bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dapagliflozin and Cardiac, Kidney, and Limb Outcomes in Patients With and Without Peripheral Artery Disease in DECLARE-TIMI 58
Authors: Bonaca Marc P. , Wiviott Stephen D. , Zelniker Thomas A. , Mosenzon Ofri , Bhatt Deepak L. , Leiter Lawrence A. , McGuire Darren K. , Goodrich Erica L. , De Mendonca Furtado Remo Holanda , Wilding John P.H. , Cahn Avivit , Gause-Nilsson Ingrid A.M. , Johanson Per , Fredriksson Martin , Johansson Peter A. , Langkilde Anna Maria , Raz Itamar , Sabatine Marc S. 
Published: August 2020

Background:
Patients with peripheral artery disease (PAD) are at heightened risk of cardiovascular complications. The sodium-glucose cotransporter 2 inhibitor dapagliflozin reduces the risk for hospitalization for heart failure (HHF) and kidney events in patients with type 2 diabetes mellitus. An increased risk of amputation has been observed with canagliflozin in 1 previous trial. We examined cardiovascular and kidney efficacy and the risk of limb-related events in patients with and without PAD in an exploratory analysis.

Methods:
A total of 17 160 patients with type 2 diabetes mellitus, including 1025 (6%) with PAD, were randomized. Key efficacy outcomes were MACE (cardiovascular [CV] death, myocardial infarction, stroke), CV death/HHF, and progression of kidney disease. Amputations, peripheral revascularization, and limb ischemic adverse events were site-reported and categorized by a blinded reviewer.

Results:

Patients in the placebo arm with PAD versus those without tended to have higher adjusted risk of CV death, myocardial infarction, or stroke (adjusted hazard ratio [HR], 1.23 [95% CI, 0.97–1.56],
P
=0.094) and significantly higher adjusted risk of CV death/HHF (adjusted HR, 1.60 [95% CI, 1.21–2.12],
P
=0.0010) and progression of kidney disease (adjusted HR, 1.51 [95% CI, 1.13 – 2.03],
P
=0.0058), and limb adverse events (adjusted HR, 8.37,
P
<0.001). The relative risk reductions with dapagliflozin for CV death/HHF (HR, 0.86, PAD; HR, 0.82, no-PAD;
P
-interaction=0.79) and progression of kidney disease (HR, 0.78, PAD; HR, 0.76, no-PAD;
P
-interaction=0.84) were consistent regardless of PAD. There were 560 patients who had at least 1 limb ischemic event, 454 patients with at least 1 peripheral revascularization, and 236 patients with at least 1 amputation, with a total of 407 amputations reported. Overall, there were no significant differences in any limb outcome with dapagliflozin versus placebo including limb ischemic adverse events (HR, 1.07 [95% CI, 0.90–1.26]) and amputation (HR, 1.09 [95% CI, 0.84–1.40]), with no significant interactions by a history of PAD versus not (
P
-interactions=0.30 and 0.093, respectively).

Conclusions:
Patients with versus without PAD are at a higher risk of CV death of CV death, HHF, and kidney outcomes, and have a consistent benefits for CV death/HHF and progression of kidney disease with dapagliflozin. Patients with PAD had a higher risk of limb events, with no consistent pattern of incremental risk observed with dapagliflozin.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01730534.
Dual Antiplatelet Therapy After Percutaneous Coronary Intervention and Drug-Eluting Stents
Authors: Khan Safi U. , Singh Maninder , Valavoor Shahul , Khan Muhammad U. , Lone Ahmad N. , Khan Muhammad Zia , Khan Muhammad Shahzeb , Mani Preethi , Kapadia Samir R. , Michos Erin D. , Stone Gregg W. , Kalra Ankur , Bhatt Deepak L. 
Published: August 2020

Background:
The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention with drug-eluting stents remains uncertain. We compared short-term (<6-month) DAPT followed by aspirin or P2Y12 inhibitor monotherapy; midterm (6-month) DAPT; 12-month DAPT; and extended-term (>12-month) DAPT after percutaneous coronary intervention with drug-eluting stents.

