bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 345: Detection of Hypercoagulant Condition Caused by Elevated Prothrombin With a Thrombin Generation Assay
Authors: Chang William C , Machlus Kellie R , Wolberg Alisa S , Ovanesov Mikhail V 
Published: July 2021

Hypercoagulability resulting from elevated prothrombin is associated with increased thrombosis risk. Patients with elevated prothrombin include those with the G20210A mutation that represents the 2nd most common risk factor for venous thrombosis in European Caucasians. We hypothesized that the commercial thrombin generation assay (TGA), which measures the rate of synthetic thrombin substrate consumption, may detect procoagulant condition caused by elevated prothrombin.
Normal pooled plasma was treated with prothrombin or other coagulation factors to increase their levels to 200% or 400% of normal. TGA was performed using the Calibrated Automated Thrombogram (CAT) platform (Stago, USA) and analyzed with and without correction for substrate consumption. As expected, addition of elevated coagulation factors resulted in elevated TGA as measured by thrombin peak height (TPH) and endogenous thrombin potential (ETP). ETP allowed detection of up to 83% of spiked samples with 200% prothrombin but TPH has failed to distinguish these samples from the procoagulant samples obtained with other coagulation factors.
For samples with 400% prothrombin, CAT failed to return values for TPH for 40% of samples and ETP for 100% of samples but the remaining 60% of TPH values were detected as the procoagulant samples. By analyzing the raw fluorescence data directly, we found that elevated prothrombin, but not other coagulation factors, resulted in thrombin substrate depletion which allowed us to correctly distinguish all samples within our dataset regarding whether or not they had added prothrombin.
We conclude that the commercially available TGA has limited utility in distinguishing samples with elevated prothrombin but additional analysis of data can address this problem. With this additional analysis, TGA may be developable into new point-of-care test to diagnose patients with hypercoagulant conditions undetectable by currently used clotting assays.

Disclaimer:
This is an informal communication and represents authors’ best judgment. These comments do not bind or obligate FDA.
Abstract 526: Thromboembolic Phenomenon in a Patient With Unexplained Transverse Aortic Thrombus
Authors: Alhawasli Hazem , Brown Alan 
Published: July 2021

A 55 year-old Caucasian male, with no known past medical history, presented to the ER complaining of left upper extremity pain with finger tingling and difficulty speaking that started 8 hours before presentation, while driving his car. In the ER, physical exam was remarkable for mild expressive aphasia with difficulty finding words. His left arm was tender without any edema or erythema and normal range of motion. His left hand fingertips appeared cyanotic (
Picture 1)
, however his radial and ulnar pulses were intact bilaterally. Laboratory evaluation revealed a platelet count 1,416,000/mcl, and normal PT/INR and PTT. CT of the brain showed no intracranial bleed. MRI of the brain showed multiple small sub-acute infarcts in the left occipital lobe, left basal ganglia and bilateral cerebellar hemispheres suggesting a shower of emboli. Because of a concern for possible aortic dissection by the ER physician, a CT angiogram of the chest was done. It revealed a large filling defect (up to 3.1 cm) in the distal transverse thoracic aorta, consistent with non-occlusive thrombus adjacent to the origin of the left subclavian artery (
Picture 2)
. Subsequently, TEE was done and again showed a large mobile thrombus attached to the inferior posterior wall of the transverse thoracic aorta (
Picture 3)
. Given the extremely mobile and large sized thrombus, with high risk for further embolization, the patient underwent surgery with excision of the aortic thrombus (
Picture 4)
. The patient had an uncomplicated post-operative course and warfarin was started empirically post-operatively.

