bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Left Ventricular Versus Traditional Chest Compressions in a Traumatic Pulseless Electrical Activity Model
Authors: Anderson Kenton L , Evans Jacqueline C , Castaneda Maria G , Boudreau Susan M , Maddry Joseph K , Morgan Jeffrey D 
Published: June 2021

ABSTRACT

Background
Prehospital cardiopulmonary resuscitation has commonly been considered ineffective in traumatic cardiopulmonary arrest because traditional chest compressions do not produce substantial cardiac output. However, recent evidence suggests that chest compressions located over the left ventricle (LV) produce greater hemodynamics when compared to traditional compressions. We hypothesized that chest compressions located directly over the LV would result in an increase in return of spontaneous circulation (ROSC) and hemodynamic variables, when compared to traditional chest compressions, in a swine model of traumatic pulseless electrical activity (PEA).

Methods
Transthoracic echocardiography was used to mark the location of the aortic root (traditional compressions) and the center of the LV on animals (n = 34) that were randomized to receive chest compressions in one of the two locations. Animals were hemorrhaged to mean arterial pressure &lt;20 to simulate traumatic PEA. After 5 minutes of PEA, basic life support (BLS) with mechanical cardiopulmonary resuscitation was initiated and performed for 10 minutes followed by advanced life support for an additional 10 minutes. Hemodynamic variables were averaged over the final 2 minutes of BLS and advanced life support periods.

Results
Six of the LV group (35%) achieved ROSC compared to eight of the traditional group (47%) (P = .73). There was an increase in aortic systolic blood pressure (P &lt; .01), right atrial systolic blood pressure (P &lt; .01), and right atrial diastolic blood pressure (P = .02) at the end of BLS in the LV group compared to the traditional group.

Conclusions
In our swine model of traumatic PEA, chest compressions performed directly over the LV improved blood pressures during BLS but not ROSC.
Oversight May Reduce Military Health System Leakage: Preventing Inappropriate Interhospital Transfers
Authors: Gragg James , Hudson Ian , Hannick Vanessa , Davis Philip , Mitchell Christopher , Ingram Joan , Hall Brian , Malish Richard 
Published: June 2021

ABSTRACT

Introduction
The Military Health System (MHS) offers an example of a socialized healthcare model, operating within a larger “purchased care” civilian healthcare market. This arrangement has facilitated a trend wherein MHS clinicians often transfer moderate-to-complex patients to surrounding civilian hospitals, despite having the capability to care for such patients in-house. In an effort to stem this behavior, two initiatives were introduced at Carl R Darnall Army Medical Center (CRDAMC): A Transfer Policy Statement and Transfer Rounds. The Transfer Policy Statement emphasized that patients ought to be transferred only for capability gaps within the hospital. Transfer Rounds were then used to review the care received by each transferred patient and assess if that care could have been delivered internally. The purpose of this study is to assess the effect of these initiatives on reducing transfers from our hospital.

Materials and Methods
We performed a retrospective chart review from July 2019 through June 2020 to identify the number of total emergency department (ED) transfers, subcategorized as either transfers we had the capability to care for or transfers we did not have the capability to care for. The Transfer Policy Statement was published in August 2019, and Transfer Rounds were instituted in November 2019. We hypothesized that the two interventions would decrease the number of monthly inappropriate transfers. This was assessed by analyzing the proportion of inappropriate to appropriate patient transfers via Cochran and Armitage using SAS 9.4 (SAS Institute, Cary, NC). The projected received an Exemption Determination from the CRDAMC’s Human Research Protections Office. The Defense Health Agency approved the data-sharing agreement.

Results
Over the study period, a total of 706 transfers met the criteria for analysis. The monthly median for total ED transfers was 64.5 (Interquartile Range (IQR) 45-74); appropriate transfers averaged 29.5 (median, IQR 24.5-36) and inappropriate 25.5 (median, IQR 9-41.5). A statistically significant downward trend in the fraction of inappropriate transfers was demonstrated by Cochran and Armitage (P &lt; .0001).

