bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperglycemia Induces Trained Immunity in Macrophages and Their Precursors and Promotes Atherosclerosis
Authors: Edgar Laurienne , Akbar Naveed , Braithwaite Adam T. , Krausgruber Thomas , Gallart-Ayala Héctor , Bailey Jade , Corbin Alastair L. , Khoyratty Tariq E. , Chai Joshua T. , Alkhalil Mohammad , Rendeiro André F. , Ziberna Klemen , Arya Ritu , Cahill Thomas J. , Bock Christoph , Laurencikiene Jurga , Crabtree Mark J. , Lemieux Madeleine E. , Riksen Niels P. , Netea Mihai G. , Wheelock Craig E. , Channon Keith M. , Rydén Mikael , Udalova Irina A. , Carnicer Ricardo , Choudhury Robin P. 
Published: July 2021

Background:
Cardiovascular risk in diabetes remains elevated despite glucose-lowering therapies. We hypothesized that hyperglycemia induces trained immunity in macrophages, promoting persistent proatherogenic characteristics.

Methods:

Bone marrow–derived macrophages from control mice and mice with diabetes were grown in physiological glucose (5 mmol/L) and subjected to RNA sequencing (n=6), assay for transposase accessible chromatin sequencing (n=6), and chromatin immunoprecipitation sequencing (n=6) for determination of hyperglycemia-induced trained immunity. Bone marrow transplantation from mice with (n=9) or without (n=6) diabetes into (normoglycemic)
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mice was used to assess its functional significance in vivo. Evidence of hyperglycemia-induced trained immunity was sought in human peripheral blood mononuclear cells from patients with diabetes (n=8) compared with control subjects (n=16) and in human atherosclerotic plaque macrophages excised by laser capture microdissection.

Results:

In macrophages, high extracellular glucose promoted proinflammatory gene expression and proatherogenic functional characteristics through glycolysis-dependent mechanisms. Bone marrow–derived macrophages from diabetic mice retained these characteristics, even when cultured in physiological glucose, indicating hyperglycemia-induced trained immunity. Bone marrow transplantation from diabetic mice into (normoglycemic)
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mice increased aortic root atherosclerosis, confirming a disease-relevant and persistent form of trained innate immunity. Integrated assay for transposase accessible chromatin, chromatin immunoprecipitation, and RNA sequencing analyses of hematopoietic stem cells and bone marrow–derived macrophages revealed a proinflammatory priming effect in diabetes. The pattern of open chromatin implicated transcription factor Runt-related transcription factor 1 (Runx1). Similarly, transcriptomes of atherosclerotic plaque macrophages and peripheral leukocytes in patients with type 2 diabetes were enriched for Runx1 targets, consistent with a potential role in human disease. Pharmacological inhibition of Runx1 in vitro inhibited the trained phenotype.

Conclusions:
Hyperglycemia-induced trained immunity may explain why targeting elevated glucose is ineffective in reducing macrovascular risk in diabetes and suggests new targets for disease prevention and therapy.
Stroke Prevention by Anticoagulants in Daily Practice Depending on Atrial Fibrillation Pattern and Clinical Risk Factors
Authors: Grimaldi-Bensouda Lamiae , Le Heuzey Jean-Yves , Ferrières Jean , Leys Didier , Davy Jean-Marc , Martinez Mikel , Dialla Olivia , Smadja Didier , Nighoghossian Norbert , Benichou Jacques , Nordon Clementine , Touzé Emmanuel , Abenhaim Lucien ,   on behalf of the PGRx-Stroke and PGRx-Atrial Fibrillation Study Groups
Published: July 2021

Background and Purpose:
The objective of the study was to assess the effectiveness of individual direct oral anticoagulants versus vitamin K antagonists for primary prevention of stroke (ischemic and hemorrhagic) in routine clinical practice in patients with various clinical risk factors depending on their atrial fibrillation (AF) patterns.

