bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrofitting for Improving Energy Efficiency: The Embodied Energy Relevance for Buildings’ Thermal Insulation
Authors: Alla Sara Abd , Bianco Vincenzo , Scarpa Federico , Tagliafico Luca A. 
Published: May 2021

Abstract
Envelope insulation is a well-known strategy to improve buildings’ energy efficiency. This paper considers two archetypes of an apartment block typology largely diffused in the Italian building stock and evaluates the energy savings resulting from the application of three insulation materials: polyurethane foam, rock wool, and resin bonded fibre-board. The energy requirements for winter heating and summer cooling are assessed with EnergyPlus and then compared to the embodied energy of the insulation materials. Hence, the energy and carbon paybacks are calculated, and a cost analysis is proposed to provide an insight into the market impact for the retrofit materials’ choice. The apartment block model is analyzed in three main cities (Rome, Milan, and Palermo) allowing to assess the impact of the climatic condition in terms of minimization of primary energy consumption and environmental emissions. Simulations showed that thermal insulation has a higher impact on winter heating and slightly affects the summer cooling requirement. In Milan, the refurbishment gains relevance as the energy and carbon payback periods are shorter than those of the city of Palermo characterized by warmer weather. Considering the embodied energy impact, this method allows us to estimate the maximum potential for energy savings in existing buildings and provides an estimation of achievable results in a short-medium period.
Use of music to enhance sleep and psychological outcomes in critically ill patients: a protocol for a systematic review and meta-analysis
Authors: Chen Lixia , Wang Fang , Li Jianhua , Cui Li , Liu Xiaoli , Han Cuihua , Qu Siqi , Wang Liang , Ji Daihong 
Published: May 2021

IntroductionMusic listening is used as a non-pharmacological intervention in various populations with positive results; however, evidence for its effect on sleep and psychological outcomes in critically ill patients remains unclear. It is essential to understand the impact of music listening for critically ill patients to optimise care and minimise the risk for harm. We will assess whether music listening improves sleep and psychological outcomes in critically ill patients.Methods and analysisWe will systematically search scientific databases for relevant studies, including PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, ProQuest, the Cochrane Central Register of Controlled Trials, China Biological Medicine Database, China National Knowledge Infrastructure Library, Wan fang databases, VIP Database for Chinese Technical Periodicals and the Chinese Clinical Trial Registry. Databases will be searched for articles published from inception to 10 June 2020. Music therapy journals and reference lists in some articles will be hand-searched. Grey literature will also be searched. We will include randomised and quasi-randomised controlled trials that used music listening to improve sleep and psychological outcomes in critically ill patients. The primary outcomes will be sleep-related outcomes, and secondary outcomes will be anxiety and depression scores and physiological outcomes. Two reviewers will independently verify study eligibility and methodological quality; disagreements will be resolved by a third reviewer or through discussion. The risk of bias will be independently determined using the Cochrane Risk of Bias Tool. The Consolidated Standards of Reporting Trials checklist will be used to examine the quality of included papers. Data will be extracted from eligible studies by two researchers. RevMan V.5.3 will be used for meta-analysis.Ethics and disseminationThis work will review existing trial data and will not introduce new patient data or interventions; therefore, ethics committee approval is not required. We will disseminate this protocol in a related peer-reviewed journal.PROSPERO registration numberCRD42019147202.
Anxiety and depressive symptoms are associated with poor sleep health
during a period of COVID-19-induced nationwide lockdown: a cross-sectional
analysis of adults in Jordan
Authors: Al-Ajlouni Yazan A , Park Su Hyun , Alawa Jude , Shamaileh Ghaith , Bawab Aziz , El-Sadr Wafaa M , Duncan Dustin T 
Published: May 2021

Background
Jordan, a Middle Eastern country, declared a state of national
emergency due to COVID-19 and a strict nationwide lockdown on 17 March
2020, banning all travel and movement around the country, potentially
impacting mental health. This study sought to investigate the
association between mental health (eg, anxiety and depressive symptoms)
and sleep health among a sample of Jordanians living through a state of
COVID-19-induced nationwide lockdown.

