bluuebunny/crossref_metadata_2025_split huggingface dataset:
About the traversability of thin-shell wormholes
Authors: Rubín de Celis E. , Simeone C. 
Published: October 2021

AbstractTraversability in relation with tides across thin-shell wormholes is analyzed. Conditions for a safe travel through a wormhole throat are established in terms of the parameters characterizing the geometries and reasonable assumptions regarding the travellers motion. Most convenient geometries turn to include the physically interesting example of wormholes connecting locally flat submanifolds as those associated to gauge cosmic strings. A certain relaxation of the conditions imposed and the corresponding extension of the set of admissible configurations is also briefly discussed.
Correlation between NLR, PLR, and LMR and Disease Activity, Efficacy Assessment in Rheumatoid Arthritis
Authors: Li Mei , Xie Lihu 
Published: October 2021

Objective. To analyze the value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) in the evaluation of disease activity and efficacy in patients with rheumatoid arthritis (RA). Methods. The clinical data of 132 newly diagnosed RA patients admitted to our hospital from November 2018 to January 2020 were retrospectively analyzed, and the NLR, PLR, and LMR were calculated. According to the 28-joint disease activity score (DAS28), all patients was divided into the remission group (n = 40) and the active group (n = 92). According to the curative effect of the active group, the patients were divided into the effective group (n = 61) and the ineffective group (n = 39). Logistic regression analysis of clinical data was to determine the influencing factors of RA disease activity. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of NLR, PLR, and LMR on disease activity and efficacy of RA. Results. The number of cases of smoking history, the number of cases of drinking history, and NLR, PLR, CRP, and ESR levels of patients in the active group were higher than those of the remission group, and the LMR level was lower than that of the remission group; the differences were statistically significant (

P

< 0.05). The results of multivariate logistic regression analysis showed that NLR, PLR, LMR, CRP, and ESR were independent influencing factors of disease activity in RA patients (

P

< 0.05). The AUC of NLR, PLR, and LMR on the disease activity of RA patients was 0.872, 0.821, and 0.824, the sensitivity was 87.6%, 70.2%, and 69.3%, and the specificity was 75.6%, 76.8%, and 84.3%, respectively. The NLR and PLR values of the effective group were lower than those of the ineffective group, and the LMR values were higher than those of the ineffective group, and the differences were statistically significant (

P

< 0.05). The AUC of NLR, PLR, and LMR on the efficacy of RA patients was 0.756, 0.732, and 0.779, the sensitivity was 68.4%, 60.2%, and 67.9%, and the specificity was 83.2%, 86.4%, and 85.1%, respectively. Conclusion. NLR, PLR, and LMR are the independent factors that affect the disease activity of RA patients and can better evaluate the disease activity and efficacy of RA.
Association of PD-1/PD-L1 Co-location with Immunotherapy Outcomes in Non–Small Cell Lung Cancer
Authors: Gavrielatou Niki , Liu Yuting , Vathiotis Ioannis , Zugazagoitia Jon , Aung Thazin Nwe , Shafi Saba , Fernandez Aileen , Schalper Kurt , Psyrri Amanda , Rimm David L. 
Published: October 2021

AbstractPurpose:Programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) interaction suppresses local T-cell responses and promotes peripheral tolerance. In the current study, we focus on PD-1/PD-L1 co-location as a surrogate for this interaction and assess its association with immunotherapy outcomes in patients with non–small cell lung cancer (NSCLC).Experimental Design:Pretreatment biopsies from a retrospective cohort of 154 immunotherapy-treated patients with advanced NSCLC were analyzed. Expression of PD-1 and PD-L1 was assessed by multiplexed quantitative immunofluorescence (QIF) and PD-1 expression in the same pixels as PD-L1 (called a co-location score) was measured using an algorithm to define overlapping expression areas. Co-location scores were correlated with immunotherapy outcomes and PD-L1 tumor proportion score.Results:PD-1/PD-L1 co-location score was associated with best overall response (P = 0.0012), progression-free survival (P = 0.0341), and overall survival after immunotherapy (P = 0.0249). The association was driven by patients receiving immune checkpoint inhibitors in the second or subsequent line of treatment. PD-L1 tumor proportion score by IHC was also correlated with best overall response and progression-free survival. PD-L1 measured within the tumor compartment by QIF did not show any significant association with either best overall response or overall survival. Finally, co-location score was not associated with PD-L1 expression by either method.Conclusions:On the basis of our findings, co-location score shows promise as a biomarker associated with outcome after immunotherapy. With further validation, it could have value as a predictive biomarker for the selection of patients with NSCLC receiving treatment with immune checkpoint inhibitors.
Association of Hyper-Polypharmacy With Clinical Outcomes in Heart Failure With Preserved Ejection Fraction
Authors: Minamisawa Masatoshi , Claggett Brian , Suzuki Kota , Hegde Sheila M. , Shah Amil M. , Desai Akshay S. , Lewis Eldrin F. , Shah Sanjiv J. , Sweitzer Nancy K. , Fang James C. , Anand Inder S. , O’Meara Eileen , Rouleau Jean-Lucien , Pitt Bertram , Pfeffer Marc A. , Solomon Scott D. , Vardeny Orly 
Published: October 2021