Conclusion
Our analysis supports the hypothesis that implementing a Transfer Policy and Transfer Rounds can significantly reduce the amount of MHS Leakage—that is the number of transferred patients that the MHS could have equally cared for. The effects of reduced patient transfers have many implications for the MHS: patients experience improved continuity of care by remaining in the same hospital system; clinicians maintain and extend their scope of practice by treating more complex patients; and patient flow and ED wait times are reduced by eliminating the transfer process. The financial implications of reduced MHS Leakage were not directly evaluated by our study, however may be assessed in future study.
Effect of Arrival Quarantine on Subsequent COVID-19 Testing in a Cohort of Military Basic Trainees
Authors: Marcus Joseph E , Frankel Dianne N , Pawlak Mary T , Casey Theresa M , Enriquez Erin , Yun Heather C 
Published: June 2021

ABSTRACT

Introduction
Basic Military Training at Joint Base San Antonio-Lackland implemented several sequential non-pharmaceutical interventions in response to coronavirus disease-2019 (COVID-19). One measure, arrival quarantine, has not been studied as a modern military disease prevention strategy. This study aimed to determine the effect of a 14-day arrival quarantine on symptomatic COVID-19 testing.

Material and Methods
A retrospective cohort study compared symptomatic COVID-19 testing among all trainees who entered Basic Military Training between March 17, 2020, and April 17, 2020, before the implementation of universal arrival COVID-19 testing, during their first 2 weeks in arrival quarantine compared to the rest of their training. Furthermore, symptomatic COVID-19 testing in the last 5 weeks of training in those who completed arrival quarantine was compared to testing in the last 5 weeks for trainees who arrived between February 16, 2020, and March 16, 2020, and did not undergo arrival quarantine. Nominal variables were compared by chi-square test, and continuous variables were compared by Mann–Whitney U test. This study was approved as a public health surveillance project by the 59th Medical Wing Institutional Review Board.

Results
Five thousand five hundred and seventy-six trainees started training between February 16, 2020, and April 17, 2020, with 2,573 trainees undergoing an arrival quarantine compared to 3,003 trainees who did not. Trainees who underwent arrival quarantine had higher rates of COVID-19 testing while in arrival quarantine (10.5 tests per 1,000 trainee-weeks vs. 2.3, P ≤ .001) and higher rates of concomitant influenza testing (74% vs. 38%, P = .001) compared to after they completed quarantine. Trainees that completed quarantine had less symptomatic COVID-19 testing after day 14 of training (2.3 tests per 1,000 trainee-weeks vs. 14.3, P ≤ .001) and influenza testing (38% vs. 74%, P = .001) compared to trainees that did not undergo arrival quarantine.

Conclusion
Arrival quarantine appears to be an effective non-pharmaceutical intervention associated with fewer symptomatic COVID-19 tests, especially after completion of quarantine.
Peculiar orbits and asymmetries in extreme trans-Neptunian space
Authors: de la Fuente Marcos C , de la Fuente Marcos R 
Published: June 2021

ABSTRACT
It is still an open question how the Solar system is structured beyond 100 au from the Sun. Our understanding of this vast region remains very limited and only recently we have become aware of the existence there of a group of enigmatic bodies known as the extreme trans-Neptunian objects (ETNOs) that have large orbits with perihelia beyond the orbit of Neptune. Four ETNOs – Sedna, Leleakuhonua, 2012 VP113, and 2013 SY99 – have perihelia beyond 50 au. The study of the ETNOs may provide much needed information on how this remote region is organized. Here, we apply machine-learning techniques to the sample of 40 known ETNOs to identify statistically significant clusters that may signal the presence of true dynamical groupings and study the distribution of the mutual nodal distances of the known ETNOs that measure how close two orbits can get to each other. Machine-learning techniques show that the known ETNOs may belong to four different populations. Results from the analysis of the distribution of nodal distances show that 41 per cent of the known ETNOs have at least one mutual nodal distance smaller than 1.45 au (first percentile of the distribution), perhaps hinting at past interactions. In this context, the peculiar pair of ETNOs made of 505478 (2013 UT15) and 2016 SG58 has a mutual ascending nodal distance of 1.35 at 339 au from the Sun. In addition, the known ETNOs exhibit a highly statistically significant asymmetry between the distributions of object pairs with small ascending and descending nodal distances that might be indicative of a response to external perturbations.
A general Bayesian framework for foreground modelling and chromaticity correction for global 21 cm experiments
Authors: Anstey Dominic , de Lera Acedo Eloy , Handley Will 
Published: June 2021

