bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimized lesion size index (o‐LSI): A novel predictor for sufficient ablation of pulmonary vein isolation
Authors: Matsuura Gen , Kishihara Jun , Fukaya Hidehira , Oikawa Jun , Ishizue Naruya , Saito Daiki , Sato Tetsuro , Arakawa Yuki , Kobayashi Shuhei , Shirakawa Yuki , Nishinarita Ryo , Horiguchi Ai , Niwano Shinichi , Ako Junya 
Published: April 2021

AbstractBackgroundAlthough the lesion size index (LSI) has been well established, it is sometimes difficult to achieve first‐pass pulmonary vein isolation (PVI) and to avoid acute pulmonary vein reconnections, even with LSI‐guided procedures. The purpose of this study was to assess the predictive accuracy of a novel parameter, the optimized lesion size index (o‐LSI), to perform PVI.MethodsThe voltage maps created by the Advisor™ high‐density (HD) grid catheter before PVI in 35 atrial fibrillation (AF) patients were examined for an association between the voltage amplitude and insufficient ablation sites (IAS), which were defined as either (i) spontaneous reconnection sites, (ii) dormant PV conduction sites unmasked with 20 mg of adenosine triphosphate disodium hydrate (ATP) injection, or (iii) PV‐LA gap sites after the initial PVI.ResultsIAS was observed in 25/1417 of the total ablation sites. IAS was significantly associated with higher bipolar voltage areas (4.20 ± 2.68 vs 2.43 ± 1.93 mV, P < .0001) but not with LSI. A novel index, o‐LSI (defined as LSI/bipolar voltage), was significantly lower in IAS than in others (1.14 [0.82, 1.81] vs 2.35 [1.31, 4.80] LSI/mV). By receiver operating characteristic analysis, an o‐LSI of 2.04 was the best cutoff value for the prediction of IAS (88% sensitivity and 55% specificity, P < .0001, areas under the curve: 0.742).ConclusionLow o‐LSI was strongly associated with IAS, potentially providing a novel index to improve first‐pass PV isolation.
A wavelet transform method to determine monsoon onset and retreat from precipitation time‐series
Authors: García‐Franco Jorge L. , Osprey Scott , Gray Lesley J. 
Published: April 2021

AbstractA new method to determine monsoon onset and retreat timings using wavelet transform methodology applied to precipitation time‐series at the pentad scale is described. The principal advantage of this method is its portability, since it can be easily adapted for any region and dataset. The application of the method is illustrated for the North American Monsoon and the Indian Monsoon using four different precipitation datasets and climate model output. The method is shown to be robust across all the datasets and both monsoon regions. The mean onset and retreat dates agree well with previous methods. Spatial distributions of the precipitation and circulation anomalies identified around the onset and retreat dates are also consistent with previous work and illustrate that this method may be used at the grid‐box scale, not just over large area‐averaged regions. The method is also used to characterize the strength and timing of the Midsummer drought (MSD) in southern Mexico and Central America. A two peak structure is found to be a robust structure in only in 33% of the years, with other years showing only one peak or no signs of a bimodal distribution. The two‐peak structure analysed at the grid‐box scale is shown to be a significant signal in several regions of Central America and southern Mexico. The methodology is also applied to climate model output from the Met Office Hadley Centre UKESM1 and HadGEM3 CMIP6 experiments. The modelled onset and retreat dates agree well with observations in the North American Monsoon but not in the Indian Monsoon. The start and end of the modelled MSD in southern Mexico and Central America is delayed by one pentad and has a stronger bimodal signal than observed.
Painful temporomandibular joint overloading induces structural remodeling in the pericellular matrix of that joint's chondrocytes
Authors: Franklin Melissa , Sperry Megan M. , Phillips Evan , Granquist Eric J. , Marcolongo Michele , Winkelstein Beth A. 
Published: April 2021

