bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated Fatty Liver Index Is Independently Associated With New Onset of Hypertension During a 10‐Year Period in Both Male and Female Subjects
Authors: Higashiura Yukimura , Furuhashi Masato , Tanaka Marenao , Takahashi Satoko , Mori Kazuma , Miyamori Daisuke , Koyama Masayuki , Ohnishi Hirofumi , Moniwa Norihito , Numata Keita , Hisasue Takashi , Hanawa Nagisa , Miura Tetsuji 
Published: July 2021

Background
Fatty liver index (FLI), a predictor of nonalcoholic fatty liver disease, has been reported to be associated with several metabolic disorders. Because of a sex difference in FLI level, we hypothesized that FLI is associated with development of hypertension to a greater extent in men or women.

Methods and Results

We investigated the relationship between FLI and development of hypertension during a 10‐year period in a general population of subjects who received annual health examinations (n=28 990). After exclusion (44.9%) of subjects with missing data and those with hypertension at baseline, a total of 15 965 subjects (men/women: 9466/6499) were included. FLI level was significantly higher in men than in women. During the 10‐year period, 2304 men (24.3%) and 745 women (11.5%) had new onset of hypertension. Multivariable Cox proportional hazard models with a restricted cubic spline showed that the hazard ratios (HRs) for development of hypertension after adjustment of age, systolic blood pressure, estimated glomerular filtration rate, habits of smoking and alcohol drinking, family history of hypertension, and diagnosis of diabetes mellitus and dyslipidemia increased gradually with increase in FLI in men and increased rapidly and then slowly with increase in FLI in women. There was a significant interaction between FLI and sex for the risk of hypertension in all of the subjects (
P
=0.049). The addition of FLI to traditional risk factors significantly improved the discriminatory capability.

Conclusions
A high level of FLI predicts the development of hypertension in both men and women, although distribution patterns of HRs were different between sexes.
Learning in the Oil Futures Markets: Evidence and Macroeconomic Implications
Authors: Leduc Sylvain , Moran Kevin , Vigfusson Robert J. 
Published: July 2021

AbstractUsing oil futures, we examine expectation formation and how it alters the macroeconomic transmission of shocks. Our empirical framework, where investors learn about the persistence of oil-price movements, successfully replicates the fluctuations in oil-price futures since the Late 1990s. By embedding this learning mechanism in an estimated model, we document that an increase in the persistence of TFP-driven fluctuations in oil demand largely accounts for investors' perceptions that oil-price movements became increasingly permanent during the 2000s. Learning alters the macroeconomic impact of shocks, making the responses time dependent and conditional on perceptions of shocks' likely persistence.
Advancing the Agency of Adolescent Girls
Authors: Edmonds Eric , Feigenberg Ben , Leight Jessica 
Published: July 2021

Abstract
More than 98 million adolescent girls are not in school. Can girls influence their schooling without changes in their family's economic environment? In Rajasthan, India, we examine the impact of a school-based life skills program that seeks to address low aspirations, narrow societal roles for girls and women, restricted networks of social support, and limited decision-making power. We find the intervention causes a 25% decline in school dropout that persists from seventh grade through the transition to high school. Improvements in socioemotional support among girls exposed to the intervention seem especially important in their decision to stay in school.
Precipitation Enhancement in Squall Lines Moving over Mountainous Coastal Regions
Authors: Wu Fan , Lombardo Kelly 
Published: July 2021

AbstractA mechanism for precipitation enhancement in squall lines moving over mountainous coastal regions is quantified through idealized numerical simulations. Storm intensity and precipitation peak over the sloping terrain as storms descend from an elevated plateau toward the coastline and encounter the marine atmospheric boundary layer (MABL). Storms are most intense as they encounter the deepest MABLs. As the descending storm outflow collides with a moving MABL (sea breeze), surface and low-level air parcels initially accelerate upward, though their ultimate trajectory is governed by the magnitude of the negative nonhydrostatic inertial pressure perturbation behind the cold pool leading edge. For shallow MABLs, the baroclinic gradient across the gust front generates large horizontal vorticity, a low-level negative pressure perturbation, and thus a downward acceleration of air parcels following their initial ascent. A deep MABL reduces the baroclinically generated vorticity, leading to a weaker pressure perturbation and minimal downward acceleration, allowing air to accelerate into a storm’s updraft. Once storms move away from the terrain base and over the full depth of the MABLs, storms over the deepest MABLs decay most rapidly, while those over the shallowest MABLs initially intensify. Though elevated ascent exists above all MABLs, the deepest MABLs substantially reduce the depth of the high-θelayer above the MABLs and limit instability. This relationship is insensitive to MABL temperature, even though surface-based ascent is present for the less cold MABLs, the MABL thermal deficit is smaller, and convective available potential energy (CAPE) is higher.
Future Changes in Wet and Dry Season Characteristics in CMIP5 and CMIP6 simulations
Authors: Wainwright Caroline M. , Black Emily , Allan Richard P. 
Published: July 2021

