bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Landmark-Based Method for Highly Reproducible Measurement of Left Atrial Appendage Volume in Computed Tomography
Authors: Schluchter Andrew , Jan Chelsea , Lowe Katherine , Vigneault Davis M. , Contijoch Francisco , McVeigh Elliot R. 
Published: December 2019

Background:
Modern computed tomographic scanning can produce 4-dimensional images of the left atrial appendage (LAA). LAA function and morphology can then be measured, to plan interventions such as occlusion and to evaluate LAA flow for thrombogenic risk analysis. A current problem here is defining a reproducible boundary between the LAA and the left atrium.

Methods:
This study used retrospectively gated 4-dimensional computed tomographic data from 25 implantation and coronary artery imaging patients. In each patient, the LAA ostium was defined at multiple time points during the RR interval. To examine the reproducibility of the definition of the LAA ostium, 3 observers analyzed all time frames in each patient 3 times. Five nonconsecutive time frames from each patient were then compared using intraclass correlation coefficients to quantify the precision of the method across patients. The correlation of LAA volumes for each time frame of each patient was determined across the different observers (interobserver) and within each observer’s own data sets (intraobserver).

Results:
The method was successful in 92% of patients. Two-way random-effect, absolute-agreement, single-measurement intraclass correlation coefficients for interobserver measurements were 0.984, 0.990, and 0.988, with intraobserver intraclass correlation coefficients of 0.989, 0.989, and 0.995. The intraclass correlation coefficient of all observations was 0.988.

Conclusions:
Classification of the LAA ostium using a stepwise procedure identifying the coumadin ridge and 2 vascular landmarks in ECG-gated computed tomography provides a viable method of establishing a highly reproducible boundary between the atrium and LAA needed to obtain LAA metrics useful for procedure planning and measuring LAA function.
Cholesterol Variability and Cranial Magnetic Resonance Imaging Findings in Older Adults
Authors: Kalani Rizwan , Bartz Traci M. , Suchy-Dicey Astrid , Elkind Mitchell S.V. , Psaty Bruce M. , Leung Lester Y. , Rice Kenneth , Tirschwell David , Longstreth W.T. 
Published: December 2019

Background and Purpose—
Serum cholesterol variability, independent of mean, has been associated with stroke, white matter hyperintensities on cranial magnetic resonance imaging (MRI), and other cardiovascular events. We sought to assess the relationship between total serum cholesterol (TC) variability and cranial MRI findings of subclinical or covert vascular brain injury in a longitudinal, population-based cohort study of older adults.

Methods—
In the Cardiovascular Health Study, we assessed associations between intraindividual TC mean, trend, and variability over ≈5 years with covert brain infarction (CBI) and white matter grade (WMG) on cranial MRI. Mean TC was calculated for each study participant from 4 annual TC measurements between 2 MRI scans. TC trend was calculated as the slope of the linear regression of the TC measurements, and TC variability was calculated as the SD of the residuals from the linear regression. We evaluated the association of intraindividual TC variability with incident CBI and worsening WMG between 2 MRI scans in primary analyses and with prevalent CBI number and WMG on the follow-up MRI scan in secondary analyses.

Results—

Among participants who were eligible for the study and free of clinical stroke before the follow-up MRI, 17.9% of 1098 had incident CBI, and 27.8% of 1351 had worsening WMG on the follow-up MRI. Mean, trend, and variability of TC were not associated with these outcomes. TC variability, independent of mean and trend, was significantly associated with the number of CBI (β=0.009 [95% CI, 0.003–0.016]
P
=0.004; N=1604) and was associated with WMG (β, 0.009 [95% CI, −0.0002 to 0.019]
P
=0.055; N=1602) on the follow-up MRI.

Conclusions—
Among older adults, TC variability was not associated with incident CBI or worsening WMG but was associated with the number of prevalent CBI on cranial MRI. More work is needed to validate and to clarify the mechanisms underlying such associations.
Long-Term Outcomes After Reversible Cerebral Vasoconstriction Syndrome
Authors: Boitet Rosalie , de Gaalon Solène , Duflos Claire , Marin Grégory , Mawet Jérôme , Burcin Cécilia , Roos Caroline , Fiedler Ursula , Bousser Marie-Germaine , Ducros Anne 
Published: December 2019

Background and Purpose—
We aimed to further investigate the long-term outcomes after reversible cerebral vasoconstriction syndrome (RCVS).