AbstractMechanical stress to the temporomandibular joint (TMJ) is an important factor in cartilage degeneration, with both clinical and preclinical studies suggesting that repeated TMJ overloading could contribute to pain, inflammation, and/or structural damage in the joint. However, the relationship between pain severity and early signs of cartilage matrix microstructural dysregulation is not understood, limiting the advancement of diagnoses and treatments for temporomandibular joint‐osteoarthritis (TMJ‐OA). Changes in the pericellular matrix (PCM) surrounding chondrocytes may be early indicators of OA. A rat model of TMJ pain induced by repeated jaw loading (1 h/day for 7 days) was used to compare the extent of PCM modulation for different loading magnitudes with distinct pain profiles (3.5N—persistent pain, 2N—resolving pain, or unloaded controls—no pain) and macrostructural changes previously indicated by Mankin scoring. Expression of PCM structural molecules, collagen VI and aggrecan NITEGE neo‐epitope, were evaluated at Day 15 by immunohistochemistry within TMJ fibrocartilage and compared between pain conditions. Pericellular collagen VI levels increased at Day 15 in both the 2N (p = 0.003) and 3.5N (p = 0.042) conditions compared to unloaded controls. PCM width expanded to a similar extent for both loading conditions at Day 15 (2N,p < 0.001; 3.5N,p = 0.002). Neo‐epitope expression increased in the 3.5N group over levels in the 2N group (p = 0.041), indicating pericellular changes that were not identified in the same groups by Mankin scoring of the pericellular region. Although remodeling occurs in both pain conditions, the presence of pericellular catabolic neo‐epitopes may be involved in the macrostructural changes and behavioral sensitivity observed in persistent TMJ pain.
Pancreas cancer: Therapeutic trials in metastatic disease
Authors: Smithy James W. , O'Reilly Eileen M. 
Published: April 2021

AbstractMetastatic pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer‐related mortality in 2021. Cytotoxic therapies are the therapeutic mainstay for PDAC. The recent approval of olaparib as maintenance therapy for germlineBRCA1/2‐mutated PDAC and pembrolizumab for mismatch repair deficient PDAC represent molecularly targeted approaches for this disease. Investigational therapeutic strategies include targeting the stroma, metabolism, tumor microenvironment, and the immune system, and selected approaches are reviewed herein.
Trends in the utilization of neoadjuvant therapy for pancreatic ductal adenocarcinoma
Authors: Brown Zachary J. , Cloyd Jordan M. 
Published: April 2021

AbstractFor patients with localized pancreatic cancer, neoadjuvant therapy (NT) is increasingly delivered before surgery to maximize the receipt of multimodality therapy and the odds of a margin‐negative resection. Three decades of refining the use of NT have led to its acceptance as a valid treatment approach for pancreatic adenocarcinoma. In this review, we discuss the rationale for and recent global trends in the utilization of NT for patients with pancreatic cancer.
Semiautomatic Assessment of Fetal Fractional Limb Volume for Weight Prediction in Clinical Praxis
Authors: Gembicki Michael , Offerman David R. , Weichert Jan 
Published: April 2021

ObjectivesSemiautomatic fractional limb volume (FLV) models have recently produced promising results for fetal birth weight (BW) estimation. We tested those models in a more unselected population hypothesizing that the FLV models would improve accuracy and precision of fetal BW estimation compared to the Hadlock model.MethodsWe compared the performance of different BW prediction models: Hadlock (biparietal diameter [BPD], abdominal circumference (AC), femur diaphysis length) and modified Lee thigh volume (TVol) and arm volume (AVol) (BPD, AC, automated fractional TVol, and AVol). Accuracy (systematic errors, mean percent differences) and precision (random errors, ± 1 SD of percent differences) were calculated.ResultsA total of 75 fetuses were included for final analysis. The Hadlock model showed the most consistent results with accurate BW estimation not significantly different from zero (−0.37 ± 8.53%). The modified fractional thigh and arm volume models were less accurate but trended toward more precise results (−2.63 ± 7.69% and −3.85 ± 7.47%, respectively). In addition, the modified TVol model showed the trend to predict more BWs within ±10% of the actual BW compared to the Hadlock model (81.3 versus 74.67%, ns).ConclusionsBased on our results, fetal weight estimation using the modified semiautomatic FLV models generates less accurate results in third‐trimester fetuses compared to the Hadlock model. Those models recently published might improve the results of BW prediction by showing a higher precision than conventional models, especially in small and large fetuses. Further studies are needed to investigate the clinical usefulness of the new models.
Sanitary Waste Landfill Effects on an Invasive Wild Pig Population
Authors: Mayer John J. , Edwards Thomas B. , Garabedian James E. , Kilgo John C. 
Published: April 2021