Methods:
Twenty-four randomized, controlled trials were selected using Medline, Embase, Cochrane library, and online databases through September 2019. The coprimary end points were myocardial infarction and major bleeding, which constituted the net clinical benefit. A frequentist network meta-analysis was conducted with a random-effects model.

Results:
In 79 073 patients, at a median follow-up of 18 months, extended-term DAPT was associated with a reduced risk of myocardial infarction in comparison with 12-month DAPT (absolute risk difference, –3.8 incident cases per 1000 person-years; relative risk, 0.68 [95% CI, 0.54–0.87]), midterm DAPT (absolute risk difference, –4.6 incident cases per 1000 person-years; relative risk, 0.61 [0.45–0.83]), and short-term DAPT followed by aspirin monotherapy (absolute risk difference, –6.1 incident cases per 1000 person-years; relative risk, 0.55 [0.37–0.83]), or P2Y12 inhibitor monotherapy (absolute risk difference, –3.7 incident cases per 1000 person-years; relative risk, 0.69 [0.51–0.95]). Conversely, extended-term DAPT was associated with a higher risk of major bleeding than all other DAPT groups. In comparison with 12-month DAPT, no significant differences in the risks of ischemic end points or major bleeding were observed with midterm or short-term DAPT followed by aspirin monotherapy, with the exception that short-term DAPT followed by P2Y12 inhibitor monotherapy was associated with a reduced risk of major bleeding. There were no significant differences with respect to mortality between the different DAPT strategies. In acute coronary syndrome, extended-term in comparison with 12-month DAPT was associated with a reduced risk of myocardial infarction without a significant increase in the risk of major bleeding.

Conclusions:
The present network meta-analysis suggests that, in comparison with 12-month DAPT, short-term DAPT followed by P2Y12 inhibitor monotherapy reduces major bleeding after percutaneous coronary intervention with drug-eluting stents, whereas extended-term DAPT reduces myocardial infarction at the expense of more bleeding events.
US Mortality Attributable to Congenital Heart Disease Across the Lifespan From 1999 Through 2017 Exposes Persistent Racial/Ethnic Disparities
Authors: Lopez Keila N. , Morris Shaine A. , Sexson Tejtel S. Kristen , Espaillat Andre , Salemi Jason L. 
Published: August 2020

Background:
Congenital heart disease (CHD) accounts for ≈40% of deaths in US children with birth defects. Previous US data from 1999 to 2006 demonstrated an overall decrease in CHD mortality. Our study aimed to assess current trends in US mortality related to CHD from infancy to adulthood over the past 19 years and determine differences by sex and race/ethnicity.

Methods:
We conducted an analysis of death certificates from 1999 to 2017 to calculate annual CHD mortality by age at death, race/ethnicity, and sex. Population estimates used as denominators in mortality rate calculations for infants were based on National Center for Health Statistics live birth data. Mortality rates in individuals ≥1 year of age used US Census Bureau bridged-race population estimates as denominators. We used joinpoint regression to characterize temporal trends in all-cause mortality, mortality resulting directly attributable to and related to CHD by age, race/ethnicity, and sex.

Results:
There were 47.7 million deaths with 1 in 814 deaths attributable to CHD (n=58 599). Although all-cause mortality decreased 16.4% across all ages, mortality resulting from CHD declined 39.4% overall. The mean annual decrease in CHD mortality was 2.6%, with the largest decrease for those >65 years of age. The age-adjusted mortality rate decreased from 1.37 to 0.83 per 100 000. Males had higher mortality attributable to CHD than females throughout the study, although both sexes declined at a similar rate (≈40% overall), with a 3% to 4% annual decrease between 1999 and 2009, followed by a slower annual decrease of 1.4% through 2017. Mortality resulting from CHD significantly declined among all races/ethnicities studied, although disparities in mortality persisted for non-Hispanic Blacks versus non-Hispanic Whites (mean annual decrease 2.3% versus 2.6%, respectively; age-adjusted mortality rate 1.67 to 1.05 versus 1.35 to 0.80 per 100 000, respectively).

