bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospitalisations for emergency-sensitive conditions in Germany during the COVID-19 pandemic: insights from the German-wide Helios hospital network
Authors: Bollmann Andreas , Hohenstein Sven , Pellissier Vincent , König Sebastian , Ueberham Laura , Hindricks Gerhard , Meier-Hellmann Andreas , Kuhlen Ralf 
Published: September 2021

BackgroundWhile there are numerous reports that describe emergency care during the early COVID-19 pandemic, there is scarcity of data for later stages. This study analyses hospitalisation rates for 37 emergency-sensitive conditions in the largest German-wide hospital network during different pandemic phases.MethodsUsing claims data of 80 hospitals, consecutive cases between 1 January and 17 November 2020 were analysed and compared with a corresponding period in 2019. Incidence rate ratios (IRRs) comparing the two periods were calculated using Poisson regression to model the number of hospitalisations per day.ResultsThere was a reduction in hospitalisations between 12 March and 13 June 2020 (coinciding with the first pandemic wave) with 32 807 hospitalisations (349.0/day) as opposed to 39 379 (419.0/day) in 2019 (IRR 0.83, 95% CI 0.82 to 0.85, p<0.01). During the following period (14 June–17 November 2020, including the start of second wave), hospitalisations were reduced from 63 799 (406.4/day) in 2019 to 59 910 (381.6/day) in 2020, but this reduction was not as pronounced (IRR 0.94, 95% CI 0.93 to 0.95, p<0.01). During the first wave hospitalisations for acute myocardial infarction, aortic aneurysm/dissection, pneumonitis, paralytic ileus/intestinal obstruction and pulmonary embolism declined but subsequently increased compared with the corresponding periods in 2019. In contrast, hospitalisations for sepsis, pneumonia, obstructive pulmonary disease and intracranial injuries were reduced during the entire observation period.ConclusionsThere was an overall reduction of absolute hospitalisations for emergency-sensitive conditions in Germany during the first 10 months of the COVID-19 pandemic with heterogeneous effects on different disease categories. The increase in hospitalisations for acute myocardial infarction, aortic aneurysm/dissection and pulmonary embolism requires attention and further studies.
Endoscopically placed venting gastrostomy can be a safe and effective palliative intervention in benign and malignant gastrointestinal obstruction
Authors: Porter Ross J , McKinlay Alastair W , Metcalfe Emma L 
Published: September 2021

IntroductionChronic gastrointestinal obstruction can precipitate a constellation of symptoms including nausea, vomiting, abdominal distension and pain that negatively impact on health-related quality of life. Decompression via venting gastrostomy can offer symptomatic relief but safety and efficacy data are sparse. This study characterises the diverse venting percutaneous endoscopic gastrostomy (vPEG) cohort at our tertiary referral centre and defines the safety and efficacy of this procedure.MethodsPatients undergoing vPEG between May 2012 and June 2020 were identified from a prospectively maintained database and demographic, procedure-related and mortality data were extracted. Retrospective analysis of case notes provided data on patient symptoms. Last follow-up was May 2021.Results27 patients (median age 63, range 18–90 years) underwent vPEG insertion. The majority of vPEGs were for patients with obstruction secondary to locally advanced or metastatic malignancy (n=21/27, 77.8%). Six procedures were performed for benign disease (n=6/27, 22.2%). No patients developed the recognised serious complications of bleeding, perforation or peritonitis from vPEG insertion. Symptoms of nausea (p=0.006), vomiting (p<0.001), abdominal distension (p<0.001) and abdominal pain (p=0.002) were improved following vPEG. Pain beyond the expected postprocedural discomfort was associated with a lower number of days survived postprocedure (p=0.026).ConclusionvPEG can be a safe and efficacious palliative intervention for benign and malignant chronic gastrointestinal obstruction. Severe postprocedural pain should be promptly investigated to exclude a potential complication. A defined clinical strategy for assessing and managing these patients would facilitate wider recognition of the benefits of vPEG and improve the safety profile in centres with more limited experience.
Dancing Against falls iN Community-dwElling older adults (DANCE): a study protocol of a stratified, block-randomised trial
Authors: Thomsen Mikkel Jacobi , Liston Matthew , Christensen Merete Grothe , Vestergaard Peter , Hirata Rogerio Pessoto 
Published: September 2021