ABSTRACTBeing opportunistic omnivores, wild pigs (Sus scrofa) readily feed on edible garbage. Given the presence of substantial volumes of edible food waste, large multi‐county and regional municipal sanitary waste landfills constitute attractive forage resources for pigs, providing a year‐round anthropogenic source of potentially high‐quality forage. Our objective was to assess the effects that a large regional landfill has on the local pigs foraging in that facility's waste disposal cells. The landfill, located on the United States Department of Energy's Savannah River Site (SRS) in South Carolina, USA, became operational in 1998 and pigs began foraging there in 2001. By 2009 >100 pigs/night were observed foraging in the landfill, suggesting landfill establishment may have important consequences for population dynamics, public safety, and disease transmission. We evaluated changes in body mass, fetal litter size, numbers of pigs removed, and wild pig‐vehicle collisions (WPVCs) before (1980–2000) and after (2001–2019) pigs began foraging in the landfill on SRS. Body mass during the after period increased to a greater extent for pigs in the vicinity of the landfill compared to pigs on the rest of SRS. Fetal litter size increased for pigs in the vicinity of the landfill, whereas it remained unchanged on the rest of SRS. Our density surrogate (number of pigs harvested) increased around the landfill during the after period by 2.9 times, whereas on the rest of the site it only increased by 53%. No WPVCs occurred adjacent to the landfill before 2001, but WPVCs increased along the 2 major roads bordering the landfill after 2001. Effects of sanitary waste landfills on wild pig populations scavenging there can present unique challenges to population management, control, public safety, and disease transmission. Potential approaches to address these challenges could be exclusion fencing to prevent access to the landfill's waste disposal cells or enhanced placement of waste cell covers to reduce access. © 2021 The Wildlife Society.
Eastern Hog‐Nosed Snake Habitat Selection at Multiple Spatial Scales in Ontario, Canada
Authors: Robson Laura E. , Blouin‐demers Gabriel 
Published: April 2021

ABSTRACTHabitat loss is the greatest contributor to the decline of species globally. To prioritize protection of imperiled species, it is important to examine habitat use at multiple spatial scales because the availability of different resources and habitat features is scale dependent. We conducted a radio‐telemetry study in the Long Point region of Ontario, Canada, in 2009 and 2010 to examine habitat selection at multiple spatial scales by eastern hog‐nosed snakes (Heterodon platirhinos), a species at risk in Canada. We documented the habitat composition of home ranges compared to the surrounding landscape, the selection of locations within home ranges based on classified satellite imagery, and the use of microhabitat features based on site characterization in the field. At the scale of the home ranges, hog‐nosed snakes avoided areas of agriculture and selected sand barrens. Within home ranges, hog‐nosed snakes selectively used areas altered by humans (e.g., residential sites, openings in tree plantations). Microhabitats used by hog‐nosed snakes had more woody debris, logs, and lower vegetative coverage than adjoining random sites. Because hog‐nosed snakes prefer open areas and require sandy soils for nesting, management efforts should focus on the conservation and maintenance of sand barrens and patches of early successional forest. © 2021 The Wildlife Society.
Short‐Term Exposure to Air Pollution and Epiglottitis: A Nested Case–Control Study
Authors: Kim So Young , Min Chanyang , Yoo Dae Myoung , Park Bumjung , Choi Hyo Geun 
Published: April 2021