Methods:
A nested case-referent study was conducted using data from 2 national registries of patients with stroke and AF. Stroke cases with previous history of AF were matched to up to 2 randomly selected referent patients with AF and no stroke. The association of individual anticoagulant use with ischemic or hemorrhagic stroke was studied in patients with or without permanent AF using multivariable conditional logistic models, controlled for clinically significant risk factors and multiple other cardiovascular risk factors.

Results:
In total, 2586 stroke cases with previous AF and 4810 nonstroke referent patients with AF were retained for the study. Direct oral anticoagulant users had lower odds of stroke of any type than vitamin K antagonist users: the adjusted-matched OR for ischemic stroke were 0.70 (95% CI, 0.50–0.98) for dabigatran, 0.68 (95% CI, 0.53–0.86) for rivaroxaban, and 0.73 (95% CI, 0.52–1.02) for apixaban while for hemorrhagic stroke they were 0.31 (95% CI, 0.14–0.68), 0.64 (95% CI, 0.39–1.06), and 0.70 (95% CI, 0.33–1.49), respectively. The effects of individual direct oral anticoagulants relative to vitamin K antagonists were similar in permanent AF and nonpermanent AF patients.

Conclusions:
Similar results were observed for each direct oral anticoagulant in real life as those observed in the pivotal clinical trials. The pattern of AF did not affect the outcome.
Chinese and Taiwanese Identities in Taiwan as Epistemic Challengers
Authors: Chu Feng-yi 
Published: July 2021

Abstract
This paper deals with two theoretical dilemmas concerning Chinese and Taiwanese identities in Taiwan: their vague classification and the unclear dynamics of change. By using grounded theory to analyse 110 in-depth interviews, the research identifies three crucial themes behind individuals’ conceptualisations and interactions with the two identities: (1) ethical narrative, (2) cultural hierarchy, and (3) political ideology. Further theoretical comparisons generate a new epistemic framework which understands identity as a discourse of value: identity in its essence is merely a generic idea; only when associated with other discourses of value can an identity acquire full functions such as arousing people’s sentiments and mobilising them to take actions. The theory suggests that Chinese and Taiwanese identities should be regarded as unique generic concepts attached with distinctive values. People seek identity change upon becoming aware that the original identity can no longer represent the values they have dearly cherished and followed.
Investigating the impact of land surface characteristics on monsoon dynamics with idealized model simulations and theories
Authors: Smyth Jane E. , Ming Yi 
Published: July 2021

AbstractMonsoons emerge over a range of land surface conditions and exhibit varying physical characteristics over the seasonal cycle, from onset to withdrawal. Systematically varying the moisture and albedo parameters over land in an idealized modeling framework allows one to analyze the physics underlying the successive stages of monsoon development. To this end we implement an isolated South American continent with reduced heat capacity but no topography in an idealized moist general circulation model. Irrespective of the local moisture availability, the seasonal cycles of precipitation and circulation over the South American monsoon sector are distinctly monsoonal with the default surface albedo. The dry land case (zero evaporation) is characterized by a shallow overturning circulation with vigorous lower-tropospheric ascent, transporting water vapor from the ocean. By contrast, with bucket hydrology or unlimited land moisture the monsoon features deep moist convection that penetrates the upper troposphere. A series of land albedo perturbation experiments indicates that the monsoon strengthens with the net column energy flux and the near-surface moist static energy with all land moisture conditions. When the land-ocean thermal contrast is strong enough, inertial instability alone is sufficient for producing a shallow but vigorous circulation and converging a large amount of moisture from the ocean even in the absence of land moisture. Once the land is sufficiently moist, convective instability takes hold and the shallow circulation deepens. These results have implications for monsoon onset and intensification, and may elucidate the seasonal variations in how surface warming impacts tropical precipitation over land.
Object-Based Verification of Atmospheric River Predictions in the Northeast Pacific
Authors: DeHaan Laurel L. , Martin Andrew C. , Weihs Rachel R. , Delle Monache Luca , Ralph F. Martin 
Published: July 2021

