bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ratchet mechanism selectively causing idiopathic macrodislodgement of an active-fixation coronary sinus lead: a case report
Authors: Golzio Pier Giorgio , Bissolino Arianna , Ceci Raffaele , Frea Simone 
Published: December 2020

Abstract

Background
‘Idiopathic’ lead macrodislodgement may be due to Twiddler’s syndrome depending on active twisting of pulse generator within subcutaneous pocket. All leads are involved, at any time from implantation, and frequently damaged. In the past few years, a reel syndrome was also observed: retraction of pacemaker leads into pocket without patient manipulation, owing to lead circling the generator. In other cases, a ‘ratchet’ mechanism has been postulated. Reel and ratchet mechanisms require loose anchoring, occur generally briefly after implantation, with non-damaged leads. We report the first case of an active-fixation coronary sinus lead selective macrodislodgement involving such ratchet mechanism.

Case summary
A 65-year-old man underwent biventricular defibrillator device implantation, with active-fixation coronary sinus lead. Eight months later, he complained of muscle contractions over device pocket. At fluoroscopy, coronary sinus lead was found near to pocket, outside of thoracic inlet. Atrial and ventricular leads were in normal position. After opening pocket, a short tract of coronary sinus lead appeared anteriorly dislocated to generator, while greater length of lead body twisted a reel behind. The distal part of lead was found outside venous entry at careful dissection. Atrial and ventricular leads were firmly anchored.

Discussion
Our case is a selective ‘Idiopathic’ lead macrodislodgement, possibly due to a ratchet mechanism between the lead and the suture sleeve, induced by normal arm motion; such mechanism incredibly, and for first time in literature involves a coronary sinus active-fixation lead.

Conclusion
Careful attention should always be paid to secure anchoring even of active-fixation coronary sinus leads.
Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report
Authors: Csavajda Ádám , Bertrand Olivier F , Merkely Béla , Ruzsa Zoltán 
Published: December 2020

Abstract

Background
The COVID-19 pandemic creates new challenges for healthcare, including invasive cardiology.

Case summary
We discuss the case of a 65-year-old man who presented with non-ST segment elevation myocardial infarction combined with bilateral pneumonia. The patient had known severe iliac artery lesions with prior interventions and bilateral subclavian artery occlusions. After unsuccessful femoral artery access, the diagnostic angiography and the right coronary artery percutaneous coronary intervention were successfully performed from ultrasound-guided lower superficial temporal artery access.

Discussion
We showed that superficial temporal access can be used as an alternate access site for diagnostic coronary angiography and intervention when standard wrist and femoral access sites are not readily accessible.
Ilio-femoral venous thrombosis with hereditary antithrombin deficiency: a case report of rare thrombotic disease and successful treatment with catheter directed thrombolysis
Authors: Miyashita Hirokazu , Tobita Kazuki , Morishita Eriko , Saito Shigeru 
Published: December 2020

Abstract

Background
Hereditary antithrombin (AT) deficiency is an uncommon autosomal dominant thrombogenic disorder, which can cause venous thromboembolism (VTE). Although conservative treatment options for hereditary AT deficiency-associated VTE such as anticoagulation (warfarin, direct oral anticoagulant, or heparin), intravenous thrombolysis, and recombinant AT are well known, interventional treatment options have not been reported so far.

Case summary
A 19-year-old man with a family history of thrombogenic diseases, referred to our hospital with left leg pain, was diagnosed with AT deficiency-associated VTE. In the absence of symptomatic relief with intravenous thrombolysis and anticoagulation, he received venous intervention and catheter directed thrombolysis (CDT) for 4 days for left iliac venous thrombosis. Following a second venous intervention, venous thrombus disappeared almost entirely on cross-sectional imaging, and his symptoms improved. He was discharged on apixaban and has been recurrence-free for one and a half years.

Discussion
This case presents CDT and maintenance therapy with apixaban as possible treatment options for VTE in patients with hereditary AT deficiency, especially following failure of conservative therapy. Individual risks and benefits should be considered when CDT is performed for acute VTE in patients with AT deficiency.
Effect of Aspirin on Activities of Daily Living Disability in Community-Dwelling Older Adults
Authors: Woods Robyn L , Espinoza Sara , Thao Le T P , Ernst Michael E , Ryan Joanne , Wolfe Rory , Shah Raj C , Ward Stephanie A , Storey Elsdon , Nelson Mark R , Reid Christopher M , Lockery Jessica E , Orchard Suzanne G , Trevaks Ruth E , Fitzgerald Sharyn M , Stocks Nigel P , Williamson Jeff D , McNeil John J , Murray Anne M , Newman Anne B 
Published: December 2020

Abstract

Background
Cerebrovascular events, dementia, and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin’s effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults.

