bluuebunny/crossref_metadata_2025_split huggingface dataset:
The hypometabolic state: a good predictor of a better prognosis in amyotrophic lateral sclerosis
Authors: Cattaneo Marina , Jesus Pierre , Lizio Andrea , Fayemendy Philippe , Guanziroli Nicoletta , Corradi Ettore , Sansone Valeria , Leocani Letizia , Filippi Massimo , Riva Nilo , Corcia Philippe , Couratier Philippe , Lunetta Christian 
Published: August 2021

BackgroundMalnutrition and weight loss are negative prognostic factors for survival in patients with amyotrophic lateral sclerosis (ALS). However, energy expenditure at rest (REE) is still not included in clinical practice, and no data are available concerning hypometabolic state in ALS.ObjectiveTo evaluate in a referral cohort of patients with ALS the prevalence of hypometabolic state as compared with normometabolic and hypermetabolic states, and to correlate it with clinical phenotype, rate of progression and survival.DesignWe conducted a retrospective study examining REE measured by indirect calorimetry in patients with ALS referred to Milan, Limoges and Tours referral centres between January 2011 and December 2017. Hypometabolism and hypermetabolism states were defined when REE difference between measured and predictive values was ≤−10% and ≥10%, respectively. We evaluated the relationship between these metabolic alterations and measures of body composition, clinical characteristics and survival.ResultsEight hundred forty-seven patients with ALS were recruited. The median age at onset was 63.79 years (IQR 55.00–71.17). The male/female ratio was 1.26 (M/F: 472/375). Ten per cent of patients with ALS were hypometabolic whereas 40% were hypermetabolic. Hypometabolism was significantly associated with later need for gastrostomy, non-invasive ventilation and tracheostomy placement. Furthermore, hypometabolic patients with ALS significantly outlived normometabolic (HR=1.901 (95% CI 1.080 to 3.345), p=0.0259) and hypermetabolic (HR=2.138 (95% CI 1.154 to 3.958), p=0.0157) patients.ConclusionHypometabolism in ALS is not uncommon and is associated with slower disease progression and better survival than normometabolic and hypermetabolic subjects. Indirect calorimetry should be performed at least at time of diagnosis because alterations in metabolism are correlated with prognosis.
Combined standard bypass and parent artery occlusion for management of giant and complex internal carotid artery aneurysms
Authors: Dodier Philippe , Wang Wei-Te , Hosmann Arthur , Hirschmann Dorian , Marik Wolfgang , Frischer Josa M , Gruber Andreas , Rössler Karl , Bavinzski Gerhard 
Published: August 2021

BackgroundComplex aneurysms do not have a standard protocol for treatment. In this study, we investigate the safety and efficacy of microsurgical revascularization combined with parent artery occlusion (PAO) in giant and complex internal carotid artery (ICA) aneurysms.MethodsBetween 1998 and 2017, 41 patients with 47 giant and complex ICA aneurysms were treated by an a priori planned combined treatment strategy. Clinical and radiological outcomes were stratified according to mRS and Raymond classification. Bypass patency was assessed. Median follow-up time was 3.9 years.ResultsAfter successful STA–MCA bypass, staged endovascular (n=37) or surgical (n=1) PAO was executed in 38 patients following a negative balloon occlusion test. Intolerance to PAO led to stent/coil treatments in two patients. Perioperative bypass patency was confirmed in 100% of completed STA–MCA bypass procedures. Long-term overall bypass patency rate was 99%. Raymond 1 occlusion and good outcome were achieved in 95% and 97% (mRS 0–2) of cases, respectively. No procedure-related mortality was encountered. Eighty-four percent of patients with preoperative cranial nerve compression syndromes improved during follow-up.ConclusionsThe combined approach of STA-MCA bypass surgery followed by parent artery occlusion achieves high aneurysm occlusion and low morbidity rates in the management of giant and complex ICA aneurysms. This combined indirect approach represents a viable alternative to flow diversion in patients with cranial nerve compression syndromes or matricidal aneurysms, and may serve as a backup strategy in cases of peri-interventional complications or lack of suitable endovascular access.
Internal cerebral vein asymmetry is an independent predictor of poor functional outcome in endovascular thrombectomy
Authors: Myint May Zin , Yeo Leonard LL , Tan Benjamin Y Q , The Ei Zune , Lim Mei Chin , Sia Ching-Hui , Teoh Hock-Luen , Sharma Vijay Kumar , Chan Bernard , Ahmad Aftab , Paliwal Prakash , Gopinathan Anil , Yang Cunli , Makmur Andrew , Andersson Tommy , Arnberg Fabian , Holmin Staffan 
Published: August 2021

