bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Axillary Access for Placement of Microaxial Ventricular Support Devices
Authors: McCabe James M. , Kaki Amir A. , Pinto Duane S. , Kirtane Ajay J. , Nicholson William J. , Grantham J. Aaron , Wyman R. Michael , Moses Jeffery W. , Schreiber Theodore , Okoh Alexis K. , Shetty Ranjith , Lotun Kapildeo , Lombardi William , Kapur Navin K. , Tayal Raj 
Published: December 2020

Background:
There has been increasing utilization of short-term mechanical circulatory support devices for a variety of clinical indications. Many patients have suboptimal iliofemoral access options or reasons why early mobilization is desirable. Axillary artery access is an option for these patients, but little is known about the utility of this approach to facilitate short-term use for circulatory support with microaxial pump devices.

Methods:
The Axillary Access Registry to Monitor Safety (ARMS) was a prospective, observational multicenter registry to study the feasibility and acute safety of mechanical circulatory support via percutaneous upper-extremity access.

Results:

One hundred and two patients were collected from 10 participating centers. Successful device implantation was 98% (100 of 102). Devices were implanted for a median of 2 days (interquartile range, 0–5 days; range, 0–35 days). Procedural complications included 10 bleeding events and 1 stroke. There were 3 patients with brachial plexus–related symptoms all consisting of C8 tingling and all arising after multiple days of support. Postprocedural access site hematoma or bleeding was noted in 9 patients. Device explantation utilized closure devices alone in 61%, stent grafts in 17%, balloon tamponade facilitated closure in 15%, and planned surgical explant in 5%. Duration of support appeared to be independently associated with a 1.1% increased odds of vascular complication per day ([95% CI, 0.0%–2.3%]
P
=0.05).

Conclusions:
Percutaneous axillary access for use with microaxial support pumps appears feasible with acceptable rates of bleeding despite early experience. Larger studies are necessary to confirm the pilot data presented here.
Effects of Evolocumab on Low‐Density Lipoprotein Cholesterol, Non–High Density Lipoprotein Cholesterol, Apolipoprotein B, and Lipoprotein(a) by Race and Ethnicity: A Meta‐Analysis of Individual Participant Data From Double‐Blind and Open‐Label Extension Studies
Authors: Daviglus Martha L. , Ferdinand Keith C. , López J. Antonio G. , Wu You , Monsalvo Maria Laura , Rodriguez Carlos J. 
Published: December 2020

Background
Prevalence of cardiovascular disease risk factors and rates of atherosclerotic cardiovascular disease outcomes vary across racial/ethnic groups. This analysis examined the effects of evolocumab on LDL‐C (low‐density lipoprotein cholesterol) levels and LDL‐C goals achievement by race/ethnicity.

Methods and Results

Data from 15 phase 2 and 3 studies of treatment with evolocumab versus placebo or ezetimibe were pooled (n=7669). Results were analyzed by participant clinical characteristics and by self‐identified race/ethnicity. Key outcomes included percent change from baseline in LDL‐C, achievement of LDL‐C <70 mg/dL, and LDL‐C reduction of ≥50% at 12 weeks and at 1 to 5 years. Across 12‐week studies, mean percent change in LDL‐C from baseline in evolocumab‐treated participants was −52% to −59% for White and −46% to −67% for non‐White participants, across clinical characteristics groups. LDL‐C <70 mg/dL was achieved in 43% to 84% and 62% to 94% and LDL‐C reduction of ≥50% in 63% to 78% and 58% to 86%, respectively. In 1‐ to 5‐year studies, mean percent change in LDL‐C was −46% to −52% for White and −49% to −55% for non‐White participants. LDL‐C <70 mg/dL was achieved in 53% to 84% and 66% to 77%, and LDL‐C reduction of ≥50% in 53% to 67% and 58% to 68%, respectively. The treatment effect on mean percent change in LDL‐C differed only in participants with type 2 diabetes mellitus, with a larger reduction in Asian participants. The qualitative interaction
P
values were nonsignificant, indicating consistent directionality of effect.

