walls of intracranial aneurysms (IAs), it is largely unknown which aneurysm characteristics favor their development.ObjectiveTo investigate possible associations between aneurysm hemodynamic and geometric characteristics and the development of blebs in intracranial aneurysms.MethodsA total of 270 IAs in 199 patients selected for surgical clipping were studied. Blebs were visually identified and interactively marked on patient-specific vascular models constructed from presurgical images. Blebs were then deleted from the vascular reconstruction to approximate the aneurysm before bleb formation. Computational fluid dynamics studies were performed in these models and in cases without blebs. Hemodynamic and geometric characteristics of aneurysms with and without blebs were compared.ResultsA total of 173 aneurysms had no blebs, while 97 aneurysms had a total of 122 blebs. Aneurysms favoring bleb formation had stronger (p<0.0001) and more concentrated inflow jets (p<0.0001), higher flow velocity (p=0.0061), more complex (p<0.0001) and unstable (p=0.0157) flow patterns, larger maximum wall shear stress (WSS; p<0.0001), more concentrated (p=0.0005) and oscillatory (p=0.0004) WSS distribution, and a more heterogeneous WSS field (p<0.0001), than aneurysms without blebs. They were also larger (p<0.0001), more elongated (p<0.0001), had wider necks (p=0.0002), and more distorted and irregular shapes (p<0.0001).ConclusionsStrong and concentrated inflow jets, high-speed, complex, and unstable flow patterns, and concentrated, oscillatory, and heterogeneous WSS patterns favor the formation of blebs in IAs. Blebs are more likely to form in large, elongated, and irregularly shaped aneurysms. These adverse characteristics could be considered signs of aneurysm instability when evaluating aneurysms for conservative observation or treatment.
Environmental sustainability in neurointerventional procedures: a waste audit
Authors: Shum Pey Ling , Kok Hong Kuan , Maingard Julian , Schembri Mark , Bañez Ramon Martin Francisco , Van Damme Vivienne , Barras Christen , Slater Lee-Anne , Chong Winston , Chandra Ronil V , Jhamb Ashu , Brooks Mark , Asadi Hamed 
Published: July 2020

BackgroundOperating rooms contribute between 20% to 70% of hospital waste. This study aimed to evaluate the waste burden of neurointerventional procedures performed in a radiology department, identify areas for waste reduction, and motivate new greening initiatives.MethodsWe performed a waste audit of 17 neurointerventional procedures at a tertiary-referral center over a 3-month period. Waste was categorized into five streams: general waste, clinical waste, recyclable plastic, recyclable paper, and sharps. Our radiology department started recycling soft plastics from 13 December 2019. Hence, an additional recyclable soft plastic waste stream was added from this time point. The weight of each waste stream was measured using a digital weighing scale.ResultsWe measured the waste from seven cerebral digital subtraction angiograms (DSA), six mechanical thrombectomies (MT), two aneurysm-coiling procedures, one coiling with tumour embolization, and one dural arteriovenous fistula embolization procedure. In total, the 17 procedures generated 135.3 kg of waste: 85.5 kg (63.2%) clinical waste, 28.0 kg (20.7%) general waste, 14.7 kg (10.9%) recyclable paper, 3.5 kg (2.6%) recyclable plastic, 2.2 kg (1.6%) recyclable soft plastic, and 1.4 kg (1.0%) of sharps. An average of 8 kg of waste was generated per case. Coiling cases produced the greatest waste burden (13.1 kg), followed by embolization (10.3 kg), MT (8.8 kg), and DSA procedures (5.1 kg).ConclusionNeurointerventional procedures generate a substantial amount of waste, an average of 8 kg per case. Targeted initiatives such as engaging with suppliers to revise procedure packs and reduce packaging, digitizing paper instructions, opening devices only when necessary, implementing additional recycling programs, and appropriate waste segregation have the potential to reduce the environmental impact of our specialty.
Clot perviousness is associated with first pass success of aspiration thrombectomy in the COMPASS trial
Authors: Mokin Maxim , Waqas Muhammad , Fifi Johanna , De Leacy Reade , Fiorella David , Levy Elad I , Snyder Kenneth , Hanel Ricardo , Woodward Keith , Chaudry Imran , Rai Ansaar T , Frei Donald , Delgado Almandoz Josser E , Kelly Michael , Arthur Adam S , Baxter Blaise W , English Joey , Linfante Italo , Fargen Kyle M , Turk Aquilla , Siddiqui Adnan H , Mocco J 
Published: July 2020

