bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract T MP90: Relationship Between Daily Blood Glucose Variability and Neurological Outcome in Acute Ischemic Stroke Patients With Diabetes Mellitus
Authors: Kubo Satoshi , Hosomi Naohisa , Yoshimoto Takeshi , Neshige Syuichiro , Himeno Takahiro , Kono Ryuuhei , Takeshima Shinnichi , Shimoe Yutaka , Takamatsu Kazuhiro , Ota Taisei , Kuriyama Masaru , Matsumoto Masayasu 
Published: July 2021

BACKGROUND:
Although hyperglycemia in acute stroke is associated with poor stroke outcomes, it remains unclear whether blood glucose variability are also associated with stroke outcomes. In this study, we examined the relationships between daily blood glucose variability and early neurological outcome in acute ischemic stroke patients with diabetes mellitus.

METHODS:
Subjects were a total of 329 acute ischemic stroke patients (216 male, 70.9 ± 9.6 years) who were either already undergoing treatment for diabetes or had a hemoglobin A1c level of >5.8% at admission from July 2006 to June 2009. The consecutive morning fasting blood glucose (BG) levels were evaluated during 7 days from admission and described as mean and successive variation (SV). The unfavorable outcome was defined by a modified Rankin Scale score of 4 to 6 at discharge.

RESULTS:
The patients with unfavorable outcome (n=86) were older (75.7 ± 10.5 vs. 69.2 ± 8.6 years, p<0.001), more frequently female (47.7% vs. 29.6%, p=0.003), less commonly had dyslipidemia (40.7% vs. 60.9%, p=0.001), less commonly took oral hypoglycemic agents (30.2% vs. 53.5%, p<0.001), and had higher NIHSS scores (median 9 vs. 3, p<0.001) than those without. The mean BG levels and SV levels in patients with unfavorable outcome were higher than those in patients without (163.3 ± 39.0 vs. 147.9 ± 34.0 mg/dl; p<0.001 and 33.7 ± 24.9 vs. 23.2 ± 15.3 mg/dl; p<0.001, respectively).

SV levels was independently associated with unfavorable outcome (OR 1.023, 95%CI 1.004-1.042, p=0.015) using logistic regression analysis controlling age, sex hypertension systolic blood pressure, NIHSS score at admission and insulin use during hospitalization, which are selected using stepwise method.
However mean BG levels did not remained as factor, which associated with unfavorable outcome with step wise method.

CONCLUSION:
Increased blood glucose variability, but not mean BG, was independently related to unfavorable outcome at discharge in acute ischemic stroke patients with diabetes mellitus.
Abstract T P276: Transient Ischemic Attack Clinic Drives Superior Patient Outcomes While Reducing Cost
Authors: Woodard Jim , Haschker Shelby 
Published: July 2021

It is estimated that 40% of all individuals that experience a TIA will ultimately suffer a stroke. As many as 50% of these patients will have a stroke within one week post TIA. Given the short time interval between TIA symptomology and stroke onset, immediate treatment is warranted. Historically treatment of TIA patients has taken place in emergency rooms and as hospital inpatients. A TIA clinic was established in 2011 as an alternative option to traditional TIA treatment. This clinic was designed to expedite diagnosis and treatment while reducing cost. Utilizing the ABCD2 tool, emergency department clinicians, PCPs and ophthalmologists referred low risk patients to the clinic. Clinic patients were scheduled to be seen in the clinic within 24-48 hours. All testing, stroke/TIA education, neurological consultation and secondary treatment plan were completed during the clinic visit.
To date, the clinic has evaluated 137 patients. There have been no reports of stroke 90-days post clinic visit. Stroke rates post TIA are estimated to be as high as 17% after 3 months. This data supports the TIA clinic’s success in secondary stroke prevention. Patients seen in the clinic reported high satisfaction scores with the clinic and the care they received. It was initially hypothesized that the TIA clinic would provide care in a more cost effective way. A cost analysis was performed comparing TIA clinic costs and the cost of treating patients admitted to the hospital. Using fiscal year 2014 data, the average cost for treating a patient in the clinic was $423. The average cost for admitting a patient to the hospital was $1,464 per patient.
The TIA clinic has shown that patients can receive timely treatment in a setting that produces the highest clinical outcomes, maintains patient satisfaction and reduces cost by 70%.
Abstract W MP22: Impact of Difference in Definitions of M1 and M2 segment of Middle Cerebral Artery on Acute Stroke Endovascular Therapy
Authors: Gulati Deepak , Ducruet Andrew , Aghaebrahim Amin , Jankowitz Brian , Jadhav Ashutosh , Jovin Tudor 
Published: July 2021

BACKGROUND:
The involvement of the different segment of middle cerebral artery has different implications in terms of acute stroke endovascular therapy as learnt from recent trials. It has been suggested in prior trials that M1 segment occlusion might benefit more from acute endovascular therapy as compared to M2 segment. Ongoing trials have different definitions for segments of middle cerebral artery.

