bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prioritizing the Role of Major Lipoproteins and Subfractions as Risk Factors for Peripheral Artery Disease
Authors: Levin Michael G. , Zuber Verena , Walker Venexia M. , Klarin Derek , Lynch Julie , Malik Rainer , Aday Aaron W. , Bottolo Leonardo , Pradhan Aruna D. , Dichgans Martin , Chang Kyong-Mi , Rader Daniel J. , Tsao Philip S. , Voight Benjamin F. , Gill Dipender , Burgess Stephen , Damrauer Scott M. ,   on behalf of the VA Million Veteran Program
Published: June 2021

Background:
Lipoprotein-related traits have been consistently identified as risk factors for atherosclerotic cardiovascular disease, largely on the basis of studies of coronary artery disease (CAD). The relative contributions of specific lipoproteins to the risk of peripheral artery disease (PAD) have not been well defined. We leveraged large-scale genetic association data to investigate the effects of circulating lipoprotein-related traits on PAD risk.

Methods:
Genome-wide association study summary statistics for circulating lipoprotein-related traits were used in the mendelian randomization bayesian model averaging framework to prioritize the most likely causal major lipoprotein and subfraction risk factors for PAD and CAD. Mendelian randomization was used to estimate the effect of apolipoprotein B (ApoB) lowering on PAD risk using gene regions proxying lipid-lowering drug targets. Genes relevant to prioritized lipoprotein subfractions were identified with transcriptome-wide association studies.

Results:

ApoB was identified as the most likely causal lipoprotein-related risk factor for both PAD (marginal inclusion probability, 0.86;
P
=0.003) and CAD (marginal inclusion probability, 0.92;
P
=0.005). Genetic proxies for ApoB-lowering medications were associated with reduced risk of both PAD (odds ratio,0.87 per 1-SD decrease in ApoB [95% CI, 0.84–0.91];
P
=9×10
−10
) and CAD (odds ratio,0.66 [95% CI, 0.63–0.69];
P
=4×10
−73
), with a stronger predicted effect of ApoB lowering on CAD (ratio of effects, 3.09 [95% CI, 2.29–4.60];
P
<1×10
−6
). Extra-small very-low-density lipoprotein particle concentration was identified as the most likely subfraction associated with PAD risk (marginal inclusion probability, 0.91;
P
=2.3×10
−4
), whereas large low-density lipoprotein particle concentration was the most likely subfraction associated with CAD risk (marginal inclusion probability, 0.95;
P
=0.011). Genes associated with extra-small very-low-density lipoprotein particle and large low-density lipoprotein particle concentration included canonical ApoB pathway components, although gene-specific effects were variable. Lipoprotein(a) was associated with increased risk of PAD independently of ApoB (odds ratio, 1.04 [95% CI, 1.03–1.04];
P
=1.0×10
−33
).

Conclusions:
ApoB was prioritized as the major lipoprotein fraction causally responsible for both PAD and CAD risk. However, ApoB-lowering drug targets and ApoB-containing lipoprotein subfractions had diverse associations with atherosclerotic cardiovascular disease, and distinct subfraction-associated genes suggest possible differences in the role of lipoproteins in the pathogenesis of PAD and CAD.
Burden of Ischemic Stroke in Patients With Congenital Heart Disease: A Nationwide, Case‐Control Study
Authors: Giang Kok Wai , Fedchenko Maria , Dellborg Mikael , Eriksson Peter , Mandalenakis Zacharias 
Published: June 2021

Background
Patients with congenital heart disease (CHD) are at increased risk of developing ischemic stroke (IS) compared with controls without CHD. However, the long‐term outcomes after IS, including IS recurrence and mortality risk, remain unclear.