Background:
Polypharmacy is associated with a poor prognosis in the elderly, however, information on the association of polypharmacy with cardiovascular outcomes in heart failure with preserved ejection fraction is sparse. This study sought to investigate the relationship between polypharmacy and adverse cardiovascular events in patients with heart failure with preserved ejection fraction.

Methods:
Baseline total number of medications was determined in 1758 patients with heart failure with preserved ejection fraction enrolled in the Americas regions of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist), by 3 categories: nonpolypharmacy (<5 medications), polypharmacy (5–9), and hyper-polypharmacy (≥10). We examined the relationship of polypharmacy status with the primary outcome (cardiovascular death, HF hospitalization, or aborted cardiac arrest), hospitalizations for any reason, and serious adverse events.

Results:

The proportion of patients taking 5 or more medications was 92.5% (inclusive of polypharmacy [38.7%] and hyper-polypharmacy [53.8%]). Over a 2.9-year median follow-up, compared with patients with polypharmacy, hyper-polypharmacy was associated with an increased risk for the primary outcome, hospitalization for any reason and any serious adverse events in the univariable analysis, but not significantly associated with mortality. After multivariable adjustment for demographic and comorbidities, hyper-polypharmacy remained significantly associated with an increased risk for hospitalization for any reason (hazard ratio, 1.22 [95% CI, 1.05–1.41];
P
=0.009) and any serious adverse events (hazard ratio, 1.23 [95% CI, 1.07–1.42];
P
=0.005), whereas the primary outcome was no longer statistically significant.

Conclusions:
Hyper-polypharmacy was common and associated with an elevated risk of hospitalization for any reason and any serious adverse events in patients with heart failure with preserved ejection fraction. There were no significant associations between polypharmacy status and mortality.
SOS—The Space Option Star: Addressing the Energy Dilemma
Authors: Woods Arthur R. , Bernasconi Marco C. 
Published: October 2021

Abstract
Humanity is facing an imminent energy dilemma in that limited proven reserves of fossil fuels could be exhausted at mid-century, and no current alternative terrestrial energy options can be sufficiently scaled to achieve the goal of divesting from fossil fuels by 2050, as called for by many governments and international organizations to address the climate emergency. Energy from space is the only near-term, technically feasible and scalable alternative currently available to humanity, but it is seldom mentioned as a potential solution. The Space Option Star (SOS) is proposed as an orbital artwork to alert the world population to the imminent energy dilemma and to the space energy option, as well as being an in situ demonstration of space-to-space wireless power transmission.
Disrupted daily routines mediate the socioeconomic gradient of depression amid public health crises: A repeated cross-sectional study
Authors: Lai Francisco Tsz Tsun , Chan Vivien Kin Yi , Li Tsz Wai , Li Xue , Hobfoll Stevan E , Lee Tatia Mei-Chun , Hou Wai Kai 
Published: October 2021

