bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Utility of Prechemoradiotherapy Albumin-to-Alkaline Phosphatase Ratio in Unresectable Locally Advanced Pancreatic Carcinoma Patients
Authors: Haksoyler Veysel , Topkan Erkan 
Published: April 2021

Background. We investigated the prognostic usefulness of prechemoradiotherapy (CRT) albumin-to-alkaline phosphatase ratio (AAPR) in unresectable locally advanced pancreatic adenocarcinoma (LAPAC) patients managed with definitive concurrent CRT (CCRT). Methods. A sum of 136 LAPAC patients who consecutively underwent definitive CCRT was retrospectively analyzed. The AAPR (serum albumin (g/dL)/serum alkaline phosphatase (IU/L)) was calculated by using the parameters obtained from the routine biochemistry tests on the first day of the CCRT. Ideal AAPR cutoff was sought by utilizing receiver operating characteristic (ROC) curve analysis. The primary and secondary endpoints were the impact of the AAPR on the overall survival (OS) and progression-free survival (PFS) results, respectively. Results. At a median follow-up of 14.8 months (range: 3.2-85.7), the median PFS and OS times were 7.5 (95% confidence interval (CI): 6.0-9.0) and 14.9 months (95% CI: 11.9-17.9), respectively. The ideal common AAPR cutoff was identified at the rounded 0.46 (area under the curve: 72.3%; sensitivity: 71.2%; specificity: 70.3%) point that dichotomized the patients into two groups: low AAPR (L-AAPR;

N
=
71

) and high AAPR (H-AAPR;

N
=
65

) groups, respectively. Comparative survival analyses showed that the L-AAPR cohort had significantly shorter median PFS (6.8 (95% CI: 5.7-7.9) versus 11.3 (95% CI: 9.9-12.7) months;

P
=
0.005

) and OS (12.8 (95% CI: 10.6-15.0) versus 19.2 (95% CI: 16.9-21.5) months;

P
=
0.001

) durations than their H-AAPR counterparts, separately. Albeit the N1-2 (

P
=
0.004

) and

CA

19
‐
9
>
90

U
/
mL

(

P
=
0.008

) were also found to be associated with inferior outcomes, yet the results of the multivariate analyses ascertained the L-AAPR as an independent indicator of diminished PFS (

P
=
0.003

) and OS (

P
=
0.002

) results. Conclusion. The present results proposed that the pretreatment

AAPR
<
0.46

was a novel independent indicator of adverse PFS and OS in unresectable LAPAC patients undergoing definitive CCRT.
Monocyte-Chemoattractant Protein-1 Levels in Human Atherosclerotic Lesions Associate With Plaque Vulnerability
Authors: Georgakis Marios K. , van der Laan Sander W. , Asare Yaw , Mekke Joost M. , Haitjema Saskia , Schoneveld Arjan H. , de Jager Saskia C.A. , Nurmohamed Nick S. , Kroon Jeffrey , Stroes Erik S.G. , de Kleijn Dominique P.V. , de Borst Gert J. , Maegdefessel Lars , Soehnlein Oliver , Pasterkamp Gerard , Dichgans Martin 
Published: April 2021

Objective:
To determine whether MCP-1 (monocyte chemoattractant protein 1) levels in human atherosclerotic plaques associate with plaque vulnerability features.

Approach and Results:

We measured MCP-1 levels in human atherosclerotic plaque samples from 1199 patients in the Athero-EXPRESS Biobank who underwent endarterectomy for treatment of carotid stenosis. We explored associations with histopathologic and molecular features of plaque vulnerability, clinical plaque manifestations, and vascular events up to 3 years after endarterectomy. Following adjustments for age, sex, and vascular risk factors, MCP-1 plaque levels were associated with histopathologic markers of plaque vulnerability (large lipid core, low collagen content, high macrophage burden, low smooth muscle cell burden, intraplaque hemorrhage) and with a composite vulnerability index (range 0–5, β per SD increment in MCP-1, 0.42 [95% CI, 0.30–0.53],
P
=5.4×10
−13
). We further found significant associations with higher plaque levels of other chemokines and proinflammatory molecules and markers of neovascularization and matrix turnover. When exploring clinical plaque instability, MCP-1 plaque levels were higher among individuals with symptomatic plaques as compared with those with asymptomatic plaques (odds ratio per SD increment in MCP-1, 1.36 [95% CI, 1.09–1.69]). MCP-1 levels were further associated with a higher risk of periprocedural major adverse vascular events and strokes occurring in the first 30 days after plaque removal.