Methods and Results
We identified all patients with CHD in Sweden who were born between 1930 and 2017 using the Swedish National Patient Register and the Cause of Death Register. Ten controls without CHD were randomly selected from the general population and matched for birth year and sex for each patient with CHD. The follow‐up of the study population was performed between January 1970 and December 2017. In total, 88 700 patients with CHD (50.6% men) and 890 450 matched controls (51.0%) were included in this study. During a mean follow‐up of 25.1±22.0 years, patients with CHD had a 5‐fold higher risk of developing an index IS (hazard ratio [HR], 5.01; 95% CI, 4.81–5.22) compared with controls. However, the risk of developing a recurrent IS was lower in patients with CHD compared with controls (HR, 0.66; 95% CI, 0.56–0.78), an observation that persisted after adjustment for cardiovascular risk factors and comorbidities. Patients with CHD were also at a significantly lower risk of all‐cause mortality after index IS than controls (HR, 0.53; 95% CI, 0.49–0.58).

Conclusions
Patients with CHD had a 5‐fold higher risk of developing index IS compared with matched controls. However, the risk of recurrent IS stroke and all‐cause mortality were 34% and 47% lower, respectively, in patients with CHD compared with controls.
Ecumenical Mysticism: On Conversion in the Eastern Tradition of Ordene de Chevalerie
Authors: Shachar Uri Zvi 
Published: June 2021

Abstract
Historians celebrate the Old French Ordene de Chevalerie as an important landmark in the history of French nobility. The version of Ordene that most scholars have studied showcases Saladin’s interest in Christian chivalry but stops short of his actual dubbing. An often-neglected prose recension of this tale that first appeared in an oriental history of Outremer goes a step further, imagining the sultan to have truly become a knight “in the Christian fashion.” This version of the story, I argue, portrays Christian dubbing not only as a ceremony through which young aristocrats were admitted into a society of warriors, but also as an instrument for spiritual ascent that non-Christians could experience without renouncing their own faith. As such, the story echoes the widespread near-eastern trope of ecumenical mysticism, in which members of various faiths were seen to partake in mystical practices that belonged to neighboring traditions.
Security and Religion: The Discursive Self-legitimation of the Chechen Authorities
Authors: Iliyasov Marat 
Published: June 2021

Abstract
This article analyses the official discourse of the Chechen authorities and posits that it reflects the government’s efforts as self-legitimation. This investigation seeks to identify the mechanisms exploited by the Chechen regime to boost self-legitimacy by examining the ‘News’ programme on the Chechen state television channel ‘Grozny’, which, in the authoritarian setting of Chechnya, became the government’s mouthpiece and a propagator of official discourse. To provide for the context and to boost findings, the study is complemented by a discursive analysis of one more historical-political television programme and a political advertisement that was broadcast by the same channel during the period in which the fieldwork took place. The collected data is processed using Critical Discourse Analysis.
Towards a climatology of fog frequency in the Atacama Desert via multi-spectral satellite data and machine learning techniques
Authors: Böhm Christoph , Schween Jan H. , Reyers Mark , Maier Benedikt , Löhnert Ulrich , Crewell Susanne 
Published: June 2021

AbstractIn many hyper-arid ecosystems, such as the Atacama Desert, fog is the most important fresh water source. To study biological and geological processes in such water-limited regions, knowledge about the spatio-temporal distribution and variability of fog presence is necessary. In this study, in-situ measurements provided by a network of climate stations equipped, inter alia, with leaf wetness sensors are utilized to create a reference fog data set which enables the validation of satellite-based fog retrieval methods. Further, a new satellite-based fog detection approach is introduced which uses brightness temperatures measured by the Moderate Resolution Imaging Spectroradiometer (MODIS) as input for a neural network. Such a machine learning technique can exploit all spectral information of the satellite data and represent potential non-linear relationships. Compared to a second fog detection approach based on MODIS cloud top height retrievals, the neural network reaches a higher detection skill (Heidke skill score of 0.56 compared to 0.49). A suitable representation of temporal variability on subseasonal time scales is provided with correlations mostly greater than 0.7 between fog occurrence time series derived from the neural network and the reference data for individual climate stations, respectively. Furthermore, a suitable spatial representativity of the neural network approach to expand the application to the whole region is indicated. Three-year averages of fog frequencies reveal similar spatial patterns for the austral winter season for both approaches. However, differences are found for the summer and potential reasons are discussed.
Application of S_TIDE in exploration of seasonal variations of internal tidal amplitudes in the northern South China Sea
Authors: LI BINGTIAN , WEI ZEXUN , WANG YONGGANG , GUO XINYU , XU TENGFEI , LV XIANQING 
Published: June 2021