Methods—
A longitudinal follow-up study was conducted in 173 RCVS patients.

Results—
Of the 172 patients who completed a mean follow-up of 9.2±3.3 years, 10 had a recurrent RCVS that was benign in all. Independent predictors of relapse were having a history of migraine and having exercise as a trigger for thunderclap headache during initial RCVS. After new delivery, the rate of postpartum RCVS was 9%.

Conclusions—
Overall, long-term outcome after RCVS is excellent.
End-of-Treatment Intracerebral and Ventricular Hemorrhage Volume Predicts Outcome
Authors: de Havenon Adam , Joyce Evan , Yaghi Shadi , Ansari Safdar , Delic Alen , Taussky Philipp , Alexander Matthew , Tirschwell David , Grandhi Ramesh 
Published: December 2019

Background and Purpose—
Trials have shown potential clinical benefit for minimally invasive clot evacuation of intracerebral hemorrhage (ICH). Prior research showing an association between ICH size and functional outcome did not fully address the spectrum of hematoma volumes seen after clot evacuation.

Methods—
In this secondary analysis of the MISTIE III trial (Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation III), we included patients randomized to the surgical arm. The primary outcome was good outcome (modified Rankin Scale score 0–3 at 1 year from study enrollment). The primary predictors were the end-of-treatment (EoT) ICH and intraventricular hemorrhage volumes and an end-of-treatment ICH stratification scale called the EoT ICH volume score.

Results—

In 246 patients, the end-of-treatment computed tomography was performed an average of 5 days from onset. For patients with good versus poor outcomes, the mean end-of-treatment ICH and intraventricular hemorrhage volumes were 12.9 versus 18.0 mL (
P
=0.002) and 0.5 versus 2.3 mL (
P
<0.001), respectively. The probability of a good outcome decreased from 73% for EoT ICH volume 3 (<5 mL) to 28% for EoT ICH volume 0 (>20 mL;
P
=0.001).

Conclusions—
After surgical clot evacuation, both ICH and intraventricular hemorrhage volumes have a strong association with good neurological outcome. The EoT ICH volume score needs independent verification, but such an approach could be used for prognostication and therapeutic planning.
A “Glorious” Dream of Awkward Romance: Humor and Desire in Wang Yun’s (1749-1819) Fanhua meng
Authors: Tan Yanbing 
Published: December 2019

AbstractWang Yun’s (1749-1819) Fanhua meng (A Dream of Glory, 1769) is one of the very few extant chuanqi plays written by women in late imperial China. Its female protagonist, who is frustrated by social restrictions placed on women, transforms into a man in a dream. The dream content revolves around the protagonist’s romantic adventures, which feature many awkward and laughable moments. As a fantasy about transgender experience, Fanhua meng has been the subject of critique for its embrace of patriarchal values as well as praise for its reflection on patriarchal depravity. These conflicting views attest to the complexity of Wang Yun’s use of humor in the play. This article explores how and why Wang Yun depicts her protagonist’s journey of desire in a comic mode, and how Wang’s contemporary male readers responded to Wang’s humor. It argues that Wang’s use of humor provides a palatable coating for a provocative reflection on the male privilege of being a desiring subject. As a whole, Wang’s play challenges the vision of worldly success promoted by the long-established and male-dominated chuanqi drama tradition. As a case study, this article draws attention to humor as a mode of self-writing for women writers in late imperial China.
The Contribution of Rain Gauges in the Calibration of the IMERG Product: Results from the First Validation over Spain
Authors: Tapiador Francisco J. , Navarro Andrés , García-Ortega Eduardo , Merino Andrés , Sánchez José Luis , Marcos Cecilia , Kummerow Christian 
Published: December 2019