Conclusions:
Higher MCP-1 plaque levels are associated with histopathologic, molecular, and clinical hallmarks of plaque vulnerability in individuals undergoing carotid endarterectomy. Our findings highlight a role of MCP-1 in clinical plaque instability in humans and complement previous epidemiological, genetic, and experimental studies supporting the translational perspective of targeting MCP-1 signaling in atherosclerosis.
Relationship Between Influenza, Temperature, and Type 1 Myocardial Infarction: An Ecological Time‐Series Study
Authors: García‐Lledó Alberto , Rodríguez‐Martín Sara , Tobías Aurelio , García‐de‐Santiago Elvira , Ordobás‐Gavín María , Ansede‐Cascudo Juan Carlos , Alonso‐Martín Joaquin , de Abajo Francisco J. 
Published: April 2021

Background
Previous studies investigating the relationship of influenza with acute myocardial infarction (AMI) have not distinguished between AMI types 1 and 2. Influenza and cold temperature can explain the increased incidence of AMI during winter but, because they are closely related in temperate regions, their relative contribution is unknown.

Methods and Results
The temporal relationship between incidence rates of AMI with demonstrated culprit plaque (type 1 AMI) from the regional primary angioplasty network and influenza, adjusted for ambient temperature, was studied in Madrid region (Spain) during 5 influenza seasons (from June 2013 to June 2018). A time‐series analysis with quasi‐Poisson regression models and distributed lag‐nonlinear models was used. The incidence rate of type 1 AMI according to influenza vaccination status was also explored. A total of 8240 cases of confirmed type 1 AMI were recorded. The overall risk ratio (RR) of type 1 AMI during epidemic periods, adjusted for year, month, and temperature, was 1.23 (95% CI, 1.03–1.47). An increase of weekly influenza rate of 50 cases per 100 000 inhabitants resulted in an RR for type 1 AMI of 1.16 (95% CI, 1.09–1.23) during the same week, disappearing 1 week after. When adjusted for influenza, a decrease of 1ºC in the minimum temperature resulted in an increase of 2.5% type 1 AMI. Influenza vaccination was associated with a decreased risk of type 1 AMI in subjects aged 60 to 64 years (RR, 0.58; 95% CI, 0.47–0.71) and ≥65 years (RR, 0.53; 95% CI, 0.49–0.57).

Conclusions
Influenza and cold temperature were both independently associated with an increased risk of type 1 AMI, whereas vaccination was associated with a reduced risk among older patients.
Susceptibility Vessel Sign in Relation With Time From Onset to Magnetic Resonance Imaging
Authors: Soize Sebastien , Manceau Pierre-François , Gauberti Maxime , Herbin Thibault , Zuber Mathieu , Pierot Laurent , Touzé Emmanuel 
Published: April 2021

Background and Purpose:
In acute ischemic stroke, the susceptibility vessel sign (SVS) on T2* MR-sequence witnesses the red blood cell content of the clot. Although clot composition strongly depends on its age in vitro, the relationship between SVS and time has not been studied. In this study, we evaluated whether the presence of SVS was related to the time from symptom onset.

Methods:
We retrospectively analyzed our institutional registry of patients with acute stroke between November 2007 and June 2018. We included patients with an ischemic stroke confirmed by diffusion-weighted imaging magnetic resonance imaging within 8 hours from symptom onset caused by M1 or M2 occlusion and with interpretable T2*-weighted images. We compared clinical and imaging variables among SVS+ and SVS− patients. Time from onset was split into tertiles. Independent markers of SVS+ were identified using multivariable logistic regression. The probability of being SVS+ given time from symptoms onset was modeled using Probit regression.

Results:

Among the 608 patients included, 433 (71.2%) were SVS+. The odds of being SVS+ increased with time from symptom onset (
P
trend=0.005). In the multivariable analysis, factors independently associated with a SVS+ were symptom onset to magnetic resonance imaging ([130–180 min] odds ratio [OR], 1.62 [95% CI, 1.03–2.53]; [>180 min] OR, 3.14 [95% CI, 1.92–5.12]), type of magnetic resonance imaging-scanner (OR, 2.83 [95% CI, 1.82–4.41]), cardioembolic cause (OR, 1.51 [95% CI, 1.02–2.24]), and baseline National Institutes of Health Stroke Scale (OR, 1.05 [95% CI, 1.01–1.08]). The probability of being SVS+ increased with time from symptom onset (
P
=0.004): around 60% at 1 hour, 70% at 3 hours, 80% at 6 hours, and 90% at 8 hours.