AbstractAn enhanced harmonic analysis (S_TIDE) approach is adopted to examine the seasonal variations of internal tidal amplitudes in the northern South China Sea (SCS). Results of idealized experiments reveal that the seasonality can be captured by S_TIDE. By applying S_TIDE to mooring data, observed seasonality of internal tidal amplitudes in the northern SCS are explored. Not diurnal and semidiurnal internal tides (ITs), but overtides and long-period constituents of ITs exhibit clear seasonal cycles. However, differences between amplitudes of the eastward velocity and the northward counterpart are evident for K1, M2 and MK3, which may be caused by the intensification of background currents. Amplitudes of those ITs are stronger at intersection time between spring and summer in the eastward direction, but weaker in the northward direction. EOF analysis reveals that modes of diurnal ITs are higher than those of seimidiurnal ITs, which induces relatively more complicated seasonal variations. In addition to intensification of background currents, influences of surface tides and stratification will also induce variations of internal tidal amplitudes, introducing tremendous difficulty in predicting variation trends of internal tidal amplitudes, which greatly reduces predictability of ITs.
Numerical Accuracy of Advection Scheme Necessary for Large-Eddy Simulation of Planetary Boundary Layer Turbulence
Authors: Kawai Yuta , Tomita Hirofumi 
Published: June 2021

AbstractRecently, large-eddy simulation (LES) has been increasingly employed in meteorological simulations because it is a promising method for turbulent parameterization. However, it is still difficult to affirm that the numerical accuracy required for a dynamical core is fully understood. In this study, we derived two theoretical criteria for the order of accuracy of the advection term in a typical situation of the atmospheric boundary layer, and demonstrate their validity by numerical experiments. In the targeted grid-spacing of O (10 m), we determined the required order of accuracy as follows: Based on the criterion of the numerical diffusion error, the upwind scheme must have at least seventh-order accuracy. The fourth-order central scheme is barely acceptable with fourth-order explicit diffusion, provided that its coefficient is one or two orders of magnitude smaller than the implicit diffusion coefficient of the third-order upwind scheme. Based on the criterion of numerical dispersion error, at minimum, the seventh or eighth order is required. The dispersion error was indirect for the energy spectra, although we expect it may affect the local turbulence mechanism. We also investigated the effects of temporal discretization for compressible models, and found that relatively lower-order time schemes are available up to the O(10 m) grid spacing if the time step is sufficiently small due to sound wave limitations. The importance of the derived criteria is that the required order of accuracy increases as the grid spacing decreases. This suggests that considerable care should be taken regarding the numerical error problem for future high-resolution LES.
Improved Perceptions of Education and Wellness Among General Surgery Residents and Faculty After the Implementation of Outpatient Scribes
Authors: Tohmasi Steven , Naaseh Ariana , Thompson Sean , Smith Brian R. 
Published: June 2021

Background Recent studies have revealed a high rate of burnout among general surgery (GS) residents. Efforts to design and implement interventions to mitigate fatigue in surgical trainees are critical. Our aim was to assess the educational and wellness impact of outpatient scribe utilization at an academic GS residency program. Methods Electronic surveys were sent to 38 GS residents and 15 faculties who used outpatient scribes for at least 12 months. Questions were scored on a 5-point Likert scale with answers of “Strongly agree” or “Agree” representing affirmative responses. Results Thirty residents and 14 faculty completed the survey, resulting in an 83% overall response rate. Twenty-eight (93%) residents and 12 (86%) faculty believed that scribes decrease the daily workload of trainees. Twenty-seven (90%) residents felt that scribes allow them more time to focus on patient care and improve the quality of their surgical education. Ninety-three percent of residents (n = 28) and faculty (n = 13) believed that scribes enhance resident well-being. Twenty-four (80%) residents reported that scribes help improve adherence to duty hour restrictions. Twenty-five (83%) residents believed that utilizing scribes is an effective fatigue mitigation strategy for surgical training programs. Conclusion Our findings demonstrate that the implementation of an outpatient scribe program at an academic GS residency program may enhance resident education and wellness.
Tympanic Membrane Pneumatocele from Auto-insufflation
Authors: Macielak Robert J. , Goates Andrew J. , Lane John I. , Carlson Matthew L. 
Published: June 2021

