bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Hospitalizations for Cardiogenic Shock at Left Ventricular Assist Device Versus Non–Left Ventricular Assist Device Centers
Authors: Wang Joseph I. , Lu Daniel Y. , MHS  , Feldman Dmitriy N. , McCullough Stephen A. , Goyal Parag , Karas Maria G. , Sobol Irina , Horn Evelyn M. , Kim Luke K. , Krishnan Udhay 
Published: November 2020

Background
Cardiogenic shock (CS) is a complex syndrome associated with high morbidity and mortality. In recent years, many US hospitals have formed multidisciplinary shock teams capable of rapid diagnosis and triage. Because of preexisting collaborative systems of care, hospitals with left ventricular assist device (LVAD) programs may also represent “centers of excellence” for CS care. However, the outcomes of patients with CS at LVAD centers have not been previously evaluated.

Methods and Results

Patients with CS were identified in the 2012 to 2014 National Inpatient Sample. Clinical characteristics, revascularization rates, and use of mechanical circulatory support were analyzed in LVAD versus non‐LVAD centers. The association between hospital type and in‐hospital mortality was examined using multivariable logistic regression models. Of 272 075 hospitalizations, 26.0% were in LVAD centers. CS attributable to causes other than acute myocardial infarction represented most cases. In‐hospital mortality was lower in LVAD centers (38.9% versus 43.3%;
P
<0.001). In multivariable analysis, the odds of mortality remained significantly lower for hospitalizations in LVAD centers (odds ratio, 0.89;
P
<0.001). In patients with CS secondary to acute myocardial infarction, revascularization rates were similar between LVAD and non‐LVAD centers. The use of intra‐aortic balloon pump (18.7% versus 18.8%) and Impella/TandemHeart (2.6% versus 1.9%) was similar between hospital types, whereas extracorporeal membrane oxygenation was used more frequently in LVAD centers (4.3% versus 0.2%;
P
<0.001).

Conclusions
Risk‐adjusted mortality was lower in patients with CS who were hospitalized at LVAD centers. These centers likely represent specialized, shock team capable institutions across the country that may be best suited to manage patients with CS.
Aging Impairs Mitochondrial Function and Mitophagy and Elevates Interleukin 6 Within the Cerebral Vasculature
Authors: Tyrrell Daniel J. , Blin Muriel G. , Song Jianrui , Wood Sherri C. , Goldstein Daniel R. 
Published: November 2020

Background
The blood‐brain barrier (BBB) is critical for cerebrovascular health. Although aging impairs the integrity of the BBB, the mechanisms behind this phenomenon are not clear. As mitochondrial components activate inflammation as mitochondria become dysfunctional, we examined how aging impacts cerebrovascular mitochondrial function, mitophagy, and inflammatory signaling; and whether any alterations correlate with BBB function.

Methods and Results
We isolated cerebral vessels from young (2–3 months of age) and aged (18–19 months of age) mice and found that aging led to increases in the cyclin‐dependent kinase inhibitor 1 senescence marker with impaired mitochondrial function, which correlated with aged mice exhibiting increased BBB leak compared with young mice. Cerebral vessels also exhibited increased expression of mitophagy proteins Parkin and Nix with aging. Using mitophagy reporter (mtKeima) mice, we found that the capacity to increase mitophagy from baseline within the cerebral vessels on rotenone treatment was reduced with aging. Aging within the cerebral vessels also led to the upregulation of the stimulator of interferon genes and increased interleukin 6 (IL‐6), a cytokine that alters mitochondrial function. Importantly, exogenous IL‐6 treatment of young cerebral vessels upregulated mitophagy and Parkin and impaired mitochondrial function; whereas inhibiting IL‐6 in aged cerebral vessels reduced Parkin expression and increased mitochondrial function. Furthermore, treating cerebral vessels of young mice with mitochondrial N‐formyl peptides upregulated IL‐6, increased Parkin, and reduced Claudin‐5, a tight junction protein integral to BBB integrity.