Conclusions:
In acute ischemic stroke, the presence of SVS depends on time from onset to imaging.
Beyond “Man” vs. Nature: Pearling and the Construction of Gender, Generation, and Heritage in Bahrain
Authors: Willis John Thabiti 
Published: April 2021

Abstract
Heritage sites and studies of the pearling industry in Arab Gulf nations focus predominantly on men who labored as merchants, boat captains, and pearl divers. They represent merchants as having reaped the greatest returns and divers as having endured the greatest hardships over the history of the industry. Recently published memoirs and interviews feature elder men’s recollections of their experiences as divers during their youth; these men focus on the hardships that they endured and attribute their success – even their survival – to chance or divine intervention. British records from the 1930s not only document the tribulations that divers reported; they also, as this article argues, depict human agency – instead of nature, chance, or divine intervention – as the main source of misfortune for divers. These findings trouble “official” representations of pearl diving, particularly the treatment of the divers, at such heritage sites.
Innovation-Centric Cluster Business Model: Findings from a Design-Oriented Literature Review
Authors: Lupova-Henry Evgeniya , Blili Sam , Zotto Cinzia Dal 
Published: April 2021

Abstract
How should a cluster be designed to foster the innovativeness of its members? In this article, we view self-aware and organised clusters as “meta-organisations” which can deliberately shape their internal structures through design-based interventions. To formulate interventions for cluster design fostering its innovativeness, we adopt a methodology combining a systematic literature review and a design-oriented synthesis. We distinguish between six cluster business model elements: actors and their roles, resources and capabilities, value flows, governance, value propositions and value-creating activities. To gain insight into the properties of these elements conducive to cluster innovativeness, we review literature at the intersection of cluster, meta-organisation, business model and innovation studies. Our study allows to consolidate the extant research into “organised” clustering and the drivers of the cluster actors’ innovativeness. It also helps identify several important unanswered questions in the literature and to suggest potentially fruitful directions for further work.
Examining the Viability of the World’s Busiest Winter Road to Climate Change Using a Process-Based Lake Model
Authors: Mullan D. J. , Barr I. D. , Flood R. P. , Galloway J. M. , Newton A. M. W. , Swindles G. T. 
Published: April 2021

AbstractWinter roads play a vital role in linking communities and building economies in the northern high latitudes. With these regions warming 2–3 times faster than the global average, climate change threatens the long-term viability of these important seasonal transport routes. We examine how climate change will impact the world’s busiest heavy-haul winter road—the Tibbitt to Contwoyto Winter Road (TCWR) in northern Canada. The FLake freshwater lake model is used to project ice thickness for a lake at the start of the TCWR—first using observational climate data, and second using modeled future climate scenarios corresponding to varying rates of warming ranging from 1.5° to 4°C above preindustrial temperatures. Our results suggest that 2°C warming could be a tipping point for the viability of the TCWR, requiring at best costly adaptation and at worst alternative forms of transportation. Containing warming to the more ambitious temperature target of 1.5°C pledged at the 2016 Paris Agreement may be the only way to keep the TCWR viable—albeit with a shortened annual operational season relative to present. More widely, we show that higher regional winter warming across much of the rest of Arctic North America threatens the long-term viability of winter roads at a continental scale. This underlines the importance of continued global efforts to curb greenhouse gas emissions to avoid many long-term and irreversible impacts of climate change.
Frontal Angle: A New Predictor of Difficulty in Endoscopic Frontal Sinus Surgery—A Preliminary Computed Tomography Study
Authors: Kołodziejczyk Paulina , Gotlib Tomasz , Niemczyk Kazimierz 
Published: April 2021