BackgroundEndovascular thrombectomy (EVT) in large vessel occlusion (LVO) in anterior circulation acute ischaemic stroke (AIS) results in good functional outcomes in only approximately 60% of the patients. Internal cerebral veins (ICVs) are easily visible, with a consistent midline location, and are linked to stroke outcomes. We hypothesize that ICV asymmetry on multiphasic CT angiogram (mCTA) can be an adjunctive predictor for poor functional outcomes.MethodsWe studied consecutive AIS patients from 2017 to 2019 with anterior circulation LVO treated with EVT regardless of intravenous thrombolysis. Asymmetrical ICV was defined as the presence of hypodensity (less opacification) on the ipsilateral occlusion side as compared with the contralateral side. The primary outcome was modified Rankin Score (mRS) score at 3 months. Secondary outcomes were good recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) 2b-3), symptomatic hemorrhage, and mortality.ResultsA total of 185 patients were included with a median age of 70 years (IQR 59–77); 87 patients (47%) were female. 82 patients (44.3%) achieved good functional outcomes (mRS 0–2) at 3 months. On multivariate analysis, National Institutes of Health Stroke Scale (NIHSS) (OR 1.076, 95% CI 1.015 to 1.140; p<0.013), poor collateral score (OR 0.285, 95% CI 0.162 to 0.501; p<0.001), asymmetrical ICV on the peak venous phase (OR 2.47, 95% CI 1.115 to 5.471; p<0.026), and late venous phase of the mCTA (OR 2.642, 95% CI 1.161 to 6.016; p<0.021) were independent risks factors of poor outcomes.ConclusionICV asymmetry is a novel radiological sign which is independently associated with poor functional outcomes in EVT, even after correction for collateral circulation. Further studies are needed to validate this finding.
Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe
Authors: Williams Michelle Claire , Shaw Leslee , Hirschfeld Cole B , Maurovich-Horvat Pal , Nørgaard Bjarne L , Pontone Gianluca , Jimenez-Heffernan Amelia , Sinitsyn Valentin , Sergienko Vladimir , Ansheles Alexey , Bax Jeroen J , Buechel Ronny , Milan Elisa , Slart Riemer H J A , Nicol Edward , Bucciarelli-Ducci Chiara , Pynda Yaroslav , Better Nathan , Cerci Rodrigo , Dorbala Sharmila , Raggi Paolo , Villines Todd C , Vitola Joao , Malkovskiy Eli , Goebel Benjamin , Cohen Yosef , Randazzo Michael , Pascual Thomas N B , Dondi Maurizio , Paez Diana , Einstein Andrew J 
Published: August 2021

ObjectivesWe aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe.MethodsThe online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries.ResultsCentres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors.ConclusionThe first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID-19 conditions during the ongoing pandemic.
Krüppel‐Like Factor 15/Interleukin 11 Axis‐Mediated Adventitial Remodeling Depends on Extracellular Signal‐Regulated Kinases 1 and 2 Activation in Angiotensin II–Induced Hypertension
Authors: Guo Yue‐Tong , Lu Yuan‐Yuan , Lu Xiao , He Shun , Li Shi‐Jin , Shao Shuai , Zhou Han‐Dan , Wang Rui‐Qi , Li Xiao‐Dong , Gao Ping‐Jin 
Published: August 2021

Background
Adventitial remodeling is a pathological hallmark of hypertension that results in target organ damage. Activated adventitial fibroblasts have emerged as critical regulators in this process, but the precise mechanism remains unclear.