METHODS:
Retrospective review of latest 71 cases of either M1/M2 confirmed on Digital Subtraction Angiography (DSA) in prospectively maintained database of acute stroke interventions at our institute is performed. Of these, 49 cases have CTA performed prior to DSA (69%). Stroke Neurologist has blindly reviewed CTA angiogram. Conventional angiogram findings are considered accurate for the exact site of occlusion. Two definitions from REVASCAT trial and SWIFT PRIME trial are then scored based on CTA and assessed in respect to findings in DSA

RESULTS:
As per RESVASCAT defintion, 34 out of 49 cases on CTA/MRA (69%) have M1 occlusion on CTA. Of these 34 cases, 32 are then found to have M1 occlusion on DSA as well. The number of M2 occlusions were 9 out of 49 (18%) on CTA and all of them were found to have M2 occlusion of DSA as well. The accuracy of RESVASCAT definition of M1 and M2 were 32/34 (94%) are 9/9 (100%) respectively.

As per SWIFT PRIME definition, 27 out of 49 cases (58%) on CTA/MRA have M1 occlusions on CTA. Of these 27 cases, all cases were found to have M1 occlusions on DSA as well. The number of M2 occlusions were 15 out of 49 (31%) on CTA and 9 were found to have M2 occlusions on DSA. The accuracy of SWIFT PRIME definition of M1 and M2 were 27/27 (100%) and 9/15(60%).
6 cases (12%) with M1 occlusions on CTA as per REVASCAT definition were defined as M2 occlusions as per SWIFT PRIME.

CONCLUSIONS:
The examination of angiographic data found discrepancies between these two definitions. The accuracy of REVASCAT definition was better for M2 whereas the accuracy of SWIFT PRIME definition was better for M1. The different definition of middle cerebral artery segments could potentially lead to discrepancies in the eligibility criteria for acute endovascular interventions. The criteria used in determining the M1 and M2 segments should be consistent across the field.
Abstract TP159: Declines in Stroke-related Hospitalizations and In-Hospital Mortality Among Male and Female California Residents, 2000-2013
Authors: Ratnasiri Anura W , Ratnasiri Buddhika M , DiLibero Ralph 
Published: July 2021

Background:
We examined stroke-related hospitalizations and in-hospital mortality trends by sex and age in California from 2000 to 2013.

Methods:
This retrospective analysis is based on data compiled by the California Office of Statewide Health and Planning Development from 2000 to 2013. Over 31.68 million inpatient events were studied, with cases from hospital discharge records identified as using the first listed diagnoses as ICD-9-CM codes 430 to 436. Hospitalization rates were expressed as the number of hospitalizations per 10,000 population and in-hospital mortality per 100,000 population, with the age and sex standardized to the year 2000 U.S. population.

Results:
We identified 1,060,006 hospitalizations and 77,908 in-hospital mortalities that were stroke-related from 2000 to 2013.

Hospitalization rates standardized for age and sex, significantly declined from 56.15 in year 2000 to 37.17 in year 2013, representing a 51.1% reduction (Rate Ratio (RR) 1.511; p <0.0001) during the study period. Rates for males declined from 52.7 to 36.6, representing a 43.8% reduction (RR 1.438; p<0.0001) and rates for females changed from 59.2 to 37.6, representing a 57.4% reduction (RR 1.574; p<0.0001. Although rates are declining for most age groups, hospitalization rates are rising for males age 35 to 59.
In-hospital mortality rates standardized for age and sex, significantly declined from 43.0 in 2000 to 25.0 in 2013, representing a 70.0% reduction (Rate Ratio (RR) 1.700; p <0.0001). Statistically significant declines in stroke-related in-hospital mortality rates were greater among females at 80.1%, while for males the decline was 62.6%. Overall, the rate difference for stroke hospitalization and in-hospital mortality among males and females narrowed significantly from 2000 to 2013.