ABSTRACTThe H i 21 cm absorption line is masked by bright foregrounds and systematic distortions that arise due to the chromaticity of the antenna used to make the observation coupling to the spectral inhomogeneity of these foregrounds. We demonstrate that these distortions are sufficient to conceal the 21 cm signal when the antenna is not perfectly achromatic and that simple corrections assuming a constant spatial distribution of foreground power are insufficient to overcome them. We then propose a new physics-motivated method of modelling the foregrounds of 21 cm experiments in order to fit the chromatic distortions as part of the foregrounds. This is done by generating a simulated sky model across the observing band by dividing the sky into N regions and scaling a base map assuming a distinct uniform spectral index in each region. The resulting sky map can then be convolved with a model of the antenna beam to give a model of foregrounds and chromaticity parametrized by the spectral indices of the N regions. We demonstrate that fitting this model for varying N using a Bayesian nested sampling algorithm and comparing the results using the evidence allows the 21 cm signal to be reliably detected in data of a relatively smooth conical log spiral antenna. We also test a much more chromatic conical sinuous antenna and find this model will not produce a reliable signal detection, but in a manner that is easily distinguishable from a true detection.
Multi-resolution characterization of molecular taxonomies in bulk and single-cell transcriptomics data
Authors: Reed Eric R , Monti Stefano 
Published: June 2021

AbstractAs high-throughput genomics assays become more efficient and cost effective, their utilization has become standard in large-scale biomedical projects. These studies are often explorative, in that relationships between samples are not explicitly defined a priori, but rather emerge from data-driven discovery and annotation of molecular subtypes, thereby informing hypotheses and independent evaluation. Here, we present K2Taxonomer, a novel unsupervised recursive partitioning algorithm and associated R package that utilize ensemble learning to identify robust subgroups in a ‘taxonomy-like’ structure. K2Taxonomer was devised to accommodate different data paradigms, and is suitable for the analysis of both bulk and single-cell transcriptomics, and other ‘-omics’, data. For each of these data types, we demonstrate the power of K2Taxonomer to discover known relationships in both simulated and human tissue data. We conclude with a practical application on breast cancer tumor infiltrating lymphocyte (TIL) single-cell profiles, in which we identified co-expression of translational machinery genes as a dominant transcriptional program shared by T cells subtypes, associated with better prognosis in breast cancer tissue bulk expression data.
O-glycoforms of polymeric immunoglobulin A1 in the plasma of patients with IgA nephropathy are associated with pathological phenotypes
Authors: Yu Guizhen , Zhang Yong , Meng Bo , Xie Xinfang , Wang Zi , Ying Wantao , Lv Jicheng , Zhang Hong 
Published: June 2021

Abstract

Background
Immunoglobulin A1 (IgA1) O-glycosylation plays an important role in the pathogenesis of IgA nephropathy (IgAN). However, variations in IgA1 O-glycoforms have not been explored. We aimed to investigate the IgA1 O-glycoforms in the hinge region (HR) of polymeric IgA1 (pIgA1) and then evaluate the association between IgA1 O-glycoforms and crescent formation in IgAN.

Methods
The discovery cohort (Cohort 1) comprised 11 crescentic IgAN patients, 10 noncrescentic IgAN patients and 10 healthy controls and the validation cohort (Cohort 2) comprised 11 crescentic IgAN patients, 9 noncrescentic IgAN patients and 9 healthy controls. A total of 143 IgAN patients with different crescent percentages (Cohort 3) were also included. pIgA1 was purified from the plasma of the participants. The variation in O-glycoforms was evaluated by estimating the molecular weights of IgA1 hinge glycopeptides using reversed-phase liquid chromatography and tandem mass spectrometry under electron-transfer/higher-energy collision dissociation fragmentation mode.

Results
In the discovery cohort (Cohort 1), the number of N-acetylgalactosamine (GalNAc) bound to one HR was lower in IgAN patients. The proportions of GalNAc3 (defined as O-glycans bound to one HR at three sites) and GalNAc4 were highest in crescentic IgAN patients, followed by noncrescentic IgAN patients, and were lowest in healthy controls [GalNAc 3: 9.92 ± 3.37% versus 6.65 ± 1.53% versus 4.05 ± 1.24% (P &lt; 0.001); GalNAc4: 45.91 ± 4.75% versus 41.13 ± 2.95% versus 40.98 ± 2.95% (P = 0.004), respectively]. The proportions of GalNAc5 and GalNAc6 were lowest in crescentic IgAN patients followed by noncrescentic IgAN patients and were highest in healthy controls [GalNAc5: 50.15 ± 4.27% versus 47.92 ± 4.09% versus 45.87 ± 3.79% (P = 0.028); GalNAc6: 6.58 ± 2.53% versus 6.04 ± 1.35% versus 4.65 ± 2.27% (P = 0.034), respectively]. These results were consistent in the validation cohort (Cohort 2). In another cohort with 143 patients with different crescent percentages (Cohort 3), the number of GalNAc in pIgA1 decreased with an increasing percentage of crescents.