Conclusions:
Although overall US mortality attributable to CHD has decreased over the past 19 years, disparities in mortality persist for males in comparison with females and for non-Hispanic Blacks in comparison with non-Hispanic Whites. Determining factors that contribute to these disparities such as access to quality care, timely diagnosis, and maintenance of insurance will be important moving into the next decade.
Earth, World, and the Human
Authors: Farrant Marc 
Published: August 2020

Abstract
This essay reads the ungraspable relation to death in Beckett’s works as a means to think through our contemporary era of climate crisis. Beckett’s singular aesthetics of human finitude can be a powerful resource for thinking the unthinkable. By envisaging finitude in terms of the limits imposed on life by both space and time, this essay seeks to ground the existential framework of Beckett’s oeuvre in terms of an always embedded self. Looking at the short story “The End,” I show how such embeddedness may work to evade totalisation or abstraction in terms of a universal worldview, yet also how it poses problems for any privileging of materiality as such. Beckett’s writings are thereby seen to produce a dynamic ethics between world and earth, the global and the local, life and death.
“All that inner space one never sees”
Authors: Maude Ulrika 
Published: August 2020

Abstract
Beckett’s prose, drama, correspondence and working notes contain numerous references to processes that pertain to unconscious, involuntary bodily functionality and materiality. In this respect, the body’s viscera and their processes cannot properly be said to belong to the subject, and yet everything over which we have agential control is premised on these deeper vegetative or physiological processes; thought and feeling, as Molloy puts it, ‘dance their sabbath’ in the ‘caverns’ of the body. If the conception of the ‘human’ is premised on rationality, then the viscera are non-human, object-like. Beckett’s anti-rationalist emphasis on affective, visceral experience in How It Is (along with the novel’s veiled allusions to Pavlov’s conditioning and Watson’s behaviourism) operates in tension with the more elevated intertextual references that signpost the humanist tradition.
Characterizing the Uncertainty and Assessing the Value of Gap-Filled Daily Rainfall Data in Hawaii
Authors: Longman Ryan J. , Newman Andrew J. , Giambelluca Thomas W. , Lucas Mathew 
Published: August 2020

AbstractAlmost all daily rainfall time series contain gaps in the instrumental record. Various methods can be used to fill in missing data using observations at neighboring sites (predictor stations). In this study, five computationally simple gap-filling approaches—normal ratio (NR), linear regression (LR), inverse distance weighting (ID), quantile mapping (QM), and single best estimator (BE)—are evaluated to 1) determine the optimal method for gap filling daily rainfall in Hawaii, 2) quantify the error associated with filling gaps of various size, and 3) determine the value of gap filling prior to spatial interpolation. Results show that the correlation between a target station and a predictor station is more important than proximity of the stations in determining the quality of a rainfall prediction. In addition, the inclusion of rain/no-rain correction on the basis of either correlation between stations or proximity between stations significantly reduces the amount of spurious rainfall added to a filled dataset. For large gaps, relative median errors ranged from 12.5% to 16.5% and no statistical differences were identified between methods. For submonthly gaps, the NR method consistently produced the lowest mean error for 1- (2.1%), 15- (16.6%), and 30-day (27.4%) gaps when the difference between filled and observed monthly totals was considered. Results indicate that gap filling prior to spatial interpolation improves the overall quality of the gridded estimates, because higher correlations and lower performance errors were found when 20% of the daily dataset is filled as opposed to leaving these data unfilled prior to spatial interpolation.
Effects of Vegetation and Topography on the Boundary Layer Structure above the Amazon Forest
Authors: Chamecki Marcelo , Freire Livia S. , Dias Nelson L. , Chen Bicheng , Dias-Junior Cléo Quaresma , Toledo Machado Luiz Augusto , Sörgel Matthias , Tsokankunku Anywhere , Araújo Alessandro C. de 
Published: August 2020

