bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diet and Prognosis in Women with Breast Cancer
Authors: McTiernan Anne 
Published: February 2021

Abstract
Women who have obesity or who have metabolic abnormalities, including diabetes, prediabetes, or hyperglycemia/insulinemia, have poorer survival compared with other women with breast cancer. Data are lacking on specific lifestyle modifications to prevent or treat these conditions to improve women's chances of survival from breast cancer. The Nurses' Health Study cohorts provide new evidence that diets with the potential to elevate circulating insulin or glucose are associated with breast cancer prognosis. The researchers found statistically significant evidence that women in the highest quintile of glycemic load had a 31% higher risk of breast cancer–specific mortality and a 26% higher risk of all-cause mortality. While a randomized controlled clinical trial testing if a reduced glycemic load diet reduces recurrence or death would be optimal, evidence from this observational study suggests that diet matters in survival from breast cancer. The dietary guidelines provided by the World Cancer Research Fund/American Institute for Cancer Research, the American Cancer Society, and the American Society for Clinical Oncology, which collectively emphasize increased intake of vegetables, fruits, whole grains, and legumes, and reduced intake of sugar, calorie-dense foods, and sugary drinks, are reasonable for most breast cancer survivors to follow for optimal health.
See related article by Farvid et al., p. 335
Transcriptomic Analysis of Right Ventricular Remodeling in Two Rat Models of Pulmonary Hypertension
Authors: Park John F. , Clark Varina R. , Banerjee Somanshu , Hong Jason , Razee Asif , Williams Tiffany , Fishbein Gregory , Saddic Lou , Umar Soban 
Published: February 2021

Background:
Right ventricular (RV) dysfunction is a significant prognostic determinant of morbidity and mortality in pulmonary arterial hypertension (PAH). Despite the importance of RV function in PAH, the underlying molecular mechanisms of RV dysfunction secondary to PAH remain unclear. We aim to identify and compare molecular determinants of RV failure using RNA sequencing of RV tissue from 2 clinically relevant animal models of PAH.

Methods:
We performed RNA sequencing on RV from rats treated with monocrotaline or Sugen with hypoxia/normoxia. PAH and RV failure were confirmed by catheterization and echocardiography. We validated the RV transcriptome results using quantitative real-time polymerase chain reaction, immunofluorescence, and Western blot. Immunohistochemistry and immunofluorescence were performed on human RV tissue from control (n=3) and PAH-induced RV failure patients (n=5).

Results:
We identified similar transcriptomic profiles of RV from monocrotaline- and Sugen with hypoxia-induced RV failure. Pathway analysis showed genes enriched in epithelial-to-mesenchymal transition, inflammation, and metabolism. Histological staining of human RV tissue from patients with RV failure secondary to PAH revealed significant RV fibrosis and endothelial-to-mesenchymal transition, as well as elevated cellular communication network factor 2 (top gene implicated in epithelial-to-mesenchymal transition/endothelial-to-mesenchymal transition) expression in perivascular areas compared with normal RV.

Conclusions:
Transcriptomic signature of RV failure in monocrotaline and Sugen with hypoxia models showed similar gene expressions and biological pathways. We provide translational relevance of this transcriptomic signature using RV from patients with PAH to demonstrate evidence of epithelial-to-mesenchymal transition/endothelial-to-mesenchymal transition and protein expression of cellular communication network factor 2 (CTGF [connective tissue growth factor]). Targeting specific molecular mechanisms responsible for RV failure in monocrotaline and Sugen with hypoxia models may identify novel therapeutic strategies for PAH-associated RV failure.
Prognostic Impact of Change in Nutritional Risk on Mortality and Heart Failure After Transcatheter Aortic Valve Replacement
Authors: González Ferreiro Rocío , López Otero Diego , Álvarez Rodríguez Leyre , Otero García Óscar , Pérez Poza Marta , Antúnez Muiños Pablo José , Cacho Antonio Carla , López Pais Javier , Juskowa Mária , Cid Álvarez Ana Belén , Trillo Nouche Ramiro , Sanmartín Pena Xoan Carlos , Sánchez Fernández Pedro Luis , Cruz-González Ignacio , González Juanatey José Ramón 
Published: February 2021

Background:
Limited data are available regarding change in the nutritional status after transcatheter aortic valve replacement (TAVR). This study evaluated the prognostic impact of the change in the geriatric nutritional risk index following TAVR.