Conclusions
Aging alters the cerebral vasculature to impair mitochondrial function and mitophagy and increase IL‐6 levels. These alterations may impair BBB integrity and potentially reduce cerebrovascular health with aging.
Association of Serum Lipoprotein (a) Levels and Coronary Atheroma Volume by Intravascular Ultrasound
Authors: Huded Chetan P. , Shah Nishant P. , Puri Rishi , Nicholls Stephen J. , Wolski Kathy , Nissen Steven E. , Cho Leslie 
Published: November 2020

Background
Lp(a) (lipoprotein (a)) is a risk factor for cardiovascular events, but the mechanism of increased risk is uncertain. This study evaluated the relationship between Lp(a) and coronary atheroma volume by intravascular ultrasound.

Methods and Results

This was a post hoc analysis of 6 randomized trials of coronary atheroma by intravascular ultrasound. The population was stratified into high (≥60 mg/dL) and low (<60 mg/dL) baseline serum Lp(a). The primary outcome was baseline coronary percent atheroma volume. A mixed model adjusted for baseline low density lipoprotein, ApoB (apoliporotein B100), non‐high density lipoprotein, sex, age, race, history of myocardial infarction, statin use, and intravascular ultrasound study was used to provide estimates of baseline plaque burden. Of 3943 patients, 17.3% (683) had Lp(a) ≥ 60 mg/dL and 82.7% (3260) had Lp(a) < 60 mg/dL. At baseline, uncorrected low density lipoprotein level (107.7 ± 32.0 versus 99.1 ± 31.5) and statin therapy (99.0% versus 97.0%) were higher in patients with high Lp(a) levels, but low density lipoprotein corrected for Lp(a) was lower (80.6 ± 32.0 versus 94.0 ± 31.4) in patients with high Lp(a) levels. Percent atheroma volume was significantly higher in the high Lp(a) group in unadjusted (38.2% [32.8, 43.6] versus 37.1% [31.4, 43.1],
P
=0.01) and risk‐adjusted analyses (38.7%±0.5 versus 37.5%±0.5,
P
<0.001). There was a significant association of increasing risk‐adjusted percent atheroma volume across quintiles of Lp(a) (Lp(a) quintiles 1‐5; 37.3 ± 0.5%, 37.2 ± 0.5%, 37.3 ± 0.5%, 38.0 ± 0.5%, 38.5 ± 0.5%,
P
=0.002).

Conclusions
Elevated Lp(a) is independently associated with increased percent atheroma volume. Further work is needed to clarify the relationship of Lp(a)‐lowering treatment with cardiovascular outcomes.
The Elusive Governance of Climate Change: Nationally Determined Contributions as Commitments and Negotiating Positions
Authors: Leinaweaver Justin , Thomson Robert 
Published: November 2020

AbstractSince the Paris Agreement of 2016, the international community’s main approach to addressing climate change is for states to determine their own commitments in a pledge and review system. Parties to the Paris Agreement formulate Nationally Determined Contributions (NDCs), which are documents that give details of their national policies and plans. They are free to formulate and present national policies as they choose, and as a result, there is substantial variation in the content and form of NDCs. This study presents a new framework for assessing and comparing the political meanings of these documents. The framework builds on two distinct ways in which NDCs can be understood. NDCs may be commitments to the international community and domestic actors. Alternatively, they may embody states’ negotiating positions in an ongoing process of national and international interactions. The framework consists of a set of thematic categories to which each sentence of these documents can be allocated. The application of this framework enables us to compare the political content of states’ NDCs systematically. The study demonstrates the validity of the framework by correlating its results with key characteristics of states. The findings also provide evidence for the two distinct perspectives on these documents.
An Initialized Attribution Method for Extreme Events on Subseasonal to Seasonal Time Scales
Authors: Wang Guomin , Hope Pandora , Lim Eun-Pa , Hendon Harry H. , Arblaster Julie M 
Published: November 2020

