bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 pandemic experiences of parents caring for children with oesophageal atresia/tracheo-oesophageal fistula
Authors: Stewart Alexandra , Smith Christina H , Eaton Simon , De Coppi Paolo , Wray Jo 
Published: May 2021

PurposeThe COVID-19 pandemic has resulted in a global health crisis of unparalleled magnitude. The direct risk to the health of children is low. However, disease-containment measures have society-wide impacts. This study explored the pandemic experiences of parents of children with oesophageal atresia/tracheo-oesophageal fistula (OA/TOF) in the UK.DesignA phenomenological approach underpinned use of an asynchronous online forum method, in collaboration with a patient support group. Data were evaluated using thematic analysis.ResultsThe online forum ran between 7 November and 18 December 2020 with 109 participants.Pandemic experiences were divided into themes relating to healthcare and disease containment. Participants described positive experiences with remote healthcare but identified limitations. Delays and cancellations led to escalation of care to an emergency level, slower developmental progress and feelings of being abandoned by services. Inpatient care was perceived as safe but caring alone was emotionally and practically challenging. Disease containment themes revealed anxiety regarding health risks, ‘collateral’ damage to well-being because of isolation, and an impact on finances and employment. Parents described a transition from worry about direct health risks to concern about the impact of isolation on socialisation and development. A process of risk–benefit analysis led some to transition to a more ‘normal life’, while others continued to isolate. Benefits to their child’s health from isolation were reported.ConclusionsParents’ experiences of caring for a child with OA/TOF during the pandemic were varied. Rapid adoption of telehealth has demonstrated the enormous potential of remote healthcare delivery but requires refinement to meet the needs of the individual. Future pandemic planning should aim to retain community healthcare services to avoid escalation of care to an emergency, manage chronic and developmental concerns, and support parental well-being. Accurate and consistent disease-specific information is highly valued by parents. Third sector organisations are ideally positioned to support this.
Single-cell multiomics dissection of basal and antigen-specific activation states of CD19-targeted CAR T cells
Authors: Bai Zhiliang , Lundh Stefan , Kim Dongjoo , Woodhouse Steven , Barrett David M , Myers Regina M , Grupp Stephan A , Maus Marcela V , June Carl H , Camara Pablo G , Melenhorst J Joseph , Fan Rong 
Published: May 2021

BackgroundAutologous T cells engineered to express a chimeric antigen receptor (CAR) specific for CD19 molecule have transformed the therapeutic landscape in patients with highly refractory leukemia and lymphoma, and the use of donor-generated allogeneic CAR T is paving the way for further breakthroughs in the treatment of cancer. However, it remains unknown how the intrinsic heterogeneities of these engineered cells mediate therapeutic efficacy and whether allogeneic products match the effectiveness of autologous therapies.MethodsUsing single-cell mRNA sequencing in conjunction with CITE-seq, we performed multiomics characterization of CAR T cells generated from healthy donor and patients with acute lymphoblastic leukemia. CAR T cells used in this study were manufactured at the University of Pennsylvania through lentiviral transduction with a CD19-4-1BB-CD3ζ construct. Besides the baseline condition, we engineered NIH-3T3 cells with human CD19 or mesothelin expression to conduct ex vivo antigen-specific or non-antigen stimulation of CAR T cells through 6-hour coculture at a 1:1 ratio.ResultsWe delineated the global cellular and molecular CAR T landscape and identified that transcriptional CAR tonic signaling was regulated by a mixture of early activation, exhaustion signatures, and cytotoxic activities. On CD19 stimulation, we illuminated the disparities of CAR T cells derived from different origins and found that donor CAR T had more pronounced activation level in correlation with the upregulation of major histocompatibility complex class II genes compared with patient CAR T cells. This finding was independently validated in additional datasets from literature. Furthermore, GM-CSF(CSF2) expression was found to be associated with functional gene productions, but it induced little impact on the CAR T activation.ConclusionsThrough integrated multiomics profiling and unbiased canonical pathway analyses, our results unveil heterogeneities in the transcriptional, phenotypic, functional, and metabolic profiles of donor and patient CAR T cells, providing mechanistic basis for ameliorating clinical outcomes and developing next-generation ‘off- the-shelf’ allogeneic products.
Diagnostic role of coronary CT angiography in paroxysmal or first diagnosed atrial fibrillation
Authors: Rottländer Dennis , Saal Martin , Degen Hubertus , Gödde Miriel , Horlitz Marc , Haude Michael 
Published: May 2021