AbstractAfter 5 years in orbit, the Global Precipitation Measurement (GPM) mission has produced enough quality-controlled data to allow the first validation of their precipitation estimates over Spain. High-quality gauge data from the meteorological network of the Spanish Meteorological Agency (AEMET) are used here to validate Integrated Multisatellite Retrievals for GPM (IMERG) level 3 estimates of surface precipitation. While aggregated values compare notably well, some differences are found in specific locations. The research investigates the sources of these discrepancies, which are found to be primarily related to the underestimation of orographic precipitation in the IMERG satellite products, as well as to the number of available gauges in the GPCC gauges used for calibrating IMERG. It is shown that IMERG provides suboptimal performance in poorly instrumented areas but that the estimate improves greatly when at least one rain gauge is available for the calibration process. A main, generally applicable conclusion from this research is that the IMERG satellite-derived estimates of precipitation are more useful (r2 > 0.80) for hydrology than interpolated fields of rain gauge measurements when at least one gauge is available for calibrating the satellite product. If no rain gauges were used, the results are still useful but with decreased mean performance (r2 ≈ 0.65). Such figures, however, are greatly improved if no coastal areas are included in the comparison. Removing them is a minor issue in terms of hydrologic impacts, as most rivers in Spain have their sources far from the coast.
CASA Prediction System over Dallas–Fort Worth Urban Network: Blending of Nowcasting and High-Resolution Numerical Weather Prediction Model
Authors: Radhakrishnan Chandrasekar , Chandrasekar V. 
Published: December 2019

AbstractThis study targeted improving Collaborative Adaptive Sensing of the Atmosphere’s (CASA) 6-h lead time predictive ability by blending the radar-based nowcast with the NWP model over the Dallas–Fort Worth (DFW) urban radar network. This study also depicts the recent updates in CASA’s real-time reflectivity nowcast system by assessing nine precipitation cases over the DFW urban region. CASA’s nowcast framework displayed better primer outcomes than the WRF Model forecast for the lead time of 1 h and 30 min. After that time, the predictive ability of the nowcast framework began decreasing compared to the WRF Model. To broaden CASA’s predictive system lead time to 6 h, the WRF Model forecasts were blended with Dynamic and Adaptive Radar Tracking of Storms (DARTS) nowcast. The HRRR model analysis was used as initial and boundary conditions in the WRF Model. The high-resolution dual-pol radar observations were assimilated into the WRF Model through the 3DVAR data assimilation technique. Three kinds of blending strategies were used and the results were compared: 1) hyperbolic tangent curve (HTW), 2) critical success index (CSIW), and 3) salient cross dissolve (Sal CD). The sensitivity studies were conducted to decide desirable parameters in the blending techniques. The outcomes proved that blending enhanced the prediction skills. Also, the overall performance of blending relies on the accuracy of the WRF forecast. Even though blending results are mixed, the HTW-based technique performed better than the other two techniques.
Biological variation in serum bone turnover markers
Authors: Wang Shuo , Mu Runqing , Zhang Xin , Yun Ke , Shang Hong , Zhao Min 
Published: December 2019

Background Serum total N-terminal propeptide of type I collagen (P1NP) and serum C-terminal telopeptide of type I collagen (CTX) are used as reference analytes of bone turnover in clinical application. Biological variation is important for clinical application of these biomarkers. However, the biological variation data of these biomarkers are not consistent. The present study determined biological variations of total P1NP and CTX and their confidence intervals in China using electrochemiluminescence. Methods We collected samples from 25 healthy individuals (17 women and 8 men, ranging from 22 to 49 years of age) at weekly intervals for six weeks. Samples were analysed in a single run in duplicate. Biological variations and their related parameters, such as reference change value and index of individuality (II) were calculated. The results were compared with individual studies in the EFLM database. Results Within-subject and between-subject biological variations were 8.0% and 32.5% for total P1NP and 11.4% and 38.7% for CTX, respectively. The index of individuality for total P1NP and CTX was 0.25 and 0.30, while the reference change value for P1NP values and CTX was 22.4% and 31.9%, respectively. Conclusions No difference was found in weekly biological variation of bone turnover markers between men and premenopausal women. Compared with daily and monthly variation, the present study based on weekly variation provided additional support for clinical application.
PCSK9 E670G polymorphism increases risk of coronary artery disease in a Chinese Han population
Authors: Lin Zhang , Wang Shi Hong , Wei Da Yong , Wang Lu Min , Zhang Zhong Wu 
Published: December 2019