AbstractClimate change will result in more dry days and longer dry spells, however, the resulting impacts on crop growth depend on the timing of these longer dry spells in the annual cycle. Using an ensemble of Coupled Model Intercomparison Project Phase 5 and Phase 6 (CMIP5 and CMIP6) simulations, and a range of emission scenarios, here we examine changes in wet and dry spell characteristics under future climate change across the extended tropics in wet and dry seasons separately. Delays in the wet seasons by up to two weeks are projected by 2070-2099 across South America, Southern Africa, West Africa and the Sahel. An increase in both mean and maximum dry spell length during the dry season is found across Central and South America, Southern Africa and Australia, with a reduction in dry season rainfall also found in these regions. Mean dry season dry spell lengths increase by 5-10 days over north-east South America and south-west Africa. However, changes in dry spell length during the wet season are much smaller across the tropics with limited model consensus. Mean dry season maximum temperature increases are found to be up to 3°C higher than mean wet season maximum temperature increases over South America, Southern Africa and parts of Asia. Longer dry spells, fewer wet days, and higher temperatures during the dry season may lead to increasing dry season aridity, and have detrimental consequences for perennial crops.
How Does Insurance Status Correlate With Trauma Mechanisms and Outcomes? A Retrospective Study at a Level 1 Trauma Center
Authors: Chun Magnus , Zhang Yichi , Nguyen An , Becnel Chad , Noguera Valeria , Taghavi Sharven , Guidry Chrissy , Hussein Mohammed , Toraih Eman , McGrew Patrick 
Published: July 2021

Objective Studies showed that a lack of insurance is associated with worse trauma outcomes. We examine insurance status and trauma mortality in a diverse metropolitan city and hypothesize that the higher risk of mortality in uninsured patients is due to insurance status and other factors. Methods A retrospective analysis of patients admitted to a Level 1 Trauma center for emergent surgery in a diverse metropolitan city from Jan 2016-May 2020 was conducted. Patients of different insurance statuses were analyzed for their injury mechanism and surgical intervention outcomes. Multivariate logistic regression was performed and the results were presented as odds ratio with 95% confidence intervals and P values. Statistical significance was set at P < .05. Results 738 patients met study criteria. Medicaid patients made up the largest proportions of injury mechanisms: 65.1% of gunshot wound cases, sharp object (41.7%), and falls (32.5%). Private insurance (OR = .13, 95% CI: .05-.35, P = .000), Medicaid (OR = .19, 95% CI: .10-.35, P = .000), Medicare (OR = .65, 95% CI: 0.28-1.51, P = .31), and other insurance (OR = .44, 95% CI 0.22-.87, P = .01) were associated with survival. Uninsured patients had the highest mortality rate resulting from trauma at 32.6% ( P < .001), and the lowest mortality rate belonged to the private insurance cohort (6.3%, P < .001). Uninsured patients accounted for 10.5% of gunshot wound cases, 8.5% of motor vehicle accident cases, 25% of sharp object cases, and 6.6% of falls. Conclusion Being uninsured was independently associated with mortality, while having insurance improved outcomes. Underlying mechanisms should be further elucidated to improve health equity and trauma outcomes in diverse patient populations.
Monitoring motherhood: Monitoring and optimizing glycaemia in women with pre-existing diabetes in pregnancy
Authors: Meek Claire L 
Published: July 2021