Objectives/HypothesisThis study investigated the impacts of air pollution and meteorological factors on the occurrence of epiglottitis.Study DesignA nested case‐control study.MethodsParticipants ≥40 years old in the Korean National Health Insurance Service‐Health Screening Cohort were analyzed. A total of 2,615 epiglottitis patients and 10,460 matched control participants were analyzed. The odds ratios (ORs) for epiglottitis associated with meteorological and air pollution factors, including sulfur dioxide (SO2, ppb), nitrogen dioxide (NO2, ppb), ozone (O3, ppb), and carbon monoxide (CO, ppm), after 3, 7, 15, and 30 days of exposure were analyzed using conditional logistic regression adjusted for total cholesterol, blood pressure, fasting blood glucose, obesity, smoking, alcohol consumption, prior upper respiratory infection, tonsillectomy, immunocompromise, autoimmune disease, and the Charlson comorbidity index.ResultsThe daily temperature range and NO2 exposure after 3 days were associated with increased rates of epiglottitis (OR = 1.03, 95% confidence interval [CI] = 1.02–1.05 for temperature range and OR = 1.78, 95% CI = 1.14–2.77 for NO2, respectively). These results were generally consistent at 7, 15, and 30 days.ConclusionsThe temperature range and NO2 exposure for 3, 7, 15, and 30 days were positively related to the occurrence of adult epiglottitis.Level of Evidence3 Laryngoscope, 131:2483–2489, 2021
Monitoring land sensitivity to desertification using the ESAI approach and evaluation of the key indicators: A spatio‐temporal study in India
Authors: Rajbanshi Joy , Das Sharmistha 
Published: April 2021

AbstractDesertification is one of the primary environmental problems that negatively affect agricultural production leading to poverty, hunger, and economic instability in a country like India. A holistic study is therefore extremely valuable rather than localized ones for addressing this issue and its' further consequences. In this study, the environmentally sensitive area index (ESAI) has been used to identify the areas vulnerable to desertification from 1992 to 2015 in India. In addition to this, the random forest (RF) model was used to identify the drivers with major influence over the phenomenon. The result revealed that the desertification process has extended from the west and spread over the southern region in the Country. Among the states of India, Rajasthan and Ladakh possess the highest mean ESAI values (1.5–1.7), where 87.61% and 83.83% of land, respectively, are critically degraded due to desertification. According to the Mann‐Kendall mutation point detection test, the years of 1996, 2009, and 2014 were identified as the abrupt change of desertification processes over the Country. The most severe form of degradation is observed in the period between 1997 and 2009, where the highly sensitive (Critical‐3) area increased up to 37.44%. Based on variable importance for the RF‐model, drought resistance has the highest importance among all the other inputs that is, 46% followed by erosion protection with 20%. Our study also points out that 33.76% of the land of the Country is still classed under a very high critical zone and without any immediate action; it may result in irreversible loss.
Weekly epistaxis duration as an indicator of epistaxis severity in hereditary hemorrhagic telangiectasia—Preliminary results from a randomized controlled trial
Authors: Wu Vincent , Lee John M. , Vozoris Nicholas T. , Faughnan Marie E. 
Published: April 2021

AbstractObjectivesThere is great interest in developing and studying novel therapies for epistaxis in hereditary hemorrhagic telangiectasia (HHT) given its associated morbidity and impact on patients' quality of life. Several recent randomized controlled trials (RCTs) have been negative, likely attributed to poorly characterized outcome measures. This study reported on and evaluated an epistaxis outcome measure, weekly epistaxis duration (WED) in an ongoing RCT, with the aim of better characterizing the measurement of epistaxis for clinical trials.Materials and methodsPatients were recruited to an ongoing phase II, double‐blind, cross‐over RCTs of oral doxycycline for HHT‐associated epistaxis. Patients were included for the epistaxis measures analysis if they had already completed the initial 3‐month run‐in period, and had received treatment of either study drug doxycycline or placebo for a minimum of 6 months. The primary measure of interest was patient‐reported outcome (PRO)‐WED, captured from prospective daily diaries. Epistaxis severity score (ESS) was collected as a secondary outcome.ResultsSeven patients were included for analysis, with 98% completion of the daily diary. The average PRO‐WED across all patients was 85.0 minutes, SD 93.2 at baseline, and 65.6 minutes, SD 59.5 during treatment/placebo. Coefficient of variance for PRO‐WED at baseline and during treatment/placebo was 0.49, SD 0.1 and 0.58, SD 0.2, respectively. Statistically significant changes in the mean PRO‐WED from baseline to treatment/placebo was noted in six patients (86%). Only two patients (29%) had a significant change in ESS, with both reporting decreased (improved) scores after treatment/placebo as compared to baseline.ConclusionsPRO‐WED was a feasible clinical trials measure, was reasonably stable during baseline measurement, and appeared to be variable with treatment state, suggesting it may provide a sensitive clinical trials PRO in HHT.
Perception of indigenous people of climate change and its impact on the Everest National Nature Preserve
Authors: Shijin Wang 
Published: April 2021