Methods:
TAVR patients were analyzed in a prospective and observational study. To analyze the change in nutritional status, geriatric nutritional risk index of the patients was calculated on the day of TAVR and at 3-month follow-up. The impact of the change in nutritional risk index after TAVR on all-cause mortality, heart failure hospitalization (HF-h), and the composite of all-cause death and HF hospitalization was analyzed using the Cox Proportional Hazards model.

Results:

Four hundred thirty-three patients were included. After TAVR, 68.4% (n=182) patients with baseline nutritional risk improved compared with 31.6% (n=84) who remained at nutritional risk. The change from no-nutritional risk to nutritional risk after TAVR occurred in 15.0% (n=25), while 85.0% (n=142) remained without risk of malnutrition. During follow-up, 157 (36.3%) patients died and 172 patients (39.7%) were hospitalized due to HF. Patients who continued to be at nutritional risk had a higher risk of mortality (hazard ratio [HR], 2.10 [95% CI, 1.30–3.39],
P
=0.002), HF-h (HR, 1.97 [95% CI, 1.26–3.06],
P
=0.000), and the composite of death and HF-h (HR, 2.0 [95% CI, 1.37–2.91],
P
<0.001). The change to non-nutritional risk after TAVR significantly impacted mortality (HR, 0.48 [95% CI, 0.30–0.78],
P
=0.003), HF-h (HR, 0.50 [95% CI, 0.34–0.74],
P
=0.001), and the composite outcome (HR, 0.44 [95% CI, 0.32–0.62],
P
<0.001).

Conclusions:
Remaining at nutritional risk after TAVR confers a poor prognosis and is associated with an increased risk of mortality and HF-h, while the change from risk of malnutrition to non-nutritional risk after TAVR was associated with a halving of the risk of mortality and HF-h. Further studies are needed to identify whether patients at nutritional risk would benefit from nutritional intervention during processes of care of TAVR programs.
Determinants of Hospital Variation in Cardiac Rehabilitation Enrollment During Coronary Artery Disease Episodes of Care
Authors: Thompson Michael P. , Yaser Jessica M. , Hou Hechuan , Syrjamaki John D. , DeLucia Alphonse , Likosky Donald S. , Keteyian Steven J. , Prager Richard L. , Gurm Hitinder S. , Sukul Devraj 
Published: February 2021

Background:
Cardiac rehabilitation (CR) is associated with improved outcomes for patients with coronary artery disease (CAD). However, CR enrollment remains low and there is a dearth of real-world data on hospital-level variation in CR enrollment. We sought to explore determinants of hospital variability in CR enrollment during CAD episodes of care: medical management of acute myocardial infarction (AMI-MM), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).

Methods:
A cohort of 71 703 CAD episodes of care were identified from 33 hospitals in the Michigan Value Collaborative statewide multipayer registry (2015 to 2018). CR enrollment was defined using professional and facility claims and compared across treatment strategies: AMI-MM (n=18 678), PCI (n=41 986), and CABG (n=11 039). Hierarchical logistic regression was used to estimate effects of predictors and hospital risk-adjusted rates of CR enrollment.

Results:

Overall, 20 613 (28.8%) patients enrolled in CR, with significant differences by treatment strategy: AMI-MM=13.4%, PCI=29.0%, CABG=53.8% (
P
<0.001). There were significant differences in CR enrollment across age groups, comorbidity status, and payer status. At the hospital-level, there was over 5-fold variation in hospital risk-adjusted CR enrollment rates (9.8%–51.6%). Hospital-level CR enrollment rates were highly correlated across treatment strategy, with the strongest correlation between AMI-MM versus PCI (R
2
=0.72), followed by PCI versus CABG (R
2
=0.51) and AMI-MM versus CABG (R
2
=0.46, all
P
<0.001).

Conclusions:
Substantial variation exists in CR enrollment during CAD episodes of care across hospitals. However, within-hospital CR enrollment rates were significantly correlated across all treatment strategies. These findings suggest that CR enrollment during CAD episodes of care is the product of hospital-specific rather than treatment-specific practice patterns.
Contemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia
Authors: Anantha-Narayanan Mahesh , Doshi Rajkumar P. , Patel Krunalkumar , Sheikh Azfar Bilal , Llanos-Chea Fiorella , Abbott Jinnette Dawn , Shishehbor Mehdi H. , Guzman Raul J. , Hiatt William R. , Duval Sue , Mena-Hurtado Carlos , Smolderen Kim G. 
Published: February 2021

Background:
Critical limb ischemia (CLI) morbidity and mortality rates have historically been disproportionately higher than for other atherosclerotic diseases, however, recent trends have not been reported. In patients admitted with CLI, we aimed to examine trends in in-hospital mortality, major amputations, length of stay, and cost of hospitalizations overall and stratified by type of revascularization procedures.