Conclusions
Similar reduction in LDL‐C levels with evolocumab was observed across racial/ethnic groups in 12‐week and 1‐ to 5‐year studies. Among those with diabetes mellitus, Asian participants had greater LDL‐C reduction.
Soluble Urokinase‐Type Plasminogen Activator Receptor, Changes of 24‐Hour Blood Pressure, and Progression of Chronic Kidney Disease
Authors: Jhee Jong Hyun , Nam Bo Young , Lee Chan Joo , Park Jung Tak , Han Seung Hyeok , Kang Shin‐Wook , Park Sungha , Yoo Tae‐Hyun 
Published: December 2020

Background
Soluble urokinase‐type plasminogen activator receptor (suPAR) is associated with cardiovascular risks and poor renal outcomes. However, whether elevated suPAR levels are associated with 24‐hour blood pressure patterns or kidney disease progression in patients with chronic kidney disease (CKD) is unclear.

Methods and Results

A total of 751 patients with CKD stage 1 to 5 were recruited from CMERC‐HI (Cardiovascular and Metabolic Disease Etiology Research Center–High Risk) cohort study (2013–2018). The relationship of serum suPAR levels to 24‐hour blood pressure parameters and CKD progression was analyzed. The median serum suPAR level was 1439.0 (interquartile range, 1026.2–2150.1) pg/mL, and the mean estimated glomerular filtration rate was 52.8±28.5 mL/min per 1.73 m
2
at baseline. Patients with higher suPAR levels had significantly higher levels of office, 24‐hour, daytime, and nighttime systolic blood pressure and nighttime diastolic blood pressure than those with lower suPAR levels. The highest suPAR tertile was associated with an increased risk of a reverse dipping pattern (odds ratio, 2.93; 95% CI, 1.27–6.76;
P
=0.01). During a follow‐up of 43.2 (interquartile range, 27.0–55.6) months, the CKD progression occurred in 271 (36.1%) patients. The highest suPAR tertile was significantly associated with higher risk of CKD progression than the lowest tertile (hazard ratio [HR], 2.09; 95% CI, 1.37–3.21;
P
=0.001). When the relationship was reevaluated with respect to each dipping pattern (dipper, extreme dipper, nondipper, and reverse dipper), this association was consistent only in reverse dippers in whom the risk of CKD progression increased (HR, 1.43; 95% CI, 1.02–2.01;
P
=0.03) with every 1‐unit increase in serum suPAR levels.

Conclusions
Elevated suPAR levels are independently associated with CKD progression, and this association is prominent in reverse dippers.
Disparities in Cardiovascular Disease Outcomes Among Pregnant and Post‐Partum Women
Authors: Gad Mohamed M. , Elgendy Islam Y. , Mahmoud Ahmed N. , Saad Anas M. , Isogai Toshiaki , Sande Mathias Isadora , Misbah Rameez Rabel , Chahine Johnny , Jneid Hani , Kapadia Samir R. 
Published: December 2020

Background
The incidence of cardiovascular disease among pregnant women is rising in the United States. Data on racial disparities for the major cardiovascular events during pregnancy are limited.

Methods and Results
Pregnant and post‐partum women hospitalized from January 2007 to December 2017 were identified from the Nationwide Inpatient Sample. The outcomes of interest included: in‐hospital mortality, myocardial infarction, stroke, pulmonary embolism, and peripartum cardiomyopathy. Multivariate regression analysis was used to assess the independent association between race and in‐hospital outcomes. Among 46 700 637 pregnancy‐related hospitalizations, 21 663 575 (46.4%) were White, 6 302 089 (13.5%) were Black, and 8 914 065 (19.1%) were Hispanic. The trends of mortality and stroke declined significantly in Black women, but however, were mostly unchanged among White women. The incidence of mortality and cardiovascular morbidity was highest among Black women followed by White women, then Hispanic women. The majority of Blacks (62.3%) were insured by Medicaid while the majority of White patients had private insurance (61.9%). Most of Black women were below‐median income (71.2%) while over half of the White patients were above the median income (52.7%). Compared with White women, Black women had the highest mortality with adjusted odds ratio (aOR) of 1.45, 95% CI (1.21–1.73); myocardial infarction with aOR of 1.23, 95% CI (1.06–1.42); stroke with aOR of 1.57, 95% CI (1.41–1.74); pulmonary embolism with aOR of 1.42, 95% CI (1.30–1.56); and peripartum cardiomyopathy with aOR of 1.71, 95 % CI (1.66–1.76).