Methods
Using Facebook, participants (n=1240) in Jordan in March 2020 were
recruited and direct to a web-based survey measuring anxiety (items from
General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive
symptoms (items from Center for Epidemiologic Studies Depression Scale),
sleep health (items from the Pittsburgh Sleep Quality Index) and
sociodemographic. A modified Poisson regression model with robust error
variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated
to examine how anxiety and depressive symptoms may affect different
dimensions of sleep health: (1) poor sleep quality, (2) short sleep
duration, (3) encountering sleep problems.

Results
The majority of participants reported having experienced mild
(33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during
lockdown, and nearly half of respondents reported depressive symptoms
during lockdown. Similarly, over 60% of participants reported having
experienced at least one sleep problem in the last week, and nearly half
reported having had short sleep duration. Importantly, anxiety was
associated with poor sleep health outcomes. For example, corresponding
to the dose–response relationship between anxiety and sleep health
outcomes, those reporting severe anxiety were the most likely to
experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short
sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem
sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive
symptoms were also associated with poor sleep health outcomes. As
compared with scoring in the first quartile, scoring fourth quartile was
associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04),
short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing
at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18).

Conclusions
Increased levels of anxiety and depressive symptoms can negatively
influence sleep health among a sample of Jordanian adults living in a
state of COVID-19-induced nationwide lockdown.
Pulmonary hypertension and home-based (PHAHB) exercise intervention: protocol for a feasibility study
Authors: McCormack Ciara , Kehoe Brona , Hardcastle Sarah J , McCaffrey Noel , McCarren Andrew , Gaine Sean , McCullagh Brian , Moyna Niall 
Published: May 2021

IntroductionNovel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme.MethodsSingle arm intervention with a pre/post comparisons design and a follow-up maintenance phase will be employed. Eligible participants (n=25) will be recruited from the Mater Misericordiae University Hospital PH Unit. Participants will undergo a 10-week home-based exercise programme, with induction training, support materials, telecommunication support and health coaching sessions followed by a 10-week maintenance phase. The primary outcomes are feasibility, acceptability, utility and safety of the intervention. Secondary outcomes will include the impact of the intervention on exercise capacity, physical activity, strength, health-related QoL and exercise self-efficacy.Ethics and disseminationEthics approval has been obtained from the Mater Misericordiae Institutional Review Board REF:1/378/2032 and Dublin City University Research Ethics DCUREC/2018/246. A manuscript of the results will be submitted to a peer-reviewed journal and results will be presented at conferences, community and consumer forums and hospital research conferences.Trial registration numberISRCTN83783446; Pre-results.
Preconception alcohol consumption and risk of miscarriage in over 4.5 million Chinese women aged 20–49 years
Authors: Chai Jian , Guo Tonglei , Deng Yuzhi , Jiang Lifang , Zhang Junxi , Xu Qin , Peng Zuoqi , He Yuan , Wang Yuanyuan , Zhang Ya , Zhang Hongguang , Wang Qiaomei , Shen Haiping , Zhang Yiping , Yan Donghai , Yang Ying , Ma Xu 
Published: May 2021

ObjectiveTo assess the impact of preconception alcohol consumption on risk of miscarriage incidence, and further evaluate the association between maternal periconception drinking abstinence and miscarriage.MethodsWe performed a population-based, retrospective cohort study in China between 1 January 2013 and 31 December 2016. Alcohol intake and potential confounding factors were reported in standard questionnaires. Participants who became pregnant were recontacted for pregnancy outcome information within 1 year. A total 4 531 680 women with available data on preconception alcohol intake and miscarriage were included in the final analyses. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs).ResultsThe prevalence of miscarriage was 2.70% among 4 531 680 women. Compared with non-drinkers, the adjusted OR of miscarriage was 1.06 (95% CI 1.02 to 1.10) and 1.59 (95% CI 1.15 to 2.20) in maternal occasional drinkers and regular drinkers, respectively. Compared with couples in which neither the male nor the female consumed alcohol, the adjusted OR for miscarriage among women was 1.09 (95% CI 1.07 to 1.10), 1.13 (95% CI 1.06 to 1.21) and 1.12 (95% CI 1.07 to 1.17) in the couples in which only the female drank alcohol, only the male drank alcohol, and both drank alcohol, respectively. The adjusted OR was 0.58 (95% CI 0.51 to 0.65) in women with alcohol abstinence compared with alcohol drinkers.ConclusionsPreconception alcohol consumption was associated with higher odds of miscarriage, and an increasing risk was found with paternal and maternal alcohol drinking. Periconception alcohol abstinence was inversely associated with miscarriage.
First-line thrombectomy strategy for anterior large vessel occlusions: results of the prospective ETIS egistry
Authors: Maïer Benjamin , Finitsis Stephanos , Bourcier Romain , Papanagiotou Panagiotis , Richard Sébastien , Marnat Gaultier , Sibon Igor , Dargazanli Cyril , Arquizan Caroline , Blanc Raphael , Piotin Michel , Lapergue Bertrand , Consoli Arturo , Eugene Francois , Vannier Stephane , Saleme Suzana , Macian Francisco , Clarençon Frédéric , Rosso Charlotte , Naggara Olivier , Turc Guillaume , Viguier Alain , Cognard Christophe , Wolff Valerie , Pop Raoul , Mazighi Mikael , Gory Benjamin 
Published: May 2021