ObjectivesThe presence of coronary artery disease (CAD) in patients hospitalised with paroxysmal or first diagnosed atrial fibrillation (AF) has major implications for antithrombotic therapy and cardiovascular event rate. Coronary CT angiography (CCTA) is a feasible tool to identify patients with concealed CAD. We aimed to evaluate the diagnostic role of early CCTA in patients hospitalised with paroxysmal or first diagnosed AF.MethodsIn a 5-year single-centre retrospective analysis, 566 patients with paroxysmal or first diagnosed AF who underwent CCTA were enrolled to investigate the presence of CAD.ResultsIn patients with paroxysmal or first diagnosed AF, CCTA revealed CAD (coronary artery stenosis ≥50%) in 39.2%. Cardiac catheterisation was performed in 31.6%, confirming CAD in 13.1% of all patients. In 8.0% percutaneous coronary intervention and in 0.5% coronary artery bypass grafting was performed. In patients with paroxysmal or first diagnosed AF: (1) angina pectoris per se does not predict CAD; (2) multivariable regression analysis revealed age, male sex and diabetes as risk factors for CAD in AF; (3) Framingham Risk Score for coronary heart disease and CHA2DS2-VASc-Score were relevant risk scores of CAD and (4) the classification of Coronary Artery Calcium score reference values according to the Multi-Ethnic Study of Atherosclerosis was a predictor of CAD.ConclusionPatients with paroxysmal or first diagnosed AF are at risk for CAD, while CCTA is a feasible diagnostic tool for CAD. We recommend to integrate CT calcium scoring and CCTA into the diagnostic workup of patients with new-onset or paroxysmal AF.
Heating triangle singularities in heavy ion collisions
Authors: Abreu Luciano M. , Llanes-Estrada Felipe J. 
Published: May 2021

AbstractWe predict that triangle singularities of hadron spectroscopy can be strongly affected in heavy ion collisions. To do it we examine various effects on the singularity-inducing triangle loop of finite temperature in the terminal hadron phase. It appears that peaks seen in central heavy ion collisions are more likely to be hadrons than rescattering effects under two conditions. First, the flight-time of the intermediate hadron state must be comparable to the lifetime of the equilibrated fireball (else, the reaction mostly happens in vacuo after freeze out). Second, the medium effect over the triangle-loop particle mass or width must be sizeable. When these (easily checked) conditions are met, the medium quickly reduces the singularity: at T about 150 MeV, even by two orders of magnitude, acting then as a spectroscopic filter.
Quantitative analysis of surfaces of cross-section in butt welding of aluminum alloy 5083 using laser–arc hybrid welding
Authors: Kim Ji-Sung , Kim Jong-Do 
Published: May 2021

The alloy aluminum of 5000 series will have relatively high strength through solid solution strengthening of Mg. However, when laser welding the 5000 series aluminum alloys, the Mg is selectively evaporated by welding heat due to its low melting and vaporization points, resulting in a reduction in the strength of welds. Therefore, laser welding application is difficult because of such a reduction in strength[Formula: see text] [M. Peel, A. Steuwer, M. Preuss and P. J. Withers, Acta Mater. 51, 4791 (2003); A. Haboudou, P. Peyre, A. B. Vannes and G. Peix, Mater. Sci. Eng. A 363, 40 (2003)]. In this paper, welding experiments were carried out using laser and laser–arc hybrids on aluminum alloy 5083 with 8-mm thickness. Tensile testing, scanning electron microscopy (SEM) analysis and electron probe microanalyzer (EPMA) analysis were carried out on specimens on which the laser and laser–arc hybrid weldings were performed. According to the tensile test results, the tensile strength during laser–arc hybrid welding was greater than 85% of the parent metal. In addition, EPMA analysis showed that the strength of the laser–arc hybrid welds was maintained by supplementing the optional evaporating Mg element, since they use the filler wire.
On the density of Cayley graphs of R.Thompson’s group F in symmetric generators
Authors: Guba V. S. 
Published: May 2021