Objective:There is a socioeconomic gradient to depression risks, with more pronounced inequality amid macroenvironmental potential traumatic events. Between mid-2019 and mid-2020, the Hong Kong population experienced drastic societal changes, including the escalating civil unrest and the COVID-19 pandemic. We examined the change of the socioeconomic gradient in depression and the potential intermediary role of daily routine disruptions.Method:We conducted repeated territory-wide telephone surveys in July 2019 and July 2020 with 1112 and 2034 population-representative Cantonese-speaking Hong Kong citizens above 15 years old, respectively. Stratified by year, we examined the association between socioeconomic indicators (education attainment, household income, employment status and marital status) and probable depression (nine-item Patient Health Questionnaire [PHQ-9] ⩾ 10) using logistic regression. Differences in the socioeconomic gradient between 2019 and 2020 were tested. Finally, we performed a path analysis to test for the mediating role of daily routine disruptions.Results:Logistic regression showed that higher education attainment in 2019 and being married in 2020 were protective against probable depression. Interaction analysis showed that the inverse association of higher education attainment with probable depression attenuated in 2020 but that of being married increased. Path analysis showed that the mediated effects through daily routine disruptions accounted for 95.9% of the socioeconomic gradient of probable depression in 2020, compared with 13.1% in 2019.Conclusion:From July 2019 to July 2020, the mediating role of daily routine disruptions in the socioeconomic gradient of depression in Hong Kong increased. It is thus implied that infection control measures should consider the relevant potential mental health impacts accordingly.
The Epidemiology and Geographic Patterns of Natural Disaster and Extreme Weather Mortality by Race and Ethnicity, United States, 1999-2018
Authors: Sharpe J. Danielle , Wolkin Amy F. 
Published: October 2021

Objectives The adverse effects that racial and ethnic minority groups experience before, during, and after disaster events are of public health concern. The objective of this study was to examine disparities in the epidemiologic and geographic patterns of natural disaster and extreme weather mortality by race and ethnicity. Methods We used mortality data from the Centers for Disease Control and Prevention from January 1, 1999, through December 31, 2018. We defined natural disaster and extreme weather mortality based on International Classification of Diseases, 10th Revision codes X30-X39. We calculated age-adjusted mortality rates by race, ethnicity, and hazard type, and we calculated age-adjusted mortality rate ratios by race, ethnicity, and state. We used geographic mapping to examine age-adjusted mortality rate ratios by race, ethnicity, and state. Results Natural disasters and extreme weather caused 27 335 deaths in the United States during 1999-2018. Although non-Hispanic White people represented 68% of total natural disaster and extreme weather mortality, the mortality rate per 100 000 population among non-Hispanic Black people was 1.87 times higher (0.71) and among non-Hispanic American Indian/Alaska Native people was 7.34 times higher (2.79) than among non-Hispanic White people (0.38). For all racial and ethnic groups, exposure to extreme heat and cold were the 2 greatest causes of natural disaster and extreme weather mortality. Racial and ethnic disparities in natural disaster and extreme weather mortality were highest in the South, Southwest, Mountain West, and Upper Midwest. Conclusions Racial and ethnic minority populations have a greater likelihood of mortality from natural disaster or extreme weather events than non-Hispanic White people. Our study strengthens the current knowledge base on these disparities and may inform and improve disaster preparedness and response efforts.
In vitro CT visualization of the biopsy location by filling the core biopsy needle with contrast media
Authors: Thunswärd Per , Eksell David , Ahlström Håkan , Magnusson Anders 
Published: October 2021

Background When performing computed tomography (CT)-guided biopsy procedures with non-disposable, automatic biopsy instruments, the actual course of the biopsy needle is not registered. Purpose To evaluate the ability to visualize the sampling location after CT-guided biopsy in vitro using a novel method, where the space between the inner needle and the outer cannula in a core biopsy needle is filled with contrast media; and to compare the grade of visibility for two different concentrations of contrast media. Material and Methods Core needle biopsies were performed in a tissue phantom using biopsy needles primed with two different iodine contrast media concentrations (140 mg I/mL and 400 mg I/mL). Commercially available needle-filling contraptions with sealing membranes were used to fill the needles. Each biopsy was imaged with CT, and the visibility was evaluated twice by three senior radiologists in a randomized order. Results The presence of traces was confirmed after biopsy, almost without exception for both concentrations. The visibility was sufficient to determine the biopsy location in all observations with the 400 mg I/mL filling, and in 7/10 observations with the 140 mg I/mL filling. The grade of visibility of the trace and the proportion of the biopsy needle course outlined were higher with the 400 mg I/mL filling. Conclusion With CT-guided biopsy in vitro, the sampling location can be visualized using a novel method of priming the biopsy needle with iodine contrast media, specifically highly concentrated contrast media.
Vasopressin-Induced Hyponatremia in Patients With Aneurysmal Subarachnoid Hemorrhage: A Case Series and Literature Review
Authors: Subba Hilamber , Riker Richard R. , Dunn Susan , Gagnon David J. 
Published: October 2021