BackgroundThe best recanalization strategy for mechanical thrombectomy (MT) remains unknown as no randomized controlled trial has simultaneously evaluated first-line stent retriever (SR) versus contact aspiration (CA) versus the combined approach (SR+CA).ObjectiveTo compare the efficacy and safety profiles of SR, CA, and SR+CA in patients with acute ischemic stroke (AIS) treated by MT.MethodsWe analyzed data of the Endovascular Treatment in Ischemic Stroke (ETIS) Registry, a prospective, multicenter, observational study of patients with AIS treated by MT. Patients with M1 and intracranial internal carotid artery (ICA) occlusions between January 2015 and March 2020 in 15 comprehensive stroke centers were included. We assessed the association of first-line strategy with favorable outcomes at 3 months (modified Rankin Scale score 0–2), successful recanalization rates (modified Thrombolysis In Cerebral Infarction (mTICI) 2b/3), and safety outcomes.ResultsWe included 2643 patients, 406 treated with SR, 1126 with CA, and 1111 with SR+CA. CA or SR+CA achieved more successful recanalization than SR for M1 occlusions (aOR=2.09, (95% CI 1.39 to 3.13) and aOR=1.69 (95% CI 1.12 to 2.53), respectively). For intracranial ICA, SR+CA achieved more recanalization than SR (aOR=2.52 (95% CI 1.32 to 4.81)), no differences were observed between CA and SR+CA. SR+CA was associated with lower odds of favorable outcomes compared with SR (aOR=0.63 (95% CI 0.44 to 0.90)) and CA (aOR=0.71 (95% CI 0.55 to 0.92)), higher odds of mortality at 3 months (aOR=1.56 (95% CI 1.22 to 2.0)) compared with CA, and higher odds of symptomatic intracranial hemorrhage (aOR=1.59 (95% CI 1.1 to 2.3)) compared with CA.ConclusionsDespite high recanalization rates, our results question the safety of the combined approach, which was associated with disability and mortality. Randomized controlled trials are needed to evaluate the efficacy and safety of these techniques.
Exploring direct detection suppressed regions in a simple 2-scalar mediator model of scalar dark matter
Authors: Claude Jérôme , Godfrey Stephen 
Published: May 2021

AbstractWe explore regions of parameter space that give rise to suppressed direct detection cross sections in a simple model of scalar dark matter with a scalar portal that mixes with the standard model Higgs. We found that even this simple model allows considerable room in the parameter space that has not been excluded by direct detection limits. A number of effects leading to this result have been previously noted. Our main new result explores interference effects between different contributions to DM annihilation when the DM mass is larger than the scalar portal mass. New annihilation channels open up and the parameters of the model need to compensate to give the correct DM relic abundance, resulting in smaller direct detection cross sections. We find that even in a very simple model of DM there are still sizeable regions of parameter space that are not ruled out by experiment.
Automatic Sublining for Efficient Sparse Memory Accesses
Authors: Heirman Wim , Eyerman Stijn , Bois Kristof Du , Hur Ibrahim 
Published: May 2021

Sparse memory accesses, which are scattered accesses to single elements of a large data structure, are a challenge for current processor architectures. Their lack of spatial and temporal locality and their irregularity makes caches and traditional stream prefetchers useless. Furthermore, performing standard caching and prefetching on sparse accesses wastes precious memory bandwidth and thrashes caches, deteriorating performance for regular accesses. Bypassing prefetchers and caches for sparse accesses, and fetching only a single element (e.g., 8 B) from main memory (subline access), can solve these issues.
Deciding which accesses to handle as sparse accesses and which as regular cached accesses, is a challenging task, with a large potential impact on performance. Not only is performance reduced by treating sparse accesses as regular accesses, not caching accesses that do have locality also negatively impacts performance by significantly increasing their latency and bandwidth consumption. Furthermore, this decision depends on the dynamic environment, such as input set characteristics and system load, making a static decision by the programmer or compiler suboptimal.