Conclusion:
Stroke-related hospitalizations and in-hospital mortality declined substantially for both sexes, but at a greater rate among females over the 14 year study period. Although rates are declining overall for both sexes and most age groups, rates of stroke-related hospitalization and in-hospital mortality rose for males age 35 to 59.
Greek polydefinites revisited
Authors: Tsiakmakis Evripidis , Borràs-Comes Joan , Espinal M.Teresa 
Published: July 2021

Abstract
This article focuses on the interpretation of the adjectives that appear in Greek polydefinite DP s. It provides empirical support to the established position that restrictive modifiers are preferred in polydefinite environments (Kolliakou 1995). At the same time, it shows that non-restrictively modified polydefinites are not excluded by grammar (Manolessou 2000). To reconcile the facts, a novel syntactic analysis of polydefiniteness as involving modification by either restrictive or non-restrictive reduced relative clauses is formulated. We extend Alexopoulou’s (2006) analysis of resumption in full relatives to polydefinites and defend that what looks like a preadjectival definite article is a resumptive clitic pronoun that values the unvalued definiteness feature of a null relative complementizer. We further defend that, while the prenominal definite article is interpreted as d-linked, the resumptive clitic is a dependent expression that is interpreted as a referentially bound anaphora.
The Place of Fault in Grotius’s Conception of Liability for Wrongdoing
Authors: Sampson Joe 
Published: July 2021

Abstract
This article compares Grotius’s treatments of liability for wrongdoing in natural law and the law of Holland to emphasise the conceptual centrality of fault in both, and places Grotius’s analyses in their historical context by tracing the treatment of strict liability in those intellectual traditions upon which he drew. It focuses in particular on the formulation of obligations quasi ex maleficio to show how the absence of fault rendered the obligation something other than delictual.
Eternity Made Temporal
Authors: Faruque Muhammad U. 
Published: July 2021

Abstract
This study investigates the Deobandī engagement with classical Sufi thought through the writings of one of modern South Asia’s most influential Sufi thinkers, namely Ashraf ʿAlī Thānavī (d. 1943). The article brings to focus Thānavī’s contributions to South Asian Sufism by showing how he sought to preserve, defend, revive, and disseminate classical Sufi teachings in a climate of social reform. The article documents how Deobandī scholars such as Thānavī – far from being propagators of shallow fundamentalist discourses – immersed themselves in the ocean of some of the most sophisticated strands of Islamic learning such as Sufi metaphysics that often employ rational methods of argumentation, alongside symbols and imageries to articulate complex metaphysical doctrines in both prose and poetry.
Alternative chemoradiotherapy in anal carcinoma patients with mutations in thymidylate synthase and dihydropyrimidine dehydrogenase genes
Authors: Saif MW , Hamal Ruchi , Siddiqui Nauman , Maloney Antonia , Smith Melissa 
Published: July 2021