Further Hematology work up was suggestive of Essential Thrombocytosis. The patient was started on hydroxyurea.
On his 3-week follow up appointment, his platelet count decreased to 202,000/mcl. Anti-coagulation was continued for 3 months. His neurologic symptoms significantly improved with only mild residual left hand finger tips claudication which resolved by 1 month post discharge.
Abstract 562: Human Carotid Atherosclerosis Plaque Progression and Vessel Material Stiffness at Follow Up Had Positive Correlation: An in vivo Vessel Stiffness MRI Follow Up Study
Authors: Wang Qingyu , Tang Dalin , Canton Gador , Guo Jian , Guo Xiaoya , Hatsukami Thomas S , Billiar Kristen L , Wu Zheyang , Yuan Chun 
Published: July 2021

It is hypothesized that artery stiffness may be associated with plaque progression. However, in vivo vessel material stiffness follow-up data is lacking in the literature.
In vivo 3D multi-contrast and Cine magnetic resonance imaging (MRI) carotid plaque data were acquired from 8 patients with follow-up (18 months) with written informed consent obtained. Cine MRI and 3D thin-layer models were used to determine parameter values of the Mooney-Rivlin models for the 81slices from 16 plaques (2 scans/patient) using our established iterative procedures. Effective Young’s Modulus (YM) values for stretch ratio [1.0,1.3] were calculated for each slice for analysis.

Stress-stretch ratio curves from Mooney-Rivlin models for the 16 plaques and 81 slices are given in Fig. 1. Average YM value of the 81 slices was 411kPa. Slice YM values varied from 70 kPa (softest) to 1284 kPa (stiffest), a 1734% difference. Average slice YM values by vessel varied from 109 kPa (softest) to 922 kPa (stiffest), a 746% difference. Location-wise, the maximum slice YM variation rate within a vessel was 306% (139 kPa vs. 564 kPa). Average slice YM variation rate within a vessel for the 16 vessels was 134%. Average variation of YM values from baseline (T1) to follow up (T2) for all patients was 61.0%. The range of the variation of YM values was [-28.4%, 215%]. For progression study, YM increase (YMI=YM
T2
-TM
T1
) showed negative correlation with plaque progression measured by wall thickness increase (WTI), (r= -0.6802, p=0.0634). YM
T2
showed strong negative correlation with WTI (r= -0.7764, p=0.0235). Correlation between YM
T1
and WTI was not significant (r= -0.4353, p= 0.2811).

Conclusion
In vivo carotid vessel material properties have large variations from patient to patient, along the vessel segment within a patient, and from baseline to follow up. Use of patient-specific, location specific and time-specific material properties could potentially improve the accuracy of model stress/strain calculations.
Abstract P104: Dietary Polychlorinated biphenyls and Long-chain Omega-3 Fish fatty acids Exposures and Risk of Heart Failure
Authors: Kippler Maria , Donat Vargas Carolina , Berglund Marika , Glynn Anders , Wolk Alicja , Åkesson Agneta 
Published: July 2021

The potential beneficial effects of fish consumption on heart failure (HF) may be modified by major food contaminants in fish. Polychlorinated biphenyls (PCBs) in particular, have been associated with well-established risk factors of HF such as coronary heart disease, hypertension, and diabetes. Likewise, experimental and cross-sectional studies in humans suggest that PCB exposure may be involved in the development of HF. We aimed to assess the association of both dietary PCB and long-chain omega-3 fish fatty acids exposures with risk of HF in two large population-based prospective cohorts.
We used the Swedish Mammography Cohort and the Cohort of Swedish Men, comprising 32,867 women and 36,545 men, free of cancer, heart failure, myocardial infarction and diabetes at baseline in 1997. A questionnaire on diet (96-food items) and lifestyle factors was completed at baseline. We calculated validated estimates of dietary PCB exposure and intake of long-chain omega-3 fish fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)]. First incident cases of HF were ascertained through computerized linkage to the National Patient Register and the Cause of Death Register, defined as hospitalizations for (listed as the primary diagnosis) or death from HF. We use multivariable-adjusted Cox regression to estimate hazard ratio (HR) and its 95% confidence interval (CI), by quintiles of dietary PCB and EPA/DHA and controlling for known HF risk factors.
During an average of 12 years of follow-up, 1,263 and 1,606 first incident cases of HF were ascertained in women and men, respectively. In multivariable-adjusted models, we observed no association between dietary PCB exposure or EPA/DHA intake and risk of HF. However, after additional mutual adjustments for PCBs and EPA/DHA, HRs for dietary PCB exposure were 1.60 (95% CI, 1.08-2.38) among women and 1.40 (95% CI, 0.97-2.02) among men, comparing extreme quintiles. The corresponding HRs for EPA/DHA intake were 0.62 (95% CI, 0.42-0.92) and 0.79 (95% CI, 0.55-1.13), respectively.
Dietary exposure to PCBs was associated with an increased risk of HF in women, while EPA/DHA intake was associated with a lower risk of HF. Results for men was less evident but showed a similar trend. The results provide important information regarding the risk-benefit analysis of fish consumption, especially in cardiovascular disease prevention.
Abstract P238: Remission/Cure of Autoimmune Diseases by a Lectin Limite Diet Supplemented With Probiotics, Prebiotics, and Polyphenols
Authors: Gundry Steven R 
Published: July 2021