We propose the
Instruction Spatial Locality Estimator
(
ISLE
), a hardware detector that finds instructions that access isolated words in a sea of unused data. These sparse accesses are dynamically converted into uncached subline accesses, while keeping regular accesses cached. ISLE does not require modifying source code or binaries, and adapts automatically to a changing environment (input data, available bandwidth, etc.). We apply ISLE to a graph analytics processor running sparse graph workloads, and show that ISLE outperforms the performance of no subline accesses, manual sublining, and prior work on detecting sparse accesses.
Abstract 13129: Chest Pain and Inflammation: A Story Where Hickam’s Dictum Prevailed
Authors: Kumar Kris , Vogt Joshua , Masri Ahmad , Golwala Harsh , Zahr Firas , Divanji Punag , Rahmouni Hind , Nazer Babak 
Published: May 2021

A 39-year-old male presented with a chief complaint of chest pain that worsened with deep breathing for one day. He was found to be tachycardic, with distant heart sounds and a skin nodule over his right upper extremity. ECG revealed diffuse ST elevations and PR segment depressions with TTE showing a small pericardial effusion. Troponin I was 8.98 ng/mL and NT-proBNP was 981 pg/mL.
One day after admission, he developed respiratory distress, and repeat TTE showed a large pericardial effusion with collapse of the RV free wall during diastole with variation of mitral and tricuspid valve inflows consistent with tamponade. Pulsus paradoxus was 24 mmHg and he was taken for pericardiocentesis. Skin nodule biopsy revealed nodular and interstitial granulomatous dermatitis. Anti-nuclear antibody and double stranded DNA antibody were positive with pericardial fluid cytology showing acute inflammation with lupus erythematosus cells. Based upon this constellation of findings, he was diagnosed with systemic lupus erythematosus (SLE) myopericarditis, and started on colchicine and immunosuppression, with resolution of symptoms.
One week into hospitalization, the chest pain recurred but was sharp and substernal, with a rising troponin from 1.23 ng/mL to 8.23 ng/mL. TTE showed depressed LVEF of 45% and RCA territory hypokinesis without effusion. CTA PE showed no evidence of thromboembolism and CT coronary demonstrated mural thickening of the mid LAD and aneurysmal dilation of the left main to the LAD and left circumflex bifurcation concerning for vasculitis. The mid RCA was occluded, and patient was taken to the cardiac catherization laboratory revealing thrombotic occlusion of the proximal-to-mid RCA. Despite serial balloon dilation, thrombotic occlusion persisted, Aspiration thrombectomy evacuated organized thrombus prior to deployment of two overlapping drug-eluting stents in the proximal-to-mid RCA, restoring flow. TTE prior to discharge showed normal LVEF and no effusion.
This case illustrates various cardiac manifestations of SLE and the unusual dynamic nature of this patient’s multiple presentations of chest pain. Avoiding “diagnostic anchoring” is important to diagnosing and treating conditions such as SLE, that can affect the heart in multiple ways.
Abstract 15329: The CADILLAC Risk Score Outperforms the TIMI Risk Score in Accurately Identifying Patients at Low Risk for In-hospital Mortality and Adverse Cardiovascular Events Following ST-Elevation Myocardial Infarction
Authors: Malamas Peter , Lall Sumeet , Dembo Brent , Zaman Ninad , Peterson Brandon , Wilson Ryan 
Published: May 2021