Background: 5-fluorouracil (5-FU) and mitomycin-C (MMC) with radiotherapy (RT) remain an established treatment for patients with anal cancer (AC). Genetic mutations in two major metabolizing enzymes for 5-FU; dihydropyrimidine dehydrogenase ( DPYD and thymidylate synthetase ( TYMS), have been associated with clinical response and toxicity. However, their place in the treatment of AC remains undetermined. Methods: We retrospectively reviewed 21 patients with AC, including T2-4, N0-1, M0 or T1-4, N2-3, and M0 treated between 2012 and 2018. All patients were treated with 5-FU 1,000 mg/m2/day via continuous intravenous (IV) infusion 1–4 and 29–32, MMC 10 mg/m2 IV bolus days 1 and 29 plus RT. Patients who developed ⩾3 grade toxicities were tested for the DPYD and TYMS genes. Treatment was either modified with reduced doses or changed to MMC 10 mg/m2 day 1 and 29 with cisplatin 25 mg/m2/week plus RT. Toxicities and responses were collected. Results: Six out of 21 patients who developed ⩾3 grade toxicities including pancytopenia, neutropenia, thrombocytopenia, mucositis, nausea, rash, and nephritis were found to have genetic mutations: TYMS 2RG/3RC ( n = 2), 3RG/3RC ( n = 1), 2R/2R ( n = 2), T YMS 3′UTR del/Ins ( n = 2), and DPYD c.2864A > T heterozygous ( n = 1). Two patients received 5-FU at a 50% reduced dose on days 29–32; one patient refused to receive 5-FU (continued with MMC and RT); one patient received only radiation therapy due to persistent pancytopenia despite the use of growth factors; two patients received an alternative regimen consisting of MMC 10 mg/m2 on day 29 with cisplatin (CDDP) 25 mg/m2/week plus RT; and two patients received cisplatin/MMC with RT from the beginning as they were prospectively detected to have TYMS abnormalities prior to dosing the chemotherapy. These patients tolerated treatment very well with only grade 2 toxicities. All the patients (4/4) on cisplatin/MMC achieved clinical complete response (cCR), while four patients (4/15) on 5-FU/MMC reached cCR at the first assessment. Radiological response showed complete response at the end of 24 weeks assessment. Conclusions: Molecular testing for DPYD and TYMS genes can allow us to identify patients who are most likely to respond or face severe toxicity to 5-FU in a potentially curable cancer. Combining radiation with CDDP with MMC in patients with AC is feasible. A prospective study based on pharmacogenetic testing comparing MMC/cisplatin with MMC/5-FU is indicated in patients with AC.
TAD cliques predict key features of chromatin organization
Authors: Liyakat Ali Tharvesh M. , Brunet Annaël , Collas Philippe , Paulsen Jonas 
Published: July 2021

Abstract
Background
Mechanisms underlying genome 3D organization and domain formation in the mammalian nucleus are not completely understood. Multiple processes such as transcriptional compartmentalization, DNA loop extrusion and interactions with the nuclear lamina dynamically act on chromatin at multiple levels. Here, we explore long-range interaction patterns between topologically associated domains (TADs) in several cell types.

Results
We find that TAD long-range interactions are connected to many key features of chromatin organization, including open and closed compartments, compaction and loop extrusion processes. Domains that form large TAD cliques tend to be repressive across cell types, when comparing gene expression, LINE/SINE repeat content and chromatin subcompartments. Further, TADs in large cliques are larger in genomic size, less dense and depleted of convergent CTCF motifs, in contrast to smaller and denser TADs formed by a loop extrusion process.

Conclusions
Our results shed light on the organizational principles that govern repressive and active domains in the human genome.
Maternal cold exposure induces distinct transcriptome changes in the placenta and fetal brown adipose tissue in mice
Authors: Ghosh Sujoy , Park Chul-Hong , Lee Jisu , Lee Nathan , Zhang Rui , Huesing Clara , Reijnders Dorien , Sones Jennifer , Münzberg Heike , Redman Leanne , Chang Ji Suk 
Published: July 2021

Abstract
Background
Brown adipose tissue (BAT) is specialized to dissipate energy in the form of heat. BAT-mediated heat production in rodents and humans is critical for effective temperature adaptation of newborns to the extrauterine environment immediately after birth. However, very little is known about whether and how fetal BAT development is modulated in-utero in response to changes in maternal thermal environment during pregnancy. Using BL6 mice, we evaluated the impact of different maternal environmental temperatures (28 °C and 18 °C) on the transcriptome of the placenta and fetal BAT to test if maternal cold exposure influences fetal BAT development via placental remodeling.

Results
Maternal weight gain during pregnancy, the average number of fetuses per pregnancy, and placental weight did not differ between the groups at 28 °C and 18 °C. However, the average fetal weight at E18.5 was 6% lower in the 18 °C-group compared to the 28 °C-group. In fetal BATs, cold exposure during pregnancy induced increased expression of genes involved in de novo lipogenesis and lipid metabolism while decreasing the expression of genes associated with muscle cell differentiation, thus suggesting that maternal cold exposure may promote fetal brown adipogenesis by suppressing the myogenic lineage in bidirectional progenitors. In placental tissues, maternal cold exposure was associated with upregulation of genes involved in complement activation and downregulation of genes related to muscle contraction and actin-myosin filament sliding. These changes may coordinate placental adaptation to maternal cold exposure, potentially by protecting against cold stress-induced inflammatory damage and modulating the vascular and extravascular contractile system in the placenta.