Objectives: The possibility of visualization of the frontal sinus during endoscopic surgery depends on 3-dimensional configuration of the frontal sinus opening (FSO). We aimed to determine the prevalence of unfavorable angulation of the lower part of the posterior wall of the frontal sinus and its relation to FSO diameter. Methods: One hundred and twenty-eight computed tomography (CT) scans were retrospectively reviewed to measure (1) the angle between the nasal floor and the plane tangent to the posterior table of the frontal sinus above the most posterior aspect of the anterior buttress (frontal angle, FA) and (2) dimensions of the FSO. Results: The FA ranged from below 30° to 90°. Nearly 13% of sinuses (16.4% of patients) showed FA about 90°, which should enable good visualization of the sinus with the 30° scope after opening and clearing the frontal recess, while 4% (6.25% of patients) showed FA ≤ 30°. The anterior–posterior diameter (A-PD) was below 5 mm in 17.6% of sinuses (26.6% of patients). There was a significant correlation between FA and A-PD. Unfavorable combination of FA and A-PD (<45°, <5 mm) was present in 5.2% of sinuses (8.6% of patients), and extremely unfavorable combination (<30°, <5 mm) in 0.8% (0.8% of patients). Conclusions: The FA shows great interindividual variability, which is very likely to reflect the possibility of inspection of the frontal sinus. This implies a need for further prospective clinical studies to validate FA as a predictor of difficulty in frontal sinus surgery.
Associations between dairy consumption and constipation in adults: A cross-sectional study
Authors: Aslam Hajara , Mohebbi Mohammadreza , Ruusunen Anu , Dawson Samantha L , Williams Lana J , Berk Michael , Holloway-Kew Kara L , Collier Fiona , Loughman Amy , Pasco Julie A , Jacka Felice N 
Published: April 2021

Objective: The current study aimed to assess the association between dairy consumption and constipation in the general adult population. Design: Data from the Geelong Osteoporosis Study were used to assess the association between dairy consumption and constipation in women ( n=632) and men ( n=609). Information on milk, yogurt and cheese, and constipation were self-reported. Total dairy was calculated by summing the intake of milk, yogurt and cheese and expressed as servings per day. Multivariable logistic regression models adjusted for irritable bowel syndrome, major depressive disorders, mobility, body mass index, age and fibre intake were used to examine the odds ratio (OR) and 95% confidence interval (CI) between the consumption of categories of total dairy, milk, yogurt, cheese, and constipation. Results: In women, consumption of 1–2 servings/d of total dairy was associated with reduced odds for constipation (OR: 0.49; 95% CI: 0.26-0.90; P=0.021) compared to consuming <1 serving/d of total dairy after adjusting for covariates. Also, consumption of 1–4 servings/d of milk was associated with marginally reduced odds for constipation (OR: 0.63; 95% CI: 0.39-1.02; P=0.058) compared to women who consumed <1 serving/d of milk after adjusting for covariates. There were no significant associations detected between other types of dairy consumption and constipation in women, and none in men. Conclusion: In women, consumption of moderate amounts of dairy is associated with reduced odds for constipation whereas in men no associations were detected between dairy consumption and constipation. Further studies are warranted to confirm results.
Central macular thickness in patients with sickle cell disease and no signs of retinopathy: a cross-sectional study of Jordanian patients
Authors: Abu-Yaghi Nakhleh E. , AlNawaiseh Ahmad M. , Khourshid Issam M. , AlRawashdeh Tala J. , Rawashdeh Majd M. Al , Zghoul Ayat M. , Shafagoj Abdallah N. , Alomairi Yousif A. , Muhsen Sana' M. , AlRyalat SaifAldeen S. 
Published: April 2021

Objectives To measure central macular thickness in Jordanian patients with sickle cell disease who did not have retinopathy and compare the findings with age- and sex-matched controls using spectral domain optical coherence tomography (SDOCT). Methods In this cross-sectional study, participants underwent visual acuity testing, slit-lamp bio-microscopy, dilated ophthalmoscopy, and SDOCT imaging to measure central macular thickness. Macular quadrant measurements and thickness difference indexes (TDIs) were compared between groups. Results Twenty eyes with sickle cell disease and 20 control eyes were enrolled. The median visual acuity in both groups was 20/20. The mean macular thickness was significantly lower in eyes with sickle cell disease than in matched controls (mean difference, 22.15 ± 6.44 µm). Peripheral quadrants were all significantly thinner in eyes with sickle cell disease, especially in superior and temporal quadrants. TDIs were lower in eyes with sickle cell disease than in control eyes. Conclusions Eyes with sickle cell disease that had no clinical evidence of retinopathy exhibited significantly lower central macular thickness in all quadrants, compared with eyes in age- and sex-matched controls. SDOCT is a non-invasive imaging modality that can detect preclinical changes in eyes with sickle cell disease and can be used to screen and monitor the disease process.
Distribution of microRNAs associated with major depressive disorder among blood compartments
Authors: Homorogan Claudia , Enatescu Virgil Radu , Nitusca Diana , Marcu Anca , Seclaman Edward , Marian Catalin 
Published: April 2021