BackgroundUnintentional falls among older adults are of primary importance due to their impact on quality of life. Falling accounts for 95% of hip fractures, leading to an approximately six times increased risk of death within the first 3 months. Furthermore, physical and cognitive parameters are risk factors for falls. The purpose of this study is to examine the effect of a 6-month salsa dance training intervention, compared with regular fitness circuit training and a control group.MethodsThis study will include 180 older adults: 90 healthy patients and 90 patients with osteoporosis. Participants will be allocated randomly in either of the groups, stratified according to age. Training groups will receive 2 weekly 1-hour training sessions, continuously through 6 months. Participants will be tested at baseline and 6 and 18 months post baseline. Primary outcome will be number of falls and secondary outcomes include bone mineral density, body composition, pain evaluation, weekly physical activity, single-task and dual-task gait patterns, balance, Fullerton Functional Fitness Test and assessment of the mini-BESTest.DiscussionThis study will investigate the effects of a specially designed dance training programme (Dancing Against falls iN Community-dwElling older adults (DANCE)) to reduce the risk of falling among older adults. The study will investigate the effect against an active and passive comparator, resulting in the possibility to state, if DANCE training should be an alternative to traditional training.Trial registration numberNCT03683849.
Randomized trial comparing the spread of erector spinae block with the combination of erector spinae block and retrolaminar block in soft embalmed Thiel cadavers
Authors: Sartawi Razan Yousef , McLeod Graeme , Mustafa Ayman , Lamb Clare 
Published: September 2021

BackgroundErector spinae plane (ESP) and retrolaminar (RL) blocks show unreliable spread. We hypothesize that the combination of ESP and RL blocks provides more extensive and reliable spread of dye than single ESP blocks. Our primary objective was to compare the spread of dye to the paravertebral spaces after the combination block and ESP block in Thiel embalmed cadavers. Spread, the primary end point, was defined as the number of paravertebral spaces colored with dye per injection.Materials and methodsA single anesthetist performed ultrasound-guided ESP (20 mL) and combination of ESP and RL (10 mL each) blocks at the third thoracic vertebra of eight soft embalmed Thiel cadavers. Tissue displacement was visualized on an adjacent strain elastography image. Cadavers were dissected 24 hours later and anatomical structures were inspected for the presence of dye.FindingsDye was visualized in more paravertebral spaces with the combination block (median 3 (IQR 3–5 (range 0–8)) vs 1.5 (IQR 0.25–2.75 (range 0–3) and difference (1.5 (0–4), p=0.04). Six out of seven (86%) combined erector spinae and RL blocks spread to at least three paravertebral spaces compared with two out of eight (25%) ESP blocks (RR 3.4, 95% CI 1.0 to 11.8; p=0.04). Contralateral spread occurred in three combination blocks and in one ESP block (OR 9.0, 95% CI 4.0 to 21.1; p<0.001).ConclusionsIn conclusion, the combination of ESP and RL blocks was more extensive and reliable than ESP block alone.
Meaning, measurement, and field application of fully softened shear strength of stiff clays and clay shales
Authors: Mesri Gholamreza , Wang Cai , Kane Thierno 
Published: September 2021

Fully softened shear strength mobilized in first-time slope failures, introduced by Skempton in 1970, corresponds to a random edge–face arrangement and interaction of clay particles in an entirely destructured fabric of stiff clays and clay shales. A series of triaxial compression tests was conducted on reconstituted normally consolidated specimens of 15 stiff clay and clay shale compositions. Based on the laboratory results an empirical correlation for secant fully softened friction angle, [Formula: see text], was developed for clay compositions with plasticity index in the range of 10%–250%, in effective normal stress range of 10–700 kPa. The laboratory measurements confirm an empirical equation for fully softened shear strength in terms of parameters [Formula: see text] and mfs. The field application of secant fully softened friction angle was examined by stability analyses of 63 first-time slope failures in 38 geologic materials. These include 45 slope failures with a segment of observed slip surface at residual condition and the back-scarp mobilizing fully softened shear strength, and 18 slope failures with entire observed slip surface at fully softened condition. The back-calculated fully softened secant friction angles for first-time slope failures are in good agreement with [Formula: see text] correlation based on laboratory tests.
Viable intermediate inflation in the mimetic DBI model
Authors: Rashidi Narges , Nozari Kourosh 
Published: September 2021

AbstractWe study the intermediate inflation in the mimetic Dirac–Born–Infeld model. By considering the scale factor as $$a=a_{0}\exp (bt^{\beta })$$

a
=

a
0

exp

(
b

t
β

)