Objective: Vasopressin may be administered to treat vasospasm following aneurysmal subarachnoid hemorrhage (aSAH). The objectives of this study were to describe five cases of suspected vasopressin-induced hyponatremia after aSAH and to review the literature. Design: Single-center, observational case series of intensive care unit (ICU) patients. Settings: Ten-bed neurological ICU at Maine Medical Center in Portland, Maine. Patients: Convenience sample of patients with aSAH treated with a vasopressin for symptomatic, radiologically confirmed vasospasm. Results: A total of five patients were included in the case series with a median age of 57 (51, 65) years and all were women. The median Glasgow coma scale score was 15 (11, 15) on admission, and the Hunt and Hess scale score was 3, (3, 4). All patients were treated with endovascular coiling of their aneurysm. Vasopressin was administered to treat symptomatic, radiographically confirmed vasospasm on median post-bleed day (PBD) 10 (10, 15) at a fixed-dose of .03 units/min. Serum sodium at baseline was 140 (140, 144) mEq/L and decreased to 129 (126, 129) mEq/L within 26 (17, 83) hours of vasopressin initiation for a median change of −16 (−10, −16) mEq/L. Serum sodium returned to baseline within 18 (14, 22) hours of stopping the infusion. Conclusions: Vasopressin use in vasospasm after aSAH may be associated with clinically significant hyponatremia within 24 hours of starting the infusion. Hyponatremia appears to resolve within 24 hours of stopping the infusion. Additional study in a larger sample size is needed to determine if a causal relationship exist.
Predisposing Factors for Posttraumatic Osteoarthritis After Malleolus Fracture Fixation in Patients Younger Than 50 Years
Authors: Beak Jong Seok , Kim Yeong Tae , Lee Sung Hyun 
Published: October 2021

Background: The purpose of this study was to identify the risk factors for posttraumatic osteoarthritis (OA) after surgery for ankle fractures in patients aged ≤50 years. Methods: We performed a retrospective review of consecutive patients who underwent surgery for ankle fractures and were followed up for a minimum period of 5 years. The patients were assigned to 2 groups according to the presence of advanced OA at the last follow-up. Binary logistic regression was used to model the correlation between risk factors and OA. Functional outcomes were assessed using the Foot and Ankle Outcome Score. Results: The data of 332 patients who met the inclusion criteria were included in the analysis. The overall rate of posttraumatic arthritis was 27.7% (nonarthritis group: 240 patients, arthritis group: 92 patients). The arthritic change was significantly affected by BMI (95% confidence interval [CI] 1.29-19.76; adjusted odds ratio [OR] ≥ 30, 6.56), fracture-dislocation injury (CI 1.66-11.57; adjusted OR, 4.06), posterior malleolus (PM) fracture (CI 1.92-12.73, adjusted OR > 25% of the articular surface, 5.72), and postoperative articular incongruence (CI 1.52-18.10; adjusted OR, 7.21). The mean scores of the arthritis group were lower than those in the nonarthritis group ( P < .05). Conclusion: Obesity, fracture-dislocation injury, concomitant large PM fracture, and articular incongruence were risk factors of posttraumatic OA after surgery for ankle fractures. Surgeons should be aware that accurate reduction is critical in patients with ankle fractures with associated large PM fractures, especially those with obesity or severe initial injuries such as fracture-dislocation. Level of Evidence: Level III, case control study.
Cardiac biomarkers as indicators of right ventricular dysfunction and recovery in chronic thromboembolic pulmonary hypertension patients after balloon pulmonary angioplasty therapy – a cardiac magnetic resonance imaging cohort study
Authors: Kriechbaum Steffen D. , Vietheer Julia M. , Wiedenroth Christoph B. , Rudolph Felix , Barde Marta , Wolter Jan‐Sebastian , Haas Moritz , Fischer‐Rasokat Ulrich , Weferling Maren , Rolf Andreas , Hamm Christian W. , Mayer Eckhard , Guth Stefan , Keller Till , Roller Fritz C. , Liebetrau Christoph 
Published: October 2021