Background
Clot density (Hounsfield units, HU) and perviousness (post-contrast increase in the HU of clot) are thought to be associated with clot composition. We evaluate whether these imaging characteristics were associated with angiographic outcomes of aspiration and stent retriever thrombectomy in COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion.

Methods
Clot density and perviousness were measured by two independent operators who were blind to all the final angiographic and clinical outcomes. The association of clot density and perviousness with the Thrombolysis In Cerebral Infarction (TICI) scale after first pass was assessed using univariate and multivariate analysis.

Results
Among all patients enrolled in COMPASS, 165 were eligible for the post-hoc analysis (81 patients in the aspiration first and 84 in the stent retriever first groups). Overall mean perviousness of clot was significantly higher in patient with mTICI 2b-3 after first pass (28.6±22.9 vs 20.3±19.2, p=0.017). Mean perviousness among patients who achieved TICI 2c/3 versus TICI 2b versus TICI 0-2a in the aspiration first group varied significantly (32.6±26.1, 35.3±24.4, and 17.7±13.1, p=0.013). The association of perviousness with first pass success was not significant in the stent retriever group. Using multivariate analysis, high perviousness (defined as cut-off >27.6) was an independent predictor of TICI 2b-3 (OR 3.82, 95% CI 1.10 to 13.19; p=0.034).

Conclusions
Clot perviousness is associated with first pass angiographic success in patients treated with the aspiration first approach for thrombectomy.
Impacts of feeding monensin sodium on production and the efficiency of milk production in dairy cows fed total mixed rations: evaluation of a confounded literature
Authors: Robinson P.H. 
Published: July 2020

The amount of milk Canadian dairy farmers produce is limited to a production quota expressed in milk fat. Because milk economic value is primarily based on fat and protein, it can be advantageous to decrease the milk fat to protein ratio. Monensin sodium has been suggested to reduce milk fat proportion and outputs, but not milk protein. Publications using lactating dairy cows were utilized to assess predictability of production responses to monensin feeding based upon their base production characteristics and diet composition. Predicted animal output changes due to monensin had poor fits with low r2 (0.31–0.44) and unevenly distributed residuals. Further assessment revealed that cow characteristics, and diets, were not independent of monensin feeding level. Thus, the 43 comparisons were clustered into levels of 10–12, 14–18, or 20–24 mg kg−1 of diet dry matter (DM). Milk fat yield reductions due to monensin differed (P < 0.05; 10–12 and 14–18 mg kg−1 DM), or tended to differ (P = 0.057; 20–24 mg kg−1 DM), from zero (i.e., no change). Monensin addition to total mixed rations of lactating dairy cows negatively impacted milk fat yield to a greater extent than milk protein.
Stem Cell Pluripotency Genes Klf4 and Oct4 Regulate Complex SMC Phenotypic Changes Critical in Late-Stage Atherosclerotic Lesion Pathogenesis
Authors: Alencar Gabriel F. , Owsiany Katherine M. , Karnewar Santosh , Sukhavasi Katyayani , Mocci Giuseppe , Nguyen Anh T. , Williams Corey M. , Shamsuzzaman Sohel , Mokry Michal , Henderson Christopher A. , Haskins Ryan , Baylis Richard A. , Finn Aloke V. , McNamara Coleen A. , Zunder Eli R. , Venkata Vamsidhar , Pasterkamp Gerard , Björkegren Johan , Bekiranov Stefan , Owens Gary K. 
Published: July 2020

Background:
Rupture and erosion of advanced atherosclerotic lesions with a resultant myocardial infarction or stroke are the leading worldwide cause of death. However, we have a limited understanding of the identity, origin, and function of many cells that make up late-stage atherosclerotic lesions, as well as the mechanisms by which they control plaque stability.