Objective Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the world. The proprotein convertase subtilisin/kexin type 9 ( PCSK9) E670G polymorphism has been reported to be associated with variability in levels of low density lipoprotein cholesterol, a risk factor for CAD. However, the relationship between PCSK9 E670G and CAD is still not fully elucidated. Methods A total of 225 patients and 189 control subjects were recruited in this study. DNA was extracted from peripheral blood samples and was genotyped by mass array method. In addition, we also conducted a meta-analysis of case-control studies to elucidate the relationship of CAD and polymorphism. Results The GG genotype of PCSK9 E670G was associated with a higher risk of CAD [odds ratio (OR) 2.994, 95% confidence interval (CI): 1.174–7.631], even adjusting for risk factors (OR 2.794, 95% CI: 1.215–7.460). Logistic regression analysis showed that the dominant genetic model increased the CAD risk (OR 2.313, 95% CI: 1.070–6.983) after adjusting the confounding factors. Meta-analysis results of 13 studies revealed that PCSK9 E670G polymorphism was correlated with CAD risk under different genetic models. Conclusion Our results demonstrated that PCSK9 E670G genotype was associated with a high risk of CAD.
Economic Outcomes Following Combinatorial Pharmacogenomic Testing for Elderly Psychiatric Patients
Authors: Jablonski Michael R. , Lorenz Raymond , Li James , Dechairo Bryan M. 
Published: December 2019

Objective: We compared economic outcomes when elderly patients with neuropsychiatric disorders received psychotropic medications guided by a combinatorial pharmacogenomic (PGx) test. Methods: This is a subanalysis of a 1-year prospective assessment of medication cost for patients with neuropsychiatric disorders receiving combinatorial PGx testing. Pharmacy claims were used to compare per member per year (PMPY) medication cost for patients ≥65 and <65 years old when medications were congruent or incongruent with the PGx test. Polypharmacy was also assessed. Results: Congruent prescribing was associated with savings of US$3497 PMPY ( P < .001) for patients ≥65 years and US$2467 PMPY ( P < .001) for patients <65, compared to incongruent prescribing. Congruent prescribing in patients ≥65 treated by primary care providers was associated with US$4113 PMPY ( P = .026) in savings, while congruent prescribing by psychiatrists was associated with US$120 PMPY ( P = .719). Congruent prescribing was also associated with one fewer neuropsychiatric medication for patients ≥65 ( P = .070). Conclusion: Congruence with PGx testing was associated with medication cost savings in elderly patients.
Effects of Exercise Intervention on Quality of Life in Adolescent and Young Adult Cancer Patients and Survivors: A Meta-Analysis
Authors: Zhi Xiaoxu , Xie Man , Zeng Yingchun , Liu Jun-e , Cheng Andy S. K. 
Published: December 2019

Background: Cancer and its treatment significantly impact the quality of life (QOL) of adolescent and young adult (AYA) patients. This meta-analysis examined the effects of exercise interventions on the generic and cancer-specific QOL of AYA cancer patients and survivors. Methods: Four databases were searched from January 2010 to September 2019. RevMan 5.3 was used to synthesize the effects of exercise intervention on the QOL of AYA cancer patients and survivors. Results: A total of 11 eligible studies have been included in this paper. Direct outcome comparisons found that pooled overall effects on generic QOL were in favor of exercise interventions, but only with marginal significance (Z= 1.96, P = 0.05). When performing the subscale analysis of the generic QOL, three trials assessed the effects of exercise interventions on the emotional domain of QOL, and the weighted mean difference (WMD) for the overall intervention effect was 3.47 (95% confidence interval [CI] = 0.42 to 6.51). Additionally, exercise interventions increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors (Z= 2.88, P = 0.004). Conclusion: Exercise interventions had positive effects on generic QOL and increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors. In addition, exercise intervention programs appear to be safe, as there were no studies that reported adverse events. Future research, with rigorous methodological standards and larger sample sizes, should be designed to confirm the positive effects of exercise interventions on the QOL of AYA cancer patients and survivors.
A descriptive analysis of health practices, barriers to healthcare and the unmet need for cervical cancer screening in the Lower Napo River region of the Peruvian Amazon
Authors: Collins Joseph H , Bowie Diana , Shannon Geordan 
Published: December 2019