Methods:

Using 2011 to 2017 National Inpatient Sample data, we identified CLI-related admissions based on
International Classification of Diseases, Ninth and Tenth Edition, Clinical Modification
codes. Primary outcomes of interest were in-hospital mortality and major amputations. Secondary outcomes were the length of stay and cost of hospitalization. We stratified outcomes based on endovascular or open surgical interventions. We also performed hierarchical multivariable regression analyses of outcomes based on age, sex, race, hospital size, type, and location.

Results:

We identified 2 643 087 CLI-related admissions between 2011 and 2017. CLI admissions increased from 0.9% to 1.4%
P
trend
<0.0001 as well as overall peripheral artery disease admissions (4.5%–8.9%,
P
trend
<0.0001). In-hospital mortality for the entire CLI cohort decreased from 3.3% to 2.7%,
P
trend
<0.0001, and major amputations decreased from 10.9% to 7%,
P
trend
<0.0001. A decline was also noted for the length of stay from 5.7 (3.1–10.1) to 5.4 (3.0–9.2) days (
P
trend
<0.0001), whereas admission costs increased from USD $11 791 ($6676–$21 712) to $12 597 ($7248–$22 748;
P
trend
<0.0001). Endovascular interventions increased (
P
trend
<0.0001) against a decline in surgical interventions (
P
trend
<0.0001). Black race, female sex, and age ≥60 years were associated with higher in-hospital mortality, whereas Black race, male sex, and age<60 years were associated with higher major amputations.

Conclusions:
A relatively small decrease in absolute numbers for mortality and major amputations were observed against a backdrop of increasing CLI admissions over recent years. Patients with CLI received more endovascular interventions than surgical interventions over time. However, admissions for endovascular interventions were characterized by higher risk patient profiles and a higher risk of major amputations as compared with surgical interventions.
An Increasing Burden of Disease: Emergency Department Visits Among Patients With Ventricular Assist Devices From 2010 to 2017
Authors: Edelson Jonathan B. , Edwards Jonathan J. , Katcoff Hannah , Mondal Antara , Reza Nosheen , Hanff Thomas C. , Griffis Heather , Mazurek Jeremy A. , Wald Joyce , Owens Anjali T. , Burstein Danielle S. , Atluri Pavan , O’Connor Matthew J. , Goldberg Lee R. , Zamani Payman , Groeneveld Peter W. , Rossano Joseph W. , Lin Kimberly Y. , Birati Edo Y. 
Published: February 2021

Background
With a growing population of patients supported by ventricular assist devices (VADs) and the improvement in survival of this patient population, understanding the healthcare system burden is critical to improving outcomes. Thus, we sought to examine national estimates of VAD‐related emergency department (ED) visits and characterize their demographic, clinical, and outcomes profile. Additionally, we tested the hypotheses that resource use increased and mortality improved over time.

Methods and Results

This retrospective database analysis uses encounter‐level data from the 2010 to 2017 Nationwide Emergency Department Sample. The primary outcome was mortality. From 2010 to 2017, >880 million ED visits were evaluated, with 44 042 VAD‐related ED visits identified. The annual mean visits were 5505 (SD 4258), but increased 16‐fold from 2010 to 2017 (824 versus 13 155). VAD‐related ED visits frequently resulted in admission (72%) and/or death (3.0%). Median inflation‐adjusted charges were $25 679 (interquartile range, $7450, $63 119) per encounter. The most common primary diagnoses were cardiac (22%), and almost 30% of encounters were because of bleeding, stroke, or device complications. From 2010 to 2017, admission and mortality decreased from 82% to 71% and 3.4% to 2.4%, respectively (
P
for trends <0.001, both).