AbstractWhen record-breaking climate and weather extremes occur, decision-makers and planners want to know whether they are random natural events with historical levels of reoccurrence or are reflective of an altered frequency or intensity as a result of climate change. This paper describes a method to attribute extreme weather and climate events to observed increases in atmospheric CO2 using an initialized subseasonal to seasonal coupled global climate prediction system. Application of this method provides quantitative estimates of the contribution arising from increases in the level of atmospheric CO2 to individual weather and climate extreme events. Using a coupled subseasonal to seasonal forecast system differs from other methods because it has the merit of being initialized with the observed conditions and subsequently reproducing the observed events and their mechanisms. This can aid understanding when the reforecasts with and without enhanced CO2 are compared and communicated to a general audience. Atmosphere–ocean interactions are accounted for. To illustrate the method, we attribute the record Australian heat event of October 2015. We find that about half of the October 2015 Australia-wide temperature anomaly is due to the increase in atmospheric CO2 since 1960. This method has the potential to provide attribution statements for forecast events within an outlook period (i.e., before they occur). This will allow for informed messaging to be available as required when an extreme event occurs, which is of particular use to weather and climate services.
Precipitation Diurnal Cycle over the Maritime Continent Modulated by the Climatological Annual Cycle
Authors: Lu Jiahao , Li Tim , Wang Lu 
Published: November 2020

AbstractThe modulation of the diurnal cycle (DC) of precipitation over the Maritime Continent (MC) by the background annual cycle mean state was studied for the period of 1998–2014 through observational analyses and high-resolution simulations using the Weather Research and Forecasting (WRF) Model. The observational analyses reveal that there are statistically significant differences in the DC amplitude between boreal winter and summer. The amplitude of precipitation DC reduces by about 35% during boreal summer compared to boreal winter, especially over the MC major islands and adjacent oceans. A precipitation budget analysis indicates that the DC amplitude difference is primarily attributed to vertically integrated convergence of the mean moisture by diurnal winds. The relative roles of the background dynamic and thermodynamic states in causing the enhanced diurnal wind activity in boreal winter are further investigated through idealized WRF simulations. The results show that the seasonal mean background moisture condition is most critical in inducing the winter–summer difference of the precipitation DC over the MC, followed by atmospheric static stability (i.e., vertical temperature gradient) and circulation conditions.
A New Algorithm with Square Conservative Exponential Integral for Transport Equation
Authors: Hao Shifeng , Cui Xiaopeng , Huang Jianping 
Published: November 2020

AbstractThe square conservative exponential integral method (SCEIM) is proposed for transport problems on the sphere. The method is a combination of the square conservation algorithm and the exponential integral method. The main emphasis in the development of SCEIM is on conservation, positive-definite, and reversibility as well as achieving comparable accuracy to other published schemes. The most significant advantage of SCEIM is to change the forward model to the backward model by setting a negative time step, and the backward model can be used to solve the inverse problem. Moreover, the polar problem is significantly improved by using a simple effective central skip-point difference scheme without major penalty on the overall effectiveness of SCEIM. To demonstrate the effectiveness and generality of the SCEIM, this method is evaluated by standard cosine bell tests and deformational flow tests. The numerical results show that SCEIM is a time-convergence method as well as a grid-convergence method, and has a strong shape-preserving ability. In the tests of the inverse problem, the sharp fronts are successfully regressed back into their initial weak fronts and the cosine bells move against the wind direction and return to the initial position with high accuracy. The numerical results of forward simulations are compared with those of published schemes, the total mass conservation, and error norms are competitive in term of accuracy.
Frontoethmoidal Extranasopharyngeal Angiofibroma With Orbital Pyocele
Authors: Kurien Regi , Mehan Raghav , Varghese Lalee , Telugu Ramesh Babu , Thomas Meera , Rupa Vedantam 
Published: November 2020

Significance Statement Extranasopharyngeal angiofibromas (ENA) are rare vascular tumors that do not conform to the clinical characteristics of typical nasopharyngeal angiofibromas. We present the management of an angiofibroma in a rare site, within the frontal sinus with a concomitant orbital pyocele, which was completely excised via an endoscopic approach. ENAs should be considered as a differential diagnosis in patients with sinonasal mass and epistaxis. Awareness of this rare entity will avoid radical surgery thus decreasing postoperative morbidity.
Legal, Social, and Occupational Problems in Persons with Alcohol Use Disorder: An Exploratory Study
Authors: Malathesh Barikar C , Kumar Channaveerachari Naveen , Kandasamy Arun , Moirangthem Sydney , Math Suresh Bada , Murthy Pratima 
Published: November 2020