By the density of a finite graph we mean its average vertex degree. For an [Formula: see text]-generated group, the density of its Cayley graph in a given set of generators, is the supremum of densities taken over all its finite subgraphs. It is known that a group with [Formula: see text] generators is amenable if and only if the density of the corresponding Cayley graph equals [Formula: see text]. A famous problem on the amenability of R. Thompson’s group [Formula: see text] is still open. Due to the result of Belk and Brown, it is known that the density of its Cayley graph in the standard set of group generators [Formula: see text], is at least [Formula: see text]. This estimate has not been exceeded so far. For the set of symmetric generators [Formula: see text], where [Formula: see text], the same example only gave an estimate of [Formula: see text]. There was a conjecture that for this generating set equality holds. If so, [Formula: see text] would be non-amenable, and the symmetric generating set would have the doubling property. This would mean that for any finite set [Formula: see text], the inequality [Formula: see text] holds. In this paper, we disprove this conjecture showing that the density of the Cayley graph of [Formula: see text] in symmetric generators [Formula: see text] strictly exceeds [Formula: see text]. Moreover, we show that even larger generating set [Formula: see text] does not have doubling property.
Deep Learning-Based Arrhythmia Detection in Electrocardiograph
Authors: Meng Yang , Liang Guoxin , Yue Mei 
Published: May 2021

This study aimed to explore the application of electrocardiograph (ECG) in the diagnosis of arrhythmia based on the deep convolutional neural network (DCNN). ECG was classified and recognized with the DCNN. The specificity (Spe), sensitivity (Sen), accuracy (Acc), and area under curve (AUC) of the DCNN were evaluated in the Chinese Cardiovascular Disease Database (CCDD) and Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database, respectively. The results showed that in the CCDD, the original model tested by the small sample set had an accuracy (Acc) of 82.78% and AUC of 0.882, while the Acc and AUC of the translated model were 85.69% and 0.893, respectively, so the difference was notable (

P

< 0.05); the Acc of the original model and the translated model was 80.12% and 82.63%, respectively, in the large sample set, so the difference was obvious (

P

< 0.05). In the MIT-BIH database, the Acc of normal (N) heart beat (HB) (99.38%) was higher than that of the atrial premature beat (APB) (87.45%) (

P

< 0.05). In a word, applying the DCNN could improve the Acc of ECG for classification and recognition, so it could be well applied to ECG signal classification.
O problema do tempo na obra de arte: Releituras de Henri Focillon
Authors: Fonseca Lorenna 
Published: May 2021

O intuito deste artigo é refletir sobre a questão do tempo na obra de arte para Henri Focillon, trazendo para o debate as diferentes interpretações críticas que o autor recebeu posteriormente. Para tanto, foram selecionados trechos de três historiadores da arte – Hans Belting, Germain Bazin e Jacques Thuillier – que apresentam suas distintas releituras sobre o pensamento de Focillon. A obra de arte foi expressa em um elo ativo com o tempo; ela seria um ato de liberdade e, da mesma maneira, poderia ser deliberada por outros eventos na História. O problema do tempo, em Focillon, por se evidenciar em um movimento paradoxal, foi recebido de modo divergente por parte de autores posteriores, não havendo um consenso interpretativo a seu respeito.
A judicialização de cirurgia bucomaxilofacial e o sistema de assistência à saúde dos servidores públicos de Pernambuco
Authors: Alcoforado Renato Ludmer Guedes , Almeida Adriana Conrado de , Porto Gabriela Granja , Silva Jackeline Carneiro da , Antunes Antonio Azoubel 
Published: May 2021

A CF/88 foi pioneira ao dispor sobre o direito à saúde como direito fundamental e regular o sistema suplementar de saúde. Vários estados brasileiros criaram planos voltados exclusivamente para seus servidores; Pernambuco foi o pioneiro a concebê-los, através do Sistema de Assistência à Saúde dos Servidores do Estado de Pernambuco. Os avanços tecnológicos, o aumento da expectativa de vida (e a consequente perda dentária precoce) e os traumas provocaram aumento do uso de órteses, próteses e materiais especiais em procedimentos invasivos – proporcionando, dentre outros benefícios, a reparação estética. Porém, há entraves ao uso desses materiais, entre eles seu alto custo e a ausência de cobertura dos planos de saúde para procedimentos estéticos. Foram analisados os processos judiciais envolvendo órteses, próteses e materiais especiais em cirurgia bucomaxilofacial contra o Sistema de Assistência dos Servidores de Pernambuco, entre janeiro de 2009 e dezembro de 2017. O propósito foi defender que a indicação do material a ser utilizado pelo cirurgião-dentista não pode ser considerada critério absoluto e que o Poder Judiciário não deve acatar tal opinião sem questioná-la. Verificou-se a necessidade de franquear maior estrutura aos magistrados, com a criação de núcleos de assistência técnica em saúde e/ou investimentos nos já existentes, a fim de subsidiar os julgadores e assegurar uma maior eficiência na solução das demandas. A metodologia aplicada foi a do estudo transversal, baseado na análise de dados quantitativos e qualitativos extraídos dos processos. Como variáveis, traçaram-se o perfil dos autores das ações e os parâmetros adotados nas decisões judiciais.
Association of Health Insurance Payer Type and Outcomes After Durable Left Ventricular Assist Device Implantation: An Analysis of the STS-INTERMACS Registry
Authors: Khatana Sameed Ahmed M. , Hanff Thomas C. , Nathan Ashwin S. , Dayoub Elias J. , Grandin E. Wilson , Rame J. Eduardo , Fanaroff Alexander C. , Giri Jay , Groeneveld Peter W. 
Published: May 2021