Conclusions
We present the first study using national‐level data to characterize the growing ED resource use and financial burden of patients supported by VAD. During the past decade, admission and mortality rates decreased but remain substantial; in 2017 ≈1 in every 40 VAD ED encounters resulted in death, making it critical that clinical decision–making be optimized for patients with VAD to maximize good outcomes.
The Maqāṣid al-Sharīʿah and Islamic Finance Debate: The Underlying Philosophy and Perspectives of Sharīʿah Scholars
Authors: Alkhan Ahmed Mansoor 
Published: February 2021

Abstract
Islamic finance is a system of finance that adheres to Sharīʿah rulings. The Sharīʿah consists of rulings where certain objectives are intended to be achieved through applying such rulings, known as maqāṣid al-sharīʿah. Since Islamic finance follows Sharīʿah rulings, this by extension means that Islamic finance should contribute in achieving certain maqāṣid. However, there has been a continued debate on whether Islamic finance has been realising/fulfilling relevant maqāṣid. The key question that arises is: if Islamic finance adheres to Sharīʿah rulings, which consists of rulings that are focused towards realising/fulfilling relevant maqāṣid, why is there a debate on Islamic finance realising/fulfilling those maqāṣid in the first place? This research delves into this question, by first exploring the philosophy of maqāṣid al-sharīʿah in relation to Islamic finance, and thereafter gains an insight into the minds of two contemporary Sharīʿah Supervisory Board scholars pertaining to the philosophy in question.
Assessment and Ranking of Climate Models in Arctic Sea Ice Cover Simulation: From CMIP5 to CMIP6
Authors: Shen Zili , Duan Anmin , Li Dongliang , Li Jinxiao 
Published: February 2021

AbstractThe capability of 36 models participating in phase 6 of the Coupled Model Intercomparison Project (CMIP6) and their 24 CMIP5 counterparts in simulating the mean state and variability of Arctic sea ice cover for the period 1979–2014 is evaluated. In addition, a sea ice cover performance score for each CMIP5 and CMIP6 model is provided that can be used to reduce the spread in sea ice projections through applying weighted averages based on the ability of models to reproduce the historical sea ice state. Results show that the seasonal cycle of the Arctic sea ice extent (SIE) in the multimodel ensemble (MME) mean of the CMIP6 simulations agrees well with observations, with a MME mean error of less than 15% in any given month relative to the observations. CMIP6 has a smaller intermodel spread in climatological SIE values during summer months than its CMIP5 counterpart. In terms of the monthly SIE trends, the CMIP6 MME mean shows a substantial reduction in the positive bias relative to the observations compared with that of CMIP5. The spread of September SIE trends is very large, not only across different models but also across different ensemble members of the same model, indicating a strong influence of internal variability on SIE evolution. Based on the assumptions that the simulations of CMIP6 models are from the same distribution and that models have no bias in response to external forcing, we can infer that internal variability contributes to approximately 22% ± 5% of the September SIE trend over the period 1979–2014.
Structure of Submesoscale Fronts of the Mississippi River Plume
Authors: Wang Tao , Barkan Roy , McWilliams James C. , Molemaker M. Jeroen 
Published: February 2021

AbstractSubmesoscale currents (SMCs), in the forms of fronts, filaments, and vortices, are studied using a high-resolution (~150 m) Regional Oceanic Modeling System (ROMS) simulation in the Mississippi River plume system. Fronts and filaments are identified by large horizontal velocity and buoyancy gradients, surface convergence, and cyclonic vertical vorticity with along-coast fronts and along-plume-edge filaments notably evident. Frontogenesis and arrest/destruction are two fundamental phases in the life cycle of fronts and filaments. In the Mississippi River plume region, the horizontal advective tendency induced by confluence and convergence plays a primary role in frontogenesis. Confluent currents sharpen preexisting horizontal buoyancy gradients and initiate frontogenesis. Once the fronts and filaments are formed and the Rossby number reaches O(1), they further evolve frontogenetically mainly by convergent secondary circulations, which can be maintained by different cross-front momentum balance regimes. Confluent motions and preexisting horizontal buoyancy gradients depend on the interaction between wind-induced Ekman transport and the spreading plume water. Consequently, the direction of wind has a significant effect on the temporal variability of SMCs, with more active SMCs generated during a coastally downwelling-favorable wind and fewer SMCs during an upwelling-favorable wind. Submesoscale instabilities (~1–3 km) play a primary role in the arrest and fragmentation of most fronts and filaments. These instabilities propagate along the fronts and filaments, and their energy conversion is a mixed barotropic–baroclinic type with horizontal-shear instabilities dominating.
The Role of Analysis Error in the Convergence of Reanalysis Production Streams in MERRA-2
Authors: El Akkraoui Amal , Carvalho David , Errico Ronald M. , Privé Nikki C. , Bosilovich Michael G. 
Published: February 2021