Methods
The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100 mg aspirin versus placebo recruited 19 114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the United States. Six basic ADLs were assessed every 6 months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after 6 months. Proportional hazards modeling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk.

Results
Over a median of 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing, and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 vs 5.3 events/1000 py; hazard ratio [HR] = 0.81, 95% confidence interval [CI]: 0.66–1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability, there were more deaths in the aspirin group (24 vs 12).

Discussion
Low-dose aspirin in initially healthy older people did not reduce the risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.
SoupX removes ambient RNA contamination from droplet-based single-cell RNA sequencing data
Authors: Young Matthew D , Behjati Sam 
Published: December 2020

Abstract

Background
Droplet-based single-cell RNA sequence analyses assume that all acquired RNAs are endogenous to cells. However, any cell-free RNAs contained within the input solution are also captured by these assays. This sequencing of cell-free RNA constitutes a background contamination that confounds the biological interpretation of single-cell transcriptomic data.

Results
We demonstrate that contamination from this "soup" of cell-free RNAs is ubiquitous, with experiment-specific variations in composition and magnitude. We present a method, SoupX, for quantifying the extent of the contamination and estimating "background-corrected" cell expression profiles that seamlessly integrate with existing downstream analysis tools. Applying this method to several datasets using multiple droplet sequencing technologies, we demonstrate that its application improves biological interpretation of otherwise misleading data, as well as improving quality control metrics.

Conclusions
We present SoupX, a tool for removing ambient RNA contamination from droplet-based single-cell RNA sequencing experiments. This tool has broad applicability, and its application can improve the biological utility of existing and future datasets.
Apparent earthquake rupture predictability
Authors: Meier Men-Andrin , Ampuero Jean-Paul , Cochran Elizabeth , Page Morgan 
Published: December 2020

SUMMARYTo what extent can the future evolution of an ongoing earthquake rupture be predicted? This question of fundamental scientific and practical importance has recently been addressed by studies of teleseismic source time functions (STFs) but reaching contrasting conclusions. One study concludes that the initial portion of STFs is the same regardless of magnitude. Another study concludes that the rate at which earthquakes grow increases systematically and strongly with final event magnitudes. Here, we show that the latter reported trend is caused by a selection bias towards events with unusually long durations and by estimates of STF growth made when the STF is already decaying. If these invalid estimates are left out, the trend is no longer present, except during the first few seconds of the smallest events in the data set, Mw 5–6.5, for which the reliability of the STF amplitudes is questionable. Simple synthetic tests show that the observations are consistent with statistically indistinguishable growth of smaller and larger earthquakes. A much weaker trend is apparent among events of comparable duration, but we argue that its significance is not resolvable by the current data. Finally, we propose a nomenclature to facilitate further discussions of earthquake rupture predictability and determinism.
Developing a charter of spiritual care for patients
Authors: Heidari Akram , Kazemi Abdolhasan , Abbasi Mohammad , Adeli Seyed hasan , Ahmari tehran Hoda , Eskandari Narges , Heidari Morteza , Khalajinia Zohre , Yoosefee Sadegh 
Published: December 2020

Abstract

Background
Spirituality is recognized as an important issue in health care, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed-upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both health-care providers and patients within the Iranian social, cultural and overall contexts and present a charter for providing spiritual care.

Methods
The first phase of the study was a systematic literature review. The next phase consisted of two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion.

Results
The review of literatures led to the identification of two main themes and 10 themes. Perspectives of health-care providers were categorized into four main themes and 10 themes, and patients’ opinions were classified into three main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements.

Conclusion
The charter of spiritual care for patients is intended to present an agreed-upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve health-care delivery system.
Formulative Strategy: Why the African Union-led International Mediation in South Sudan Failed to Prevent Atrocity Crimes
Authors: Ifediora Obinna F 
Published: December 2020

AbstractThe puzzle of the African Union mediation is that it enjoys regional effectiveness in leading peace processes and yet often fails to prevent atrocity crimes. While existing studies focus on the lack of capacity to explain failures, I draw on atrocity mediation literature that emphasizes coercive strategies for ripening to explore widely significant factors associated with the AU mediation. I adopt the “framework of mediator behavior” in international mediation studies to analyze AU policies on conflict responses and the mediation in South Sudan. My approach is consistent with the content analysis of qualitative data. I find that the significant factor in the AU mediation is the “patient” policy, like “strategic patience.” The policy reflects formulative strategy of conflict mediation that describes the mediator who controls the process but shifts control of substantive decision-making to the parties. Formulative strategy is technically non-coercive, so the AU embraces it to respect sovereignty. The paradox is that formulative strategy is the AU legitimacy source—which anchors effectiveness—and failure. The AU mediation failed because of strategic choice, not the lack of capabilities. This study contributes to a broader understanding of the AU mediation and challenges mediator behavior assumptions.
A multicriteria function for polymer gear design optimization
Authors: Tavčar Jože , Černe Borut , Duhovnik Jože , Zorko Damijan 
Published: December 2020