, we show that in some ranges of the intermediate parameters b and $$\beta $$
β
, the model is free of the ghost and gradient instabilities. We study the scalar spectral index, tensor spectral index, and the tensor-to-scalar ratio in this model and compare the results with Planck2018 TT, TE, EE + lowE + lensing + BAO + BK14 data at 68% and 95% CL. In this regard, we find some constraints on the intermediate parameters that lead to the observationally viable values of the perturbation parameters. We also seek the non-Gaussian features of the primordial perturbations in the equilateral configuration. By performing the numerical analysis on the nonlinearity parameter in this configuration, we show that the amplitude of the non-Gaussianity in the intermediate mimetic DBI model is predicted to be in the range $$-16.7<f^{equil}<-12.5$$

-
16.7
<

f

equil

<
-
12.5

. We show that, with $$0<b\le 10$$

0
<
b
≤
10

and $$0.345<\beta <0.387$$

0.345
<
β
<
0.387

, we have an instabilities-free intermediate mimetic DBI model that gives the observationally viable perturbation and non-Gaussianity parameters.
The mass of a Lifshitz black hole
Authors: Giribet Gaston , Lavia Edmundo 
Published: September 2021

AbstractIt is well known that massive 3D gravity admits solutions that describe Lifshitz black holes as those considered in non-relativistic holography. However, the determination of the mass of such black holes remained unclear as many different results were reported in the literature presenting discrepancies. Here, by using a robust method that permits to tackle the problem in the strong field regime, we determine the correct mass of the Lifshitz black hole of the higher-derivative massive gravity and compare it with other results obtained by different methods. Positivity of the mass spectrum demands an odd normalization of the gravity action. In spite of this fact, the result turns out to be consistent with computations inspired in holography.
INK4 Tumor Suppressor Proteins Mediate Resistance to CDK4/6 Kinase Inhibitors
Authors: Li Qing , Jiang Baishan , Guo Jiaye , Shao Hong , Del Priore Isabella S. , Chang Qing , Kudo Rei , Li Zhiqiang , Razavi Pedram , Liu Bo , Boghossian Andrew S. , Rees Matthew G. , Ronan Melissa M. , Roth Jennifer A. , Donovan Katherine A. , Palafox Marta , Reis-Filho Jorge S. , de Stanchina Elisa , Fischer Eric S. , Rosen Neal , Serra Violeta , Koff Andrew , Chodera John D. , Gray Nathanael S. , Chandarlapaty Sarat 
Published: September 2021

Abstract

Cyclin-dependent kinases 4 and 6 (CDK4/6) represent a major therapeutic vulnerability for breast cancer. The kinases are clinically targeted via ATP competitive inhibitors (CDK4/6i); however, drug resistance commonly emerges over time. To understand CDK4/6i resistance, we surveyed over 1,300 breast cancers and identified several genetic alterations (e.g., FAT1, PTEN, or ARID1A loss) converging on upregulation of CDK6. Mechanistically, we demonstrate CDK6 causes resistance by inducing and binding CDK inhibitor INK4 proteins (e.g., p18INK4C). In vitro binding and kinase assays together with physical modeling reveal that the p18INK4C–cyclin D–CDK6 complex occludes CDK4/6i binding while only weakly suppressing ATP binding. Suppression of INK4 expression or its binding to CDK6 restores CDK4/6i sensitivity. To overcome this constraint, we developed bifunctional degraders conjugating palbociclib with E3 ligands. Two resulting lead compounds potently degraded CDK4/6, leading to substantial antitumor effects in vivo, demonstrating the promising therapeutic potential for retargeting CDK4/6 despite CDK4/6i resistance.

Significance:
CDK4/6 kinase activation represents a common mechanism by which oncogenic signaling induces proliferation and is potentially targetable by ATP competitive inhibitors. We identify a CDK6–INK4 complex that is resilient to current-generation inhibitors and develop a new strategy for more effective inhibition of CDK4/6 kinases.
This article is highlighted in the In This Issue feature, p. 275
Supporting the Next Generation of Scientists to Lead Cancer Immunology Research
Authors: Alspach Elise , Chow Ryan D. , Demehri Shadmehr , Guerriero Jennifer L. , Gujar Shashi , Hartmann Felix J. , Helmink Beth A. , Hudson William H. , Ho Won Jin , Ma Leyuan , Maier Barbara B. , Maltez Vivien I. , Miller Brian C. , Moran Amy E. , Parry Erin M. , Pillai Padmini S. , Rafiq Sarwish , Reina-Campos Miguel , Rosato Pamela C. , Rudqvist Nils-Petter , Ruhland Megan K. , Sagiv-Barfi Idit , Sahu Avinash Das , Samstein Robert M. , Schürch Christian M. , Sen Debattama R. , Thommen Daniela S. , Wolf Yochai , Zappasodi Roberta 
Published: September 2021