AbstractObservational data from two field campaigns in the Amazon forest were used to study the vertical structure of turbulence above the forest. The analysis was performed using the reduced turbulent kinetic energy (TKE) budget and its associated two-dimensional phase space. Results revealed the existence of two regions within the roughness sublayer in which the TKE budget cannot be explained by the canonical flat-terrain TKE budgets in the canopy roughness sublayer or in the lower portion of the convective ABL. Data analysis also suggested that deviations from horizontal homogeneity have a large contribution to the TKE budget. Results from LES of a model canopy over idealized topography presented similar features, leading to the conclusion that flow distortions caused by topography are responsible for the observed features in the TKE budget. These results support the conclusion that the boundary layer above the Amazon forest is strongly impacted by the gentle topography underneath.
The Key Role of Coupled Chemistry–Climate Interactions in Tropical Stratospheric Temperature Variability
Authors: Yook Simchan , Thompson David W. J. , Solomon Susan , Kim Seo-Yeon 
Published: August 2020

AbstractThe purpose of this study is to quantify the effects of coupled chemistry–climate interactions on the amplitude and structure of stratospheric temperature variability. To do so, the authors examine two simulations run on version 4 of the Whole Atmosphere Coupled Climate Model (WACCM): a “free-running” simulation that includes fully coupled chemistry–climate interactions and a “specified chemistry” version of the model forced with prescribed climatological-mean chemical composition. The results indicate that the inclusion of coupled chemistry–climate interactions increases the internal variability of temperature by a factor of ~2 in the lower tropical stratosphere and—to a lesser extent—in the Southern Hemisphere polar stratosphere. The increased temperature variability in the lower tropical stratosphere is associated with dynamically driven ozone–temperature feedbacks that are only included in the coupled chemistry simulation. The results highlight the fundamental role of two-way feedbacks between the atmospheric circulation and chemistry in driving climate variability in the lower stratosphere.
Using Spectrograms from Underwater Total Pressure Sensors to Detect Passing Vessels in a Coastal Environment
Authors: Rätsep Margus , Parnell Kevin E. , Soomere Tarmo , Kruusmaa Maarja , Ristolainen Asko , Tuhtan Jeffrey A. 
Published: August 2020

AbstractMonitoring vessel traffic in coastal regions is a key element of maritime security. For this reason, additional ways of detecting moving vessels are explored by using the unique structure of their wake waves based on pressure measurements at the seabed. The experiments are performed at a distance of about 2 km from the sailing line using novel multisensor devices called “hydromasts” that track both pressure and near-bed water flow current velocities. The main tool for the analysis is a windowed Fourier transform that produces a spectrogram of the wake structure. It is shown that time series from the pressure sensors, measured at a frequency of 100 Hz, 0.2 m above the seabed are a valid source of input data for the spectrogram technique. This technique portrays the properties of both divergent and transverse waves with an accuracy and resolution that is sufficient for the evaluation of the speed and distance of the detected vessels from the measurement device. All the detected passings are matched with vessels using automatic identification system (AIS) data. The use of several time series from synchronized multisensor systems substantially suppresses noise and improves the quality of the outcome compared to one-point measurements. Additional information about variations in the water flow in wakes provides a simple and reasonably accurate tool for rapid detection of ship passages.
Near-Surface Vortex Formation in Supercells from the Perspective of Vortex Patch Dynamics
Authors: Dahl Johannes M. L. 
Published: August 2020

AbstractIn many supercell simulations, near-ground vortex formation results from the collapse of an elongated region of enhanced vertical vorticity. In this study, this “roll-up” mechanism is analyzed by investigating the behavior of several 2D elliptic vortex patches. The problem is treated as a nonlinear initial value problem, which is better suited to describe the roll-up mechanism than the more commonly employed normal-mode analysis. Using the Bryan Cloud Model 1, it is demonstrated that the condition for vortex formation is an initial finite-amplitude nonuniformity within the vortex patch. Vortex formation results from differential self-advection due to the flow induced by the patch itself. Background straining motion may either aid or suppress vortex-patch axisymmetrization depending on the initial orientation of the patch relative to the deformation axis. It is also found that in some cases numerical dispersion may lead to nonuniformities that serve as seed for axisymmetrization, thus resulting in unphysical vortex development.
Blood sampling from peripherally inserted central catheter is effective and safe for patients with head and neck cancers
Authors: Zhang Yuejiao , Zhang Shoude , Chen Jinhua , Zhao Ruiyi 
Published: August 2020