Background:
Due to the high cost of left ventricular assist device (LVAD) therapy, payer type may be an important factor in determining eligibility. How payer type influences outcomes after LVAD implantation is unclear. We, therefore, aimed to study the association of health insurance payer type with outcomes after durable LVAD implantation.

Methods:
Using STS-INTERMACS (Society of Thoracic Surgeons-Interagency Registry for Mechanically Assisted Circulatory Support), we studied nonelderly adults receiving a durable LVAD from 2016 to 2018 and compared all-cause mortality and postindex hospitalization adverse event episode rate by payer type. Multivariable Fine-Gray and generalized linear models were used to compare the outcomes.

Results:

Of the 3251 patients included, 26.0% had Medicaid, 24.9% had Medicare alone, and 49.1% had commercial insurance. Compared with commercially insured patients, mortality did not differ for patients with Medicaid (subdistribution hazard ratio, 1.00 [95% CI, 0.75–1.34],
P
=0.99) or Medicare (subdistribution hazard ratio, 1.09 [95% CI, 0.84–1.41],
P
=0.52). Medicaid was associated with a significantly lower adjusted incidence rate (incidence rate ratio, 0.88 [95% CI, 0.78–0.99],
P
=0.041), and Medicare was associated with a significantly higher adjusted incidence rate (incidence rate ratio, 1.16 [95% CI, 1.03–1.30],
P
=0.011) of adverse event episodes compared with commercially insured patients.

Conclusions:
All-cause mortality after durable LVAD implantation did not differ significantly by payer type. Payer type was associated with the rate of adverse events, with Medicaid associated with a significantly lower rate, and Medicare with a significantly higher rate of adverse event episodes compared with commercially insured patients.
Association Between Angiotensin Receptor–Neprilysin Inhibition, Cardiovascular Biomarkers, and Cardiac Remodeling in Heart Failure With Reduced Ejection Fraction
Authors: Murphy Sean P. , Prescott Margaret F. , Maisel Alan S. , Butler Javed , Piña Ileana L. , Felker G. Michael , Ward Jonathan H. , Williamson Kristin M. , Camacho Alexander , Kandanelly Ritvik R. , Solomon Scott D. , Januzzi James L. 
Published: May 2021

Background:
Sacubitril/valsartan (S/V) treatment is associated with reverse cardiac remodeling and reductions in biomarkers reflecting ventricular wall stress and myocardial injury, such as NT-proBNP (N-terminal pro-B-type natriuretic peptide), hs-cTnT (high-sensitivity cardiac troponin T), and soluble suppressor of tumorigenicity 2 (sST2). How longitudinal changes in these biomarkers analyzed collectively are associated with cardiac remodeling in patients with heart failure with reduced ejection fraction treated with S/V is uncertain.

Methods:
In a prospective study of S/V in patients with heart failure with reduced ejection fraction, this prespecified exploratory analysis included patients with serially collected biomarkers and echocardiographic measures of cardiac remodeling through 12 months of treatment. A multivariate latent growth curve model assessed associations between simultaneous changes in biomarkers and left ventricular ejection fraction and left atrial volume index.

Results:

Seven hundred fifteen out of 794 total study participants were included (mean age 65 years, 73% male). Mean baseline left ventricular ejection fraction and left atrial volume index were 29% and 40 mL/m
2
, respectively. Adjusted geometric mean baseline concentrations for biomarkers included NT-proBNP of 649 pg/mL, hs-cTnT of 15.9 ng/L, and sST2 of 24.7 ng/mL. Following initiation of S/V, circulating concentrations of NT-proBNP, hs-cTnT, and sST2 significantly decreased within 30 days and remained significantly different than baseline at all subsequent timepoints. From baseline to month 12, decreases in adjusted biomarker concentrations averaged −27.9% (95% CI, −35.1% to −20.7%;
P
<0.001) for NT-proBNP; −6.7% (95% CI, −8.8% to −4.7%;
P
<0.001) for hs-cTnT; and −1.6% (95% CI, −2.9% to −0.4%;
P
<0.001) for sST2. NT-proBNP concentrations were predictive of later changes in hs-cTnT. The magnitude of reductions in NT-proBNP and hs-cTnT concentrations associated with improvements in left ventricular ejection fraction and left atrial volume index. There was no association between changes in sST2 and changes in other measures.