The CADILLAC and TIMI risk scores have been used to predict events following revascularization following STEMI. Utilizing these scores may help to identify patients at low risk for mortality and major adverse cardiac events (MACE) following STEMI. We aimed to compare the prognostic accuracy of CADILLAC and TIMI risk scores for identifying patients with low risk for mortality and MACE.
Retrospective review at a tertiary medical center of patients presenting with STEMI from 2014-2018, excluding those who presented with cardiogenic shock, cardiac arrest, or need for mechanical circulatory support. MACE was defined as sustained ventricular arrhythmias, ACS, CHF, and stroke. Low risk patient (CADILLAC 0-2, TIMI 0-1) outcomes were compared to high risk (CADILLAC>2, TIMI>1) using chi square, ROC, and logistic regression analyses. The study includes 341 patients. In hospital CADILLAC score for low risk patients had significantly lower event rate compared to high risk (4.7% vs. 11.7%, odds ratio = 0.37, 95% CI 0.16-0.85, p= 0.028). In hospital TIMI score comparing low vs. high risk patients showed no difference (8.3% vs. 7.2%, odds ratio= 1.18, 95% CI 0.39 - 3.59, p= 0.48). ROC curve predicting event rate showed CADILLAC (C=0.66, odds ratio 1.18; 95% CI 1.04 - 1.33; p=0.0064) vs. TIMI (C= 0.57, odds ratio 1.20; 95% CI 0.98 - 1.46; p=0.071). Evaluating 30 day and 1 year follow up, CADILLAC better predicted event rates vs. TIMI (Figure 1). Logistic regression for CADILLAC at 1 year shows significant association with event rates independent of parameters comprising either risk score (odds ratio 1.29; 95% CI 1.07 - 1.57; p=0.011) while TIMI does not (odds ratio 1.21; 95% CI 0.93 - 1.56; p=0.16). In conclusion, patients defined as low risk by CADILLAC following STEMI have significantly reduced in-hospital event rates. Utilizing this scoring system may help to guide feasibility of early hospital discharge. CADILLAC outperforms TIMI in its prognostic ability both in-hospital and follow ups.
Ischemic Stroke, Inflammation, and Endotheliopathy in COVID-19 Patients
Authors: McAlpine Lindsay S. , Zubair Adeel S. , Maran Ilavarasy , Chojecka Pola , Lleva Paul , Jasne Adam S. , Navaratnam Dhasakumar , Matouk Charles , Schindler Joseph , Sheth Kevin N. , Chun Hyung , Lee Alfred I. , Spudich Serena , Sharma Richa , Sansing Lauren H. 
Published: May 2021

Background and Purpose:
Reports indicate an increased risk of ischemic stroke during coronavirus disease 2019 (COVID-19) infection. We aimed to identify patients with COVID-19 and ischemic stroke and explore markers of inflammation, hypercoagulability, and endotheliopathy, a structural and functional disturbance of the vascular endothelium due to a stressor.

Methods:
This was a retrospective, observational cohort study comparing acute ischemic stroke patients with and without COVID-19 across 3 hospitals. Timing of stroke onset during COVID-19 course and markers of inflammation, hypercoagulability, and endothelial activation were evaluated by COVID-19 status and stroke cause.

Results:

Twenty-one patients with ischemic stroke were diagnosed with COVID-19 during the study period. Patients with COVID-19 had a similar age and burden of vascular risk factors compared with the control cohort (n=168). We identified a temporal correlation between stroke onset and the peak of acute phase reactants, including CRP (C-reactive protein), ferritin, and d-dimer. In subsets of patients with labs available, embolic stroke of undetermined source was associated with elevated IL (interleukin)-6 (median, 171 [interquartile range, 13–375] versus 8 [4–11],
P
<0.01) and sIL (soluble IL)-2 receptor (1972 [1525–4720] versus 767 [563–1408.5],
P
=0.05) levels. Stroke patients with COVID-19 demonstrated elevated levels of endothelial activation markers compared with non-COVID-19 stroke controls (median von Willebrand activity 285.0% [interquartile range, 234%–382%] versus 150% [128%–183%],
P
=0.034; von Willebrand antigen 330.0% [265%–650%] versus 152% [130%–277%],
P
=0.007, and factor VIII 301% [289%–402%] versus 49% [26%–94%],
P
<0.001).

Conclusions:
Ischemic stroke in patients with COVID-19 is associated with endotheliopathy and a systemic inflammatory response in patients with vascular risk factors. Further research evaluating endothelial and inflammatory markers in the setting of ischemic stroke and COVID-19 in larger, prospective cohorts is needed to validate the findings.