Objective: To evaluate the validity of laboratory tests for blood sampling from a peripherally inserted central catheter. Methods: A total of 22 patients diagnosed with head and neck cancers were enrolled. In total, 101 paired blood samples were taken both via venipuncture and peripherally inserted central catheter for hematology and biochemistry testing. Paired t tests and linear correlation analysis were used to evaluate the results. Blood sampling–related pain was recorded by visual analogue scales and numerical rating scales. Infusion occlusion, hemolysis, and catheter-related blood stream infection were also recorded. Results: The peripherally inserted central catheter–associated test results were slightly lower than those with venipuncture. Some parameters differed more than others. However, the degree of difference was less than 5% for every pair. There was a high correlation between the test results with two methods of blood sampling with the representative equation approximately being “y = x.” According to visual analogue scales and numerical rating scale analysis, the pain degree with peripherally inserted central catheter was significantly lower than that of the venipuncture (p < 0.001). No case of infusion occlusion, catheter-related blood stream infection was reported with both methods. Hemolysis rate in blood samples from peripherally inserted central catheter (1/101) was much lower than that seen with venipuncture (11/101) with significant difference (p = 0.0056). Conclusion: Blood sampling via peripherally inserted central catheter and venipuncture showed equivalent reliability in laboratory testing. Compared with venipuncture, blood sampling via peripherally inserted central catheter causes less pain and is safer. Blood sampling via peripherally inserted central catheter is strongly recommended for clinical use.
Influence of Superficial Venous Ablation on Deep Venous Dilation and Reflux in Patients With Saphenous Varicose Veins
Authors: Nishibe Toshiya , Nishibe Masayasu , Akiyama Shinobu , Nukaga Saori , Maekawa Koki , Kano Masaki , Ogino Hitoshi , Koizumi Jun , Dardik Alan 
Published: August 2020

Background: To investigate the influence of superficial venous ablation on deep venous dilation and reflux in patients with saphenous varicose veins, and to elucidate the association between superficial venous reflux and deep venous morphology and hemodynamics. Methods: The data of 154 patients with 223 limbs, who underwent endovenous radiofrequency ablation (RFA) of the great saphenous vein for primary varicose veins between September 2014 and March 2016 in Eniwa Midorino Clinic, were retrospectively analyzed. Overall venous hemodynamics of the leg, including functional venous volume (VV) and venous filling index (VFI), was assessed using air-plethysmography. Saphenous and deep vein reflux and diameter were evaluated with duplex scanning. Results: Hemodynamic and morphologic changes were evaluated before and 1 month after RFA. The VV and VFI were significantly decreased in postoperative values than in preoperative values ( P < .001). Limbs with deep venous reflux significantly decreased postoperatively than preoperatively ( P < .001). There were significant differences in the diameter of the common femoral vein (CFV) and popliteal vein (PV) between the preoperative and postoperative values ( P < .001). There were strong to moderate correlations between the VV and the diameter of the CFV or PV (CFV, r = 0.47, P < .001; PV, r = 0.35, P < .001), while there were moderate to weak correlations between the VFI and the diameter of the CFV or PV (CFV, r = 0.23, P < .001; PV, r = 0.33, P <.001). Conclusions: Superficial venous ablation significantly reduced deep venous dilation and reflux in patients with saphenous varicose veins. Significant correlations existed between the VV or VFI, which reflected superficial venous reflux, and the diameter of the deep veins. These findings reveal that volume overload due to superficial venous reflux is associated with deep venous morphology and hemodynamics.