Abstract
A reliable method of optimization of polymer gears remains, to date, an open challenge, due to the lack of specific material characterization of polymers and to the complex nonlinear relations between different geometric and operating parameters. For spur and helical gears, the authors herein have developed the optimization algorithm, which primarily enables variation of geometry according to various criteria: the number of teeth (z1, z2), face width (b), helix angle (β), and normal module (mn). The method enables a better insight into how design parameters influence the target criteria. The main paper contribution is a newly developed multicriteria function that enables a simultaneous consideration of different criteria such as root/flank stress, gear bulk/flank temperature, wear, deformation, quality, cost, and volume.
Sex- and age-related differences in the distribution of bladder cancer metastases
Authors: Rosiello Giuseppe , Palumbo Carlotta , Deuker Marina , Stolzenbach Lara Franziska , Martin Thomas , Tian Zhe , Gallina Andrea , Montorsi Francesco , Black Peter , Kassouf Wassim , Shariat Shahrokh F , Saad Fred , Briganti Alberto , Karakiewicz Pierre I 
Published: December 2020

Abstract

Objective
Our objective was to investigate age- and sex-related differences in the distribution of metastases in patients with metastatic bladder cancer.

Methods
Within the National Inpatient Sample database (2008–2015), we identified 7040 patients with metastatic bladder cancer. Trend test and Chi-square test analyses were used to evaluate the relationship between age and site of metastases, according to sex.

Results
Of 7040 patients with metastatic bladder cancer, 5226 (74.2%) were men and 1814 (25.8%) were women. Thoracic, abdominal, bone and brain metastases were present in 19.5 vs. 23.0%, 43.6 vs. 46.9%, 23.9 vs. 18.7% and 2.4 vs. 2.9% of men vs. women, respectively. Bone was the most common metastatic site in men (23.9%) vs. lung in women (22.4%). Increasing age was associated with decreasing rates of abdominal (from 44.9 to 40.2%) and brain (from 3.2 to 1.4%) metastases in men vs. decreasing rates of bone (from 21.0 to 13.3%) and brain (from 5.1 to 2.0%) metastases in women (all P &lt; 0.05). Finally, rates of metastases in multiple organs also decreased with age, in both men and women.

Conclusions
The distribution of metastases in bladder cancer varies according to sex. Moreover, differences exist according to patient age and these differences are also sex-specific. In consequence, patient age and sex should be considered in the interpretation of imaging, especially when findings are indeterminate.
Preferences for Northern Hardwood Silviculture among Family Forest Owners in Michigan’s Upper Peninsula
Authors: Helman Alexander C , Kelly Matthew C , Rouleau Mark D , Dickinson Yvette L 
Published: December 2020

AbstractManaging northern hardwood forests using high-frequency, low-intensity regimes, such as single-tree selection, favors shade-tolerant species and can reduce tree species diversity. Management decisions among family forest owners (FFO) can collectively affect species and structural diversity within northern hardwood forests at regional scales. We surveyed FFOs in the Western Upper Peninsula of Michigan to understand likely future use of three silvicultural treatments—single-tree selection, shelterwood, and clearcut. Our results indicate that FFOs were most likely to implement single-tree selection and least likely to implement clearcut within the next 10 years. According to logistic regression, prior use of a treatment and perceived financial benefits significantly increased the odds for likely use for all three treatments. Having received professional forestry assistance increased likely use of single-tree selection but decreased likely use of shelterwood. We discuss these results within the context of species diversity among northern hardwood forests throughout the region.
Characterizing Canopy Openness in Open Forests: Spherical Densiometer and Canopy Photography Are Equivalent but Less Sensitive than Direct Measurements of Solar Radiation
Authors: Russavage Emily , Thiele Jake , Lumbsden-Pinto Joanna , Schwager Kathy , Green Tim , Dovciak Martin 
Published: December 2020