AbstractAccurate forecasts of atmospheric rivers (ARs) provide advance warning of flood and landslide hazards and greatly aid effective water management. It is, therefore, critical to evaluate the skill of AR forecasts in numerical weather prediction (NWP) models. A new verification framework is proposed that leverages freely available software and metrics previously used for different applications. Specifically, AR detection and statistics are computed for the first time using the Method for Object-Based Diagnostic Evaluation (MODE). In addition, the measure of effectiveness (MoE) is introduced as a new metric for understanding AR forecast skill in terms of size and location. The MoE provides a quantitative measure of the position of an entire forecast AR relative to observation, regardless of whether the AR is making landfall. In addition, the MoE can provide qualitative information about the evolution of a forecast by lead time, with implications about the predictability of an AR. We analyze AR forecast verification and skill using 11 years of cold-season forecasts from two NWP models: one global and one regional. Four different thresholds of integrated vapor transport (IVT) are used in the verification, revealing differences in forecast skill that are based on the strength of an AR. In addition to MoE, AR forecast skill is also addressed in terms of intensity error, landfall position error, and contingency-table metrics.
Life stress, sleep disturbance and depressive symptoms: The moderating role of prefrontal activation during emotion regulation
Authors: Lee Kyung Hwa , Lee Ha Young , Park Inkyung , Jeon Jeong Eun , Kim Nambeom , Oh Seong Min , Jeon Sehyun , Kim Soohyun , Lee Yu Jin , Kim Seog Ju 
Published: July 2021

Objectives: Evidence suggests that emotion regulation difficulty may play an important role in the association between life stress, sleep disturbance and depressive symptoms. We proposed two models depicting the possible moderating roles of prefrontal cortex activation during emotion regulation in the associations among these variables and tested them. We hypothesized that (1) the association between stress and sleep disturbance would differ across prefrontal cortex activation during emotion regulation (moderation model) and (2) the indirect effects of stress on depressive symptoms through sleep disturbance would depend on prefrontal cortex activation during emotion regulation (moderated mediation model). Methods: Forty-eight healthy adults without sleep disorders based on nocturnal polysomnography participated in this study. They received functional magnetic resonance imaging scans while performing an emotion regulation task. They also completed questionnaires assessing life stress, sleep disturbance and depressive symptoms. The proposed models were tested using the PROCESS macro for SPSS. Results: As hypothesized, there was a significant moderating effect of prefrontal cortex activation during emotion regulation on the association between life stress and sleep disturbance. Furthermore, right lateral prefrontal cortex activation had a moderating role in the indirect effect of life stress on depressive symptoms through sleep disturbance. Conclusion: These findings highlight the important role of prefrontal cortex function during emotion regulation in the associations between stress, sleep disturbance and depressive symptoms. Increasing lateral prefrontal cortex recruitment when regulating the emotional response to negative life events may be critical for the prevention and intervention of depression as well as sleep problems.
Impact of Treatment for Nasal Cavity Disorders on Sleep Quality: Systematic Review and Meta‐analysis
Authors: Fried Jacob , Yuen Erick , Zhang Kathy , Li Andraia , Rowan Nicholas R. , Schlosser Rodney J. , Nguyen Shaun A. , Gudis David A. 
Published: July 2021