Conclusions
These findings provide evidence that environmental cold temperature sensed by the mother can modulate the transcriptome of placental and fetal BAT tissues. The ramifications of the observed gene expression changes warrant future investigation.
Pre-existing cardiovascular disease rather than cardiovascular risk factors drives mortality in COVID-19
Authors: O’Gallagher Kevin , Shek Anthony , Bean Daniel M. , Bendayan Rebecca , Papachristidis Alexandros , Teo James T. H. , Dobson Richard J. B. , Shah Ajay M. , Zakeri Rosita 
Published: July 2021

Abstract
Background
The relative association between cardiovascular (CV) risk factors, such as diabetes and hypertension, established CV disease (CVD), and susceptibility to CV complications or mortality in COVID-19 remains unclear.

Methods
We conducted a cohort study of consecutive adults hospitalised for severe COVID-19 between 1st March and 30th June 2020. Pre-existing CVD, CV risk factors and associations with mortality and CV complications were ascertained.

Results
Among 1721 patients (median age 71 years, 57% male), 349 (20.3%) had pre-existing CVD (CVD), 888 (51.6%) had CV risk factors without CVD (RF-CVD), 484 (28.1%) had neither. Patients with CVD were older with a higher burden of non-CV comorbidities. During follow-up, 438 (25.5%) patients died: 37% with CVD, 25.7% with RF-CVD and 16.5% with neither. CVD was independently associated with in-hospital mortality among patients < 70 years of age (adjusted HR 2.43 [95% CI 1.16–5.07]), but not in those ≥ 70 years (aHR 1.14 [95% CI 0.77–1.69]). RF-CVD were not independently associated with mortality in either age group (< 70 y aHR 1.21 [95% CI 0.72–2.01], ≥ 70 y aHR 1.07 [95% CI 0.76–1.52]). Most CV complications occurred in patients with CVD (66%) versus RF-CVD (17%) or neither (11%; p < 0.001). 213 [12.4%] patients developed venous thromboembolism (VTE). CVD was not an independent predictor of VTE.

Conclusions
In patients hospitalised with COVID-19, pre-existing established CVD appears to be a more important contributor to mortality than CV risk factors in the absence of CVD. CVD-related hazard may be mediated, in part, by new CV complications. Optimal care and vigilance for destabilised CVD are essential in this patient group. Trial registration n/a.
Haemolymphangioma of the small bowel mesentery in adults: two case reports and a literature review
Authors: Du Yao , Zhang Jiang Nan , Zhu Lu Lu , Wang Yi , Li Wei Ping 
Published: July 2021

Abstract
Background
Haemolymphangioma arising from the small bowel and its mesentery is extremely rare in the clinical setting. To date, only 8 cases of small bowel haemolymphangioma have been reported, and there have been no previously reported cases of haemolymphangioma in the small bowel mesentery (PubMed). The formation of this tumour is mostly congenital, but the exact mechanism is still unclear. As a benign tumour, the presentation of the disease may vary from a simple well-defined cystic lesion to an aggressive ill-defined lesion mimicking malignancy. However, there are no typical symptoms, and preoperative diagnosis is difficult.

Case presentation
We present two cases of haemolymphangioma in the small bowel mesentery in a 54-year-old man and a 52-year-old woman. Both of them came to the hospital due to an abdominal mass. In the first case, a cystic teratoma in the left abdominal area was considered after abdominal plain computed tomography (CT) and magnetic resonance imaging (MRI) scans. After taking an enhanced CT scan, a lipoma was considered based on the images. In the second case, cystic masses of the left upper and middle abdomen were observed on abdominal ultrasonography. An abdominal plain CT scan showed an irregular low-density mass in the left upper and middle abdomen. With an enhanced CT scan, haemolymphangioma was considered based on the images. After complete surgical removal, the masses were found to originate from the small bowel mesentery and had not invaded into the peripheral lymphatic tissue. In case 1 in this study, the routine pathology diagnosis was lymphangioma, while in case 2, the diagnosis was haemangioma. The final diagnosis was confirmed to be haemolymphangioma by immunohistochemistry in both cases. No recurrence was evident during 4 months of follow-up. We review the previous case reports of haemolymphangioma in the abdominal cavity and discuss their clinical features, diagnosis, treatment and prognosis.

Conclusions
The clinical manifestations of abdominal haemolymphangiomas can vary for both location and size. Abdominal CT examination has important clinical value for haemolymphangioma in the abdominal cavity. The final diagnosis of haemolymphangioma depends on a postoperative pathological examination. In addition, postoperative regular follow-up is necessary.