Background: Very few studies have examined the extent and nature of legal, social, and occupational problems among persons who have SUDs. This study was aimed at studying the prevalence and patterns of the aforementioned problems among individuals with alcohol use disorders (AUDs) and their relationship with the quantity of alcohol consumed and other variables. Methods: We conducted a cross-sectional study of adult patients with a diagnosis of AUDs admitted to the deaddiction unit of a tertiary care facility in India, using a semistructured questionnaire prepared for this study. Results: The mean age (SD) of the 91 subjects (95.6% males) was 40.3 years (8.5). Majority of them (92.3%) had started alcohol consumption before the age of 25 years. Common problems reported were work absenteeism (83.5%), a major altercation with spouse (69.3%), assaulting someone while intoxicated (53.8%), and driving under the influence of alcohol (59.3%). Significant association was found between being unemployed and having a police complaint lodged against them (chi-square = 5.7, P = 0.01). Quantity of alcohol consumed per day was significantly more among those who had a history of work absenteeism ( Z = 2.27, P = 0.01), major altercation with spouse ( Z = 2.25, P = 0.02) and assaulted someone under intoxication ( Z = 2.33, P = 0.02). Conclusion: The quantity of alcohol consumed is significantly more in those who had several legal, social, and occupational problems when compared to those who did not have, highlighting the need for routine assessment of the aforementioned problems among patients of AUDs. Treatment of AUDs should be multidisciplinary, with targeted interventions tailored to the aforementioned problems. Doing so will go a long way in reducing the harm to patients and the community at large.
Safely repositioning dual-lumen ECMO cannulas with a transfemoral lasso snare
Authors: O’Neil Erika R , Coleman Ryan D , Vogel Adam M , Chartan Corey A , Kukreja Kamlesh U 
Published: November 2020

Introduction: Dual-lumen cannulas were designed to provide venovenous extracorporeal membrane oxygenation (VV ECMO) with single-vessel access. Anatomic and size considerations may make appropriate placement challenging in children. Dual-lumen cannulas are repositioned in 20–69% of pediatric patients, which can be difficult without transient discontinuation of ECMO support. Methods: We repositioned three dual-lumen ECMO cannulas introduced via the right internal jugular vein using a transfemoral snare technique under real-time ultrasound and fluoroscopy. Results: Two of three patients were supported on VV ECMO and one on veno-veno-arterial (VV-A) ECMO. Two of the three patients had their dual-lumen cannula repositioned under ultrasound and fluoroscopy guidance and one was repositioned just with ultrasound. No patient experienced a complication from the transfemoral snare technique such as femoral hematoma, hemorrhage or limb ischemia. Conclusion: We describe three patients who successfully had dual-lumen cannulas repositioned without cessation of ECMO using a transfemoral “lasso” technique.
The effects of proprioceptive training on anterior cruciate ligament reconstruction rehabilitation: A systematic review and meta-analysis
Authors: Ma Jiang , Zhang Di , Zhao Tianyu , Liu Xiaoxiao , Wang Ju , Zheng Hui , Jin Song 
Published: November 2020

Objective: To determine the effectiveness of proprioceptive training on knee function and proprioception following anterior cruciate ligament reconstruction. Data sources: PubMed, EMBASE, The Cochrane Library, Ovid, EBMSCO- host, ScienceDirect, CNKI, VIP, WanFang Data and CBM were searched until 2nd October 2020. Review methods: Trials with proprioceptive training for patients with anterior cruciate ligament reconstruction were included. Study screening, data extraction, risk of bias and quality assessments were performed independently by two researchers. We performed a stratified analysis based on the quality of the study. Sensitivity analyses were performed if the heterogeneity was high. Results: Seventeen trials with 878 participants were included, and 12/17 with low quality. After stratified analysis, the pooled effect of high-quality studies showed significant improvement for proprioceptive training group in range of motion ( P < 0.05, I2 = 0%), but no differences in Cincinnati knee rating system score ( P > 0.05, I2 = 83%), hop test ( P>0.05, I2 = 0%) and proprioception ( P = 0.17, I2 = 77%) compared to conventional training group; while the pooled effect of low-quality studies showed significant differences in knee functional improvement ( P < 0.00001, I2 = 69%), but no difference in proprioception ( P > 0.05, I2 = 84%) between two groups. The pooled effect of all studies showed a significant benefit in both function and proprioception. Conclusion: The effects of proprioceptive training on knee functional and proprioceptive improvement after anterior cruciate ligament reconstruction is mixed. It is more likely that proprioceptive training in high-quality studies has few detectable effects and that low-quality studies show an effect because of an unconscious bias. A large well designed high-quality study needs to be undertaken in the future.
CO2-based C-arm computed tomography (CACT) of the pelvic arteries: feasibility and diagnostic performance in comparison to CO2-angiography in patients with peripheral arterial disease
Authors: S Becker Lena , Dewald Cornelia LA , Maschke Sabine K , Werncke Thomas , Meyer Bernhard C , Wacker Frank K , Hinrichs Jan B 
Published: November 2020