Despite recent advances in care, women with diabetes in pregnancy are still at increased risk of multiple pregnancy complications. Offspring exposed to hyperglycaemia in utero also experience long-term health sequelae, affecting neurocognitive and cardiometabolic status. Many of these adverse consequences can be prevented or ameliorated with good medical care, specifically to optimize glycaemic control. The accurate assessment of glycaemia in pregnancy is therefore vital to safeguard the health of mother and child. However, there is no consensus about the best method of monitoring glycaemic control in pregnancy. Short-term changes in insulin dosage and lifestyle, with altered appetite, insulin sensitivity and red cell turnover create difficulties in interpretation of standard laboratory measures such as HbA1c. The ideal marker would provide short-term feedback on daily or weekly glycaemic control, with additional capability to predict pregnancies at high risk of suboptimal outcomes. Several novel biochemical markers are available which allow assessment of dynamic changes in glycaemia over weeks rather than months. Continuous glucose monitoring devices have advanced in accuracy and provide new opportunities for robust assessment of glycaemia in pregnancy. Recent work from the continuous glucose monitoring in pregnant women with type 1 diabetes trial (CONCEPTT) has provided information about the ability of different markers of glycaemia to predict pregnancy outcomes. The aim of this review is to summarize the care for women with pre-existing diabetes in pregnancy and to highlight the important role of glycaemic monitoring in pregnancy.
Quantitative breast density measurement based on three-dimensional images: a study on cone-beam breast computed tomography
Authors: Liu Aidi , Yin Lu , Ma Yue , Han Peng , Wu Yalin , Wu Yaopan , Ye Zhaoxiang 
Published: July 2021

Background Breast density is an independent predictor of breast cancer risk. Quantitative volumetric breast density (QVBD) is expected to provide more information on the prediction of breast cancer risk. Purpose To evaluate the reliability of QVBD measurements based on cone-beam breast computed tomography (CBBCT) images. Material and Methods A total of 216 breasts were used to evaluate the stability of QVBD measurements based on CBBCT images and the correlations between this volumetric measurement and visual and area-based measurement methods. The intra- and inter-observer consistency of QVBD measurements were compared. Visual breast density (VBD) was evaluated with Breast Imaging Reporting and Data System (BI-RADS) standard on CBBCT images. The correlation between QVBD and VBD was evaluated by Spearman correlation coefficient. Receiver operating characteristic (ROC) curve was used to assess the sensitivity and specificity of the volumetric method in distinguishing dense and non-dense breasts. The correlation between QVBD and quantitative area-based breast density (QABD) was determined with Pearson correlation coefficient. Then, the breast volume measured with CBBCT images was compared with the breast specimen obtained during nipple-sparing mastectomy (NSM) by Pearson correlation coefficient and linear regression. Results Excellent intra- and inter-observer consistency was found from QVBD measurements. The volumetric method distinguished dense and non-dense breasts at a cutoff value of 9.5%, with 94.5% sensitivity and 77.1% specificity. Positive correlations were found between QVBD and QABD ( r=0.890; P<0.001) and between the volume measured with CBBCT images and Archimedes method ( r=0.969; P<0.001). Conclusion CBBCT images can evaluate breast density reliably on a continuous scale.
Diagnostic value of mammography for accompanying non-mass enhancement on preoperative breast MRI
Authors: Kim Yunju , Jung Hae Kyoung , Park Ah Young , Ko Kyung Hee , Jang Hyunkyung 
Published: July 2021