ObjectiveTo determine the impact of treatment for patients with nasal obstruction secondary to allergic rhinitis (AR) and nasal septal deviation (NSD) on sleep quality.Data SourcesPrimary studies were identified though PubMed, Scopus, Cochrane Library, and Web of Science.Review MethodsA systematic review was performed by querying databases for articles published through August 2020. Studies were included that reported on objective sleep parameters (apnea‐hypopnea index) and sinonasal and sleep‐specific patient‐reported outcome measures: Rhinoconjunctivitis Quality of Life Questionnaire, Nasal Obstruction Symptom Evaluation, Epworth Sleepiness Scale (EpSS), and Pittsburgh Sleep Quality Index (PSQI).ResultsThe database search yielded 1414 unique articles, of which 28 AR and 7 NSD studies were utilized for meta‐analysis. A total of 9037 patients (8515 with AR, 522 with NSD) were identified with a mean age of 35.0 years (35.3 for AR, 34.0 for NSD). Treatment for AR and NSD significantly improved subjective sleep quality. For AR, the EpSS mean difference was −1.5 (95% CI, –2.4 to –0.5; P =. 002) and for the PSQI, –1.7 (95% CI, –2.1 to –1.2; P <. 00001). For NSD, the EpSS mean difference was −3.2 (95% CI, –4.2 to –2.2; P <. 00001) and for the PSQI, –3.4 (95% CI, –6.1 to –0.6; P =. 02).ConclusionSubjective sleep quality significantly improved following treatment for AR and NSD. There were insufficient data to demonstrate that objective metrics of sleep quality similarly improved.
Experience with the Crescent® cannula for adult respiratory VV ECMO: a case series
Authors: Fleet Daniel , Morris Idunn , Faulkner Gail , Harvey Chris 
Published: July 2021

Introduction: The Crescent® is a recently introduced dual lumen cannula by which veno-venous extracorporeal membrane oxygenation (VV ECMO) is delivered. It has a number of features that enhance its ease of placement, pressure-flow dynamics and may reduce catheter-related complication rates. Methods: We present the first case series of its kind analysing this device by means of a retrospective observational study of prospectively collected data from the first year of its use in a high volume severe acute respiratory failure centre (Glenfield, UK). We compare complication rates of the Crescent®, with data from the international ELSO database and our own historic centre data and discuss subjective clinician experience of introducing this device. Results: Over the first 12 months of its use (23/09/2019–23/09/2020), 54 patients were cannulated using a Crescent® catheter. There were no serious/life-threatening adverse events and a low number of minor cannula-related complications. Subjectively users found it has a number of advantages over other devices and configurations, not captured within current data collection frameworks. Conclusion: The Crescent® is a safe and effective device by which to deliver VV ECMO support to patients with severe acute respiratory failure.
Association Between 45° Flexion Anteroposterior Elbow Radiographs and Diagnostic Accuracy of Capitellum Osteochondritis Dissecans
Authors: Saper Michael G. , Bompadre Viviana , Schmale Gregory A. , Menashe Sarah , Burton Monique , Nagle Kyle , Thapa Mahesh 
Published: July 2021

Background: An anteroposterior (AP) radiograph of the elbow in 45° of flexion has been suggested to increase the diagnostic accuracy of capitellum osteochondritis dissecans (OCD). Purpose: To assess the diagnostic performance, inter- and intraobserver reliability, and confidence level for identifying capitellum OCD using plain radiographs (AP, lateral, and 45° flexion AP). Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: This was a retrospective study of pediatric and adolescent patients with capitellum OCD and a control group. Six independent clinicians who were blinded to the official radiologists’ reports reviewed images on 2 separate occasions, 1 week apart. A 5-point Likert scale was used to assess the clinicians’ level of confidence. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for individual and combinations of radiographic views. Inter- and intraobserver reliability was determined using Cohen kappa (κ) coefficients. Results: A total of 28 elbows (mean age, 12.5 ± 2 years) were included. There were no differences in age ( P = .18), sex ( P = .62), or laterality ( P > .999) between groups. There were marked variations in the diagnostic accuracy between views: sensitivity (AP, 85.1; lateral, 73.2; 45° flexion AP, 91.7), specificity (AP, 89.3; lateral, 91.7; 45° flexion AP, 91.1), PPV (AP, 88.8; lateral, 89.8; 45° flexion AP, 91.1), NPV (AP, 85.7; lateral, 77.4; 45° flexion AP, 91.6), and accuracy (AP, 87.2; lateral, 82.4; 45° flexion AP, 91.4). Standard radiographs (AP and lateral views) failed to diagnose capitellum OCD in 4.8% of cases. The sensitivity of the 3 combined views was 100%. Confidence intervals in the clinicians’ diagnostic assessments were similar for each view (AP, 4.0; lateral, 4.0; and 45° flexion AP, 4.1). Interobserver reliability was substantial for AP and lateral views (κ = 0.65 and κ = 0.60, respectively) but highest for the 45° flexion AP radiographs (κ = 0.72). Intraobserver reliability for the 45° flexion AP view was moderate to almost perfect (κ = 0.45 to 0.93). Conclusion: The 45° flexion AP view can detect capitellum OCD with excellent accuracy, a high level of confidence, and substantial interobserver agreement. When added to standard AP and lateral radiographs, the 45° flexion AP view aids in the identification of capitellum OCD.
Clinical ethics committees in nursing homes: what good can they do? Analysis of a single case consultation
Authors: Magelssen Morten , Karlsen Heidi 
Published: July 2021