Methods and Results
Interleukin 11 (IL‐11) knockout and wild‐type mice were subjected to angiotensin II (Ang II) infusion to establish models of hypertension‐associated vascular remodeling. IL‐11 mRNA and protein were increased especially in the adventitia in response to Ang II. Compared with wild‐type mice, Ang II–treated IL‐11 knockout mice showed amelioration of vascular hypertrophy, adventitial fibrosis, macrophage infiltration, and inflammatory factor expression. Recombination mouse IL‐11 exacerbated adventitial fibrosis in Ang II–infused wild‐type mice. Interestingly, IL‐11 neutralizing antibody attenuated adventitial fibrosis, macrophage infiltration, and inflammatory factor expression after Ang II infusion for 7 days. Mechanistically, in primary cultured adventitial fibroblasts, Krüppel‐like factor 15 negatively regulated Ang II–induced IL‐11 expression. Ang II increased extracellular signal‐regulated kinases 1 and 2 activation, especially in adventitia, and caused biphasic extracellular signal‐regulated kinases 1 and 2 activation in adventitial fibroblasts. A rapid and early activation increased IL‐11 production through decreasing Krüppel‐like factor 15 expression, which, in turn, induced the second extracellular signal‐regulated kinases 1 and 2 activation, resulting in posttranscriptional profibrotic gene expression.

Conclusions
These results demonstrate that extracellular signal‐regulated kinases 1 and 2 activation is important for Krüppel‐like factor 15–mediated IL‐11 expression in adventitial fibroblasts to promote adventitial remodeling in Ang II–induced hypertension. Therefore, targeting the Krüppel‐like factor 15/IL‐11 axis might serve as a new therapeutic strategy for vascular diseases.
Domains of Physical Activity in Relation to Stiffness Index in the General Population
Authors: Arnold Natalie , Deiseroth Arne , Hahad Omar , Diestelmeier Simon , Schulz Andreas , Daubenbüchel Andrea , Gori Tommaso , Binder Harald , Pfeiffer Norbert , Prochaska Jürgen , Beutel Manfred , Lackner Karl J. , Münzel Thomas , Wild Philipp S. 
Published: August 2021

Background
Regular exercise training represents an important modifier of arterial stiffness (AS). Therefore, sex‐specific relations between domains of physical activity (PA; commuting, domestic, and leisure‐time PA, including active sport and occupational PA) with AS were investigated.

Methods and Results

Stiffness index by digital photoplethysmography was investigated in 12 650 subjects from the GHS (Gutenberg Health Study). Self‐reported PA was evaluated by the “Short Questionnaire to Assess Health‐Enhancing Physical Activity” and reported as activity score peer week, being a combined measure of duration, frequency, and intensity of PA. Multivariable linear regression analysis demonstrated strong beneficial effects of repetitive activities, such as active commuting or leisure‐time PA–related walking on AS in men, but not in women. Lower AS associated with endurance training was also found among men and premenopausal women. In contrast, intense occupational PA was related to stiffer vessels in men (
P
<0.0001) and women (
P
=0.0021) in a fully adjusted model. Combination of both, performing endurance training and having stiffness index values below median, resulted in the best survival. In contrast, subjects with elevated stiffness index at baseline without any endurance activities demonstrated the worst survival.

Conclusions
In this population representative sample, a differential impact of domains of self‐reported PA on AS was demonstrated. Our data strengthen the importance of regular endurance PA to induce a reduction of AS, which, in turn, may improve cardiovascular prognosis. We also report deleterious effects of intense occupational PA on stiffness index, a finding that needs further confirmation by larger prospective trials.
A Virtual Reality Embodiment Technique to Enhance Helping Behavior of Police Toward a Victim of Police Racial Aggression
Authors: Kishore Sameer , Spanlang Bernhard , Iruretagoyena Guillermo , Halan Shivashankar , Szostak Dalila , Slater Mel 
Published: August 2021