Background Successful surgical treatment for localized breast cancer can depend on accurate diagnosis for accompanying non-mass enhancement (NME) on preoperative breast magnetic resonance imaging (MRI). Purpose To evaluate the diagnostic value of mammography for accompanying NME adjacent to index cancer on preoperative breast MRI Material and Methods Among 569 consecutive patients who underwent preoperative breast MRI from January 2016 to August 2018 for ultrasound-guided biopsy-proven breast cancer, 471 patients who underwent initial mammography and subsequent surgery were finally included. Two radiologists retrospectively reviewed preoperative MRI findings of the 471 patients and detected accompanying NME adjacent to index cancer. MRI, mammography, and histopathology findings of the accompanying NME were evaluated using Pearson’s chi-square test, Mann–Whitney U test, and logistic regression analysis. The area under the receiver operating characteristic curve (AUC) of MRI and combined MRI and mammography was calculated in differentiating benign from malignant accompanying NME. The reference standard was surgical pathologic findings. Results MRI revealed 93 accompanying NME lesions in 92 (19.5%) of the 471 patients, showing 55 (59.1%) malignant and 38 (40.9%) benign lesions. On multivariate analysis, malignant NME lesions were more associated with mammography-positive findings ( P = 0.000), clumped or clustered ring internal enhancement ( P = 0.015), and extensive intraductal component presence of index tumor ( P = 0.007) compared with benign lesions. The AUC increased after correlation with mammography showing 0.649 (95% confidence interval [CI] 0.533–0.765) for MRI and 0.833 (95% CI 0.747–0.919) for combined MRI and mammography. Conclusion Mammography is valuable in predicting malignancy for accompanying NME on preoperative breast MRI.
Morphological changes in the pons and cerebellum during the first two weeks in term infants with pontine and cerebellar injury and profound neonatal asphyxia
Authors: Hayakawa Katsumi , Tanda Koichi , Nishimura Akira , Kinoshita Daisuke , Nishimoto Masakazu , Kizaki Zenro , Ohno Koji 
Published: July 2021

Background The morphological changes in the pons and cerebellum of neonates experiencing profound asphyxia in the early period of life remain to be clarified. Purpose To assess the changes in the size of the pons and cerebellum during the first two weeks of life in term neonates with pontine and cerebellar injury caused by hypoxic-ischemic encephalopathy in comparison with a control group. Material and Methods Two groups were investigated: a group with pontine/cerebellar injury (PCI) (n = 10) demonstrated by magnetic resonance imaging (MRI) diffusion-weighted imaging; and a control group without PCI – focal-multifocal white matter injury and a normal pattern (n = 24). The anteroposterior diameter (APD) and height of the pons and cerebellar vermis, and the transverse width of the cerebellum were measured twice in the first and second weeks of life. Differences between the groups were analyzed statistically using paired and unpaired Student’s t-test at a significance level of P < 0.05. Results In the PCI group, the pontine APD and cerebellar vermian height were significantly decreased in the second week. An increase of pons and cerebellar size was evident during the first two weeks of life in the control groups. Conclusion Infants with PCI and profound asphyxia show rapid decreases in pontine APD and cerebellar vermian height within the first two weeks of life.
Diagnostic performance of tomosynthesis for evaluation of bone tumors and tumor-like lesions: a comparison with radiography
Authors: Park Sekyoung , Lee In Sook , Song You Seon , Bae Ji Hyun , Kim Jeong Il , Kim Chang Won 
Published: July 2021

Background Even though radiologic diagnosis of bone tumors and tumor-like lesions is usually based on radiographs, radiographically faint imaging features sometimes remain challenging due to overlapping anatomical structures. Purpose To compare tomosynthesis with radiography for the evaluation of bone tumors and tumor-like lesions. Material and Methods Forty-seven bone tumors and tumor-like lesions were assessed with radiographs and tomosynthesis images. Two radiologists independently analyzed imaging features of lesions, including margin, periosteal reaction, cortical thinning, matrix mineralization, cortical destruction (such as pathologic fracture), and extraosseous soft-tissue extension. Computed tomography (CT) imaging was used as a reference method. Diagnostic performances of radiography and tomosynthesis were analyzed and compared based on sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. Effective radiation dose was compared among the three imaging modalities by phantom studies. Results Inter-observer variability (kappa value) for imaging features was slight to moderate on radiography (0.167–0.588), whereas it was nearly perfect on tomosynthesis (0.898–1.000) except for extraosseous soft-tissue extension (0.647 vs. 0.647). Tomosynthesis showed significantly higher sensitivity than radiography in evaluating the margin for bone tumors or tumor-like lesions (1.00 vs. 0.85; P = 0.016), and significantly higher accuracy than radiography in evaluating the margin and matrix mineralization for those (1.00 vs. 0.85; P = 0.016 and 0.91 vs.0.77; P = 0.023, respectively). In phantom studies, mean effective radiation doses were highest in order of CT, tomography, and radiography. Conclusion Tomosynthesis increases sensitivity and accuracy of the margin as well as accuracy of the matrix mineralization of bone tumors and tumor-like lesions compared to radiography.
Adipose Stem Cell–Derived Exosomes Ameliorate Chronic Rotator Cuff Tendinopathy by Regulating Macrophage Polarization: From a Mouse Model to a Study in Human Tissue
Authors: Wang Chongyang , Zhang Yao , Zhang Guangcheng , Yu Weilin , He Yaohua 
Published: July 2021