AbstractIn forest ecosystems, canopy openness affects understory light availability, plant growth, and tree species recruitment, thus shaping future forest composition, structure, and functional diversity. Foresters must correctly and quickly measure canopy openness to meet their management objectives. To help guide the selection of an appropriate method for measuring canopy openness, we compared three common techniques that vary in cost, complexity, and time required for measurements and data processing: smartphone-based hemispherical photography, spherical densiometer measurements, and direct measurements of solar radiation (using AccuPAR ceptometer). We measured canopy openness using these three methods on 28 permanent forest health monitoring plots in pine-oak forests of the Central Pine Barrens of Long Island in New York State. By analysis of variance and regression analyses, we found the three methods (particularly densiometer and hemispherical photographs) yielded broadly equivalent and strongly positively correlated descriptions of canopy openness. The direct measurements of solar radiation seemed to have a greater potential to detect subtle variation in forest understory light. Forest managers may sufficiently characterize canopy openness using quick and cheap methods (e.g., spherical densiometers) and avoid larger costs of devices for direct light measurements (e.g., ceptometers) and the larger data-processing times of hemispherical photography.
Prolonged Post-Discontinuation Antibiotic Exposure in Very Low Birth Weight Neonates at Risk for Early-Onset Sepsis
Authors: Le Jennifer , Greenberg Rachel G , Benjamin Daniel K , Yoo YoungJun , Zimmerman Kanecia O , Cohen-Wolkowiez Michael , Wade Kelly C ,   Administrative Core Committee of the Best Pharmaceuticals for Children Act–Pediatric Trials Network, Benjamin Daniel K , Hornik Christoph , Zimmerman Kanecia , Kennel Phyllis , Beci Rose , Hornik Chi Dang , Kearns Gregory L , Laughon Matthew , Paul Ian M , Sullivan Janice , Wade Kelly , Delmore Paula , Taylor-Zapata Perdita , Lee June , Anand Ravinder , Sharma Gaurav , Simone Gina , Kaneshige Kim , Taylor Lawrence , Green Thomas 
Published: December 2020

AbstractBackgroundPremature, very low birth weight (VLBW) neonates are at risk for early-onset sepsis and receive ampicillin and gentamicin post-birth. Antimicrobial stewardship supports short-course antibiotics, but how long antibiotic concentrations remain therapeutic post-last dose is unknown.MethodsUsing Monte Carlo simulations (NONMEM 7.3), we analyzed antibiotic exposures in a retrospective cohort of 34 689 neonates (&lt;1500 g, 22-27 weeks of gestation). Therapeutic exposure for ampicillin and gentamicin was evaluated relative to the minimum inhibitory concentration (MIC) for common pathogens (MIC 0.25-8 mcg/mL for group B streptococcus [GBS] and Escherichia coli). Post-discontinuation antibiotic exposure (PDAE) was defined as the time from the last dose to time when concentration decreased below MIC.ResultsNeonates had a median (range) gestational age of 26 (22-27) weeks and BW, 790 g (400-1497) . All ampicillin dosing regimens (50-100 mg/kg every 8-12 hours for 2-6 doses) achieved therapeutic exposures &gt; MIC range. After the last dose, the PDAE mean (95% confidence interval [CI]) ranged from 34 to 50 hours (17–79) for E. coli (MIC 8) and 82 to 104 hours (95% CI: 39-122) for GBS (MIC 0.25); longer PDAE occurred with higher dose, shorter interval, and longer course. Short-course ampicillin (2 doses, 50 mg/kg every 12 hours) provided PDAE 34 hours for E. coli and 82 hours for GBS. Single-dose 5 mg/kg gentamicin provided PDAE &gt; MIC 2 for 26 hours.ConclusionsIn VLBW neonates, ampicillin exposure remains therapeutic long after the last dose. Short-course ampicillin provided therapeutic exposures throughout the typical blood culture incubation period.
Baryons shaping dark matter haloes
Authors: Cataldi P , Pedrosa S E , Tissera P B , Artale M C 
Published: December 2020

ABSTRACT
In this work, we aim at investigating the effects of baryons on the dark matter (DM) haloes structure, focusing on the correlation between the presence and importance of stellar discs and the halo shapes. We study the properties of a subsample of DM haloes from Fenix and eagle cosmological simulations. We inspect the central regions of haloes in the mass range $[10.9-992.3] \times 10^{10} \ \rm M_{\odot }$ at z = 0, comparing the hydrodynamic runs and their dark matter only (DMo) counterparts. Our results indicate that baryons have a significant impact on the shape of the inner halo, mainly within ∼20 per cent of the virial radius. We find haloes to be more spherical when hosting baryons. While the impact of baryons depends on the mass of the haloes, we also find a trend with morphology which suggests that the way baryons are assembled is also relevant in agreement with previous works. Our findings also indicate that disc galaxies preferentially form in haloes whose DMo counterparts were originally more spherical and with stronger velocity anisotropy. The presence of baryons alter the orbital structure of the DM particles of the haloes, which show a decrease in their velocity anisotropy, towards more tangentially biased orbits. This relative decrease is weaker in the case of disc-dominated galaxies. Our results point out to a cosmological connection between the final morphology of galaxies and the intrinsic properties of their DM haloes, which gets reinforce by the growth of the discs.