ABSTRACTDue to production time constraints, most reanalyses are produced in multiple parallel streams instead of a single continuous one. These streams cover separate segments of the reanalysis time period with short overlaps to allow reconstruction of the official record. A fundamental assumption justifying this approach is that the streams will be assimilating the same observations during the periods where they overlap, and so will eventually converge to a similar atmospheric state, making discontinuities at stream junctions negligible. This assumption is revisited in this work by examining the impact of analysis error on the differences between MERRA-2 overlapping streams in three historical periods. Comparison results are shown in terms of standard deviations of stream differences as well as the spectral decomposition of the variance of their differences. Residual differences were found at the end of each year of overlap, with larger values observed in the earlier segments of the presatellite era. By drawing parallels with analysis error statistics estimated from the GMAO OSSE system, these differences are shown to reflect the varying constraint of data with the varying observing network, and to further carry the imprint of errors that the data assimilation process is not able to mitigate. As such, they are unlikely to be reduced by longer spinup periods. The ability of data assimilation to ensure continuity in the parallel streams is put into question when the observing system coverage is inadequate or simply when the data assimilation system as a whole is suboptimal.
Suicidal ideation in older Ghanaian women: The roles of bodily pain, functional limitation, and chronic health conditions
Authors: Muruthi James R , Spafford Sarah G , Osa Maggie L , DeLouize Alicia , Kowal Paul , Biritwum Richard , Snodgrass J Josh 
Published: February 2021

Background: Although approximately 79% of the world’s suicides occur in low- and middle-income countries (LMICs), the limited research in these regions has primarily focused on the rates of suicide attempts (SA) and ideation among men and younger members of the population. Aim: This study investigated the associations between bodily pain, functional limitation, chronic health conditions, and suicidal ideation among older Ghanaian women with a positive screen for depression. Methods: Data was obtained from the World Health Organization’s Study on global AGEing and adult health (SAGE) Ghana Wave 1, a nationally representative sample. Based on the interpersonal theory of suicide, we used logistic regression analysis to investigate the associations between the variables. Results: Functional limitation, bodily pain, hopelessness, and hypertension were significantly associated with a higher risk of suicidal ideation after accounting for sociodemographic and other confounding factors. Conclusions: Early interventions designed to decrease hopelessness, hypertension, and functional limitations may lead to reduced suicide ideation among older Ghanaian women who screen positive for depression.
Patients’ attitudes toward conventional and herbal treatments for depression and anxiety: A cross-sectional Israeli survey
Authors: Burstein Or , Shamir Alon , Abramovitz Nurit , Doron Ravid 
Published: February 2021

Background: As many patients view conventional antidepressants and anxiolytics negatively, it is not surprising that the willingness to apply these treatments is far from ideal, thus posing a critical barrier in promoting an effective and durable treatment. Aim: The present study aimed to explore patients’ attitudes toward conventional and herbal treatments for depression and anxiety, while considering cultural and demographic factors, to further elucidate the antecedes that putatively determine the treatment’s outcome. Methods: During June 2017, a cross-sectional survey was conducted using stratified sampling from a large-scale Israeli volunteer online panel. The final sample included 591 Jewish Israeli adults that reported they were suffering from depression or anxiety. Results: A heterogeneous range of attitudes toward treatment was found: for example, a large group of patients did not utilize prescription medications (39%), a professional consultation (12.9%), or any form of treatment (17.4%). Interestingly, these patients were significantly more likely to support naturally-derived treatments and were less concerned with scientific proof. Further, adverse effects were demonstrated as a prominent factor in the choice of treatment. A higher incidence of adverse effects was associated with an increased willingness to consider an alternative herbal treatment. Noteworthy attitudes were found in orthodox-Jewish individuals, who showed similar consultation rates, but utilized more psychological, rather than pharmacological treatments. Conclusions: It is proposed that patients’ perspectives and cultural backgrounds are needed to be taken into consideration during the clinical assessment and choice of treatment. The findings imply that a particular emphasis should be placed on patients that discard conventional pharmacological options and on distinct cultural aspects. Several recommendations for revising the current policy are advocated to promote more culturally-informed and patient-oriented care.