Conclusions
The number of GalNAc in IgA1 HRs was lower in IgAN patients, especially in crescentic IgAN patients, and may be associated with a severe IgAN phenotype.
Early Outcomes After Carotid Endarterectomy and Carotid Artery Stenting: A Propensity-Matched Cohort Analysis
Authors: Sastry Rahul A , Pertsch Nathan J , Sagaityte Emilija , Poggi Jonathan A , Toms Steven A , Weil Robert J 
Published: June 2021

Abstract

BACKGROUND
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) represent options to treat many patients with carotid stenosis. Although randomized trial data are plentiful, estimated rates of morbidity and mortality for both CEA and CAS have varied substantially.

OBJECTIVE
To evaluate rates of adverse outcomes after CAS and CEA in a large national database.

METHODS
We analyzed 84 191 adult patients undergoing elective, nonemergent CAS (n = 81 361) or CEA (n = 2830), from 2011 to 2018, in the American College of Surgeons’ National Surgical Quality Improvement Program database. Odds of adverse outcomes (30-d rates of stroke, myocardial infarction (MI), cardiac arrest, prolonged length of stay (LOS), readmission, reoperation, and mortality) were evaluated in propensity-matched (n = 2821) cohorts through logistic regression.

RESULTS
In the propensity-matched cohorts, CAS had increased odds of periprocedural stroke (odds ratio [OR] 1.97, 95% CI 1.32-2.95) and decreased odds of cardiac arrest (OR 0.33, 95% CI 0.13-0.84) and 30-d reoperation (OR 0.59, 95% CI 0.44-0.80) compared to CEA. Relative odds of MI, prolonged LOS, discharge to destination other than home, 30-d readmission, or 30-d mortality were statistically similar. In the unmatched patient population, rates of adverse outcomes with CEA were constant over time; however, for CAS, rates of stroke increased over time. In both the matched and unmatched patient cohorts, patients 70 yr and older had lower rates of post-procedural stroke with CEA, but not with CAS, compared to younger patients.

CONCLUSION
In a propensity-matched analysis of a large, prospectively collected, national, surgical database, CAS was associated with increased odds of periprocedural stroke, which increased over time. Rates of MI and death were not significantly different between the 2 procedures.
Radiation and adjuvant drug-loaded liposomes target glioblastoma stem cells and trigger in-situ immune response
Authors: Pizzocri Marco , Re Francesca , Stanzani Elisabetta , Formicola Beatrice , Tamborini Matteo , Lauranzano Eliana , Ungaro Federica , Rodighiero Simona , Francolini Maura , Gregori Maria , Perin Alessandro , DiMeco Francesco , Masserini Massimo , Matteoli Michela , Passoni Lorena 
Published: June 2021

Abstract

Background
The radio- and chemo-resistance of glioblastoma stem-like cells (GSCs), together with their innate tumor-initiating aptitude, make this cell population a crucial target for effective therapies. However, targeting GSCs is hardly difficult and complex, due to the presence of the blood–brain barrier (BBB) and the infiltrative nature of GSCs arousing their dispersion within the brain parenchyma.

Methods
Liposomes (LIPs), surface-decorated with an Apolipoprotein E-modified peptide (mApoE) to enable BBB crossing, were loaded with doxorubicin (DOXO), as paradigm of cytotoxic drug triggering immunogenic cell death (ICD). Patient-derived xenografts (PDXs) obtained by GSC intracranial injection were treated with mApoE-DOXO-LIPs alone or concomitantly with radiation.