All autoimmune diseases are highly associated with increased rates of coronary artery and vascular disease secondary to immune cell attack on epithelial cells. The causes of autoimmune disease (AID) seem to be multifactorial. However, the idea that derangement of the microbiome, breaches of the intestinal barrier (leaky gut) and introduction into the human diet of plant defense molecules such as lectins, which are capable of molecular mimicry, prompted our group to investigate the application of a lectin limited diet, coupled with probiotics and prebiotics (The Pant Paradox Protocol) to impact biomarker proven autoimmune disease activity in humans and their impact on endothelial biomarkers of inflammation.
One hundred and two consecutive patients with immunoassay markers of autoimmune disease activity, i.e., RF, anti-CCP, ANA, Histone, etc, and signs and symptoms of RA, Lupus, Sjogrens, Crohns, Colitis, Scleroderma, Mixed Connective Tissue Disease, and biomarkers of endothelial inflammation, were enrolled into a program of elimination of major dietary lectins, consisting of all grains and pseudo grains, beans and legumes, peanuts, cashews, nightshades, squashes, and Casein A1 milk products (The Plant Paradox Program), supplemented with probiotics and prebiotics including resistant starches and polyphenol supplements. All pts initially low Vit D levels and low Omega 3 index and adiponectin levels above 16mg/dl. Biomarkers of inflammation, hs-CRP, TNF-alpha, IL-6, fibrinogen, myeloperoxidase and autoimmune markers were measured every 3 months.
95/102 patients achieved complete resolution of autoimmune markers and inflammatory markers within 9 months. The other 7/102 patients all had reduced markers, but incomplete resolution. 80/102 patients were weaned from all immunosuppressive and/or biologic medications without rebound.
We conclude that a lectin limited diet, supplemented with pro and prebiotics, and polyphenols are capable of curing or putting into remission most autoimmune diseases.
Abstract 17274: Timed up and Go Test Predicts One-Year Mortality Among Patients Cardiovascular Events After Percutaneous Coronary Intervention
Authors: Khan Nadeem , Singh Mandeep 
Published: July 2021

Timed Up and Go test predicts one-year mortality among patients cardiovascular events after percutaneous coronary intervention
Nadeem A. Khan, R. Jay Widmer, Amrit Kanwar, Mohammed A. Al-Hijji, Abdallah El Sabbagh, Ryan J. Lennon, Rajiv Gulati, Amir Lerman, Arashk Motiei, Mandeep Singh

Background:
Frailty is frequently seen in older adults and among patients with cardiovascular disease (CVD). Timed Up and Go Test (TUG) is a reliable and validated measure of frailty. We aim to assess 1-year mortality and stratify patients based on the performance on the test.

Methods:
Patients ≥55 years and referred to the cardiac catheterization laboratory underwent the TUG, a simple test to measure static and dynamic balance. We timed the patients while they were instructed to rise from the chair, walk 3 meters (or 10 feet), turn around, and walk back to the chair and sit down. Timing was divided in four categories [<7 sec (controls), 8-10 sec, 11-14 sec, and > 15 sec]. Mortality at one year was evaluated using a Cox proportional hazards model.

Results:
Those with TUG >15s were older (75.8 ±9.1years vs. 71.2±9.2 years in controls; P<0.001) and more women (42% vs. 29%) had TUG >15s, P=0.002. Patients with TUG >15 s had a significantly increased risk of mortality on follow-up (HR 3.88, 95% CI 1.97-7.66; P<0.001, Figure) which remained significant after adjusting for age and sex (HR 1.86, 95% CI 1.05, 3.30).