Conclusions:
Following initiation of S/V, NT-proBNP, hs-cTnT, and sST2 concentrations decreased significantly. Longitudinal changes in NT-proBNP and hs-cTnT together associated with left atrial and left ventricular reverse remodeling.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02887183.
Sex, HIV Status, and Measures of Cardiac Stress and Fibrosis in Uganda
Authors: Kipke Jasmine , Margevicius Seunghee , Kityo Cissy , Mirembe Grace , Buggey Jonathan , Yun Chun‐Ho , Hung Chung‐Lieh , McComsey Grace A. , Longenecker Chris T. 
Published: May 2021

Background
Biomarkers of myocardial stress and fibrosis are elevated in people living with HIV and are associated with cardiac dysfunction. It is unknown whether sex influences these markers of heart failure risk in sub‐Saharan Africa, where HIV burden is high and where the vast majority of women with HIV live.

Methods and Results

Echocardiograms and 6 plasma biomarkers (suppression of tumorigenicity‐2, growth differentiation factor 15, galectin 3, soluble fms‐like tyrosine kinase‐1, NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], and cystatin C) were obtained from 100 people living with HIV on antiretroviral therapy and 100 HIV‐negative controls in Uganda. All participants were ≥45 years old with ≥1 major cardiovascular risk factor. Multivariable linear and logistic regression models were used to assess associations between biomarkers, echocardiographic variables, HIV status, and sex, and to assess whether sex modified these associations. Overall, mean age was 56 years and 62% were women. Suppression of tumorigenicity‐2 was higher in men versus women (
P
<0.001), and growth differentiation factor 15 was higher in people living with HIV versus controls (
P
<0.001). Sex modified the HIV effect on cystatin C and NT‐proBNP (both
P
for interaction <0.025). Women had more diastolic dysfunction than men (
P=
0.02), but there was no evidence of sex‐modifying HIV effects on cardiac structure and function. Cardiac biomarkers were more strongly associated with left ventricular mass index in men compared with women.

Conclusions
There are prominent differences in biomarkers of cardiac fibrosis and stress by sex and HIV status in Uganda. The predictive value of cardiac biomarkers for heart failure in people living with HIV in sub‐Saharan Africa should be examined, and novel risk markers for women should be further explored.
Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis
Authors: Walters Arthur S. , Paueksakon Paisit , Adler Charles H. , Moussouttas Michael , Weinstock Leonard B. , Spruyt Karen , Bagai Kanika 
Published: May 2021

Background
Patients with restless legs syndrome (RLS) have increased silent microvascular disease by magnetic resonance imaging. However, there has been no previous autopsy confirmation of these magnetic resonance imaging findings. RLS is also frequently associated with inflammatory and immunologically mediated medical disorders. The postmortem cortex in patients with RLS was therefore evaluated for evidence of microvascular and immunological changes.

Methods and Results

Ten microvascular injury samples of precentral gyrus in 5 patients with RLS (3 men, 2 women; mean age, 81 years) and 9 controls (2 men, 7 women; mean age, 90 years) were studied by hematoxylin and eosin stains in a blinded fashion. None of the subjects had a history of stroke or neurologic insults. In a similar manner, the following immunohistochemistry stains were performed: (1) glial fibrillary acidic protein (representing gliosis, reactive change of glial cells in response to damage); (2) CD3 (a T‐cell marker); (3) CD19 (a B‐cell marker); (4) CD68 (a macrophage marker); and (5) CD117 (a mast cell marker). Patients with RLS had significantly greater silent microvascular disease (
P
=0.015) and gliosis (
P
=0.003). T cells were increased in RLS compared with controls (
P
=0.009) and tended to colocalize with microvascular disease (
P
=0.003). Other markers did not differ. There was no correlation between microvascular lesion load and RLS severity or duration.

Conclusions
Patients with RLS had statistically significantly more silent cerebral microvascular disease and gliosis than controls compatible with previous magnetic resonance imaging studies and with studies showing a link between RLS and hypertension, clinical stroke, and cardiovascular disease. T‐cell invasion may be a secondary phenomenon.