Methods:
We conducted a comprehensive single-cell RNA sequencing of advanced human carotid endarterectomy samples and compared these with single-cell RNA sequencing from murine microdissected advanced atherosclerotic lesions with smooth muscle cell (SMC) and endothelial lineage tracing to survey all plaque cell types and rigorously determine their origin. We further used chromatin immunoprecipitation sequencing (ChIP-seq), bulk RNA sequencing, and an innovative dual lineage tracing mouse to understand the mechanism by which SMC phenotypic transitions affect lesion pathogenesis.

Results:

We provide evidence that SMC-specific Klf4- versus Oct4-knockout showed virtually opposite genomic signatures, and their putative target genes play an important role regulating SMC phenotypic changes. Single-cell RNA sequencing revealed remarkable similarity of transcriptomic clusters between mouse and human lesions and extensive plasticity of SMC- and endothelial cell-derived cells including 7 distinct clusters, most negative for traditional markers. In particular, SMC contributed to a Myh11
-
, Lgals3
+
population with a chondrocyte-like gene signature that was markedly reduced with SMC-
Klf4
knockout. We observed that SMCs that activate Lgals3 compose up to two thirds of all SMC in lesions. However, initial activation of Lgals3 in these cells does not represent conversion to a terminally differentiated state, but rather represents transition of these cells to a unique stem cell marker gene–positive, extracellular matrix-remodeling, “pioneer” cell phenotype that is the first to invest within lesions and subsequently gives rise to at least 3 other SMC phenotypes within advanced lesions, including Klf4-dependent osteogenic phenotypes likely to contribute to plaque calcification and plaque destabilization.

Conclusions:

Taken together, these results provide evidence that SMC-derived cells within advanced mouse and human atherosclerotic lesions exhibit far greater phenotypic plasticity than generally believed, with Klf4 regulating transition to multiple phenotypes including Lgals3
+
osteogenic cells likely to be detrimental for late-stage atherosclerosis plaque pathogenesis.
Beckett as Muse for Egyptian Playwrights
Authors: ElHalawani Amina 
Published: July 2020

Abstract
In 1962, Beckett’s theatre debuted in Egypt and, ever since, it has inspired Egyptian playwrights. This paper examines how two Egyptian writers engaged with Beckett’s Waiting for Godot, as an example of both Beckett’s work and so-named absurdist theater, revealing it to have more potential for political and social engagement than traditionally understood. Masir Sursar [Fate of a Cockroach] by Tawfiq Al-Hakim and Musafir Layl [Night Traveller] by Salah Abdul Saboor make a good case study of these effects.
Written in Sand
Authors: Doshi Neil 
Published: July 2020

Abstract
This article reinterprets the Algerian writer Mohammed Dib’s 1992 novel Le désert sans détour through the analysis of its reference to Samuel Beckett’s En attendant Godot. I argue that for Dib, Beckett offers an important model for a post-revolutionary politics that expresses extreme skepticism over clichéd notions of historical progress and universal humanism. Recuperating this ignored Beckettian strand in Dib’s novel, I revise the critical reception that has read the text as apolitical and focused on spirituality. I offer a better understanding of Dib’s aesthetic as one emerging out of a dialectical tension between discourses of Sufi illumination and a Beckettian politics radically enmeshed in the world.
From Waiting for Godot to Andrzej Stasiuk
Authors: Wiśniewski Tomasz , Kręglewska Katarzyna 
Published: July 2020

Abstract
Beckett’s importance for Polish culture was established by the first production of Waiting for Godot in 1957. Since then, his significance has evolved in aesthetic, social and political terms. This may be illustrated by a model that focuses on: 1) the post-war sense of frustrated expectations (Waiting for Godot); 2) the approaching fall of the Iron Curtain (Catastrophe); and 3) a contemporary search for a new geo-political identity (“neither”). Direct and indirect parallels between Beckett and Polish artists are discussed (Jerzy Kreczmar, Antoni Libera, and Andrzej Stasiuk).
Calibrating Hourly Precipitation Forecasts with Daily Observations
Authors: Cattoën C. , Robertson D. E. , Bennett J. C. , Wang Q. J. , Carey-Smith T. K. 
Published: July 2020