AbstractUsing interviews and surveys of 212 households in villages situated at different elevations in the Everest National Nature Preserve (ENNP), correlations and comparative analyses were employed to reveal the residents’ perceptions and understanding of climate change and its effects on the ENNP. Results showed that: (1) nearly all residents thought that climate warming and ice–snow landscape decrease were very significant, but there was an obvious difference between the residents’ cognition and observations to the change of runoff; (2) higher altitude is, more obvious warming is, and stronger residents’ perception of climate change and its impacts is in the ENNP, for which educational level and age were the main factors affecting their degree of perception; (3) especially, higher altitude is, more frequent the tourism participation of residents is and higher their income is; and (4) because the centralized pollutant treatment facilities have a low efficiency, and because the area receives a large number of tourists whose activities are spatially scattered, the potential risk of environmental pollution has been increasing in recent years. At present there is an urgent need for policy suggestions at the strategic level of national ecological security and interregional equity principles concerning the adaptation to climate and environmental changes in the ENNP.
Genetic variants related to successful migraine prophylaxis with verapamil
Authors: Cutrer Fred Michael , Moyer Ann M. , Atkinson Elizabeth J. , Wang Liguo , Tian Shulan , Wu Yanhong , Garza Ivan , Robertson Carrie E. , Huebert Carey A. , Moore Brenda E. , Klein Christopher J. 
Published: April 2021

AbstractBackgroundCurrently, there is no biologically based rationale for drug selection in migraine prophylactic treatment.MethodsTo investigate the genetic variation underlying treatment response to verapamil prophylaxis, we selected 225 patients from a longitudinally established, deeply phenotyped migraine database (N = 5983), and collected uninterrupted quantitated verapamil treatment response data and DNA for these 225 cases. We recorded the number of headache days in the four weeks preceding treatment with verapamil and for four weeks, following completion of a treatment period with verapamil lasting at least five weeks. Whole‐exome sequencing (WES) was applied to a discovery cohort consisting of 21 definitive responders and 14 definitive non‐responders, and the identified single nucleotide polymorphisms (SNPs) showing significant association were genotyped in a separate confirmation cohort (185 verapamil treated patients). Statistical analysis of the WES data from the discovery cohort identified 524 SNPs associated with verapamil responsiveness (p < 0.01); among them, 39 SNPs were validated in the confirmatory cohort (n = 185) which included the full range of response to verapamil from highly responsive to not responsive.ResultsFourteen SNPs were confirmed by both percentage and arithmetic statistical approaches. Pathway and protein network analysis implicated myo‐inositol biosynthetic and phospholipase‐C second messenger pathways in verapamil responsiveness, emphasizing the earlier pathogenic understanding of migraine. No association was found between genetic variation in verapamil metabolic enzymes and treatment response.ConclusionOur findings demonstrate that genetic analysis in well‐characterized subpopulations can yield important pharmacogenetic information pertaining to the mechanism of anti‐migraine prophylactic medications.
Toward more robust and reproducible diffusion kurtosis imaging
Authors: Henriques Rafael N. , Jespersen Sune N. , Jones Derek K. , Veraart Jelle 
Published: April 2021

AbstractPurposeThe general utility of diffusion kurtosis imaging (DKI) is challenged by its poor robustness to imaging artifacts and thermal noise that often lead to implausible kurtosis values.Theory and MethodsA robust scalar kurtosis index can be estimated from powder‐averaged diffusion‐weighted data. We introduce a novel DKI estimator that uses this scalar kurtosis index as a proxy for the mean kurtosis to regularize the fit.ResultsThe regularized DKI estimator improves the robustness and reproducibility of the kurtosis metrics and results in parameter maps with enhanced quality and contrast.ConclusionOur novel DKI estimator promotes the wider use of DKI in clinical research and potentially diagnostics by improving the reproducibility and precision of DKI fitting and, as such, enabling enhanced visual, quantitative, and statistical analyses of DKI parameters.