Background: Ought nursing homes to establish clinical ethics committees (CECs)? An answer to this question must begin with an understanding of how a clinical ethics committee might be beneficial in a nursing home context – to patients, next of kin, professionals, managers, and the institution. With the present article, we aim to contribute to such an understanding. Aim: We ask, in which ways can clinical ethics committees be helpful to stakeholders in a nursing home context? We describe in depth a clinical ethics committee case consultation deemed successful by stakeholders, then reflect on how it was helpful. Research design: Case study using the clinical ethics committee’s written case report and self-evaluation form, and two research interviews, as data. Participants and research context: The nursing home’s ward manager and the patient’s son participated in research interviews. Ethical considerations: Data were collected as part of an implementation study. Clinical ethics committee members and interviewed stakeholders consented to study participation, and also gave specific approval for the publication of the present article. Findings/results: Six different roles played by the clinical ethics committee in the case consultation are described: analyst, advisor, support, moderator, builder of consensus and trust, and disseminator. Discussion: The case study indicates that clinical ethics committees might sometimes be of help to stakeholders in moral challenges in nursing homes. Conclusions: Demanding moral challenges arise in the nursing home setting. More research is needed to examine whether clinical ethics committees might be suitable as ethics support structures in nursing homes and community care.
Ethical dilemmas faced by frontline support nurses fighting COVID-19
Authors: Liu Xinyi , Xu Yingying , Chen Yuanyuan , chen Chen , Wu Qiwei , Xu Huiwen , Zhu Pingting , Waidley Ericka 
Published: July 2021

Background: In 2019, an outbreak of COVID-19 broke out in Hubei, China. Medical workers from all over the country rushed to Hubei and participated in the treatment and care of COVID-19 patients. These nurses, dedicated to their professional practice, volunteered to provide compassion and expert clinical care during the pandemic. As with other acts of heroism, the ethical dilemmas associated with working on the front line must be considered for future practice. Purpose: To explore the ethical dilemmas of frontline nurses of Jiangsu Province in China during deployment to Wuhan to fight the novel coronavirus pneumonia, and to provide a basis for developing strategies to help nursing staff address personal and practice concerns in order to work more effectively during this pandemic and other disasters in the future. Research design and method: Using the phenomenological research method and the purpose sampling method, semi-structured interviews were conducted with 10 nurses, post-deployment to Wuhan, who had worked on the front line to fight the novel coronavirus. Ethical considerations: The research proposal was approved by the Research Ethic Committee of Yangzhou University, China. Findings: From the analysis of the interviews of the 10 participants, three main themes were identified: ethical dilemmas in clinical nursing, ethical dilemmas in interpersonal relationships, and ethical dilemmas in nursing management. Conclusion: During a quick response to public health emergencies, where nurses are deployed immediately as a call to action, the issues surrounding ethical dilemmas from several perspectives must be considered. This research suggests that a team approach to proactive planning and open communication during the emergency is an efficient and productive strategy to improve the nurses’ experience and sense of well-being.