Background Patients with substantially impaired kidney function and peripheral arterial disease (PAD) underwent comparative CO2-based depiction of the pelvic arteries (PAs). Purpose To evaluate the feasibility and diagnostic performance of CO2-based C-arm computed tomography (CACT) and compare its depiction of PAs with CO2-digital subtraction angiography (DSA). Material and Methods Fifteen patients (10 men, mean age 70 ± 11 years) with PAD received CO2-DSA and CO2-CACT of the PAs, depicted from the aorta to femoral arteries. These were divided into nine segments (135 in total) and graded by two independent readers for image quality (IQ; 1 = sufficient, 2 = minimal impairments, 3 = insufficient, 4 = outside field of view) and subsequent stenosis grading (SG; grade 1: normal to grade 4: occlusion), under exclusion of all segments with insufficient IQ. Inter-observer and inter-modality agreement calculation and subsequent consensus reading were performed and correlated to a standard of reference (StOR), representing a modality consensus. Results Of 135 segments, 117 showed sufficient IQ, excluding 18 segments (10 CACT, 8 DSA). Inter-observer agreement for IQ and consecutive SG demonstrated good to excellent agreement: IQDSA: κ = 0.83, IQCACT: κ = 0.76; StenosisDSA: κ = 0.71, StenosisCACT: κ = 0.84. Inter-modality agreement for SG lay at κ = 0.76 and κ = 0.65, respectively. More stenoses could be detected by CACT, and analysis of pooled consensus values of SG in CACTcons versus StOR showed an excellent agreement (κ = 0.96) that proved considerably higher than the moderate agreement between consensus values in DSAcons versus StOR (κ = 0.43). Conclusion CO2-CACT proved feasible, and has the potential to optimize angiographic work-up of PAD in patients with contraindications for other contrast media.
Use of bioinformatic analyses in identifying characteristic genes and mechanisms active in the progression of idiopathic thrombocytopenic purpura in individuals with different phenotypes
Authors: Zhang Mengyi , Guo Binhan 
Published: November 2020

Objective To explore the mechanism underlying the progression of newly diagnosed idiopathic thrombocytopenic purpura (ITP) to its chronic or remission state using bioinformatic methods. Methods GSE56232 and GSE46922 gene expression profile datasets were downloaded from Gene Expression Omnibus (GEO). Differentially expressed genes were identified and characteristic genes were screened by weighted gene co-expression network analysis. These genes were used for function enrichment analysis and construction of a protein–protein interaction network. Finally, characteristic genes were verified to determine potential molecular mechanisms underlying ITP progression. Results We found that characteristic genes in the chronic ITP group were mainly involved in intracellular processes and ion binding, while characteristic genes in the remission ITP group were involved in intracellular processes and nuclear physiological activities. We identified a sub-network of characteristic genes, LMNA, JUN, PRKACG, SMC3, which may indicate the mechanism by which newly diagnosed ITP progresses to chronic. Although no meaningful signaling pathways were found, the expression of NR3C1, TPR, SMC4, PANBP2, CHD1, and U2SURP may affect ITP progression from newly diagnosed to remission. Conclusion Our findings improve the understanding of the pathogenesis and progression of ITP, and may provide new directions for the development of treatment strategies.