Conclusions
Significant racial disparities exist in major cardiovascular events among pregnant and post‐partum women. Further efforts are needed to minimize these differences.
Temporal Trends and Sex Differences in Intensity of Healthcare at the End of Life in Adults With Heart Failure
Authors: Van Spall Harriette G. C. , Hill Andrea D. , Fu Longdi , Ross Heather J. , Fowler Robert A. 
Published: December 2020

Background
Patients with chronic disease prefer an adequately supported death at home, but often die in the hospital. We assessed temporal trends and sex differences in healthcare intensity and location of death among decedents with heart failure.

Methods and Results

This was a retrospective cohort study of adults with heart failure who died between April 1, 2004 and March 31, 2017 in Ontario, Canada. We used population‐based administrative databases to assess healthcare utilization during the last 6 months of life and applied multilevel multivariable logistic regression to assess whether sex was independently associated with location of death. Among 396 024 decedents with heart failure, mean (SD) age was 81.8 (10.7) years, 51.5% were women, and 53.4% had in‐hospital deaths. From 2004 to 2016, there was an increase in patients receiving mechanical ventilation (15.1%–19.6%), hemodialysis (5.2%–6.8%), and cardiac revascularization (1.7%–2.3%). Relative to men, women spent fewer days in a hospital (mean, 16.4 versus 18.3; mean difference, 1.9; 95% CI, 1.7–2.0;
P
<0.001) and in an intensive care unit (mean, 2.1 versus 3.0; mean difference, 0.9; 95% CI, 0.8–0.9;
P
<0.001); and less commonly received mechanical ventilation (15.5% versus 20.8%;
P
<0.001); hemodialysis (4.8% versus 7.7%;
P
<0.001); or cardiac catheterization (2.8% versus 4.6%;
P
<0.001). Female sex was independently associated with lower odds of in‐hospital death (odds ratio, 0.88; 95% CI, 0.87–0.89). Mean (SD) 6‐month direct healthcare cost was greater for in‐hospital ($52 349 [$55 649]) than out‐of‐hospital ($35 998 [$31 900]) death.

Conclusions
Among decedents with heart failure, invasive care in the last 6 months increased in prevalence over time but was less common in women, who had lower odds of dying in a hospital.
Fellatio among male sanctuary-living chimpanzees during a period of social tension
Authors: Brooker Jake S. , Webb Christine E. , Clay Zanna 
Published: December 2020

Abstract
Same-sex sexual behaviour has been documented across the animal kingdom, and is thought to reflect and enhance dyadic cooperation and tolerance. For instance, same-sex fellatio — the reception of a partner’s penis into another’s mouth — has been reported in several mammalian species other than humans. Although same-sex sexual behaviour is observed in our close relatives, the chimpanzees, fellatio appears to be very rare — as yet there are no published reports clearly documenting its occurrence. At Chimfunshi Wildlife Orphanage in Zambia, we observed an instance of fellatio occurring during a post-conflict period between two adult male chimpanzees (born and mother-reared at the sanctuary) where one of the males was the victim. We discuss this event with respect to the putative functions of homosexual behaviour in great apes. Given its rarity in chimpanzees, this fellatio between adult males also highlights the apparent behavioural flexibility present in our close relatives.
Decreased integration of the frontoparietal network during a working memory task in major depressive disorder
Authors: Tan Wenjian , Liu Zhening , Xi Chang , Deng Mengjie , Long Yicheng , Palaniyappan Lena , Yang Jie 
Published: December 2020

Background: Working memory deficits are a common feature in major depressive disorder and are associated with poor functional outcomes. Intact working memory performance requires the recruitment of large-scale brain networks. However, it is unknown how the disrupted recruitment of distributed regions belonging to these large-scale networks at the whole-brain level brings about working memory impairment seen in major depressive disorder. Methods: We used graph theory to examine the functional connectomic metrics (local and global efficiency) at the whole-brain and large-scale network levels in 38 patients with major depressive disorder and 41 healthy controls during a working memory task. Altered connectomic metrics were studied in a moderation model relating to clinical symptoms and working memory accuracy in patients, and a machine learning method was employed to assess whether these metrics carry enough illness-specific information to discriminate patients from controls. Results: Global efficiency of the frontoparietal network was reduced in major depressive disorder (false discovery rate corrected, p = 0.014); this reduction predicted worse working memory performance in patients with less severe illness burden indexed by Brief Psychiatric Rating Scale (β =–0.43, p = 0.035, t =–2.2, 95% confidence interval = [–0.043,–0.002]). We achieved a classification accuracy and area under the curve of 73.42% and 0.734, respectively, to discriminate patients from controls based on connectomic metrics, and the global efficiency of the frontoparietal network contributed most to the diagnostic classification. Conclusions: We report a putative mechanistic link between the global efficiency of the frontoparietal network and impaired n-back performance in major depressive disorder. This relationship is more pronounced at lower levels of symptom burden, indicating the possibility of multiple pathways to cognitive deficits in severe major depressive disorder.
Parents’ Experience with the CO-OP Approach: A Consolidation of Three Qualitative Investigations
Authors: Martini Rose , Capistran Julie , Centauro Jazz , Coego Eva , Nadarajah Mayoore , Venne Josée , Zwicker Jill G. 
Published: December 2020