Background: Chronic rotator cuff (RC) tendinopathy is one of the most prevalent causes of shoulder pain. Growing evidence suggests that macrophages play a significant role in the proinflammatory response, resolution of inflammation, and tissue healing of tendinopathy. In particular, enhancement of M2 macrophage (M2φ) activity contributes to the accelerated healing of tendinopathy. Therefore, a treatment that enhances M2φ polarization would be useful for patients with this common musculoskeletal disorder. Purpose: To investigate whether adipose stem cell–derived exosomes (ASC-Exos) enhance M2φ polarization and ameliorate chronic RC tendinopathy. Study Design: Controlled laboratory study. Methods: First, we compared the effects of ASC-Exos on polarization of mouse bone marrow–derived macrophages between a classically activated phenotype (M1φ) and an alternatively activated phenotype (M2φ) in vitro. In total, 72 C57BL/6 mice were assigned to normal cage activity (n = 24) or 5 weeks of treadmill overuse (n = 48). The supraspinatus tendon of each treadmill overuse mouse was treated with ASC-Exos (n = 24) or saline (n = 24). Histological and biomechanical outcomes were assessed 4 weeks after treatment. Finally, tissue samples from human patients with RC tendinopathy were obtained to assay the effect of ASC-Exos on the M1φ/M2φ balance in tissue-resident macrophages. Results: ASC-Exos inhibited M1φ polarization and augmented M2φ polarization in vitro and in vivo. Mice in the ASC-Exos group showed less severe pathological changes than those in the saline group, including less cellular infiltration, disorganization of collagen, and ground substance deposition. The modified Bonar score of the ASC-Exos group (mean ± SD, 7.68 ± 1.03) was significantly lower than that of the saline group (9.81 ± 0.96; P < .05). Furthermore, the maximum failure load was significantly higher in the ASC-Exos group than in the saline group (4.23 ± 0.66 N vs 3.86 ± 0.65 N; P < .05), as was stiffness (3.38 ± 0.34 N/m vs 2.68 ± 0.49 N/m; P < .05). Conclusion: ASC-Exos–mediated polarization balance of M1φ/M2φ contributes to the amelioration of chronic RC tendinopathy. Regulation of the M1φ/M2φ balance could be a new target for the treatment of chronic RC tendinopathy. Clinical Relevance: Administration of ASC-Exos is a cell-free approach that may become a novel treatment option for chronic RC tendinopathy and should be explored further.
Introducing in clinical practice a new laser suction handpiece for percutaneous nephrolithotomy
Authors: Bar-Yaakov Noam , Hertzberg Haim , Marom Ron , Jikia Jemal , Mano Roy , Beri Avi , Yossepowitch Ofer , Sofer Mario 
Published: July 2021

Objective: To assess a novel combined laser suction handpiece (LSH) for performing PCNL in a clinical setting. Methods: The study comprised 40 consecutive PCNLs performed between May 2019 and February 2020. The first 20 procedures (Group A) were performed with conventional ultrasonic or pneumatic devices and the other 20 (Group B) were performed with the use of the new LSH. All patients were treated by tubeless supine PCNL. The groups were compared for demographics, clinical data, operative time, lithotrite effectiveness, stone clearance rate (SCR), and outcome. Results: Groups A and B were similar in age, and in stone size, complexity, and density (Hounsfield units) ( p < 0.05). The average operative time was 99 and 78 min, SCR 143 and 200 mm3/min, hospital stay 1.6 and 1.1 days, and stone-free rate 90% and 95%, respectively. Despite a trend toward better results with the new LSH, none of these comparisons reached statistical significance. Ineffective lithotripsy with the initial device (ultrasonic) requiring conversion to another modality (ballistic) occurred in six (30%) procedures in Group A, while all procedures were effectively accomplished with the LSH in Group B ( p = 0.02). There were two complications in Group A and none in Group B ( p > 0.05). Conclusions: The LSH is as effective and safe as the traditional lithotrites for performing PCNLs. This new tool completes the capabilities of the holmium laser high-power machines, enabling them to serve as the sole platform for all endourological treatments.