AbstractCalibrated high-temporal-resolution precipitation forecasts are desirable for a range of applications, for example, flood prediction in fast-rising rivers. However, high-temporal-resolution precipitation observations may not be available to support the establishment of calibration methods, particularly in regions with low population density or in developing countries. We present a new method to produce calibrated hourly precipitation ensemble forecasts from daily observations. Precipitation forecasts are taken from a high-resolution convective-scale numerical weather prediction (NWP) model run at the hourly time step. We conduct three experiments to develop the new calibration method: (i) calibrate daily precipitation totals and disaggregate daily forecasts to hourly; (ii) generate pseudohourly observations from daily precipitation observations, and use these to calibrate hourly precipitation forecasts; and (iii) combine aspects of (i) and (ii). In all experiments, we use the existing Bayesian joint probability model to calibrate the forecasts and the well-known Schaake shuffle technique to instill realistic spatial and temporal correlations in the ensembles. As hourly observations are not available, we use hourly patterns from the NWP as the template for the Schaake shuffle. The daily member matching method (DMM), method (iii), produces the best-performing ensemble precipitation forecasts over a range of metrics for forecast accuracy, bias, and reliability. The DMM method performs very similarly to the ideal case where hourly observations are available to calibrate forecasts. Overall, valuable spatial and temporal information from the forecast can be extracted for calibration with daily data, with a slight trade-off between forecast bias and reliability.
Reliability and Validity of the Spoken Knowledge in Low Literacy in Diabetes in Measuring Diabetes Knowledge Among Hispanics With Type 2 Diabetes
Authors: Hu Jie , Amirehsani Karen A. , McCoy Thomas P. , Wallace Debra C. , Coley Sheryl L. , Zhan Fei 
Published: July 2020

Purpose The purpose of the study was to examine the reliability and validity of the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) scale in measuring diabetes knowledge among Hispanics with type 2 diabetes (T2DM). Methods A total of 111 Hispanic participants with T2DM were recruited from clinics and churches in the Southeastern US. The Spanish version of the SKILLD was used. Internal consistency reliability and exploratory factor analysis (EFA) were examined for the Spanish SKILLD. Spearman rank correlations of SKILLD scores with the Summary of Diabetes Self-Care Activities (SDSCA) scores were inspected for evidence of convergent validity along with A1C level and duration of diabetes. Results The average SKILLD score was 35.1% (SD = 23.4%). The correct response for each SKILLD item ranged from 4.5% to 56.8%. The estimated reliability via internal consistency was adequate (Kuder-Richardson 20 = 0.706). EFA of the SKILLD items modestly indicated 1 factor could be retained. Spearman rank correlations of SKILLD scores with diabetes self-care activities were significant and positive for foot self-care. Higher SKILLD scores were significantly correlated with duration of diabetes, using insulin, having a high education level, ever attending a diabetes class, or having a parent with diabetes. Conclusion The Spanish SKILLD showed acceptable reliability and adequate validity in this sample of Hispanics with T2DM. SKILLD scores indicated low diabetes knowledge in this sample. Patient-centered diabetes education tailored to low literacy needs of Hispanics is needed.
Applying a Solution-Focused Approach to Life With Diabetes: Insights Gleaned via Twitter
Authors: Greenwood Deborah A. , Ross Tami A. , Reifsnider Elizabeth 
Published: July 2020