Objectives: To undertake an descriptive analysis of the health needs, healthcare practices and barriers to accessing healthcare faced by women in Lower Napo River Region, Peru, and to understand health literacy regarding cervical cancer and the need for more effective cervical cancer screening services. Methods: We performed a community-based needs assessment adapting Demographic and Health survey methodology with additional questions determining female health literacy on cervical cancer and assessing the availability and need for cervical cancer screening services. We surveyed women (N = 121) across all households in six communities along the Lower Napo River, Loreto, Peru, in May 2015. Data were collected as part of the larger Amazon Community Based Participation Cervical Cancer Screen-and-Treat Programme. Survey data were compared to national results from ENDES 2014. Results: Comparison between our findings and the ENDES 2014 survey highlighted considerable inequality between indigenous or mixed indigenous, rural populations in Loreto, Peru, and national population data averages over level of formal education, literacy, barriers to accessing healthcare and maternal and sexual health. Even though only 5.9% (N = 7/117) of women had no formal health insurance coverage, money was reported as the leading barrier accessing healthcare (N = 88/117, 75.2%). Health literacy regarding cervical and breast cancer was poor. A high proportion of women highlighted fear of screening processes (70.8%, N = 80/113) and lack of available services (53.6%, N = 60/112) as barriers to cervical cancer screening. Conclusion: Although progress has been made in improving healthcare access in Peru, such gains have not been experienced equitably and women living in remote communities face persistent marginalization regarding their health. There is a significant need for education related to and screening for cervical cancer in this region that is tailored to the reality of women’s lives in remote communities in Loreto.
Effect of tofacitinib on cardiovascular events and all-cause mortality in patients with immune-mediated inflammatory diseases: a systematic review and meta-analysis of randomized controlled trials
Authors: Xie Wenhui , Xiao Shiyu , Huang Yanrong , Sun Xiaoying , Zhang Zhuoli 
Published: December 2019

Background: We aimed to systematically assess a possible association of tofacitinib therapy with cardiovascular events (CVEs) and all-cause mortality. Methods: Systematic searches of PubMed, Embase, and Cochrane Library were conducted from inception through March 2019. Randomized controlled trials in patients with immune-mediated inflammatory diseases (IMIDs) reporting safety data were included. Included studies compared tofacitinib with placebo or 5 mg tofacitinib with 10 mg tofacitinib. The primary and secondary outcome measures were all CVEs [major adverse cardiovascular events (MACEs)/venous thromboembolism events (VTEs)] and all-cause mortality. Results: 29 studies randomizing 13,611 patients were included. Compared with placebo, there was no significant increased risk of all CVEs (OR = 1.07, 95% CI 0.49–2.34), MACEs (OR 1.54, 95% CI 0.42–5.59), or all-cause mortality (OR = 1.13, 95% CI 0.26–4.95), but a decreased rate of VTEs (OR 0.03, 95% CI 0.00–0.21) in patients with IMIDs initiating tofacitinib. Meanwhile, paired comparison showed 10 mg tofacitinib twice daily was associated with a significantly lower incidence of all CVEs (OR = 0.56, 95% CI 0.33–0.96), MACEs (OR = 0.48, 95% CI 0.22–1.05), or all-cause mortality (OR = 0.47, 95% CI 0.19–1.17), but a trend toward an increase in VTEs risk (OR = 1.47, 95% CI 0.25–8.50), compared with the 5 mg regimen. Conclusion: Compared with placebo, there was no augmented risk of CVEs and all-cause mortality in patients with IMIDs following tofacitinib treatment in a short-term perspective, whereas 10 mg twice daily tofacitinib appeared to be associated with reduction in cardiovascular and all-cause mortality risks, except VTEs, relative to the 5 mg twice daily dose. Long-term studies and postmarketing risk monitoring are increasingly needed to develop a better understanding.