Objective Major depressive disorder (MDD) is a recurrent disorder with an increasing incidence. Alterations in key signaling pathways of the nervous system, such as the Wnt and MAPK pathways, mediated through microRNAs (miRNAs) provide crucial information regarding the etiopathology of MDD. We aimed to analyze whether the heterogeneity of literature findings regarding differential expression of miRNAs in the blood could arise from their different distributions among blood compartments. Methods We performed a pilot study analyzing the differential expression of miR-26a, miR-494, miR-30c, miR-93, and miR-101 and investigated their levels in white blood cells, total plasma (TP), exosomes from plasma, and exosome depleted plasma (EDP) in patients with MDD before and after antidepressant treatment with escitalopram and in healthy controls. Results MiR-494 was more abundant in EDP, and miR-26a and miR-30c were predominantly more abundant in TP relative to other blood compartments. Moreover, miR-30c, miR-101, and miR-26a, were significantly downregulated in TP of patients with MDD compared with controls. After antidepressant treatment, only miR-494 was significantly differently expressed in EDP. Conclusions This proof-of-principle study suggests that identifying the miRNA abundance in different blood compartments is crucial for biomarker development and could enrich the current knowledge regarding MDD pathophysiology.
A Conceptual and Large-Scale Empirical Examination of the Welcoming Empowerment Monitoring Approach (WEMA) for School Safety and Substance Use Reduction
Authors: Astor Ron Avi , Benbenishty Rami , Watson Kate R. 
Published: April 2021

Purpose: Research shows that many evidence-based school programs are not sustained after the demonstration period is complete. This article outlines the Welcoming Empowerment Monitoring Approach and builds on data at each school—to address school safety and reduce substance use. Method: The study used California Healthy Kids Survey data across 145 schools in Southern California at five points in time over an 8-year period. Results: From project inception through 3 years after the project completed, all manifestations of school victimization dropped and were sustained. Lifetime alcohol and marijuana use also declined for all students during the overall period assessed. Discussion: Schools, districts, and regions tailored interventions according to each school’s and region’s specific needs. Combinations of ground-up solutions, evidence-based programs, building internal capacity, and connecting the school to resources helped reduce victimization and substance use.
Usefulness of high definition sialoendoscope for evaluation of lacrimal drainage system in congenital nasolacrimal duct obstruction
Authors: Gupta Nishi , Singla Poonam , Ganesh Suma 
Published: April 2021

Purpose: Sialoendoscope was used as a dacryoendoscope, high- definition images of the lacrimal drainage system (LDS) were captured and its performance in congenital nasolacrimal duct obstruction (CNLDO) is reported. Methods: Nasal endoscopy was done as the first in all the cases using a 0°, 2.7 mm nasal endoscope (Karl Stroz Tutlingan Germany). This was followed by Dacryoendoscopy (DEN) of the lacrimal drainage system from puncta till the valve of Hasner. DEN was performed under general anaesthesia in 26 children (including 17 primary and 9 failed probing cases). All cases were examined using 0.8 mm sialoendoscope (Karl Storz, Tuttlingen, Germany) with fibreoptic light transmission with a side port for irrigation. Results: We were able to obtain high-definition images of canaliculi, lacrimal sac, sac duct junction, proximal, mid and distal segments of nasolacrimal duct in all the children with CNLDO. In 17 primary cases 16 had distal membranous obstruction and I case had proximal canalicular obstruction. In nine children with history of failed probing, five had membranous obstruction, two had dacryoliths, two had NLD malformation at different levels. An overall success rate of 88.4% was achieved. Conclusion: Sialoendoscope can be used as high-definition dacryoendoscope for diagnostic and therapeutic use in CNLDO. Useful information can be obtained on dacryoendoscopy in complex CNLDO cases.