BackgroundIn chronic thromboembolic pulmonary hypertension, right heart failure determines outcome. Balloon pulmonary angioplasty therapy allows right heart recovery, which can be monitored by cardiac magnetic resonance imaging. This study evaluates whether cardiac biomarkers (NT‐proBNP, MR‐proANP, sST2, and PAPP‐A) are associated with cardiac magnetic resonance imaging findings prior to and after balloon pulmonary angioplasty therapy.MethodsThis observational cohort study enrolled 22 chronic thromboembolic pulmonary hypertension patients who underwent balloon pulmonary angioplasty therapy and completed a six‐month follow‐up including cardiac magnetic resonance imaging. Biomarker levels were compared with findings for right heart morphology and function derived from cardiac magnetic resonance imaging.ResultsPulmonary hemodynamics improved after balloon pulmonary angioplasty therapy [pulmonary vascular resistance: 7.7 (6.0–9.0) vs. 4.7 (3.5–5.5) wood units, p < 0.001; mean pulmonary artery pressure 41 (38–47) vs. 32 (28–37) mmHg, p < 0.001]. Cardiac magnetic resonance imaging findings indicated right heart maladaptation at baseline and recovery after therapy [right ventricular end‐diastolic volume 192 (141–229) ml vs. 143 (128–172) ml, p = 0.002; right ventricular end‐systolic volume 131 (73–157) ml vs. 77 (61–99) ml (p < 0.001); right ventricular ejection fraction (RVEF) 34 (28–41) % vs. 52 (41–54) %; p < 0.001]. Biomarker level cut‐offs [NT‐proBNP 347 ng/L (area under the curve (AUC) 0.91), MR‐proANP 230 pg/L (AUC 0.78), PAPP‐A 14.5 mU/L (AUC 0.81), and sST2 48.0 ng/ml (AUC 0.88)] indicated a RVEF ≤ 35% at baseline. The dynamics of NT‐proBNP (rs = −0.79; p < 0.001), MR‐proANP (rs = –0.80; p < 0.001), and sST2 (rs = –0.49; p = 0.02) correlated inversely with the improvement in RVEF after therapy. A relative decrease of NT‐proBNP < 53% (AUC 0.86) and MR‐proANP < 24% (AUC 0.82) indicated a limited RVEF response.ConclusionsIn chronic thromboembolic pulmonary hypertension patients, cardiac magnetic resonance imaging findings illustrate right heart failure and recovery after balloon pulmonary angioplasty therapy. Cardiac biomarker levels correlate with right heart parameters at baseline and their dynamics after therapy.
Influence of Graft Bending Angle on Femoral Tunnel Widening After Double-Bundle ACL Reconstruction: Comparison of Transportal and Outside-In Techniques
Authors: Lee Do Kyung , Kim Jun Ho , Lee Byung Hoon , Kim Hyeonsoo , Jang Min Jae , Lee Sung-Sahn , Wang Joon Ho 
Published: October 2021

Background: Previous studies have suggested that increased mechanical stress due to acute graft bending angle (GBA) is associated with tunnel widening and graft failure after anterior cruciate ligament (ACL) reconstruction. Few studies have compared the GBA between the outside-in (OI) and the transportal (TP) techniques. Purpose: To evaluate the influence of GBA on clinical outcomes and tunnel widening after ACL reconstruction with OI versus TP technique. Study Design: Cohort study; Level of evidence, 3. Methods: Included in the study were 56 patients who underwent double-bundle ACL reconstruction (n = 28 in the OI group and n = 28 in the TP group). Clinical outcomes (Lysholm, International Knee Documentation Committee, Tegner score, and knee laxity) 1 year postoperatively were evaluated. Computed tomography scans at 5 days and 1 year postoperatively were used for imaging measurements, and the femoral tunnel was divided into the proximal third, middle, and aperture sections. The GBA and cross-sectional area (CSA) were measured using image analysis software and were compared between groups. A correlation analysis was performed to determine if the GBA affected clinical outcomes or tunnel widening. Results: No significant difference was observed in clinical outcomes between the groups. The GBA of both the anteromedial (AM) and posterolateral bundles were more acute in the OI group compared with the TP group ( P < .05). The CSA at the AM tunnel aperture increased significantly in the OI group (84.2% ± 64.3%) compared with the TP group (51.4% ± 36.7%) ( P = .04). However, there were no differences in the other sections. In the Pearson correlation test, GBA was not correlated with tunnel widening or clinical outcomes. Conclusion: Regardless of technique, the GBA did not have a significant influence on tunnel widening or clinical outcomes. Considering a wider AM tunnel aperture, a more proximal and posterior AM tunnel position might be appropriate with the OI technique.