Abstract
Recent success in the use of immunotherapy for a broad range of cancers has propelled the field of cancer immunology to the forefront of cancer research. As more and more young investigators join the community of cancer immunologists, the Arthur L. Irving Family Foundation Cancer Immunology Symposium provided a platform to bring this expanding and vibrant community together and support the development of the future leaders in the field. This commentary outlines the lessons that emerged from the inaugural symposium highlighting the areas of scientific and career development that are essential for professional growth in the field of cancer immunology and beyond. Leading scientists and clinicians in the field provided their experience on the topics of scientific trajectory, career trajectory, publishing, fundraising, leadership, mentoring, and collaboration. Herein, we provide a conceptual and practical framework for career development to the broader scientific community.
Modelagem 3D de edifícios históricos: a influência do LOD no processo de reconstrução virtual
Authors: Vilela João Paulo Chagas Maia , Lopes Ricardo Ferreira , Lima Fernando 
Published: September 2021

O presente artigo é fruto de uma pesquisa que investiga a modelagem tridimensional (3D) de edifícios históricos mediante diferentes configurações de LOD (Level Of Detail). No âmbito do patrimônio virtual, a criação de modelos 3D requer tempo, conhecimento técnico e sobretudo, planejamento. O LOD, neste caso, influencia na construção, representação e processamento dos modelos produzidos. Este estudo tem como objetivo principal investigar como o LOD interferiu no processo de reconstrução virtual de um edifício histórico localizado no município de Juiz de Fora, Minas Gerais, Brasil. A metodologia empregada valeu-se da combinação das pesquisas bibliográfica e experimental. Foi utilizada a técnica de modelagem semântica. A modelagem 3D do edifício foi desenvolvida em cinco diferentes LODs, cada qual atrelado às estruturas semânticas da arquitetura investigada. A partir disso, foram coletados quatro dados referentes à modelagem de cada LOD: tamanho do arquivo, tempo de modelagem, tempo de renderização e a quantidade de dados do modelo. Posteriormente, estes dados foram comparados. O experimento demonstrou relação direta entre os fluxos de trabalho e os LODs dos modelos. Acredita-se que ao investigar o processo de modelagem 3D, é possível oferecer suporte a futuros trabalhos da área, bem como ampliar as discussões sobre questões teórico-práticas voltadas à construção de modelos 3D de edifícios históricos.
One-Year Committed Exercise Training Reverses Abnormal Left Ventricular Myocardial Stiffness in Patients With Stage B Heart Failure With Preserved Ejection Fraction
Authors: Hieda Michinari , Sarma Satyam , Hearon Christopher M. , MacNamara James P. , Dias Katrin A. , Samels Mitchel , Palmer Dean , Livingston Sheryl , Morris Margot , Levine Benjamin D. 
Published: September 2021

Background:
Individuals with left ventricular (LV) hypertrophy and elevated cardiac biomarkers in middle age are at increased risk for the development of heart failure with preserved ejection fraction. Prolonged exercise training reverses the LV stiffening associated with healthy but sedentary aging; however, whether it can also normalize LV myocardial stiffness in patients at high risk for heart failure with preserved ejection fraction is unknown. In a prospective, randomized controlled trial, we hypothesized that 1-year prolonged exercise training would reduce LV myocardial stiffness in patients with LV hypertrophy.

Methods:

Forty-six patients with LV hypertrophy (LV septum >11 mm) and elevated cardiac biomarkers (N-terminal pro-B-type natriuretic peptide [>40 pg/mL] or high-sensitivity troponin T [>0.6 pg/mL]) were randomly assigned to either 1 year of high-intensity exercise training (n=30) or attention control (n=16). Right-heart catheterization and 3-dimensional echocardiography were performed while preload was manipulated using both lower body negative pressure and rapid saline infusion to define the LV end-diastolic pressure-volume relationship. A constant representing LV myocardial stiffness was calculated from the following: P=S×[Exp {a (V–V
0
)}–1], where “P” is transmural pressure (pulmonary capillary wedge pressure – right atrial pressure), “S” is the pressure asymptote of the curve, “V” is the LV end-diastolic volume index, “V
0
” is equilibrium volume, and “a” is the constant that characterizes LV myocardial stiffness.