Abstract
There is an alarming level of violence by police in the US toward African Americans. Although this may be rooted in explicit racial bias, the more intractable problem is overcoming implicit bias, bias that is non-conscious but demonstrated in actual behavior. If bias is implicit, it is difficult to change through explicit methods that attempt to change attitudes. We carried out a study using virtual reality (VR) with 38 officers in a US police department, who took part in an interrogation of an African American suspect alongside an officer who was racially abusive toward the suspect. Seventeen of the participants witnessed the interview again from a third person perspective (Observer) and 21 from the embodied perspective of the suspect, now a victim of the interrogation (Victim condition), having been assigned randomly to these two groups. Some weeks later, all witnessed aggression by an officer toward an African American man in a virtual cafe scenario. The results show that the actions of those who had been in the Victim condition were coded as being more helpful toward the victim than those in the Observer condition. We argue that such VR exposures operate at the experiential and implicit level rather than the explicit, and hence are more likely to be effective in combating aggression rooted in implicit bias.
The African SWIFT Project: Growing Science Capability to Bring about a Revolution in Weather Prediction
Authors: Parker Douglas J. , Blyth Alan M. , Woolnough Steven J. , Dougill Andrew J. , Bain Caroline L. , de Coning Estelle , Diop-Kane Mariane , Kamga Foamouhoue Andre , Lamptey Benjamin , Ndiaye Ousmane , Ruti Paolo , Adefisan Elijah A. , Amekudzi Leonard K. , Antwi-Agyei Philip , Birch Cathryn E. , Cafaro Carlo , Carr Hamish , Chanzu Benard , Clarke Samantha J. , Coskeran Helen , Danuor Sylvester K. , de Andrade Felipe M. , Diakaria Kone , Dione Cheikh , Diop Cheikh Abdoulahat , Fletcher Jennifer K. , Gaye Amadou T. , Groves James L. , Gudoshava Masilin , Hartley Andrew J. , Hirons Linda C. , Ibrahim Ishiyaku , James Tamora D. , Lawal Kamoru A. , Marsham John H. , Mutemi J. N. , Okogbue Emmanuel Chilekwu , Olaniyan Eniola , Omotosho J. B. , Portuphy Joseph , Roberts Alexander J. , Schwendike Juliane , Segele Zewdu T. , Stein Thorwald H. M. , Taylor Andrea L. , Taylor Christopher M. , Warnaars Tanya A. , Webster Stuart , Woodhams Beth J. , Youds Lorraine 
Published: August 2021

Abstract
Africa is poised for a revolution in the quality and relevance of weather predictions, with potential for great benefits in terms of human and economic security. This revolution will be driven by recent international progress in nowcasting, numerical weather prediction, theoretical tropical dynamics, and forecast communication, but will depend on suitable scientific investment being made. The commercial sector has recognized this opportunity and new forecast products are being made available to African stakeholders. At this time, it is vital that robust scientific methods are used to develop and evaluate the new generation of forecasts. The Global Challenges Research Fund (GCRF) African Science for Weather Information and Forecasting Techniques (SWIFT) project represents an international effort to advance scientific solutions across the fields of nowcasting, synoptic and short-range severe weather prediction, subseasonal-to-seasonal (S2S) prediction, user engagement, and forecast evaluation. This paper describes the opportunities facing African meteorology and the ways in which SWIFT is meeting those opportunities and identifying priority next steps. Delivery and maintenance of weather forecasting systems exploiting these new solutions requires a trained body of scientists with skills in research and training, modeling and operational prediction, and communications and leadership. By supporting partnerships between academia and operational agencies in four African partner countries, the SWIFT project is helping to build capacity and capability in African forecasting science. A highlight of SWIFT is the coordination of three weather forecasting “Testbeds”—the first of their kind in Africa—which have been used to bring new evaluation tools, research insights, user perspectives, and communications pathways into a semioperational forecasting environment.
Deriving Effective Decision-Making Strategies of Prosthetists: Using Hidden Markov Modeling and Qualitative Analysis to Compare Experts and Novices
Authors: Saravanan Pratima , Menold Jessica 
Published: August 2021

Objective This research focuses on studying the clinical decision-making strategies of expert and novice prosthetists for different case complexities. Background With an increasing global amputee population, there is an urgent need for improved amputee care. However, current prosthetic prescription standards are based on subjective expertise, making the process challenging for novices, specifically during complex patient cases. Hence, there is a need for studying the decision-making strategies of prosthetists. Method An interactive web-based survey was developed with two case studies of varying complexities. Navigation between survey pages and time spent were recorded for 28 participants including experts ( n = 20) and novices ( n = 8). Using these data, decision-making strategies, or patterns of decisions, during prosthetic prescription were derived using hidden Markov modeling. A qualitative analysis of participants’ rationale regarding decisions was used to add a deep contextualized understanding of decision-making strategies derived from the quantitative analysis. Results Unique decision-making strategies were observed across expert and novice participants. Experts tended to focus on the personal details, activity level, and state of the residual limb prior to prescription, and this strategy was independent of case complexity. Novices tended to change strategies dependent upon case complexity, fixating on certain factors when case complexity was high. Conclusion The decision-making strategies of experts stayed the same across the two cases, whereas the novices exhibited mixed strategies. Application By modeling the decision-making strategies of experts and novices, this study builds a foundation for development of an automated decision-support tool for prosthetic prescription, advancing novice training, and amputee care.
Coopetition in a merger process: Regulators and management of coopetitive tensions
Authors: Thelisson Anne-Sophie 
Published: August 2021