Objective: The differential of an external auditory canal mass is broad. One rare potential cause is a pneumatocele of the tympanic membrane, which has only been described 1 other time in the literature. This report serves to describe the second case of this pathology, including its unique presentation, and benign clinical course. Methods: Case report. Results: A case is discussed in which a pneumatocele of the tympanic membrane was incidentally identified during evaluation of contralateral otologic pathology. The etiology was suspected to be habitual auto-insufflation. After cessation of this practice, the pneumatocele was noted to resolve without further intervention. Conclusion: A tympanic membrane pneumatocele represents a rare cause of an external auditory canal mass. The diagnosis can be made clinically via history, palpation, and otoscopy during auto-insufflation, potentially avoiding further diagnostic testing. Depending on the etiology, resolution can occur after lifestyle modification; however, further interventions may definitively treat the condition if so required.
Head and Neck Injury Patterns among American Football Players
Authors: Mehta Neil K. , Siegel Justin , Cowan Brandon , Johnson Jared , Hojjat Houmehr , Chung Michael T. , Carron Michael A. 
Published: June 2021

Importance: American football is a popular high-impact sport, leading to 2.7 million injuries in the United States annually. Recent evidence in football-related neurological damage has spurred national interest in player-safety. Football players injure their head and neck in up to 26% of total injuries. Variation in injury patterns between age groups and correlated hospitalizations for football-related head and neck injury has yet to be characterized. Objective: Our aim is to evaluate injury patterns among American-football related head and neck trauma. Methods: A retrospective cohort study of patients with football-related head and neck injury in the National Electronic Injury Surveillance System (NEISS). Results: Nearly 100 000 ED visits for football-related head and neck injuries occur annually. Males comprised 95% of patients, with a median age of 13. The head comprised 70% of injuries followed by the face (13%). The most common diagnoses were concussions (39%), internal organ injury (26%), and lacerations (11%). Pediatric patients were more likely to sustain concussions while adults experienced more lacerations ( P < .05%). Fractures and nerve damage were rare injuries but caused a disproportionate share of hospitalizations. Conclusion: Pediatric males are most likely to present for emergency care from football-related injury to the head and neck. Evaluating physicians can anticipate concussions, internal organ injury, and lacerations among presenting patients. Concussions, facial fractures, and nerve damage are injuries most likely to lead to hospitalization.
Systemic lupus erythematosus patients have a distinct structural and functional skin microbiota compared with controls
Authors: Zhou Hao-Yue , Cao Nv-Wei , Guo Biao , Chen Wen-Jun , Tao Jin-Hui , Chu Xiu-Jie , Meng Xiang , Zhang Tian-Xiang , Li Bao-Zhu 
Published: June 2021