Background. In the cognitive orientation to daily occupational performance (CO-OP) approach, parent involvement is critical for transferring skills from therapeutic settings to everyday contexts. Purpose. This study aimed to gain insight into the experience of parents whose children with developmental coordination disorder participated in CO-OP intervention. Method. This consolidation of three small qualitative studies investigating parents’ experience involved an inductive qualitative content analysis of 10 parent interviews and 1 parent focus group. Findings. Four overarching themes emerged as depicting parents’ experience. Although parents recognized the improvements their children made with the intervention, they also expressed several challenges, such as incorporating CO-OP tasks into daily routines, shifting of parent–child relationship and feeling self-efficacious with the approach. Implications. This study highlights that parent observation of intervention sessions is not enough to support parents applying CO-OP at home. Research is needed to understand how to best engage parents in the CO-OP approach.
Examining the Racial Dynamic of the Victim-offender Dyad in Homicide-suicide: Does Intraracial Homicide Encourage Perpetrator Suicide?
Authors: Zimmerman Gregory M. , Fridel Emma E. , Gerdes Madison 
Published: December 2020

Objectives: Compared to homicide-only, homicide-suicide is understudied in the criminological literature. This study investigates the victim-offender relationship—one of the most well-established correlates of homicide-suicide—from a new angle. In addition to examining the familiarity/closeness of the victim-offender relationship, this study investigates whether the racial composition (interracial versus intraracial) of the victim-offender dyad impacts the likelihood of committing suicide following homicide. Method: This study uses data on 26,858 homicide and homicide-suicide cases distributed across 3,178 places and 45 U.S. states from the National Violent Death Reporting System appended to information from the American Community Survey. Hierarchical logistic regression models examine the independent and joint contribution of: (1) the familiarity/closeness of the victim-offender relationship; and (2) the racial composition of the victim-offender dyad on homicide-suicide. Results: Killing familiar and same-race victims independently increase the odds of suicide following homicide; additionally, the odds of suicide following homicide are highest for offenders with both familiar and same-race victims. Conclusions: The findings suggest that homicide-suicide research should account for different aspects of the victim-offender relationship. Additionally, the importance of race/ethnicity extends to even the rarest of crimes.
Role of involvement in bullying as predictor for hospital-treated assault exposures among former adolescent psychiatric inpatients
Authors: Oulasmaa Lauri E , Riipinen Pirkko K , Hakko Helinä H , Riala Kaisa R 
Published: December 2020

Objective Bullying is a common problem among children and adolescents. Previous studies have investigated the associations between involvement in bullying and various psychosocial and mental health outcomes thoroughly. However, only few studies have focused on the association between bullying and exposure to assaults. This study investigated whether the likelihood for severe assault exposure varies among three subgroups of bullying behavior: bullies/bully-victims, victims of bullying, and those not involved in bullying. Method The study population consisted of 508 adolescents (208 boys, 300 girls) aged between 13 and 17 years (mean age 15.5 years), admitted for psychiatric inpatient treatment between the years 2001–2006. Adolescents were interviewed at index hospitalization using semi-structured interview, K-SADS-PL, to assess DSM-IV based adolescent psychiatric disorders, and to obtain information on bullying behavior. Treatment episodes for assault incidents were obtained from the Finnish National Care Register for Health Care covering the entire-life of the study participants up to end of year 2016. Results 14.4% (n = 73) of the study participants had experienced severe physical or sexual assault leading to hospital treatment during their lifetime. Results of Cox regression analysis showed that girl bullies/bully-victims had nearly threefold increased likelihood for later assault exposure. Conclusions Since bullying behavior in childhood and adolescence is a significant predictor for later exposure to severe assault in girls, it should be paid attention to and intervened as early as possible. Moreover, psychosocial risk factors should be taken into account considering those in hospital treatment for severe assault exposure.
Aortic flow below and visceral circulation during aortic counterpulsation: Evaluation of an in vitro model
Authors: de Jong Monique MJ , Parise Orlando , Matteucci Francesco , Rutten Marcel , Devos Maxime , Romano Mario , Micali Linda Renata , Parise Gianmarco , Maessen Jos G , Gelsomino Sandro 
Published: December 2020