Results
Our results indicated that mApoE, through the engagement of the low-density lipoprotein receptor (LDLR), promotes mApoE-DOXO-LIPs transcytosis across the BBB and confers target specificity towards GSCs. Irradiation enhanced LDLR expression on both BBB and GSCs, thus further promoting LIP diffusion and specificity. When administered in combination with radiations, mApoE-DOXO-LIPs caused a significant reduction of in vivo tumor growth due to GSC apoptosis. GSC apoptosis prompted microglia/macrophage phagocytic activity, together with the activation of the antigen-presenting machinery crucially required for anti-tumor adaptive immune response.

Conclusions
Our results advocate for radiotherapy and adjuvant administration of drug-loaded, mApoE-targeted nanovectors as an effective strategy to deliver cytotoxic molecules to GSCs at the surgical tumor margins, the forefront of glioblastoma (GBM) recurrence, circumventing BBB hurdles. DOXO encapsulation proved in situ immune response activation within GBM microenvironment.
Fifty-millimeter abscess in the ileum caused by perforation from anisakiasis successfully treated with conservative therapy without drainage
Authors: Kawanishi Koki , Ikeda Yoshifumi , Furotani Masahiko , Tsuboi Sayaka , Kanno Takayuki , Niwa Toru , Nagaoka Tsunehiro , Tabata Yoshinari , Kitano Masayuki 
Published: June 2021

ABSTRACT
Intestinal anisakiasis is not only a rare but also a difficult to diagnose parasitic disease. The symptoms are not specific and are often severe and abrupt; therefore, patients are sometimes diagnosed as having surgical abdomen. The clinical imaging findings are remarkable, including ascites, enteritis, ileus, eosinophilic granuloma and sometimes perforation. We experienced a case of intestinal anisakiasis diagnosed on the basis of the Anisakis-specific immunoglobulin A level from paired sera and treated successfully with conservative therapy, although ileum perforation was complicated by a 50-mm abscess. Even the large abscess could be treated without drainage in thiscase.
Threshold models improve estimates of molt parameters in datasets with small sample sizes
Authors: Terrill Ryan S , Fong Youyi , Wolfe Jared D , Zellmer Amanda J 
Published: June 2021

Abstract
The timing of events in birds’ annual cycles is important to understanding life history evolution and response to global climate change. Molt timing is often measured as an index of the sum of grown feather proportion or mass within the primary flight feathers. The distribution of these molt data over time has proven difficult to model with standard linear models. The parameters of interest are at change points in model fit over time, and so least-squares regression models that assume molt is linear violate the assumption of even variance. This has led to the introduction of other nonparametric models to estimate molt parameters. Hinge models directly estimate changes in model fit and have been used in many systems to find change points in data distributions. Here, we apply a hinge model to molt timing, through the introduction of a double-hinge (DH) threshold model. We then examine its performance in comparison to current models using simulated and empirical data. Our results suggest that the Underhill–Zucchini (UZ) and Pimm models perform well under many circumstances and appear to outperform the DH model in datasets with high variance. The DH model outperforms the UZ model at low sample sizes of birds in active molt and shorter molt durations and provides more realistic confidence intervals at smaller sample sizes. The DH model provides a novel addition to the toolkit for estimating molt phenology, expanding the conditions under which molt can accurately be estimated.
The Defence of Grace after the 1626 Proclamation
Authors: Hampton Stephen 
Published: June 2021

Abstract
Chapter 4 establishes the ongoing promotion of the Reformed Conformist approach to grace during the 1630s, in the face of an attempt to stifle such opinions by royal proclamation in 1626. Using Ward’s professorial determinations at the Cambridge Commencement, it shows how he ensured that the Reformed vision of grace still held a prominent place within Cambridge and exhibited its compatibility with English Church polity. The chapter also explores Ward’s editorial collaboration with Davenant in the publication of Davenant’s academic works. It underlines that their work ensured that the University press remained a vehicle for Reformed Conformity throughout the 1630s.
Gracious Disciples and Frightened Magistrates
Authors: Westerkamp Marilyn J. 
Published: June 2021

Abstract
This chapter begins with the Quakers in England, the appeal of the Quaker movement in New England, including Hutchinson's followers, and the threat that Quakers posed to the New England magistracy. It examines Hutchinson’s followers in some detail, but the Quaker/ Magistrate conflict is central to the chapter. The response of the governors and clerics mirrored so completely the official responses to the Hutchinsonians that the Quaker crisis becomes a venue through which the same social, political, and ideological issues are encountered and resolved. This is less a second-generation event than the last gasp of the founding generation.