Conclusions:
The TUG test predicts one year mortality among patients referred to the cardiac catheterization laboratory. These data underscore the importance of frailty assessment in patients with CVD.
Implementation of the Convention on Rights of the Child (CRC) in Tanzania, 2005–2011: A Critical Review
Authors: Masabo Conrad John 
Published: July 2021

Abstract
This paper presents a critical review of the implementation of three selected articles of the Convention on the Right of the Child (CRC): Article 1 which defines of who is a child; Article 28 which stipulates the child’s rights to basic education; and Article 32, which calls on governments to protect the child from labour. Its analysis draws on the Tanzania 3rd, 4th, and 5th combined CRC implementation report, the CSO’s CRC implementation alternative report, and the CRC Committee’s observations. The findings suggest that, although there have been remarkable commitment and promising progress in making children’s rights a reality for Tanzanian children, there were still some challenges and dilemmas that emerged during their implementation. Thus, the study recommends for the harmonisation of the understanding of who is a child in addition to main-streaming work as an integral part of children’s childhood life.
European Support for Arab Parliaments: A Successful Way to Democracy?
Authors: Völkel Jan Claudius 
Published: July 2021

Abstract
This article contributes to the Special Issue “Parliaments in the Middle East and North Africa: A Struggle for Relevance.” In the Euro-Mediterranean region, several international parliamentary initiatives are engaged in parliamentary diplomacy and cooperation. Aside from the European Parliament, the Parliamentary Assembly of the Union for the Mediterranean (pa-UfM) and the Parliamentary Assembly of the Mediterranean (pam) cross the shores. In addition, a number of national European parliaments, as well as governmental and non-governmental organizations, cooperate with Arab parliaments in a bilateral manner.
Based on the author’s own research in Brussels, Amman, Cairo, Rabat, Tunis, and Valletta, the article analyzes cross-Mediterranean parliamentary relations and argues that parliamentary cooperation could facilitate an increase in Arab parliaments’ overall relevance, eventually leading to advanced democratization; however, the authoritarian regimes still in place in most Arab countries still successfully prevent a meaningful strengthening of national legislatures. International support offers thus require broader transformations in their partner countries before yielding success.
Jordan’s Election Law: Reinforcing Barriers to Democracy
Authors: Karmel E.J. , Linfield David 
Published: July 2021

Abstract
Since the 2016 introduction of a proportional open-list voting system to Jordan’s parliamentary elections, the Jordanian government has faced ongoing demands for reform. In response, the government has continually pointed to the many liberal democracies in Europe that use similar electoral systems. However, the issue is not that an undemocratic system is in place but rather that the system is unconducive to democratic reform given Jordan’s broader socio-political environment. This legal comment will explore the key facets of Jordan’s 2016 election law, discussing how the system – which could be effective in other contexts – impedes political change in Jordan and thus maintains the same patronage-fueled electoral dynamics that have prevailed since the reintroduction of parliamentary life in Jordan three decades ago.
Central Asian Precipitation Shaped by the Tropical Pacific Decadal Variability and the Atlantic Multidecadal Variability
Authors: Jiang Jie , Zhou Tianjun , Chen Xiaolong , Wu Bo 
Published: July 2021

AbstractKnown as one of the largest semiarid to arid regions in the world, central Asia and its economy and ecosystem are highly sensitivity to the changes in precipitation. The observed precipitation and related hydrographic characteristics have exhibited robust decadal variations in the past decades, but the reason remains unknown. Using the pacemaker experiments of the Community Earth System Model (CESM1.2), we find that the tropical Pacific decadal variability (TPDV) and the Atlantic multidecadal variability (AMV) are the main drivers of the interdecadal variations in central Asian precipitation during 1955–2004. Both the decadal-scale warming of the tropical Pacific and North Atlantic are favorable for wetter conditions over central Asia. The positive TPDV is accompanied with high sea level pressure (SLP) over the Indo–western Pacific warm pool. Southwesterly winds along the northwestern flank of the high SLP can transport more moisture to southeastern central Asia. The warm AMV can excite a circumglobal teleconnection (CGT) pattern. A trough node of the CGT to the west of central Asia drives an anomalous ascending motion and increased precipitation over this region. The results based on the CESM model are further demonstrated by the pacemaker experiments of MRI-ESM2-0. Based on the observational TPDV and AMV indices, we reasonably reconstruct the historical precipitation over central Asia. Our results provide hints for the decadal prediction of precipitation over central Asia.
Composition of Uroliths seen in patients in Abuja, Nigeria: a single centre retrospective analysis of 155 stones
Authors: Undie Celsus Ukelina , Nnana Ewomazino Ibanga , Torporo Kalenebari Raymond 
Published: July 2021