Purpose The purpose of this study was to explore responses of people with diabetes (PWD) when exposed to a solution-focused brief therapy (SFBT) approach. This approach focuses on solutions rather than the problems and what is desired in life rather than what will not occur. Methods Ten SFBT questions were presented for discussion during 1 hour of a Twitter chat on November 14, 2018, during a World Diabetes Day multiple-hour chat. Verbatim transcripts of Twitter data were downloaded from Symplur Signals LLC. Thirty-two participants from 4 countries created 358 tweets, 118 retweets, and 1.5 million impressions. A qualitative content analysis was then completed. Results Five themes emerged regarding the desired future state: more living life, laughter and humor, self-compassion, resilience, and support. There was an overwhelming sense of burden associated with diabetes yet a global feeling of hope, acceptance, and being “capable” to manage diabetes. Conclusion Employing SFBT, asking future-directed questions with a focus on solutions and the desired state, generated impactful insights around life with diabetes. Diabetes care and education specialists can incorporate SFBT as a tool to focus diabetes care, education, and support in partnership with PWD. Use of SFBT in diabetes demonstrates potential to strengthen resilience and confidence needed to manage this challenging condition.
The Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19
Authors: Fiorentino Michele , Pentakota Sri Ram , Mosenthal Anne C , Glass Nina E 
Published: July 2020

Background: Coronavirus disease 2019 (COVID-19) has a substantial mortality risk with increased rates in the elderly. We hypothesized that age is not sufficient, and that frailty measured by preadmission Palliative Performance Scale would be a predictor of outcomes. Improved ability to identify high-risk patients will improve clinicians’ ability to provide appropriate palliative care, including engaging in shared decision-making about life-sustaining therapies. Aim: To evaluate whether preadmission Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19. Design: Retrospective observational cohort study of patients admitted with COVID-19. Palliative Performance Scale was calculated from the chart. Using logistic regression, Palliative Performance Scale was assessed as a predictor of mortality controlling for demographics, comorbidities, palliative care measures and socioeconomic status. Setting/participants: Patients older than 18 years of age admitted with COVID-19 to a single urban public hospital in New Jersey, USA. Results: Of 443 admitted patients, we determined the Palliative Performance Scale score for 374. Overall mortality was 31% and 81% in intubated patients. In all, 36% (134) of patients had a low Palliative Performance Scale score. Compared with patients with a high score, patients with a low score were more likely to die, have do not intubate orders and be discharged to a facility. Palliative Performance Scale independently predicts mortality (odds ratio 2.89; 95% confidence interval 1.42–5.85). Conclusions: Preadmission Palliative Performance Scale independently predicts mortality in patients hospitalized with COVID-19. Improved predictors of mortality can help clinicians caring for patients with COVID-19 to discuss prognosis and provide appropriate palliative care including decisions about life-sustaining therapy.
Effects of cyclosporin A pre-treatment combined with etomidate post-treatment on lung injury induced by limb ischemia-reperfusion in rats
Authors: Zou Haibo , Sun Xiaofeng 
Published: July 2020

Objectives To investigate the influence of cyclosporin A (CsA) pre-treatment and etomidate (ETO) post-treatment on lung injury induced by limb ischemia-reperfusion (I/R) in rats. Methods Rats were randomly divided into five groups: sham, I/R, I/R+CsA, I/R+ETO, and I/R+CsA+ETO. Limb I/R lung injury was established by bilateral clamping of the femoral arteries for 2 hours. Following reperfusion for 3 hours, blood gas analysis was performed. Pathological changes were assessed using immunohistochemistry. The apoptosis index (AI) and wet/dry weight ratio (W/D) were calculated. Levels of Fas protein and FasL mRNA were assessed by western blotting and RT-PCR, respectively. Tumor necrosis factor (TNF)-α and interleukin (IL)-1β were detected by ELISA. Results I/R resulted in decreased PaO2 but increased AI, W/D, Fas, FasL mRNA, TNF-α and IL-1β. Scattered punctate apoptosis and necrosis were observed by immunohistochemistry. Compared with the I/R group, the I/R+ETO and I/R+CsA groups showed increased SpO2, decreased AI, W/D, Fas, FasL mRNA, TNF-α and IL-1β, and decreased numbers of apoptotic and necrotic cells. Combined treatment with CsA+ETO resulted in more dramatic changes in these parameters. Conclusions ETO post-treatment and CsA pretreatment reduced lung injury induced by limb I/R in rats. The mechanism may be related to synergistic inhibition of Fas/FasL signaling.