Coopetitive tensions can arise as strategic decisions are imposed on firms that challenge them to pursue competition and collaboration with other organizations. Regulators—such as the state—can interfere in merger strategies. Using a longitudinal case study, the objective of the study is: (1) to analyze which regulators influence coopetitive tensions in a merger process (including negotiation and integration stages); and (2) to explore how coopetitive tensions are coped with during the process. We found that the state and customers have architectural roles as regulators during the process (negotiation period, deal, and integration process). We explore coopetition paradox management at different levels (interorganizational, organizational, and individual levels) over the merger process. Points for practitioners Our study sheds light on tensions experienced by managers with conflicting identities at the beginning of the integration and on the way they coped with such tensions. Indeed, our study shed lights on the integration principle as managers were able to transcend the paradox in their decisions and actions implemented at the organizational level through reorganizing the organization and favoring tandem teams and joint piloting.
Hyperdense middle cerebral artery sign predicts favorable outcome after decompressive craniectomy in patients with malignant middle cerebral artery infarction
Authors: Xu Zhihua , Duan Jinfeng , Yang Benqiang , Huang Xin , Liang Guobiao , Duan Yang 
Published: August 2021

Background Malignant middle cerebral artery infarction (MMI) is a life-threatening cerebral vascular event. Early decompressive craniectomy (DC) has proven to be an effective treatment strategy. However, the ideal candidate for DC continues to be debated. Purpose To investigate whether a hyperdense middle cerebral artery sign (HMCAS) provides prognostic value after DC in patients with MMI. Material and Methods We reviewed clinical information and radiological parameters on computed tomography of 42 patients with MMI who underwent DC. Functional outcome was assessed according to the modified Rankin scale (mRS) at three months as follows: favorable outcome (mRS ≤ 4) versus unfavorable outcome (mRS > 4). Logistic regression analysis was used to identify predictors of functional outcome after DC in patients with MMI. Results Age (odds ratio [OR] = 0.87; 95% confidence interval [CI] = 0.78–0.97; P = 0.014) and HMCAS (OR = 7.40; 95% CI = 1.35–40.48; P = 0.021) were associated with functional outcome. The area under the receiver operating characteristic curve for predicting favorable outcome using the combination of age and HMCAS was 0.882, and the sensitivity and specificity were 0.947 and 0.696, respectively. Conclusion Patients with MMI with HMCAS, as well as younger patients, often showed a favorable outcome after DC in this study.
Risk factors for clavicular midshaft fractures after hook plate fixation for the treatment of Neer type II clavicular fractures
Authors: Li Yihan , Tian Qingxian , Leng Kunpeng , Guo Meng 
Published: August 2021

Objective Neer type II fractures are common, and hook plate fixation is one of the recommended treatments. Although clavicular midshaft fractures after hook plate fixation are rare, such fractures increase patients’ suffering and worsen their functional outcomes. This study was performed to identify the risk factors for this complication. Methods From 2009 to 2018, 425 patients were admitted with Neer type II clavicular fractures. According to the selection criteria, 352 patients were included in this retrospective observational study. All patients were divided into either the complications group (patients with midshaft fractures) or the control group (patients without midshaft fractures). Data collected included patient demographics and surgical, hook plate, and screw characteristics. The chi-square test was used to conduct between-group comparisons of risk factors. Statistically significant variables were included in a logistic regression model. Results In both the complications group (n = 21) and control group (n = 331), significantly more patients of advanced age and significantly more patients treated with hook plates that were not bent during surgery developed midshaft fractures. Conclusion The risk of a clavicular midshaft fracture after hook plate fixation may be significantly increased by advanced age or a lack of hook plate bending.