Abstract
Background
Uroliths are stones formed in the urinary tract. Analysis of stones helps to identify risk factors for their development and prevention of recurrence. Standard stone analysis using modern technology is not routinely done in Nigeria. This study sought to determine the chemical composition of urinary stones seen in Abuja, Nigeria.

Methods
This was a retrospective study on composition of uroliths. Urinary stones surgically removed from 155 patients through minimal access surgical procedures between January 2015 and August 2019 were analysed. Optical crystallography and infrared spectroscopy were used to determine the chemical composition of the urinary stones.

Results
A total of 155 urinary stones were assembled from the patients. More stones were removed from male patients and the male to female ratio was 1.9:1. Stones were rare in the extremes of age. The predominant location (89.7%) of stones was in the upper urinary tract. All stones were of mixed composition with calcium oxalate accounting for 93.55%. Calcium oxalate, calcium phosphate and uric acid stones were more common in the upper tract, while 2 of the 3 struvite stones were found in the lower tract.

Conclusion
Stones found in this study were of mixed composition with the most common constituent being Calcium oxalate and the least common, struvite.
The infant gut resistome is associated with E. coli and early-life exposures
Authors: Lebeaux Rebecca M. , Coker Modupe O. , Dade Erika F. , Palys Thomas J. , Morrison Hilary G. , Ross Benjamin D. , Baker Emily R. , Karagas Margaret R. , Madan Juliette C. , Hoen Anne G. 
Published: July 2021

Abstract
Background
The human gut microbiome harbors a collection of bacterial antimicrobial resistance genes (ARGs) known as the resistome. The factors associated with establishment of the resistome in early life are not well understood. We investigated the early-life exposures and taxonomic signatures associated with resistome development over the first year of life in a large, prospective cohort in the United States. Shotgun metagenomic sequencing was used to profile both microbial composition and ARGs in stool samples collected at 6 weeks and 1 year of age from infants enrolled in the New Hampshire Birth Cohort Study. Negative binomial regression and statistical modeling were used to examine infant factors such as sex, delivery mode, feeding method, gestational age, antibiotic exposure, and infant gut microbiome composition in relation to the diversity and relative abundance of ARGs.

Results
Metagenomic sequencing was performed on paired samples from 195 full term (at least 37 weeks’ gestation) and 15 late preterm (33–36 weeks’ gestation) infants. 6-week samples compared to 1-year samples had 4.37 times (95% CI: 3.54–5.39) the rate of harboring ARGs. The majority of ARGs that were at a greater relative abundance at 6 weeks (chi-squared p < 0.01) worked through the mechanism of antibiotic efflux. The overall relative abundance of the resistome was strongly correlated with Proteobacteria (Spearman correlation = 78.9%) and specifically Escherichia coli (62.2%) relative abundance in the gut microbiome. Among infant characteristics, delivery mode was most strongly associated with the diversity and relative abundance of ARGs. Infants born via cesarean delivery had a trend towards a higher risk of harboring unique ARGs [relative risk = 1.12 (95% CI: 0.97–1.29)] as well as having an increased risk for overall ARG relative abundance [relative risk = 1.43 (95% CI: 1.12–1.84)] at 1 year compared to infants born vaginally.

Conclusions
Our findings suggest that the developing infant gut resistome may be alterable by early-life exposures. Establishing the extent to which infant characteristics and early-life exposures impact the resistome can ultimately lead to interventions that decrease the transmission of ARGs and thus the risk of antibiotic resistant infections.