Introduction: This study aimed to test a computer-driven cardiovascular model for the evaluation of the visceral flow during intra-aortic balloon pump (IABP) assistance. Methods: The model includes a systemic and pulmonary circulation as well as a heart contraction model. The straight polyurethane tube aorta had a single visceral while four windkessel components mimicked resistance compliance of the brachiocephalic, renal and sub-mesenteric, pulmonary, and systemic circulation. Twelve flow probes were placed in the circuit to measure pressures and flows with the IABP on and off. Results: With the balloon off, the meantime to reach the steady state was 48 ± 16 s; with the balloon on, this figure was 178 ± 20 s. The stability of pressure and flow signals was obtained after 72 ± 11 min. The number of cycles of stability of the system was 93 [86–103]. Measurements were reliable either with samples of 10 or 20 beats. Bland Altman method demonstrated the reliability of measurements. Finally, all measurements were comparable to published in vivo data. Conclusion: The presented mock circulation was reliable and gave values with high accuracy both at baseline and during mechanical assistance. This system allows evaluation of the mesenteric flow during IABP, under different clinical/hemodynamic conditions. Nonetheless, its translational potential needs to be further evaluated
Clinical characteristics and outcomes of adults with peripheral extracorporeal membrane oxygenation in a developing country: A single center 8-year retrospective study
Authors: Pirompanich Pattarin , Patiyakul Napakul , Daorattanachai Kiattichai , Homvises Boonlawat , Tantiyavarong Pichaya 
Published: December 2020

Introduction: In our institute, we began using peripheral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in 2010, and peripheral veno-venous (VV) ECMO in 2015. This study aimed to describe clinical characteristics and outcomes in those patients. Methods: We reviewed retrospective data of adults receiving peripheral ECMO from January 2010 to December 2017 and divided it into two groups for analysis: VA- and VV-ECMO. Results: There were 28 patients in the VA group and 12 in VV. For VA, the mean (SD) age was 58.5 (17.2) years. The most common indication was cardiac arrest (12 patients, 42.9%); 15 patients (53.6%) were on intra-aortic balloon pump concomitantly. In the VV cohort, the mean age was 53.3 (16.2) years. Eleven (91.7%) patients had acute respiratory distress syndrome as an indication. The mortality rate of VA-ECMO was 85.7%, and VV was 58.3%. Conclusion: The mortality rate in our ECMO center was considerably higher than that in the international registry report. Improved team education, rigid patient selection criteria, and a reimbursement protocol should lead to ameliorated outcomes. Trial Registration: TCTR20190120001. Registered January 19, 2019
A new treatment paradigm for phlegmasia cerulea dolen: Single stage endovascular pharmacomechanical thrombectomy with venoplasty and stenting
Authors: Tan GuangMing , Yan Bryan PY 
Published: December 2020

Background Phlegmasia Cerulae Dolen (PCD) is potentially a lethal disease but there is currently no established treatment algorithm for it. The aim of this study was to assess the safety and effectiveness of single stage endovascular pharmacomechanical thrombectomy with venoplasty and stenting in the treatment of PCD. Method This was a retrospective single centre observational study of consecutive patients who underwent endovascular intervention for the treatment of PCD between June 2016 and March 2020. Clinical and procedural details were recorded. Procedural and clinical success rate, procedural complications, and 30 days mortality were reported. Result 11 patients were treated during the study period. 2 (18.2%) had active malignancy. 63.6% were uncomplicated PCD on presentation. Common iliac vein compression or stenosis were demonstrated in all patients. Venous stents were implanted in all cases and procedures were successful in all cases. All patients had symptoms improvement at 72 hours post procedure. Other than 2 major bleeding complications, there was no other adverse event. The 30 days mortality was 18.2%. Active malignancy and the presence of anaemia were significantly associated with major complications. Conclusion Single stage endovascular thrombectomy and stenting was effective and safe in the treatment of patients with PCD. Common Iliac vein compression was a common underlying cause of PCD.