Objective The skin is the second most affected organ after articular involvement in systemic lupus erythematosus (SLE) patients. Cutaneous involvement occurs in approximately 80% of patients during the course of SLE. Interaction between the host and skin microorganism is a complex process. There are few studies on the diversity of skin microbes in SLE patients. Therefore, this study aims to explore the relationship between skin microorganisms and SLE. Methods A total of 20 SLE patients, 20 controls with rosacea and 20 healthy controls were selected as study subjects. Both the skin microbiota of rash region and non-rash region for each SLE patient were collected.16S rRNA gene sequencing was used to detected skin microbiota from 80 specimens. α-Diversity and β-diversity of skin microbiota were analyzed based on operational taxonomic units (OTUs) and minimal entropy decomposition (MED). Using Wilcoxon test and Linear Discriminate Analysis Effect Size (LEfSe), skin microbial diversity and composition were analyzed. Functional capabilities of microbiota were estimated through Kyoto Encyclopedia of Genes and Genomes database. Results Compared to rash region of SLE, diversity and richness were increased in healthy controls, and decreased in non-rash region of SLE and rash region of controls with rosacea. Additionally, changes of skin microbial composition were found at different taxonomic levels between four groups. For example, genus Halomonas was increased and genera Pelagibacterium, Novosphingobium, and Curvibacter were decreased in rash region compared to non-rash region of SLE based on OTUs and MED. Based on OTUs, metabolic pathways were also found differences in SLE patients, such as Xenobiotics Biodegradation and Metabolism. Conclusion Compositions and diversity of skin microbiota in SLE patients are changed. This pilot study provides some suggestive evidence for further exploration of skin microbiota in SLE patients with cutaneous involvement.
Is the Indian Dietary Pattern Associated WithType 2 Diabetes? A Pan-India Randomized Cluster Sample Study
Authors: Nagarathna Raghuram , Anand Akshay , Nanda Sapna , Patil Suchitra S. , Singh Amit , Rajesh S. K. , Nagendra H. R. 
Published: June 2021

Background: Diabetes is associated strongly with many neurodegenerative diseases and is also a lifestyle disorder. A good glycemic status depends on diet management and physical activity. There are several studies available on the relationship between diet habits and impact on diabetes. Purpose: The objective of this study was to check the association of different dietary factors with glucose levels and lipid values in type 2 diabetes from a part of a large nationwide trial. Methods: This was the data fromapan-India multicentered cluster randomized controlled study covering 60 states and 4 union territories; 17,285 individuals were surveyed for dietary factors. Amongst them, data of 12,500 individuals were analyzed.Males were 54% and 60% individuals were from urban areas. Results: The analysis of the results showed that consumption (usual/often) of milk(odds ratio, OR = 7.180), meat (OR = 6.81), less fiber (OR = 17.77), and less fruits (OR = 14.71) was strongly and positively associated with fasting blood glucose ( P<.001). The postprandial blood glucose (PPBG) in diabetes individuals also had a strong positive association ( P<.001) with consumption (usual/often) of meat (OR = 22.82) and milk (OR = 17.19). In prediabetes individuals, milk was significantly ( P<.001) associated with fasting blood glucose (OR = 2.74). In nondiabetes individuals also, milk was significantly associated with postprandial blood glucose (OR = 2.56). Consumption of meat was associated with high cholesterol (OR = 1.465). Consumption of junk food was associated significantly ( P <.001)with the status of known diabetes (OR = 1.345) and known hypertension (OR = 1.247). Conclusion: Consumption of milk, meat, less vegetables, less fruits, and junk food has a significant effect on the glycemic status and cholesterol levels, and also on the status of known diabetes and hypertension.
Ethics and the Simulation Facilitator: Taking your Professional Role Seriously
Authors: de Wijse-van Heeswijk Marieke 
Published: June 2021

Background: When selecting, managing, and debriefing simulations, facilitators wishing to maintain appropriate standards, face demanding ethical challenges especially in learning contexts. Aim: This article considers why facilitators need to attend to ethical issues in facilitating simulation games. Issues examined include the influence of complexity in socio-technical system simulation games, perceptions of both facilitator and participants’ behaviors by including belief systems. Intervention: A multidisciplinary integrative view of ethical facilitation from a reflective perspective has been used in this article. Method: Literature, interviews and case descriptions were employed to examine what might constitute ethical facilitation. Results: A three layered framework of perspectives on ethical facilitation is proposed and two case study examples are used to describe its application. Further research is being conducted on facilitator tools for dealing with ethical issues. Conclusions: While ethical facilitation is undoubtedly complex, tangible perspectives with scientific foundations can be established and applied on the continuum of open and closed simulation games.