Results:

Thirty-one participants (exercise group [n=20]: 54±6 years, 65% male; and controls (n=11): 51±6 years, 55% male) completed the study. One year of exercise training increased max by 21% (baseline 26.0±5.3 to 1 year later 31.3±5.8 mL·min
–1
·kg
–1
,
P
<0.0001, interaction
P
=0.0004), whereas there was no significant change in max in controls (baseline 24.6±3.4 to 1 year later 24.2±4.1 mL·min
–1
·kg
–1
,
P
=0.986). LV myocardial stiffness was reduced (right and downward shift in the end-diastolic pressure-volume relationship; LV myocardial stiffness: baseline 0.062±0.020 to 1 year later 0.031±0.009), whereas there was no significant change in controls (baseline 0.061±0.033 to 1 year later 0.066±0.031, interaction
P
=0.001).

Conclusions:
In patients with LV hypertrophy and elevated cardiac biomarkers (stage B heart failure with preserved ejection fraction), 1 year of exercise training reduced LV myocardial stiffness. Thus, exercise training may provide protection against the future risk of heart failure with preserved ejection fraction in such patients.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03476785.
Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated With Outcome
Authors: Samuels Noor , van de Graaf Rob A. , van den Berg Carlijn A.L. , Uniken Venema Simone M. , Bala Kujtesa , van Doormaal Pieter Jan , van der Steen Wouter , Witvoet Elbert , Boiten Jelis , den Hertog Heleen , Schonewille Wouter J. , Hofmeijer Jeannette , Schreuder Floris , Schreuder Tobien A.H.C.M.L. , van der Worp H. Bart , Roos Yvo B.W.E.M. , Majoie Charles B.L.M. , Burke James F. , van Es Adriaan C.G.M. , van der Lugt Aad , Roozenbeek Bob , Lingsma Hester F. , Dippel Diederik W.J. ,   on behalf of the MR CLEAN Registry Investigators
Published: September 2021

Background and Purpose:
Optimal blood pressure (BP) management in the acute phase of ischemic stroke remains an unresolved issue. It is uncertain whether guidelines for BP management during and after intravenous alteplase can be extrapolated to endovascular treatment (EVT) for stroke due to large artery occlusion in the anterior circulation. We evaluated the associations between systolic BP (SBP) in the first 6 hours following EVT and functional outcome as well as symptomatic intracranial hemorrhage.

Methods:
Patients of 8 MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry centers, with available data on SBP in the 6 hours following EVT, were analyzed. We evaluated maximum, minimum, and mean SBP. Study outcomes were functional outcome (modified Rankin Scale) at 90 days and symptomatic intracranial hemorrhage. We used multivariable ordinal and binary regression analysis to adjust for important prognostic factors and studied possible effect modification by successful reperfusion.

Results:
Post-EVT SBP data were available for 1161/1796 patients. Higher maximum SBP (per 10 mm Hg increments) was associated with worse functional outcome (adjusted common odds ratio, 0.93 [95% CI, 0.88–0.98]) and a higher rate of symptomatic intracranial hemorrhage (adjusted odds ratio, 1.17 [95% CI, 1.02–1.36]). The association between minimum SBP and functional outcome was nonlinear with an inflection point at 124 mm Hg. Minimum SBP lower and higher than the inflection point were associated with worse functional outcomes (adjusted common odds ratio, 0.85 per 10 mm Hg decrements [95% CI, 0.76–0.95] and adjusted common odds ratio, 0.81 per 10 mm Hg increments [95% CI, 0.71–0.92]). No association between mean SBP and functional outcome was observed. Successful reperfusion did not modify the relation of SBP with any of the outcomes.

Conclusions:
Maximum SBP in the first 6 hours following EVT is positively associated with worse functional outcome and an increased risk of symptomatic intracranial hemorrhage. Both lower and higher minimum SBP are associated with worse outcomes. A randomized trial to evaluate whether modifying post-intervention SBP results in better outcomes after EVT for ischemic stroke seems justified.
The Dammed Body: Thinking Historically about Water Security & Public Health
Authors: Derr Jennifer L. 
Published: September 2021

Abstract
This essay traces the historical relationship between the construction of the Nile River and the prevalence of disease in Egypt in the long twentieth century, with an eye to the relevance of this history to other regions on the African continent impacted by the construction of large dams. Beginning in the second decade of the nineteenth century and stretching through the 1970s, the Nile River underwent a dramatic process of transformation. Two large dams–the 1902 Khazan Aswan and the Aswan High Dam–were constructed on the river. Networks of perennial irrigation canals facilitated the practice of year-round agricultural production and the High Dam provided electricity. The remaking of Egypt's riparian ecologies also had important implications for the health of Egypt's population as these ecologies were associated with new landscapes of disease and approaches to biomedical treatment.